January 31, 2006

Dear Saira:

Answering your questions based on the assumption that you were suspected of having PCO:

1) PCO stands for Poly Cystic Ovarian Syndrome. A condition involves forming cysts in the ovaries which causes hormonal imbalance.

2) You are not diagnosed with something that would shatter your life

3) Yes this may affect your fertility, but fortunately this can be treated and overcome.

4) Yes I believe you can and probably will be a mother.

Symptoms to look for

Menstrual irregularity, infertility, acne, male-pattern hair loss, rarely deepening of the voice, excess body hair in a male distribution.

Your doctor may want to do the following studies

Ultrasonography of your abdomen, check your following hormone levels (LH, FSH, estradiol, testosterone, cortisole, and prolactin)

Your doctor must make sure the other conditions (i.e. - hyperandrogenism, hyperprolactinemia, congenital adrenal hyperplasia, and ovarian and adrenal tumors) causing the symptoms by mimicking PCO.

Treatment options

1) Hirsutism - removal of hair by mechanical means, oral contraceptive alone or in combination with spironolactone.  

2) Obesity —diet and exercise- may result in restoration of normal ovulatory cycles

3) Infertility - critical to complete a basic evaluation of the couple before initiating therapy in an infertile woman, including a semen analysis of the male. Medication such as metformin, should be tried before using fertility drugs such as clomiphene

4)  High glucose due to insulin resistant – low carbohydrate diet, exercise, weight

Treatment should be guided by the objective findings.

Mind you, your physician has the luxury of seeing you in person and do a thorough physical exam, there for you should be doing things under his/her guidance.

This is just a general advice. I assume no responsibility.

Good luck.

Kiritharan Arunasalam, B. Sc., M.D., F.R.C.P.C.

Internal Medicine

Headwaters Health Care Center

Orangeville, Ontario, Canada.