If a woman's weight is excessive, the physician should be aggressive in championing a weight-loss program. Medications effective for weight loss (in addition to lifestyle modifications) that have been specifically studied in women with PCOS include metformin, acarbose, sibutramine, and orlistat (Xenical). Metformin is probably the first-line medication for obesity or weight reduction in patients with PCOS. Metformin results in a decrease in body mass index (BMI) of 1 to 2 kg per m2 or weight loss up to 6 lb, 10 oz to 8 lb, 13 oz (3 to 4 kg)10,46,49; acarbose results in an approximate 3 kg per m2 decrease in BMI24; sibutramine results in a decrease in BMI of 5.8 kg per m2 and weight loss of 31 lb, 11 oz (14.4 kg)26; and orlistat results in weight loss of approximately 11 lb (5 kg).50 However, a recent systematic review suggested that metformin is not effective for lowering BMI in patients with PCOS.1
That makes a lot of sense. It's kind of a shame, though; although he does keep a roof over her head, which is much more than she could hope for (though she'll probably end up homeless at some point anyway), imo she would have kept her tumblr following and suckers who'd donate much longer had she dated somebody who matched her aesthetic and who she could take ~cool~ photo ops with rather than a dirty older man who serves to illustrate how miserable and unglamorous the lifestyle really is. Her relationship with Lurch has caused her to become almost a PSA about what junkie life is like beneath all the staging so many of them do on social media.
Shahin et al. [65] Randomised controlled trial using with an active control arm for comparative effectiveness. One menstrual cycle. 147 women aged less than 35 years with un-explained infertility and recurrent clomiphene resistance for ovulation induction. Anovulatory participants were excluded (n = 28). Anovulation was diagnosed by serum oestradiol < 200 ng/ml and absence of a dominant ovarian follicle on day 9 of the menstrual cycle. Complete data sets available for 119 women. All women received Clomiphene citrate (clomiphene) 150 mg on menstrual cycle days 3–7. A randomised group also took Cimicifuga racemosa 20 mg per day between days 1–12. Cimicifuga racemosa described as ‘phytoestrogens’ was provided in the commercial preparation Klimadynon®, manufactured by Norica in Germany. A trigger injection (human chorionic gonadotropin, 10 000 IU) and timed intercourse was recommended when a dominant follicle > 17 mm was observed. Pregnancy rate measured as increasing serum human chorionic gonadotropin (HCG) over two days. Clinical pregnancy defined as detection of gestational sac with embryonic heart-beat. Endometrial thickness measured by ultrasound concurrent with follicle maturation monitoring. Number of days to ovulation (trigger injection) Serum concentration for FSH oestradiol and LH. Luteal progesterone measured on days 21–23 of the menstrual cycle. Miscarriage and multiple pregnancy rates. Pregnancy rate in clomiphene alone group was 20.3% and 43.3% in the clomiphene plus Cimicifuga racemosa group (P < 0.01). Clinical pregnancy rate in the combination group was 36.7% versus 13.6% in the clomiphene alone group (P < 0.01). Endometrial thickness in combination group was 8.9 (±1.4) versus 7.5 (±1.3) (p < 0.001). Days to ovulation in clomiphene alone group was 13.0 ± 1.1 and in the clomiphene plus Cimicifuga racemosa group 14.2 ± 1.3 (n.s.). Luteal progesterone peak (ng/ml) in combination group was 13.3 (±3.1) versus 9.3 (±2.0) in clomiphene alone group (p < 0.01). All other hormone measures were not significantly different No detailed current baseline criteria for other causes of infertility. Confounding factors include current male fertility status. This may have caused an imbalance between the two groups. There is no description of the distribution of excluded (anovulatory) participants between groups.
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.

Lifestyle measures to achieve a weight loss of 5%-10% in overweight women can help regulate ovulation and periods. Although the basic approach of nutrition is needed, it can be more challenging to lose weight and maintain weight loss with PCOS. Dr. Dunaif from Northwestern is very encouraging that even “a little bit of weight reduction and exercise can improve insulin sensitivity.”

Agreed, sounds like a bunch of insecure teenagers trying to tear people down for things they can't help so they can feel better about their own misshapen bodies. Luna is shitty enough of her own accord; no need to get all up in arms over things that she has no control over when she doesn't even pretend to be a flawless aphrodite like many of the cows here. It's just self-serving tryhardery at that point.

My brother was a Heroin addict who started taking Benzos between his shooting up, like Luna, versus the other way around. He was an addict, he took benzos to keep up whatever feeling he was chasing. Thats inherently different than an anxiety or depression patient taking them for relief of symptoms. Im sure it does happen, there's always that risk but I wouldn't go out there and say that Benzo use is always a gateway.


A 2-hour oral glucose tolerance test can be easily performed to assess the risk of diabetes in a PCOS woman. If necessary, prevention of diabetes may require lifestyle management with weight loss, diet and exercise, and possibly the addition of insulin-sensitizing agents such as metformin, or other medications. Fasting lipid measurements in the blood also can be performed to predict the risk for future cardiovascular disease and may likewise require lifestyle management, along with oral statins and other medications to correct increased triglyceride and low-density lipoprotein (LDL)-cholesterol levels and/or decreased high-density lipoprotein cholesterol (HDL-C) levels.

Many health experts believe that numerous variables, including genetics, might be a factor in the development of PCOS. For example, you might find your sister, mother, aunt or grandmother has PCOS. It is clear that hormone imbalance is a primary influencing factor in PCOS as well as a condition called insulin resistance. Insulin is a potent hormone which is released by the pancreas as a result of food intake, in particular carbs. Insulin conveys sugar out from the blood and moves it into other cells such as muscle, liver and even fat cells. The sugar is then changed into energy or in some cases stored as fat. Sometimes this process is defective which is called insulin resistance.
In practice, CC treatment can initiate the menstrual cycle as early as the second day. Classically, this drug treatment has been initiated between the third and fifth day of the menstrual cycle and maintained for 5 days. Ovulation typically occurs seven days after the last CC tablet is taken. Seven days after the probable date of ovulation, follicular rupture can be confirmed by progesterone levels greater than 3 ng/dL (evaluated only at the beginning of the treatment to verify the response to CC when US is unavailable) and pregnancy can be confirmed by measuring the blood beta fraction of human chorionic gonadotropin (βhCG) 7 days after the progesterone measurement. The couple should maintain their usual frequency of sexual intercourse, including during the fertile period. This protocol is ideal for primary healthcare centers with limited subsidiary resources.

Kilicdag [63] Randomised comparative effectiveness trial. Eighty women, 40 with hyperprolactin-aemia, 40 with cyclical mastalgia. Herbal extract Vitex agnus-castus 40 mg in the commercial preparation Agnucaston® by Biomeks, Germany. Comparison of difference between Vitex agnus-castus and Bromocriptine for serum prolactin concentration on days 5–8 of the menstrual cycle. Mean prolactin concentration before and after in the V.agnus-castus arm; 946mIU/L (±173.5) to 529mIU/l (±279.7), p < 0.0001. In the Bromocriptine arm; 885.0 mIU/l (±177.5) to 472.68mIU/L (±265.6), p < 0.0001. All participants completed the trial. Adverse reactions; zero reported in V. agnus-castus group; 12.5% of participants reported adverse reactions in the Bromocriptine group (nausea and vomiting).
Pwedeng magrekomenda ang doktor ng mga lifestyle changes bilang PCOS treatment. Kasama dito ang pag-ehersisyo, para sa kahit maliit na pagbawas sa timbang. Ang kawalan ng kahit limang porsyento ng ating timbang ay makakatulong na sa pagbuti ng ating kondisyon. Bilang ehersisyo, tingnan ang pagtakbo, pagbisikleta, paglangoy, o ang mga simpleng routine na kinabibilangan ng mga push-up, crunches, stretching exercises, at iba pa.
Limitations of direct insulin testing and cumbersome calculations have led to research for indirect serum markers to provide evidence of IR. SHBG correlations to IR as previously mentioned have been inconsistent. Adiponectin is a protein found in adipose tissue associated with both inflammation and insulin action. Recent studies have linked plasma adiponectin level to IR (but not hyperandrogenism) measured by HOMA[56-58]. Serum soluble glycoprotein-130 levels (local cytokine) have been inversely correlated to IR[59]. Resistin plasma levels have been correlated with fasting glucose and HOMA-IR in PCOS women[60]. Inhibin A levels in PCOS women were not found to correlate with IR in PCOS women[61]. Most of these serum markers share common limitations and have been poorly studied. How they might vary with different PCOS phenotypes is unknown. None are adequately compared to IR measured by clamp studies. Their usefulness serially in clinical practice to monitor patients over time and undergoing treatment is also unknown. Some genetic work has recently shown promise. Although far from clinical use, microarray analysis of genes in muscle, adipose tissue and the liver shows alterations in the setting of IR[62]. Serum genetic markers may lead to future genetic techniques to detect and monitor IR.
An animal study compared the effectiveness of Cinnamomum cassia and the pharmaceutical Metformin on hormone concentration in rats with PCOS [48] (Table 1). Both interventions demonstrated significant improvements compared to controls at 15 days for measures of testosterone ng/ml (control 0.747 ± 0.039; metformin 0.647 ± 0.027; Cinnamomum cassia 0.625 ± 0.029); LH ng/ml (control 7.641 ± 0.267; metformin 6.873 ± 0.214; Cinnamomum cassia 6.891 ± 0.221) and insulin resistance (HOMA-IR) (control 10.018 ± 0.217; metformin 7.067 ± 0.184 Cinnamomum cassia 8.772 ± 0.196) (p < 0.05) [48]. The metabolic effects for Cinnamomum cassia were further demonstrated in overweight women with oligo/amenorrhoea and PCOS in a placebo controlled RCT [66] (Table 2). However, although the RCT had low risks for bias, it was a pilot study primarily investigating feasibility. Outcomes were promising for metabolic profile in PCOS however the sample size was small and the authors recommended further studies.
First-line medical therapy usually consists of an oral contraceptive to induce regular menses. The contraceptive not only inhibits ovarian androgen production but also increases sex hormone-binding globulin (SHBG) production. ACOG recommends use of combination low-dose hormonal contraceptive agents for long-term management of menstrual dysfunction. [3] If symptoms such as hirsutism are not sufficiently alleviated, an androgen-blocking agent may be added. Pregnancy should be excluded before therapy with oral contraceptives or androgen-blocking agents is started.
This is A LOT of benzodiazepines. I remember the last batch she got too, and it wasn't that long ago. She's using more than I am, and I'm using them legally for a partial spinal cord injury. The FUCK, Luna. Being dependant on heroin isn't enough for you or something? This bothers me more than the heroin, honestly. The withdrawal from benzos can actually kill you, unlike heroin. Not to mention that using multiple CNS depressants together is dangerous af. Narcan won't bring you back from that shit.
Kilicdag [63] Randomised comparative effectiveness trial. Eighty women, 40 with hyperprolactin-aemia, 40 with cyclical mastalgia. Herbal extract Vitex agnus-castus 40 mg in the commercial preparation Agnucaston® by Biomeks, Germany. Comparison of difference between Vitex agnus-castus and Bromocriptine for serum prolactin concentration on days 5–8 of the menstrual cycle. Mean prolactin concentration before and after in the V.agnus-castus arm; 946mIU/L (±173.5) to 529mIU/l (±279.7), p < 0.0001. In the Bromocriptine arm; 885.0 mIU/l (±177.5) to 472.68mIU/L (±265.6), p < 0.0001. All participants completed the trial. Adverse reactions; zero reported in V. agnus-castus group; 12.5% of participants reported adverse reactions in the Bromocriptine group (nausea and vomiting).
Examen físico. El médico te tomará la presión arterial, el índice de masa corporal (IMC) y la medida de la cintura. También observarán tu piel en busca de vello excesivo en el rostro, pecho o espalda, acné o decoloración de la piel. Además, puede examinarte en busca de caída del cabello o signos de otras condiciones de salud (como glándula tiroides agrandada).
Debido a los cambios hormonales, las mujeres con PCOS tienen un mayor riesgo de desarrollar ciertas afecciones de salud serias como la diabetes tipo 2, la hipertensión (presión arterial alta) y trastornos del corazón y los vasos sanguíneos. A menudo, las mujeres con PCOS tienen problemas de fertilidad. Es decir, la capacidad para quedar embarazadas.
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.
Lifestyle change is considered the first-line treatment for infertility in obese women with PCOS. Preconception counseling, administering folic acid to reduce the risk of fetal neural tube defects, encouragement of physical activity and identification of risk factors, such as obesity, tobacco use and alcohol consumption, should be performed. A 5 to 10% loss in body weight over a period of six months regardless of body mass index may be associated with improvement in central obesity, hyperandrogenism and ovulation rate 9. However, no studies with the proper methodology have assessed the live birth rate, which is the primary reproductive outcome 10.
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What you're talking about actually exists - it's called loperamide or Imodium, a widespread drug that exerts an effect only on the mu opioid receptors in the myenteric plexus. It cannot cross the blood-brain barrier. On the other hand, if you want an analgesic, you will have to cross the blood-brain barrier. With cannabinoles, you have different affinities and activities acting on different systems, while for an opioid analgesic the same process that gives the addictive rush. From a purely neurochemical perspective, the difference is that for cannabinoids, the addictive-euphoric and the pain-relieving effects take place on different receptors and it's possible to isolate cannabinoids that have no or little psychoactive effects while for opioids, the effect that gives pain relief is exactly the same as that responsible for addiction. Some opioids have a relatively slow absorption or they can be packaged as an extended release pill that keeps it from hitting the opioid receptors hard and fast. This will prevent it from having the addictive rush that causes compulsive redosing and addiction. But any systemically administered opioid that kills pain will also be at least a little addictive and euphoric. Hope that helps.
A long-term study suggested that metformin continued to improve the metabolic profile of women with PCOS over a 36-month treatment course, particularly improving circulating high-density lipoprotein cholesterol (HDL-C), diastolic blood pressure, and body mass index (BMI). [61] However, data are insufficient as yet to recommend metformin to all women with PCOS.

Bergmann J, Luft B, et al. [62] Randomised, placebo controlled double blind study. Three months or 3 menstrual cycles. Women with fertility disorders, (n = 67). Two sub-groups. Herbal extract Phyto-Hypophyson® by Steril-Pharma GmbH Herrsching, Germany; contains Vitex agnus-castus plus Chelledonium majus and Silybum marianum (St Mary’s thistle) in homeopathic form. Additional herbal extracts have reported activity in hepatic function. There are no reports for direct reproductive effects. 150 drops per day (7.5 ml per day). Primary outcome for participants with amenorrhoea: at least one spontaneous menses. Oligomenorrhoeic subgroup - clinical outcomes were significantly improved in the treatment arm at 82% compared to 45% in placebo arm P = 0.021. When the amenorrheic group were included in analysis, differences were not significant p = 0.19. Diagnosis for anovulatory amenorrhoea is not well described. Non-statistically significant take home baby rates were complicated by insufficient sample size. 366 patients are required to have a 95% chance, as significant at the 5% level, an increase in take home baby rates from 6% in the placebo group to 18% in the experimental group. The authors conclude that this preparation may be useful if given 3–6 months, yet they only tested for 3 months.
With our 5-Element System, we show you how to use Food as Medicine to balance your insulin levels and hormones. Our 5% solution…making small changes over time using our diet plans, recipes, and 24/7 support…will help you to successfully change your eating habits, choosing foods to support your healing and eliminate those persistent sugar and simple-carb cravings.
There is no cure yet, but there are many ways you can decrease or eliminate PCOS symptoms and feel better. Your doctor may offer different medicines that can treat symptoms such as irregular periods, acne, excess hair, and elevated blood sugar. Fertility treatments are available to help women get pregnant. Losing as little as 5% excess weight can help women ovulate more regularly and lessen other PCOS symptoms. The ideal way to do this is through nutrition and exercise.

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

A secondary analysis of two randomized, double blind, placebo-controlled trials that included 182 children of mothers with PCOS reported that children exposed to metformin had higher BMI and increased prevalence of overweight/obesity at 4 years of age. The study found that at 4 years of age, the metformin group had higher weight z-score than the placebo group; difference in means 0.38 (0.07 to 0.69), p=0.017, and higher BMI z-score; difference in means 0.45 (0.11 to 0.78), p=0.010. There were also more overweight/obese children in the metformin group; 26 (32%) than in the placebo group; 14 (18%) at 4 years of age; odds ratio (95% CI): 2.17 (1.04 to 4.61), p=0.038. More studies are needed to examine this association. [94]
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Hola, hace unos 6 años me detectaron SOP, me mandaron la píldora ya que no habia otro tipo de tratamiento, me lo diagnosticaron por mi falta de regla y exceso de bello. Hace como unos 6 meses deje la píldora para ver como reaccionaba mi cuerpo, no reacciono bien, volvi a las reglas irregulares y ahora llevo 3 meses sin que me baje. vi vuestra pag de casualidad, y quisiera saber si tomando vuestras pastillas se regulara de forma natural la regla y si hay posiblidad de que baje.
Medications to cause ovulation. Medications can help the ovaries to release eggs normally. These medications also have certain risks. They can increase the chance for a multiple birth (twins or more). And they can cause ovarian hyperstimulation. This is when the ovaries release too many hormones. It can cause symptoms such as abdominal bloating and pelvic pain.
Medical management of PCOS is aimed at the treatment of metabolic derangements, anovulation, hirsutism, and menstrual irregularity. The use of insulin-sensitizing drugs to improve insulin sensitivity is associated with a reduction in circulating androgen levels, as well as improvement in both the ovulation rate and glucose tolerance. [3] The Endocrine Society has published a clinical practice guideline on hirsutism evaluation and treatment in premenopausal women. [51] ACOG notes that eflornithine in conjunction with laser treatment is superior to laser therapy alone in treating hirsutism. [3]
This thread fucks me up. I feel so much pity and sadness for this poor girl. Sort of hits close to home, when I turned 18 I moved in with a boy and got really sick and hooked on drugs for 2 years. I left him and got better, never did I ever get as bad as Luna but it could have happened had I been complacent like she is. I hope she finds the courage to leave. I think there's still beauty and potential underneath all the grime and illness, I even like her art sometimes and wish she'd spend more time on her paintings instead of on drugs. Lurch should be in prison for destroying this poor girl before she even had a chance. Sage for blog post.(USER HAS BEEN PUT OUT TO PASTURE)
In some cases, a woman doesn’t make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries can develop many small cysts. These cysts make hormones called androgens. Women with PCOS often have high levels of androgens. This can cause more problems with a woman’s menstrual cycle. And it can cause many of the symptoms of PCOS.
A total of 33 studies were included in this review. Eighteen pre-clinical studies reported mechanisms of effect and fifteen clinical studies corroborated pre-clinical findings, including eight randomised controlled trials, and 762 women with menstrual irregularities, hyperandrogenism and/or PCOS. Interventions included herbal extracts of Vitex agnus-castus, Cimicifuga racemosa, Tribulus terrestris, Glycyrrhiza spp., Paeonia lactiflora and Cinnamomum cassia. Endocrine outcomes included reduced luteinising hormone (LH), prolactin, fasting insulin and testosterone. There was evidence for the regulation of ovulation, improved metabolic hormone profile and improved fertility outcomes in PCOS. There was evidence for an equivalent effect of two herbal medicines and the pharmaceutical agents bromocriptine (and Vitex agnus-castus) and clomiphene citrate (and Cimicifuga racemosa). There was less robust evidence for the complementary combination of spirinolactone and Glycyrrhiza spp. for hyperandrogenism.
Although metformin is associated with better clinical pregnancy rates (positive beta hCG) (pooled OR 2.31; 95% CI: 1.52 to 3.51; 8 trials; 707 women), there is no evidence of better live birth rates (the main variable used to evaluate the effectiveness of a treatment for infertility) when this drug is used alone (pooled OR 1.80, 95% CI: 0.52 to 6.16; 3 trials; 115 women) or in combination with CC (pooled OR 1.16; 95% CI: 0.85 to 1.56; 7 trials; 907 women) 36. From a reproduction standpoint, there is also no benefit for its use in short (less than four weeks) or long (more than four weeks) periods prior to starting CC treatment in women with PCOS. Therefore, the use of metformin should be restricted to the treatment of glucose intolerance or type 2 diabetes in women with PCOS and should not be used to induce ovulation 9,36.
Methadone is said to not get people "high," but I beg to differ. It doesn't give any of the euphoria that heroin does, nor the rush, but it definitely has a body high to it. I've never taken a dose of methadone over 30mg (which is a typical maintenance dose, btw) and got so high off that I couldn't walk straight. Mentally I was nearly clear though. Maybe Lurch likes feeling physically retarded and it takes him 130mg to get there? Who knows.

Goodman, N. F., Cobin, R. H., Futterweit, W., Glueck, J. S., Legro, R. S., & Carmina, E. (2015). American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome - part 1. Endocrine Practice, 11, 1291–300.

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