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A cream called eflornithine (Vaniqua) may be pre-
scribed to rub on affected areas of skin. Some re-
Rarely, your doctor may suggest surgery to control
search trials suggest that it can reduce unwanted hair
PCOS symptoms and improve fertility, for example
growth, although this effect quickly wears off after
laparoscopic ovarian drilling. This is a type of keyhole
procedure used to destroy the testosterone-producing
Drugs taken by mouth can also treat hair growth. They
tissue on your ovaries. As levels of testosterone fall,
work by reducing the amount of testosterone that you
your PCOS symptoms improve and ovaries start to re-
make, or by blocking its effect. Drugs include:
Cyproterone acetate is an antitestosterone drug. This
is commonly combined with oestrogen as a special
Preventing long-term problems
contraceptive pill called Dianette. Dianette is com-
A healthy lifestyle is important to help prevent the pos-sible long term complications of PCOS, for example,
monly prescribed to regulate periods, to help reduce hair growth, to reduce acne, and is a good contracep-
you should: eat a healthy diet, exercise regularly, lose
weight if you are overweight or obese, and not smoke.
The combined contraceptive pill Yasmin (a combina-
tion of ethinylestradiol and drospirenone) has been
shown to help if Dianette is not suitable.
Other medications are sometimes advised by a spe-
cialist if the above treatments do not help.
PCOSupport Organziation Polycystic Ovarian Syn-drome Association, PO. Box 3403, Englewood CO
Drugs taken by mouth to treat hair growth take 3-9 months to work fully. You need then to carry on taking
them otherwise hair growth will recur. Removing hair
Information for Patients
by the methods above may be advised whilst waiting
Polycystic ovary syndrome. NHS National Library for Health
Clinical Knowledge Summaries, 2007. www.cks.nhs.uk, ac-
This medicine increases the sensitivity of muscle cells
to insulin (reduces insulin resistance). This means
your body needs less insulin to control your blood
Long-term consequences of polycystic ovary syndrome
sugar levels. Reduced insulin levels in the blood
(Green-top 33). London (UK): Royal College of Obstetricians
means your ovaries will produce less testosterone. As
and Gynaecologists (RCOG), 2003. www.rcog.org.uk, ac-cessed 2 February 2010
the testosterone levels drop symptoms such as excess hair and irregular periods will improve, and
Lord JM, Flight IH, Norman RJ; Metformin in polycystic ovary
your ovaries will start to release eggs (improve fertil-
syndrome: systematic review and meta-analysis. BMJ. 2003
ity). Fertility medicines including clomifene can stimulate
your ovaries to release eggs. You can take these for up to a year. If clomifene makes you ovulate but you
South Tyneside NHS Foundation Trust,
don't become pregnant after 6-12 months, your doctor
might suggest hormone therapy or surgical treatment.
You can also consider assisted conception, such as IUI (intrauterine insemination) IVF (in vitro fertilisa-
Tyne and Wear
South Tyneside Foundation NHS Trust
Tel 0191 404 1000 (Main Switchboard)
Being overweight or obese is not the underlying
cause of PCOS. However, if you are overweight or
Irregular or absent periods occur in about 7
obese, excess fat can make insulin resistance worse.
Polycystic ovary syndrome (PCOS) is one of the
High levels of insulin can contribute to further weight
most common female endocrine disorders affecting
Excessive hair (hirsutism) particularly on the
gain producing a 'vicious cycle'. Losing weight, al-
though difficult, can help break this cycle.
The term polycystic ovaries describes ovaries that
Thinning of scalp hair or male-pattern bald-
Are any tests needed?
These cysts are egg-containing follicles that have not
Tests may be advised to clarify the diagnosis, and to
developed properly due to a number of hormonal
Difficulty in maintaining a healthy body
Blood tests may be taken to measure hormones. .
It is estimated that 20 - 30% of women in the UK
Fertility problems (difficulty conceiving)
An ultrasound scan of the ovaries may be advised.
have polycystic ovaries. But only 10 - 15% have
An ultrasound scan is a painless test that uses sound
waves to create images of structures in the body.
If you are diagnosed with polycystic ovary syndrome
PCOS can be diagnosed by any combination of
The scan can detect the typical appearance of PCOS
(PCOS) it means that your hormones are not in bal-
blood test results, an ultrasound scan or from a
with the many follicles (small cysts) in slightly
ance. The three types of hormones made by your
history of symptoms. Sometimes the cysts may not
ovaries are the ones most affected. They are called
be seen during a scan but a diagnosis can still be
Also, you may be advised to have an annual screen-
oestrogens, androgens, and progesterone.
made using symptoms and blood test results.
ing test for diabetes or prediabetes (impaired glucose
These hormones affect a lot of things that go on in
tolerance). A regular check for other cardiovascular
your body, including when you have your period,
Causes for PCOS
risk factors such as blood pressure, and blood cho-
when your ovaries release eggs, how hair grows on
lesterol, may be advised to detect any abnormalities
PCOS and insulin resistance
your face and body, and the condition of your skin.
Insulin is a hormone made in the pancreas which
as early as possible. Exactly when and how often the
helps the body use energy from food. Insulin resis-
checks are done depends on your age, your weight,
Polycystic ovary syndrome (PCOS), formerly known
tance occurs when the body does not respond to
and other factors. After the age of 40, these tests are
as the Stein-Leventhal syndrome, is a condition
normal levels of insulin and this results in more
where at least two of the following occur, and often
insulin production. High levels of insulin encourage
the body to store fat which can lead to weight gain.
At least 12 follicles (tiny cysts) develop in your
As weight goes up, insulin resistance increases.
The symptoms of PCOS can be controlled using a
Insulin also promotes the production of testoster-
combination of lifestyle changes, cosmetic measures
The balance of hormones that you make in the
one in the body. Testosterone is often thought of
and medication. Studies show that physical activity
ovaries is altered. In particular, your ovaries
as a male hormone but women need a small
and weight loss are the most effective ways to im-
make more testosterone (male hormone) than
amount. However, having even slightly higher
prove insulin resistance and symptoms. Losing just
amounts can upset the balance of hormones in the
five to ten per cent of body weight may be all that's
You do not ovulate each month. Some women
body and lead to acne, excess hair and irregular
needed to correct the hormonal imbalance, thus re-
periods. Irregular periods may result in infertility.
storing ovulation and fertility, and helping improve
In PCOS, although the ovaries usually have many
Long term health concerns associated with PCOS
follicles, they do not develop fully and so ovulation
are linked to insulin resistance and include heart
often does not occur. If you do not ovulate then you
Hair growth is due to the increased level of the hor-
mone testosterone . Unwanted hair can be removed
Therefore, it is possible to have polycystic ovaries
by waxing, hair-removing creams, electrolysis, and
without the typical symptoms that are in the syn-
Your genetic makeup is probably important. PCOS
laser treatments. These need repeating every now
is not strictly inherited from parents to children, but
and then, although electrolysis and laser treatments
may be more long-lasting (not normally available on
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Mayo Medical Laboratories Test Catalog [Previous Drugs Detectable by Drug Screen This test specifically screens for each of the drugs listed below. Results for drugs indicated by # are quantitative in plasma, all others are qualitative. All results are qualitative in urine and gastric fluid. Plasma (and Gastric) Analgesics: Acetaminophen (Tylenol )# Acetylsalicylate