Polycystic Ovaries & Polycystic Ovarian Syndrome

There is a lot of information available out there about polycystic ovaries, and one important thing that I need to point out here is that an ultrasound finding of polycystic ovaries is not the same thing as having the metabolic disease called Polycystic Ovarian Syndrome. This is why if you have an ultrasound finding of a polycystic ovary you should not be alarmed, particularly if you have normal periods. It is not uncommon for polycystic ovaries to show up the scan of a patient who has periods and who will get pregnant. In fact it is thought that only a small proportion of the estimated 20% of middle class women who have polycystic ovaries will actually go on to have Polycystic Ovarian Syndrome.

Reasons for the Increase in Diagnosis Numbers

The number of women who are being (correctly) diagnosed with Polycystic Ovarian Syndrome (PCOS) appears to me to be on the increase. This is likely to be due to factors such as the obesity epidemic and also the change in the UK population dynamics. The UK population for example now includes more women from South Asia and the Middle East who are at risk of developing this disease. Many of these women have abnormal endocrine disease, may suffer from thyroid disease, and can have abnormal adrenal disease (Congenital Adrenal Hyperplasia). They can also have high levels of male hormones like Testosterone and Androstenedione. In these cases it is common to find a strong history of either early onset or late onset diabetes, and in these families the male members often have premature balding under the age of 30.

Overweight Risk

We now know that PCOS is associated with Diabetes, Metabolic Syndrome, and with infertility because PCOS patients do not ovulate and may need ovulation induction treatment. PCOS also increases the risk of miscarriage, and leaving the condition untreated is therefore very risky as far as your reproductive health is concerned. The situation could be most serious for women who are overweight because they run the risk of developing Diabetes and becoming infertile.

Symptoms & Physical Examination

The most noticeable symptom of the condition in the patient is irregular periods that can be very heavy and can be spaced by more than 6 weeks. When examining physical signs, indicators for this condition can also include increased facial and body hair (particularly on the abdomen and back), acne, male pattern baldness in the family, a history of a late puberty, and a black mark in the armpit known as Acanthosis Nigrans.

Taking Action

Getting an early diagnosis is the best way to safeguard your reproductive health and, as you may read in medical literature the combined oral contraceptive pill can protect the PCOS ovary, and can stop the disease from getting worse. It is really important therefore to see a Gynaecologist who has a specialist interest in this disease, and who also works with an interested Endocrinologist. I always like to exclude Diabetes because PCOS is related to Insulin Resistance, and this is the precursor to Diabetes. I carry out a formal Glucose Tolerance Test as part of my screening, and if my patient is screened positive, I ensure that they are seen by an Endocrinologist.

When it comes to treatment there are a number of things that can be done depending on the individual circumstances. These can include working with a Dermatologist to address the acne and hair loss (Dianette, sometimes a combined pill, and Cypropterone Acetate), use of the drug Metformin (particularly if you want to become pregnant), ovulation induction with Clomiphene (sometimes with Clomiphene – great for weight loss and improving ovarian function), ovarian drilling (a laprosopic keyhole treatment), and often dietary advice.

For more information visit my main website, or to arrange for an appointment call 0203 318 0263 or contact me online.

Outpatient Services

You may already have visited my website via the search engines (this Blog is part of that website although not linked via the menu) because you are searching for information about gynaecological services or obstetrics. You will see that I do list many of the main services on there with some detailed information. There are however many different outpatient services that I offer and I’d just like to give you an outline of some of the main ones here.

The Wellwoman Health Check is something I’ve written about in more detail on this Blog before but it is a very popular service which includes a full history examination, an assessment of an ultrasound scan, and the chance to discuss all of your health concerns. It also includes a Ca 125 test. This is a test to detect a protein called Ca 125 in the blood as the presence of a high level of this protein could be an indication of the presence of ovarian cancer cells. High levels of Ca 125 however can indicate conditions other than ovarian cancer such as endometriosis (where pieces of womb tissue are found outside the womb itself), fibroids (benign tumours in the womb), and of course pregnancy. All things considered the Wellwoman Health Check can be a great way to put your mind at ease about any health worries you may have, identify / detect possible threats to your health, examine and identify any symptoms you may be experiencing, explain smear results that you may have questions about, and get a clear snapshot of your health and wellbeing at this point.

Other outpatient services include Screening for thrombosis risk for contraception and hormone replacement therapy. HRT is something I’ve also written about earlier in this Blog and on my website, and this subject is something that I am asked regularly about. HRT advice is therefore an important outpatient service that I offer.

I also offer assessments for the treatment of premenstrual tension, urinary incontinence, and therapeutic management of polycystic ovarian disease and hirsutism (hairiness). I am also able to offer treatment of genital tract disorders such as bacterial vaginosis. Another outpatient service that I offer is the treatment for vaginal prolapse, both operative and non-surgical treatment treatments. Vaginal prolapse can have some very unpleasant symptoms and I am pleased to be able to offer help, advice and treatment options.

For more information about the different outpatient services visit my website, contact me online, or call 0203 318 0263.

A Thorough Health Check Designed For Women

For many women today it’s often the case that they lead very busy lives, and the only time they are really able to speak to a medical professional about any aspect of their health is when they visit their doctor or for example when they have their smear test. It is however unlikely that a woman will be able to talk over all of her medical concerns with her doctor within the time allocated for a normal appointment, and it may have been some time since her last smear test. It may also be the case that she has concerns or questions relating to that last smear test and these have left a nagging worry in the back of her mind.

As you read this you may have some health concerns of your own that you would like to opportunity to talk to a medical professional about, preferably to a specialist in women’s health. Perhaps for example you may have been experiencing very heavy periods, or you may have reason to believe that you are at risk of ovarian cancer or osteoporosis. It could also be the case that your quality of life is being affected in a very negative way by PMT and you would like to find a way to at least effectively deal with the symptoms.

For some women it’s a case of having health concerns such as pelvic pain, or they are concerned about other problems that they simply don’t want or feel able to talk about with a friend, their loved ones, or their GP e.g. a problem with your sexual health.

The Wellwoman Health Check

One service that seems to work particularly well for many different women is to have a health check with an experienced women’s health specialist that allows them to address all of their health concerns in one go. For example, I offer the Wellwoman Health Check. This is a private and thorough health check where, as well as well as covering all the important aspects of your general health, you can receive a comprehensive and reliable assessment of other areas of your health where you feel you may have cause for concern. This includes:

Assessing your risk of and answering any questions that you may have about ovarian cancer, osteoporosis, or sexual health concerns.

Offering a cervical smear and ovarian cancer screening, and answering your concerns and questions about smear results.

Addressing your concerns and answering your questions about heavy and painful periods, PMT, causes of pelvic pain, or pain during intercourse.

Covering any concerns and questions that you may have about HRT to enable you to make an informed choice.

If you are in the London area and you have would like more information about the Wellwoman Health Check, or you would like to make an appointment for one at a hospital near you please call 020 7390 8041.