What is it?
Polycystic ovarian syndrome is a common hormonal disorder that is clinically characterized by irregular menstrual cycles, lack of regular ovulation, abnormal facial hair growth, infertility, obesity and polycystic ovaries (enlarged, cystic ovaries). This disorder affects approximately 6% of all reproductive age women. Recent evidence indicates that polycystic ovarian syndrome is a disorder characterized by insulin resistance and a compensatory elevated insulin level, which are found in both the overweight and non-overweight women with the syndrome.
Diagnosis
The diagnosis of polycystic ovarian syndrome is typically made by your physician by taking your history, doing a physical exam, performing an ultrasound and measuring some of your hormone levels. Once the diagnosis is established treatment options can be discussed. If you are not trying to get pregnant the best therapy is weight reduction if you are overweight and birth control pills to regulate your menstrual cycle.
Treatment
Traditional therapy for women with infertility secondary to polycystic ovarian syndrome has been ovulation induction using clomiphene citrate as a first line agent. Due to this recognition regarding insulin levels and resistance, the use of insulin sensitizing agents such as metformin (Glucophage®) for ovulation induction have recently been studied with promising results. Frequently clomiphene citrate and metformin are used together. Insulin-lowering agents for ovulation induction in women with Polycystic Ovarian Syndrome are an attractive alternative due to their low cost, minimal side effects and decreased risk for multiple pregnancies compared with other agents.
Since the use of metformin for ovulation induction in women with polycystic ovarian syndrome is relatively new, the best method for ovulation induction is yet to be determined. The physicians at MUSC and Southeastern Fertility Center individualize patient care and your treatment may involve the use of metformin alone or in combination with other medications.
by: John Schnorr, M.D.
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