That pic in the last thread with her collarbones made me laugh so much. Bitch has her arms bent at an awkward angle behind her back you can see where the neck squashes awkwardly on her shoulder because of the abnormal way shes twisting and sticking her neck out. Imagine being a fly on the wall at hers (one of the many) and seeing her take a selfie like that kek


Weight loss achieved through dietary changes and exercise can help women with PCOS in several ways. Like men and women without PCOS, losing weight reduces a person's risk of cardiovascular disease and non-insulin dependent (type 2) diabetes. Weight loss also helps to lower the level of insulin in the body which, in turn, reduces the ovaries' production of testosterone.
^ Jump up to: a b Nafiye Y, Sevtap K, Muammer D, Emre O, Senol K, Leyla M (2010). "The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome". Fertil. Steril. 93 (6): 1864–9. doi:10.1016/j.fertnstert.2008.12.024. PMID 19171332.
yeah, the constant nitpicking about things she can't help is annoying. people are desperate for milk so they'll try to make a topic out of everything. for example, that anon who was saying how gross her arm looks because it has stretch marks and loose skin. what's she supposed to do about that? shes a shitty person but i gaurentee none of the anons on this thread are perfect or even attractive enough to be such nitpickers
Two clinical studies examined the androgen lowering effects of Glycyrrhiza Glabra. A single arm clinical trial demonstrated reduced testosterone in healthy women aged 22–26 years (n = 9) over two menstrual cycles. Treatment with Glycyrrhiza glabra, 7 grams per day reduced testosterone from 27.8(±8.2) to 17.5 (±6.4), p < 0.05 [55]. Another single arm clinical trial investigated the effects of Glycyrrhiza glabra in women with PCOS, (n = 32). Glycyrrhiza glabra 3.5 g per day was added to anti-androgen pharmaceutical treatment, Spirinolactone 100 mg/day over two menstrual cycles. An unwanted side effect for Spirinolactone was the flare of androgens during the initial phase of treatment. This study demonstrated reduced concentrations of testosterone during the first four days of treatment at 103 ± 29 ng/d in the Spirinolactone group compared to 91 ng/d (±19) when combined with Glycyrrhiza glabra (p < 0.05) [54] (Table 1). Consistent laboratory and clinical outcomes were demonstrated however limitations included design shortcomings. Both clinical studies were open label observational design with small sample sizes; one included healthy participants. Rigorous studies are needed to confirm the androgen lowering effects of Glycyrrhiza spp. in hyperandrogenism and PCOS.
Anecdotally, oral contraceptives are among the most common agents used to treat menstrual irregularities in women with PCOS. However, there are few studies examining their effect on menstrual cycles in women with PCOS. Cyproterone acetate plus ethinyl estradiol has been extensively studied, but it is not available in the United States. Studies suggest that the following agents may improve menstrual irregularities (e.g., oligomenorrhea): spironolactone (in an open-label study),22 acarbose,24 rosigli-tazone,32 and metformin.10,11,32,47,51 Metformin is probably the best choice because it may improve insulin resistance in addition to improving menstrual irregularities.
^ Jump up to: a b Nafiye Y, Sevtap K, Muammer D, Emre O, Senol K, Leyla M (2010). "The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome". Fertil. Steril. 93 (6): 1864–9. doi:10.1016/j.fertnstert.2008.12.024. PMID 19171332.
Vitamin D deficiency may play some role in the development of the metabolic syndrome, so treatment of any such deficiency is indicated.[74][75] However, a systematic review of 2015 found no evidence that vitamin D supplementation reduced or mitigated metabolic and hormonal dysregulations in PCOS.[76] As of 2012, interventions using dietary supplements to correct metabolic deficiencies in people with PCOS had been tested in small, uncontrolled and nonrandomized clinical trials; the resulting data is insufficient to recommend their use.[77]
Polycystic ovarian syndrome is classified as a disorder which encompasses a group of symptoms that collectively indicate a distinct health issue. This means that the symptoms associated with PCOS will vary from woman to woman. Your PCOS experience is probably very different from another woman with this condition but that does not mean you are alone! PCOS is a condition which can affect between 5 – 10% of all women and is the most common cause of infertility.8 You may be wondering how you ended up in this group of women but unfortunately the precise reason polycystic ovarian syndrome develops isn’t completely clear. 8 Having said that, many experts believe insulin as well as hormone imbalances have a strong influence on PCOS and the severity of its symptoms.
The Center for Young Women’s Health (CYWH) is a collaboration between the Division of Adolescent and Young Adult Medicine and the Division of Gynecology at Boston Children’s Hospital. The Center is an educational entity that exists to provide teen girls and young women with carefully researched health information, health education programs, and conferences.

magandang araw po, ask lang po ang resulta po ba ng mataas na PROLACTIN ay nangangahulugang hindi magkaka anak ang isang babae? sobrang taas po ng prolactin level result q 62.77 ng/ml kumpara sa normal na 5 – 25 ng/ml., anu pu ba ang pwedeng gawin para mapababa sa normal ito? maraming salamat po at sana’y masagot ang tanong q kung meron kau pagkakataon, godbless po!
Clinical trials have shown that metformin can effectively reduce androgen levels, improve insulin sensitivity, and facilitate weight loss in patients with PCOS as early as adolescence. [55, 56, 57, 58] One study concluded that the use of metformin throughout pregnancy was associated with a 9-fold decrease in gestational diabetes in women with PCOS. [59] In addition to having the potential to reduce gestational diabetes in pregnant women with PCOS, metformin may also reduce the risk of preeclampsia in this population. [60]
Sperm capacitation must be evaluated to perform the low-complexity treatment (semen evaluation after preparation to estimate the number of sperm with progressive motility, which includes those that theoretically have the ability to ascend the female reproductive tract in vivo and fertilize the egg in the fallopian tube). Thus, the semen is centrifuged and the concentration of capacitated sperm recovered is measured as follows: >10 million recovered motile sperms (any infertility treatment is viable); >5 million (IUI, in vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI) may be performed); between 1 and 5 million (IVF or ICSI may be performed); and <1 million (only ICSI can be performed) 27,28. It is worth noting that if the patient presents with bilateral tubal occlusion in the initial assessment, sperm capacitation is only performed to evaluate the possibility of performing IVF or ICSI 8.
The use of gonadotropins for timed intercourse is associated with an ovulation rate of approximately 70%, a clinical pregnancy rate of 20% per cycle and a multiple live birth rate of 5.7% 9. Due to the cost of the treatment, the need for regular monitoring of the follicular development via ultrasound and the higher pregnancy rates with IUI, the use of gonadotropin is not routine for timed intercourse. Instead, this medication is used in IUI 26 or high-complexity treatments (IVF or ICSI) 9.
I thought that too at first (i've been following her since she was like 16, unfollowed for a while, then when i refollowed came back to grimy heroin luna). It's because her hair is longer and she's gotten thinner. That's really it. Everything else from her youth looks so much better. The light in her eyes, the freckles, the friendships, the cute babydoll dresses… She just looked happier…. I mean sure she was chunky and her hair was always mangled, but she was happy and that's much more important IMO.

Mammalian ovary development undergoes important changes during the perinatal period, moment when follicles are assembled and start to develop in a process not well known, involving endocrine and paracrine factors. In order to investigate the effect of two different hormonal environments on the early development of the ovary, we used an autologous transplant model in which Syrian hamster fetal ovaries were grafted under the kidney capsule of males hosts previously unilaterally or bilaterally orchidectomized. After 35 days of graft, ovaries and kidney parenchyme of the host male did not present signs of rejection. Ovaries contained primordial, primary follicles, secondary follicles and few tertiary follicles with morphological features similar to ovaries of control females of 35 days of age. Healthy primary and secondary follicles of experimental groups had frequency distribution and size similar to control ovaries but tertiary follicles were scarce in control as well as in grafts where they were mainly atretic. PCNA, marker of proliferation, was immuno detected in granulosa cells of growing follicles and the marker of apoptosis, Caspase 3 active, was evident mainly in secondary follicles. Immunoreactivity for steroidogenic proteins, StAR, 3-βHSD and aromatase detected in the follicular wall cells and the decreased serum levels of FSH without important changes in testosterone in bilateral orchidectomized males that received ovarian graft, and testosterone decreased without changes in FSH levels in unilateral orchidectomized males (UO) with ovarian graft, all together suggest the effect of steroid hormones produced by the ovary. In conclusion, the experimental model of autologous transplant presents evidence of early ovary development under the kidney capsule and its functional integration to the endocrine axis of the host male.
There is growing evidence that mood disturbances, mostly severe depression, are common in PCOS women , in whom impaired quality of life from body image concerns cause fatigue, sleep disturbance and changes in eating habits. In addition, many PCOS patients report feeling abnormal, unfeminine, and embarrassed due to unwanted hair, often hiding their hair growth and covering their face when talking to others. Understanding how a woman feels about her body image and improving this perception are essential components of any management plan that provides overall health care to women with PCOS.
The unfortunate truth is that there is no cure for PCOS. But because the disorder can have a profound effect on your health and well-being, treatment is a must. There is one important thing to know about your options: Because the cause of PCOS is still unknown, appropriate therapies are based on a woman’s individual concerns. Is she bothered most about excess hair growth? Does she want to have a baby? Does she need to get her periods back on track?
Si tienes un acné grave como síntoma del síndrome de ovario poliquístico, este podría mejorar si parte de tu tratamiento incluye los anticonceptivos orales o los antiandrógenos. Si tu acné no mejora tras el tratamiento, tu médico te podría remitir a un dermatólogo para que te lo trate. El dermatólogo también podría recomendarte medicamentos para reducir el oscurecimiento de la piel y para prevenir el crecimiento excesivo del vello.
If you’ve been told you have PCOS, you may feel frustrated or sad. You may also feel relieved that at last there is a reason and treatment for the problems you have been having, especially if you have had a hard time keeping a healthy weight, or you have excess body hair, acne, or irregular periods. Having a diagnosis without an easy cure can be difficult. However, it’s important for girls with PCOS to know they are not alone. Finding a health care provider who knows a lot about PCOS and is someone you feel comfortable talking to is very important. Keeping a positive attitude and working on a healthy lifestyle even when results seem to take a long time is very important, too! Many girls with PCOS tell us that talking with a counselor about their concerns can be very helpful. Other girls recommend online chats. The Center for Young Women’s Health offers a free and confidential monthly online chat for girls and young women with PCOS.
Hi Dokbru, simula po kasi nag ka hyperacidity ako last october hindi n naman po nag regular ang menstruation ko. Minsan isang buwan konti lang lalabas n dugo n medyo parang putik pa ang kulay nya s ngaun po mag 2months n po akong d dinadatnan. Di naman po ako mabuntis kasi wala po dito asawa ko.. Nung high school pa po kc ako nkaranas na ako ng di nireregla at 5months po un .. Anu po pwede kung gawin?
Although aromatase inhibitors have been used in women with PCOS as an alternative method to avoid the anti-estrogenic effect of CC on the endometrium, these compounds are not typically used in clinical practice to treat infertility in these patients. Their mechanism of action is based on reducing the peripheral conversion of androgens to estrogens in ovarian granulosa cells by blocking aromatase. Consequently, a decrease in estrogen serum levels and in its negative feedback in the hypothalamus and pituitary gland is noted, resulting in increased endogenous gonadotropin release 41.
Paeonia lactiflora in combination with Glycyrrhiza spp. Aqueous extract Shakuyaku- kanzo-to (TJ-68)	One laboratory study examined the effects for the combination Paeonia lactiflora and Glycyrrhiza uralensis on testosterone, oestradiol, FSH and LH in sterilised female rats [53].	Two single arm clinical trials examined androgen concentrations Following treatment with Paeonia lactiflora and Glycyrrhiza uralensis in the Chinese herbal combination Shakuyaku-kanzo-to. One included infertile oligomenorrhoeic women with hyperandrogenism (n = 8) [58] and the other included women with oligo/amenorrhoea and PCOS (n = 34) [59].	1. Reduced total and free testosterone [53, 58, 59].

Polycystic (say: pah-lee-SIS-tik) ovary syndrome (PCOS) is a common hormone imbalance that affects about 1 in 10 women. Girls as young as 11 can get PCOS. Do you have PCOS or common signs of PCOS? Read answers to commonly asked questions about PCOS below, or go straight to our Living Well With PCOS [ PDF 459K] guide and PCOS Fitness Worksheet [ PDF 504K].

When the former NFL cheerleader Natalie Nirchi stopped menstruating at age 17, she was diagnosed with polycystic ovary syndrome (PCOS), a hormone disorder affecting up to 10 percent of women of reproductive age. She didn’t initially show any of the physical symptoms, like excess hair growth, cystic acne, or obesity, but a blood test revealed that she had high levels of testosterone and an ultrasound showed cysts on her ovaries.
Insulin-sensitizing agents are indicated for most women with PCOS because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Of all the drugs used to treat manifestations of PCOS, metformin (Glucophage) has the most data supporting its effectiveness. Table 1 details the most common medications used to treat manifestations of PCOS.6–27
Chicken and egg: was Luna an asshole who started drugs and became even more of an asshole, or did she start drugs that turned into an asshole? A lot of what's wrong with her has little to do with her addiction - e.g. her desperate attempts at focusing everything into a mad scramble for sympathy (some bum died, so she wrote a story that made it look as if he had been her closest friend so people tell her they're sorry etc.) derive from her being an asshole, not from her addiction. Anyone who consciously wants to become a junkie for an aesthetic is already way deeply fucked imho.
The prescription cream eflornithine HCl can slow the growth of new hair when applied as directed on the face and other areas – but it won’t remove existing hair. 20,21 Your doctor may also prescribe a medication called an anti-androgen. In the United States, a medication called spironolactone is used to slow new hair growth. In other countries, cyproterone acetate is widely used but it is not available in the United States.  
PCOS es un complemento que ayuda a equilibrar los niveles hormonales (exceso de testosterona) en las mujeres con SOP. Esos desequilibrios hormonales provocan en la mayoría de los casos signos externos de hiperandrogenismo como exceso de vello, caída excesiva del cabello y acné. Al regular tus niveles hormonales, conseguirás suavizar y mejorar esos signos externos 🙂
meh. I think she takes selfies (including the body posi ones) because it helps her cultivate her image rather than because she thinks she's gorgeous. She's not like many of the other cows in that she doesn't try to hide her cellulite or mismatching eye sockets or her flab. Her imperfections feed into her junkie chic look, which is why calling them out every time she posts a picture ad nauseum doesn't make sense. She knows she has these features and doesn't seem to care, she mentions them herself, and she might even like how they fit into her style. She's totally comfortable with them and places a much higher importance on aesthetic than having a beautiful body.
Preclinical and clinical studies provide preliminary evidence that six herbal medicines may have beneficial effects for women with oligo/amenorrhea, hyperandrogenism and PCOS. The quality of the evidence is variable and strongest for Vitex agnus-castus and Cimicifuga racemosa in the management of oligo/amenorrhea and infertility associated with PCOS; and Cinnamomum cassia for improving metabolic hormones in PCOS. Evidence for Tribulus terrestris, Glycyrrhiza spp. alone and in combination with Paeonia lactiflora and Paeonia lactiflora combined with Cinnamon cassia is promising but in an emergent phase. Further investigations into the mechanisms of effect for herbal extracts are needed to complete our understanding of the reproductive endocrinological effects for herbal medicine for these common conditions.
Your health care provider will ask you a lot of questions about your menstrual cycle and your general health, and then do a complete physical examination. You will most likely need to have a blood test to check your hormone levels, blood sugar, and lipids (including cholesterol). Your health care provider may also want you to have an ultrasound test. This is a test that uses sound waves to make a picture of your reproductive organs (ovaries and uterus) and bladder (where your urine is stored). In girls with PCOS, the ovaries may be slightly larger (often >10cc in volume) and have multiple tiny cysts.
i understand that it's kind of the name of the game on this website but it just gets repetitive and boring after a while hearing people say the same things over and over again about her looks when 1) she really couldn't change it unless she had a ton of money (but we all know that'd just go to drugs) 2) like >>403879 and >>403866 said, she knows she's unattractive so there's no point in pointing out her bad physical qualities when everyone, including herself, gets it. and 3) most of the things that are being pointed out and mocked are normal and a lot of the people who post on this thread probably have the same things (like stretch marks. even if you aren't fat you can get those lol)
Why treat IR in PCOS women? For many years only PCOS women with DM were treated. As the link between IGT and CAD became more apparent, many PCOS women with IGT were treated. We now understand that IR is often the first step in a progression to DM and CAD. Those who now advocate treatment for IR do so for the following reasons: reduction of insulin and androgen levels, prevention of IGT and DM, potential for improved ovulation, symptomatic improvement, prevention of MS[63]. Ultimately, secondary prevention in young women with identifiable and treatment precursor conditions is far more desirable and easier than treatment of these same women later in life with serious disease.
Two important things to note are that the long term safety effects of use are not known (but the drug has been in use for decades already) and spironolactone IS NOT SAFE in pregnancy, so it is commonly used in conjunction with birth control pills. This use of birth control pills also protects against abnormal growth of the lining of the uterus. Some women cannot take birth control pills, in which case it is important to use other means of birth control if you are sexually active while taking spironolactone.

The definitive cause of PCOS is unknown, but researchers have found a strong link to insulin resistance, a genetic condition often associated with diabetes, in which the muscle, fat, and liver cells do not respond properly to insulin and thus cannot easily absorb glucose (sugar) from the bloodstream. As a result, the body produces higher and higher levels of insulin to help glucose enter the cells.
Where US is available, CC treatment should be initiated between the third and fifth day of the menstrual cycle and the couple should abstain from intercourse (this is not a mandatory measure) until the tenth day of the cycle (when the presence of dominant follicles with a mean diameter of 10 mm or more is assessed via US). Sexual activity is allowed if the patient presents with monofollicular or bifollicular development. The goal of sexual abstinence until the tenth day of the cycle is to minimize the risk for multiple gestations.
A woman should shed this lining at least four times a year, says Dunaif. One option: taking progesterone (often called a “progesterone challenge”). But the resulting bleed can be heavy for some women. Another: Take birth control pills to get the regular cycle back online. These have the added benefit of lowering male hormones, too. What’s more, there are noted benefits of taking hormonal birth control that are true across the board, like getting regular, predictable periods and having up to a 20 and 50 percent lower risk of colon (colorectal) cancer and ovarian cancer, respectively. (4)
Ask your health care provider about treating hair growth. Only you and your health care provider can decide which treatment is right for you. Options may include bleaching, waxing, depilatories, spironolactone (spi-ro-no-lac-tone), electrolysis, and laser treatment. Spironolactone is a prescription medicine that can lessen hair growth and make hair lighter and finer. However, it can take up to 6-8 months to see an improvement.
A randomized study suggested that combined metformin/letrozole and bilateral ovarian drilling are similarly effective as second-line treatment in infertile women with clomiphene citrate–resistant PCOS. [52] In this study, 146 patients were given metformin and letrozole, and 73 underwent bilateral ovarian drilling. There was significant reduction in testosterone, fasting insulin, and ratio of fasting glucose to fasting insulin in the metformin/letrozole group. There was significant reduction in follicle-stimulating hormone (FSH), luteinizing hormone (LH), and ratio of LH to FSH in the bilateral drilling group. There was no significant difference between the patients in the 2 groups regarding cycle regularity, ovulation, pregnancy rate, and abortion rate. [52]
Positive effects for Vitex agnus-castus in oligo/amenorrhoea and infertility was demonstrated in three placebo controlled RCTs [61, 62, 64]. In a study including women with menstrual irregularity and infertility (n = 96), menstrual cyclicity was significantly improved for women treated with Vitex agnus-castus (Mastodynon® 30 drops per day for three months) compared to placebo (p = 0.023) [61] (Table 2). Another study, including women with sub fertility (n = 67), showed improved menstrual cyclicity for a sub-group of women with oligomenorrhoea following treatment with Vitex agnus-castus (Phyto-Hypophyson® 7.5 ml per day) compared to placebo, (p = 0.023) [62] (Table 2). A third study including women with hyperprolactinaemia (n = 37) demonstrated improved menstrual cyclicity by an increased average number of luteal days from 3.4 days (±5.0) to 10.5 days (±4.3) (p < 0.005) following treatment with Vitex agnus-castus (Strotan® 20 mg per day) for three months. The placebo group reported average number of days in the luteal phase was 3.4 (±5.1) at baseline and 5.5 (±5.2) at three months, which was not significant (p = 0.22) [64] (Table 2). Methodological shortcomings included not reporting baseline characteristics for subgroups and small sample sizes; however clinical outcomes demonstrated physiological effects consistent with laboratory and animal findings (Tables 1 and ​and22).
The name ‘Polycystic Ovarian Syndrome’ points to the ovaries because it was long considered to be a reproductive issue. But it is now widely accepted that polycystic ovaries develop as a result of endocrine disorders characterized by a series of hormone imbalances: hyperandrogenism (specifically excess testosterone) and Insulin Resistance due to excess insulin that can trigger a cascade of other hormonal problems.4 From a systemic point of view, the continuing and/or increase of PCOS symptoms is likely due to a continuing hormonal imbalance.
PCOS is a multifaceted syndrome that affects multiple organ systems with significant metabolic and reproductive manifestations. Treatment should be individualized based on the patient's presentation and desire for pregnancy (Figure 219,29–35). Devices and medications used to treat manifestations of PCOS, and their associated adverse effects, are described in Table 2.19,29–33,36
The diagnostic workup should begin with a thorough history and physical examination. Clinicians should focus on the patient's menstrual history, any fluctuations in the patient's weight and their impact on PCOS symptoms, and cutaneous findings (e.g., terminal hair, acne, alopecia, acanthosis nigricans, skin tags).19 Patients should also be asked about factors related to common comorbidities of PCOS.
We used the following definitions. PCOS according to the Rotterdam diagnostic criteria, specified by the presence of two out of three features; oligo/amenorrhoea, hyperandrogenism and polycystic ovaries on ultrasound [29, 30]. Associated endocrine features for PCOS included elevated LH [31], which is strongly associated with infertility (p = 0.0003) [32] and miscarriage [33] and elevated fasting glucose which is prevalent in approximately 31% of women with PCOS including normal weight women [34].
Aparte de preguntarte sobre tus antecedentes médicos, el médico te hará un examen físico, que incluirá pesarte y evaluar algunos signos específicos, como el acné, el crecimiento del vello y el oscurecimiento de la piel. Es posible que te haga un examen ginecológico para descartar otras posibles causas de tus síntomas, pero esto no siempre es necesario para hacer el diagnóstico.

The advantages of CC use are low cost, oral administration, few side effects (flushing, headache, visual disturbances and abdominal discomfort), the induction of monofollicular development in most cases 16 and a low rate of multiple gestations (2 to 13%) 17. The initial dose is 50 mg/day for five days (starting between the second and fifth day of the menstrual cycle) and may be increased to 150 mg/day 17,18; however, doses greater than 100 mg/day usually do not offer additional benefits (may be useful in obese women) 18. The ovulation rate may reach 75 to 80% 19 with a conception rate of 22% per cycle 20 and a cumulative pregnancy rate between 60 and 70% in six cycles 9. There is no evidence that the administration of human chorionic gonadotropin (hCG) in the mid-cycle increases ovulation rates (OR 0.99; 95% CI: 0.36-2.77) or clinical pregnancy (OR 1.02; 95% CI: 0.56-1.89) 21,22. CC treatment should be limited to six ovulatory cycles and US monitoring is not mandatory (it is recommended only in the first ovulatory cycle to adjust the dose based on the ovarian follicular growth and development and for endometrial assessment) 17,18. Additional cycles of ovulation induction with CC (maximum of twelve cycles) may be individually evaluated based on the cost-effectiveness and age of women and after discussion with the couple 9. The incidence of ovarian hyperstimulation syndrome (OHSS; increased capillary permeability with consequent third-space fluid sequestration and hemoconcentration) associated with the use of CC is low, approximately 1 to 6% 17,23.


Studies have attempted for years to show an advantage to metformin for ovulation induction and as an adjunct to more advanced fertility treatments. In ovulatory PCOS women metformin was associated with improved serum and follicular fluid AMH levels as well as insulin values; these changes were not seen in anovulatory PCOS women[71]. Despite the demonstration of negative effects of IR on reproductive outcome, the vast majority of evidence does not show improvement in live birth rates when metformin is used strictly for fertility[72], although treatment does improve ovulatory status[72,73].

There have been many studies on PCOS in the past several years; however, most are fairly small. Also, many studies examine medication effects on surrogate markers (e.g., androgen levels) rather than clinical outcomes (e.g., hirsutism). The study results are often conflicting, and in a recent systematic review, only 33 of 115 possible studies met basic inclusion criteria (e.g., randomized controlled trials), suggesting that many of the data in the literature may have methodologic flaws.1
It's trendy to be ~body posi~ and have massive self confidence even if you're conventionally ugly right now. Especially if you're not conventionally attractive, actually. It's the in thing with the group she wants to be part of. I don't see how you guys don't get that she's working that angle hard. She wants to be seen a martyr and a hero for defying unconventional beauty standards and seeing worth in herself when society doesn't.
This is an important distinction; given her longtime love for drugs, tendency to abuse everything she gets, and unwillingness to go sober even when she's not on H, there's a good chance that Luna has 'polysubstance dependence' and is chasing the feeling of being 'not sober' by abusing her meds. The drugs she abuses don't have to get her high if that is the case, just do enough to make her feel a change in her consciousness (e.g. sedation, calm). It's common in people with untreated mental illness. Luna probably hates herself so much that she just can't handle being left alone with her sober self.

There have been many studies on PCOS in the past several years; however, most are fairly small. Also, many studies examine medication effects on surrogate markers (e.g., androgen levels) rather than clinical outcomes (e.g., hirsutism). The study results are often conflicting, and in a recent systematic review, only 33 of 115 possible studies met basic inclusion criteria (e.g., randomized controlled trials), suggesting that many of the data in the literature may have methodologic flaws.1
Polycystic ovary syndrome represents 80% of anovulatory infertility cases. Treatment initially includes preconception guidelines, such as lifestyle changes (weight loss), folic acid therapy to prevent the risk of fetal neural tube defects and halting the consumption of tobacco and alcohol. The first-line pharmacological treatment for inducing ovulation consists of a clomiphene citrate treatment for timed intercourse. The second-line pharmacological treatment includes the administration of exogenous gonadotropins or laparoscopic ovarian surgery (ovarian drilling). Ovulation induction using clomiphene citrate or gonadotropins is effective with cumulative live birth rates of approximately 70%. Ovarian drilling should be performed when laparoscopy is indicated; this procedure is typically effective in approximately 50% of cases. Finally, a high-complexity reproduction treatment (in vitro fertilization or intracytoplasmic sperm injection) is the third-line treatment and is recommended when the previous interventions fail. This option is also the first choice in cases of bilateral tubal occlusion or semen alterations that impair the occurrence of natural pregnancy. Evidence for the routine use of metformin in infertility treatment of anovulatory women with polycystic ovary syndrome is not available. Aromatase inhibitors are promising and longer term studies are necessary to prove their safety.
Medical therapy inhibits hair growth without eliminating hair already present. Therefore, medical therapy usually is combined with mechanical methods of hair removal, such as electrolysis or lasers. Electrolysis refers to the insertion of an electrode to destroy individual hair follicles. It is ideal for removing small areas of sparse hair of any color. Laser hair removal is a common, safe and effective cosmetic procedure that also is performed for removal of unwanted facial and body hair. Laser therapy is more expensive than electrolysis but is faster, less painful, and requires fewer sessions. Laser therapy destroys hair by targeting the pigment (melanin) in the hair follicle and is ideally suited for dark-haired, light-skinned individuals. Longer-wavelength lasers with cooling devices can be used for individuals who have red, true blond, or white hair and for dark-skinned people. With appropriate therapy, there is up to a 70% reduction in hair density in treated areas, with remaining hairs becoming thinner in diameter within 3-6 months of treatment. Most patients then require some degree of maintenance treatment, usually every 6-12 months.

Endometrial hyperplasia and endometrial cancer (cancer of the uterine lining) are possible, due to overaccumulation of uterine lining, and also lack of progesterone resulting in prolonged stimulation of uterine cells by estrogen.[53][102] It is not clear whether this risk is directly due to the syndrome or from the associated obesity, hyperinsulinemia, and hyperandrogenism.[103][104][105]
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