PCOS Treatment Options Help?

[Kim_8 2]

Hi All -

Finally went to the OBGYN after a 10 year break (I hate going there). Anyway, they just called to say I'm diagnosed with Polycystic Ovarian Syndrome (PCOS). The doc wanted to put me on Birth Control pills, but I'm 38 and a smoker. I don't think this is such a great idea. I've talked to the nurse who will discuss with the doc again - she agrees that BC is not the way to go.

Can anyone with any experience here tell me what alternate treatment options are and if they are as effective as birth control?

Thanks!

Kim

[Tricia K. 0]

Kim,

I have PCOS and used to take metformin, but it really didn't do much for me. At the advice of my PCP and my surgeon, I stopped taking it the day of my surgery.

You may wish to discuss taking metformin (Glucophage) or Actos with your doctor. They are actually diabetic medications but help some people with PCOS. There's also the option of taking another form of birth control called Depo-provera. It is a progestin only birth control that's administered by a shot every 11-13 weeks. So, you don't have to worry about taking a pill every day. From what I've read (see link below), the risks for heart attacks or strokes may be linked directly to smoking rather than the combination of smoking/birth control.

http://www.uihealthcare.com/topics/womenshealth/wome5315.html

[ralheit 1]

I was on Depo-provera for more than a year. It was great because you never had a period. But it is alos notorious for causing weight gain!

[Kim_8 2]

Hi Guys - thanks for the info. I looked at the Depo-provera site and the only thing I didn't like was that if you had adverse reactions, the only thing you could do is wait for the medication to wear off - which in this case is a pretty long time. I also read about Metformin - lots of side effects with this one. Tricia - why did your PCP take you off the Metformin? What do you take now - if anything? Ralheit - did you have any adverse reaction to the depo-provera?

[Tricia K. 0]

Hi Guys - thanks for the info. I looked at the Depo-provera site and the only thing I didn't like was that if you had adverse reactions, the only thing you could do is wait for the medication to wear off - which in this case is a pretty long time. I also read about Metformin - lots of side effects with this one. Tricia - why did your PCP take you off the Metformin? What do you take now - if anything? Ralheit - did you have any adverse reaction to the depo-provera?

You're very welcome, Kim. My doctors took me off of it because they felt that with the surgery, I wouldn't need to take it anymore. Losing weight helps a lot with controlling PCOS. I don't take anything now.

What are your symptoms with PCOS? Mine were very minimal considering all of the symptoms that can occur with the syndrome - obesity (if you can call that minimal) and excess hair growth on upper arms and abdomen, which is all but gone now.

I do still take Depo-provera though, but only for birth control reasons. I've been on it for almost 6 years and haven't had any adverse reactions to it. It didn't cause me to gain weight - I was actually able to lose a little bit of weight while on it and doing Atkin's. I love it because I haven't had a period the entire time I've taken it. I'll be going off of it early next year as we hope to get pregnant.

I hope this helps.

[Kim_8 2]

Thanks Tricia. I appreciate the insight. Maybe mine will go away, too. I would love the birth control shot - just know that I've heard that smoking is an issue with birth control. I could stop smoking --- ughhh.

I've got high blood pressure (mostly high anyway, although sometimes I'll get a normal reading). I've got excessive hair growth and the hormone tests came back pretty elevated... ok I'm a guy :-). Kidding. Also acne and obesity. I'm checking on the insulin results.

It's nice to hear that your symptoms are going away with weight loss. I'm down to 180 ish now... wonder how low it will have to go before I start seeing some changes?

[Elisabethsew 50]

It would NOT be a good idea to go on birth control pills if you're in your late 30's, a smoker and overweight. That's a triple threat. I do NOT smoke but was on birth control pills (low dose) and nearly died in January when I had pulmonary emboli (blood clots in both lungs).

Because many people with PCOS develop diabetes, nearly all patients are placed on glucophage. Make sure you ask a lot of questions before taking medications. You might also consider seeing an endocrinologist.

[Kim_8 2]

Elizabeth -

Thanks for the info. Wow - that's pretty scarry. I did talk to the nurse this afternoon after she talked to the doctor. They want to try me on a one month dose of Provera and then have blood work re-done at the end of that time. Does that sound reasonable to you? My DHEA levels were at 342 (normal 40-325) and Testosterone was 88 (normal 20-75). They said the one dose of Provera would confirm the PCOS diagnosis. I also just talked to the nurse again about the glucophage and they said that's not given unless the person is trying to get pregnant.... I thought glucophage was metformin and used to control blood sugar... what would that have to do with getting pregnant. So confused and wish I would have chosen a medical profession instead of a computer geek. :-)

[Tricia K. 0]

Elizabeth -

Thanks for the info. Wow - that's pretty scarry. I did talk to the nurse this afternoon after she talked to the doctor. They want to try me on a one month dose of Provera and then have blood work re-done at the end of that time. Does that sound reasonable to you? My DHEA levels were at 342 (normal 40-325) and Testosterone was 88 (normal 20-75). They said the one dose of Provera would confirm the PCOS diagnosis. I also just talked to the nurse again about the glucophage and they said that's not given unless the person is trying to get pregnant.... I thought glucophage was metformin and used to control blood sugar... what would that have to do with getting pregnant. So confused and wish I would have chosen a medical profession instead of a computer geek. :-)

Kim, you really need to speak with someone else, one who knows what they're talking about. That nurse is completely misinformed. And, as far as I know, they don't have one month doses of Depo-provera. One shot lasts for 11-13 weeks, regardless. And, one can't diagnose PCOS by having someone take Depo-provera for a month. Mine was diagnosed after reviewing my medical history, asking a series of questions to determine if I had some of the symptoms and THEN going to the endocrinologist to have a fasting blood test done. I was given 1 pill to take the evening before - one that is supposed to shut down a particular gland. If the test results showed that this gland was still producing after taking the pill, that confirmed the PCOS diagnosis.

Please, please, please go see someone else.

[Elisabethsew 50]

Hi Kim,

Did they do a pelvic sonogram or transvaginal sonogram? If so, THAT is usually how they diagnose PCOS and then confirm the degree of the PCOS with the hormonal blood levels. I have never heard of giving glucophage to get pregnant. It's to regulate insulin levels. I really think you would do better seeing an endocrinologist. They deal with this type of problem all the time and can best determine a treatment plan individualized to you.

The medical profession is not all it's cracked up to be. LOL. I will give you some inside advice, however. Stay out of hospitals in July and August. That's when the medical students of yesterday are now out "practicing" as interns. A lot of RNs take vacation in those months. LOL.

[Tricia K. 0]

Hi Kim,

Did they do a pelvic sonogram or transvaginal sonogram? If so, THAT is usually how they diagnose PCOS and then confirm the degree of the PCOS with the hormonal blood levels. I have never heard of giving glucophage to get pregnant. It's to regulate insulin levels. I really think you would do better seeing an endocrinologist. They deal with this type of problem all the time and can best determine a treatment plan individualized to you.

The medical profession is not all it's cracked up to be. LOL. I will give you some inside advice, however. Stay out of hospitals in July and August. That's when the medical students of yesterday are now out "practicing" as interns. A lot of RNs take vacation in those months. LOL.

Great idea on the sonogram, Elisabeth! After my diagnosis was confirmed with the blood test, I went for a sonogram, which ruled out the existence of cysts on my ovaries - thankfully.

The whole idea about giving Glucophage to assist in getting pregnant is absurd. :paranoid

[Kim_8 2]

Hi guys - just picked up the prescription. It's called Medroxyprogesterone. No, no sonogram was done. They went strictly off my symptoms and off of the elevated readings on the two hormones. What they quoted me as provera over the phone is reading on the prescription as I listed above. It does say that it can cause pulmonary embolism. I thought about the pregnancy comment and was wondering if he only treats with Metformin when you are trying to get pregnant is because the other solution is some form of birth control or hormone that could be harmful to the baby?? Just a thought. I'm not crazy about taking this stuff at all. Tons of just lovely possible side effects. So, start with a new obgyn or straight to the endocrinologist? Too bad - he was pretty nice and works at Baylor Women's Center (which is pretty reputable around here). I would have thought he was informed. Also - wondering what the reason behind the one month deal is... Nurse said that if it lowered the levels of testosterone and DHEA then that would mean a positive PCOS diagnosis. Not sure how all that works. He did not test my insulin levels. Ok, well this is scattered... I'm a little rattled. Thanks so much guys again for the help!!!! Oh yea - and I'll try to get this little issue wrapped up PDQ... no July or August visits to the hospital for me. LOL

[Chickie 15]

Kim, you really need to speak with someone else, one who knows what they're talking about. That nurse is completely misinformed. And, as far as I know, they don't have one month doses of Depo-provera. One shot lasts for 11-13 weeks, regardless. And, one can't diagnose PCOS by having someone take Depo-provera for a month. Mine was diagnosed after reviewing my medical history, asking a series of questions to determine if I had some of the symptoms and THEN going to the endocrinologist to have a fasting blood test done. I was given 1 pill to take the evening before - one that is supposed to shut down a particular gland. If the test results showed that this gland was still producing after taking the pill, that confirmed the PCOS diagnosis.

Please, please, please go see someone else.

Provera is different to Depo-Provera. Depo is the birth control, and Provera is used to induce a period.

http://www.healthsquare.com/newrx/pro1361.htm

Why is this drug prescribed?

Provera is derived from the female hormone progesterone. You may be given Provera if your menstrual periods have stopped or a female hormone imbalance is causing your uterus to bleed abnormally. Provera is also prescribed to prevent abnormal growth of the uterine lining in women taking estrogen replacement therapy.

Other forms of medroxyprogesterone, such as Depo-Provera, are used as a contraceptive injection and prescribed in the treatment of endometrial cancer.

Some doctors prescribe Provera to treat endometriosis, menopausal symptoms, premenstrual tension, sexual aggressive behavior in men, and sleep apnea (temporary failure to breath while sleeping).

[Chickie 15]

It's called Medroxyprogesterone.

Ahh, ok. You *were* given Depo-Provera.

I am not sure if I would take Depo. A lot of women with PCOS have very bad side effects from Depo. Not everyone.. But a lot do.

It may be worth checking out www.soulcysters.net . There are a lot of ladies over there who may be able to give you some advice.

[Kim_8 2]

Thanks Sam! I'll go take a look.