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Polycystic Ovarian Syndrome
Introduction
Polycystic ovarian syndrome is a clinical diagnosis in patients with androgen excess (increase in male hormones which can cause acne, excess hair growth, and alopecia), anovulation and menstrual irregularities, and/or insulin resistance. The ovaries, when seen on an ultrasound, are usually slightly enlarged and contain multiple small cysts at their periphery. Due to the ovulatory disfunction, infertility may also be a problem.
Treatment
Treatment is based on the current reproductive plans of the patient. The androgen excess and irregular menstrual cycles can both be improved with the use of birth control pills. Metformin (Glucophage) can be used to treat any existing insulin resistance, and can also change the body's hormonal balance, restoring ovulation. If pregnancy is desired, in addition to metformin, ovulation-inducing medications such as clomiphene citrate (Clomid) can be used to restore ovulation. In refractory cases, laparoscopic procedures such as ovarian drilling can be employed with great success.
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