The most effective treatment of insulin resistance associated with PCOS is weight loss and exercise. Has it been difficult to lose weight, the treatment may be possible. combined with Metformin, but studies show that weight loss (with or without Metformin) is more effective than metformin alone.
Ca.20% of women with PCOS are normal strong. For these women is exercise to strengthen insulin sensitivity and appropriate. metformin the best treatment. Both overweight and normal strong PCO'ere can benefit from metformin treatment.
Among physicians, there is disagreement, partly on the merits of Metformin to treat insulin resistance associated with PCOS and partly on the impact. However, many doctors today started to deal with PCOS Metformin to increase sensitivity to insulin.
Metformin is originally a blood sugar-lowering product, which is used to treat type II diabetes.
According to a digest with the Medicines catalog and various studies causes Metformin that insulin sensitivity is increased, leading to the production of insulin from the pancreas and reduce insulin concentrations in the blood fall. It describes the following effects, which may not always seen in practice!
Your blood sugar levels fall due:
- A reduced degradation of glykogendepoter from the liver, ie. glucosefrigivelse to reduced blood
- An increased uptake of glucose into muscle cells
- A reduced uptake of glucose from the gut
- Androgens production from the ovaries decreases because there no longer is a hyper-stimulation of the androgenic-producing tissue
- More regular ovulation and contraction
- Improved balance of fat in the blood, including cholesterol and thus reduced risk of cardiovascular disease
- Reduced risk for type II diabetes
Easier to lose weight because:
- The regulation of appetite in the brain works better and satiety feeling reborn
- Sugar inclusion in the fatty tissue reduced
Do we have the desire pregnancy, Metformin will increase pregnancy chances:
- The woman will have more regular ovulation and contraction
- If hormone stimulation is currently associated with fertility treatment, increased sensitivity to klomifen and FSH treatment
- There is a reduced risk of spontaneous abortion
- There is a reduced risk of developing diabetes during pregnancy
Besides the controversy about the merits of metformin for insulin resistance in PCOS, there is also disagreement over whether we should continue Metformin Therapy, when a pregnancy is established. The trend is overwhelming enough that it can continue for 12 weeks pregnancy!
Side effects of Metformin
Not all women can tolerate Metformin. Therefore usually taken control blood tests before and during treatment, like Trappes dose slowly up to approx. 2000mg a day.
Some can not even tolerate a single tablet (500mg) daily, while others tolerate even high doses. If we can not tolerate Metformin, can console themselves with the fact that the most effective treatment is weight loss and exercise.
General side effects of Metformin is:
- Metal taste in the mouth
Experience shows, however, that the side effects usually disappear after 2-3 weeks, and genes can be reduced if the tablets are taken in the context of a meal.
Treatment of hirsutism
Hirsutism occurs because of the increase amounted to the influence of follicles. How bad it is depends on the individual woman's susceptibility to androgens.
- Contraceptive pill can be attempted, but are not always effective against hirsutism
- Spironolactone (Spiron) is an anti-which sometimes can have little effect
- Hair removal by laser-epilering is probably the most effective, but it is expensive, and the effect is not permanent
Treatment of Acne
Acne is due, the effects of skin oil glands, and the degree it is again dependent on each woman's sensitivity to androgens.
- Contraceptive pill can be attempted, but are not always effective
Treatment of pregnancy wish
PCOS is no barrier to becoming pregnant, but it has often needed to get some help for it, because a pregnancy requires a normal ægudvikling and ovulating!
Many PCOS women get in between a perfectly normal ovulation, and therefore, there is also a chance to become pregnant at quite usual.
Some PCOS women never discover they have PCOS and get their children to completely natural way.
Laparoscopic capsule destruction (ovariebrænding)
The treatment is to reduce the amount of androgens producing cells in the ovary, in order to normalize the disturbed LH / FSH balance, so that there is ovulating again. Using a small cut below the navel, called with a kind of telescope and the laser destroyed a bit of ovarian capsule, which contains the androgenic producing cells.
The treatment is often effective, but the effect is transient, and therefore not used very often.
The treatment is to compensate for the unbalanced hormonal balance which disrupts ovulation. What is the problem is that LH is too high compared to FSH, so ægudviklingen get stuck half way and ovulation is still lacking.
The first treatment attempt is to lure pituitary gland to produce more FSH.
To that used Klomifen / Pergotime tablets. The resulting study will honor 70-75% 30-40% ovulating and becoming pregnant within 6 treatment trials. Not all PCOS patients respond properly to Klomifen, they say that they are klomifenresistente.
The next attempt is to provide FSH in the form of injections under the skin.
This is often more effective, but there is also a risk of getting put to good time in ægudviklingen since PCO-ovaries often reacts very sensitive to stimulation:
- There is a risk that too many mature eggs, then doing too many children at once
- There is a risk of over-stimulate the ovaries, so you get sick of it.
- Of the ovaries is a specialist task, which is under close scrutiny by the ovaries through regular ultrasound scans.
Hormone treatment can be combined with artificial insemination treatment, or IVF, if necessary. Read more about fertility treatment at the homepage of the Fertility Clinic at Amtssygehuset in Jolo.
Source: PCO Association, www.pcoinfo.dk
This article is formed on the Health Guide on 26.09.06