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I agree that seeing a gynaecologist directly might make the most sense as regardless of history taking by the GP, the ultimate confirmatory diagnosis is still ultrasound of your ovaries. They would be better placed to discuss with you on treatment modalities.
What is Polycystic Ovary Syndrome (PCOS)? Polycystic ovary syndrome (PCOS) is a result of a hormonal disorder commonly found in women of reproductive age. These affected women may have a variety of symptoms or even no symptoms at all. They can have one or several symptoms and to various degrees of severity. The common symptoms include irregular or infrequent or prolonged menses and signs of excess male hormone (androgen) levels (facial acne, excess facial and body hair called hirsutism and even male pattern baldness).
Women diagnosed with Polycystic ovarian syndrome commonly experience irregular menstural periods. It is important to get evaluated early and to consider treatment for period regulation as not having your periods for a prolonged period of time can lead to excessive build up of your womb lining. One of the most useful medications that is common prescribed for girls with PCOS is the birth control pill. This is an very effective way to regulate your periods.
PCOS is associated with infertility because it is associated with a lack of ovulation. You ovulate 2 weeks before your period, but if your periods are irregular, then it becomes difficult to predict when ovulation will take place. You can confirm if you are ovulating with urine ovulation test kits or blood test. If indeed you’re ovulating regularly, then PCOS should not affect your fertility.
Scalp hair loss is one of the manifestations of the effects of increased male hormones in PCOS. Management includes the contraceptive pill which suppresses the ovary (hence suppresses testosterone production by the ovary) as well as the medications that block the effect of testosterone at the level of the hair follicle (eg Spironolactone). Metformin plays a role in treating insulin resistance in PCOS and can potentially help the associated hair loss. Other non-related causes of scalp hair loss that should be looked out for include iron deficiency and thyroid hormone abnormalities.
TCM physician can help to treat Polycystic Ovarian Syndrome by performing acupuncture treatments for the patient to stimulate the meridians around the ovaries for ovulation to occur. Chinese herbal medicine can also be prescribed to help the patient to regulate her menstrual cycle. TCM physicians can also initiate a TCM weight management treatment plan for the patient if the PCOS patient is overweight. This is because weight reduction is an important way to help the patient achieve regular ovulation. A weight reduction of just 5% can lead to significant improvement in PCOS.  1.
I’ll be frank, it’s been some time since I had to manage PCOS for anyone, but as I recall the common issues with it are: Acne Weight gain Hirsutism (hair growth) Difficulty conceiving If your main issue is acne, Dianette is a reasonable option - although it is not recommended as a contraceptive. I would advise you to seek the advice of a gynaecologist if conceiving is an issue or perhaps a dermatologist if acne is the main overriding concern. This is what I would advise if seeing someone for the first time. I would presume that you have had an ultrasound scan done.
PCOS is a fairly common condition in Singapore that usually goes under-diagnosed. You are right, it's advisable to have a more stable skin condition, before going for acne scar treatments (in particular, fractional lasers). However certain acne scar treatments like subcision are safe to do, even during minor acne outbreaks. I noticed you mentioned you are taking contraceptive pills. As such we should consider adding on Spironlactone (which has an anti-androgenic effect) that reduces oiliness. In fact, spironolactone might be a better idea as a first-line for the PCOS-associated acne.
thanks for your question. In a nutshell, yes you should definitely see your GP regarding your irregular periods to rule out certain things, PCOS being one of them. Excess body hair (hirsutism in medical speak) and irregular periods are some common characteristics of PCOS, with the others including being overweight and having acne. So what you’ve told me is certainly suggestive. Thyroids disorders are also a rare cause of irregular periods, especially if you know that you have a family history of thyroid problems. This can also be screened for easily when you see your GP.
You should visit your gynaecologist for check up, blood tests and ultrasound scan of your pelvis to confirm the diagnosis of PCOS and to exclude other causes of irregular, painful, and heavy menses. Your gynaecologist can give you advice and treatment plan based on your test results and ultrasound scan report. Studies have shown there is slight increased risk of breast cancer in women who are taking oral contraceptive pills. The risk is higher in those women who have strong family history of breast cancer or abnormal breast cancer gene.
Hi,Progesterone pills are commonly given as one of the management options for patients with PCOS. These pills are usually taken for a week every 3 months of not having your natural period. Many girls affected by PCOS may not get their periods for many months, and the main purpose of a progesterone pill such as Norcolut is mainly to induce a withdrawal bleed once every 2-3 months. This is to maintain a healthy endometrial lining. However, if you are trying to conceive, then taking a progesterone such as Norcolut may not be the most suitable.
Hi,I'm sorry to hear that you have been troubled with fertility issues. Yes, PCOS can result in difficulty conceiving, and this is usually because you don't ovulate regularly, hence unable to predict when the next ovulation will occur. There are medications available that can help with this. If you are able to ovulate with medication but still unable to get pregnant, then the cause for the infertility may not be PCOS related. I would suggest speaking to your fertility doctor about this and he/she will be able to suggest other tests (if clinically relevant) to do.
A pelvic ultrasound scan is a very useful non-invasive tool in making the diagnosis of PCOS (polycystic ovarian syndrome) as it allows us to visualize the multiple small ovarian cysts (follicles) which are arranged circumferentially around the ovary like a "string of black pearls" as it is often described. Women who suffer from PCOS may also have an abnormal hormone profile and this is another way of making the diagnosis in addition to the PCOS symptoms that some women may complain of.
In PCOS, the most common reason for difficulty conceiving is the lack of ovulation. Ovulation (when the egg is released) occurs 14 days before the next period. If you're having irregular periods, then it becomes difficult to predict ovulation. There are certain medications available (for example Clomiphene) that may help to induce ovulation. If you're having regular periods, that means that you're ovulating regularly, and PCOS is not likely the cause of the infertility. As there may be other reasons for the infertility, a check up of both partners would be beneficial.