Polycystic Ovary Syndrome
Polycystic Ovary Syndrome or PCOS affects 6 to 10% of women in the United States and is part of the Insulin Resistance Syndrome.
Women who have it typically experience two or more of these symptoms: obesity, acne, infertility, irregular menstrual cycles, ovarian cysts, and hair growth on the face, chest and back. They often have insulin resistance and other features of IRS, or even Type 2 diabetes. While all women produce some male hormones such as androgens and testosterone, women with PCOS typically produce higher levels than normal.
Because many of the symptoms of PCOS can be caused by other medical conditions, PCOS is diagnosed by comparing a person’s history of symptoms and experiences with the results of a physical exam and lab tests. Ovarian cysts may be seen on a pelvic ultrasound and a blood test can be done to measure hormone levels to find out if PCOS is the cause.
PCOS is caused by a blend of genetics and lifestyle factors. Similar to insulin resistance and Type 2 diabetes, PCOS improves with weight loss, exercise and healthier eating habits. These lifestyle changes are often combined with hormones, insulin-sensitizing medications and sometimes androgen-blocking drugs. These, combined with low-estrogen birth control pills, help bring hormone levels under control, and can improve acne and unusual body and facial hair. Insulin sensitizing medications, such as Avandia or Actos, look promising for approval in the future to treat PCOS. Metformin is useful because it turns off production of glucose by the liver, and improves insulin sensitivity. Metformin may help weight loss and have the positive side effect of increasing fertility and enabling pregnancy.
Birth Control and Diabetes
There are many forms of birth control available. In general, the choice you make can be based on the same reasons a woman without diabetes would make it. The only difference is the risk for blood clots may increase with Type 2 diabetes and oral contraceptives.
The risk for blood clots also increases if you smoke, don't exercise, are overweight, are over age fifty, have high blood pressure, or high cholesterol. If you have these risk factors and choose to use an oral contraceptive anyway, be sure to use a low-dose pill and have your cholesterol and blood pressure checked regularly.
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