PCOS symptoms|diet|cure|treatment fact-2

Pcos affect women in many ways.

1.Pcos is the major factor causing infertility in women by stopping natural ovulation.

2.Pcos causes thinning of hair in the head.

3.Pcos causes embarrassing hair growth in face,chest and torso.

4.Pcos causes irregular menstrual periods.

5.Pcos may cause sudden outbreaks of acne.

6.Pcos causes considerable weight gain.

PCOS symptoms|diet|cure|treatment fact-3

The pcos symptoms are listed below.

1.Inability to conceive.

2.Appearance of acne after skipped menstrual periods.

3.Thinning of hair on the head.

4.Sudden weight gain.

5.Increased hair growth on face,chest and torso.

PCOS symptoms|diet|cure|treatment fact-4

Devise a pcos diet plan suitable to your health condition by consulting your
doctor.The following diet tips may help.

1.Take whole grain foods.

2.Add lots of fiber to your diet.

3.Consume more vegetables.

4.Drink lots of plain water between helpings and in between meals and avoid
beverages.

5.Cut down your alcohol intake.

6.Avoid deep frying of food and switch to baking even if the taste is reduced.

7.Avoid sweets and ice cream.

8.Do not skip meals but eat sensibly

PCOS symptoms|diet|cure|treatment fact-5

Pcos symptoms can be easily controlled by insulin regulating drugs.Drugs also can be
used to regularize your menstrual cycle and to prevent acne and facial hair growth.

Plan a proper workout routine and stick to it since it was found that exercises really
help reduce weight and subsequent normalization and optimization of hormone
levels.

What is polycystic ovary syndrome (PCOS)?

Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can

affect a woman's menstrual cycle, ability to have children, hormones, heart, blood
vessels, and appearance. With PCOS, women typically have:

* high levels of androgens (AN-druh-junz). These are sometimes called male

hormones, although females also make them. * missed or irregular periods * many
small cysts (sists) in their ovaries. Cysts are fluid-filled sacs.

How many women have polycystic ovary syndrome (PCOS)?

About one in ten women of childbearing age has PCOS. It can occur in girls as young
as 11 years old. PCOS is the most common cause of female infertility (not being able
to get pregnant).

What causes polycystic ovary syndrome (PCOS)?

The cause of PCOS is unknown. Most researchers think that more than one factor
could play a role in developing PCOS. Genes are thought to be one factor. Women
with PCOS tend to have a mother or sister with PCOS. Researchers also think insulin
could be linked to PCOS. Insulin is a hormone that controls the change of sugar,
starches, and other food into energy for the body to use or store. For many women
with PCOS, their bodies have problems using insulin so that too much insulin is in the
body. Excess insulin appears to increase production of androgen. This hormone is
made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are
higher than normal can lead to acne, excessive hair growth, weight gain, and
problems with ovulation.

Does polycystic ovary syndrome (PCOS) run in families?

Most researchers think that PCOS runs in families. Women with PCOS tend to have a
mother or sister with PCOS. Still, there is no proof that PCOS is inherited.

What are the symptoms of polycystic ovary syndrome (PCOS)?

Not all women with PCOS share the same symptoms. These are some of the
symptoms of PCOS:

* infrequent menstrual periods, no menstrual periods, and/or irregular bleeding *

infertility (not able to get pregnant) because of not ovulating * increased hair growth
on the face, chest, stomach, back, thumbs, or toes—a condition called hirsutism
(HER-suh-tiz-um) * ovarian cysts * acne, oily skin, or dandruff * weight gain or
obesity, usually carrying extra weight around the waist * insulin resistance or type 2
diabetes * high cholesterol * high blood pressure * male-pattern baldness or
thinning hair * patches of thickened and dark brown or black skin on the neck, arms,
breasts, or thighs * skin tags, or tiny excess flaps of skin in the armpits or neck area
* pelvic pain * anxiety or depression due to appearance and/or infertility * sleep
apnea—excessive snoring and times when breathing stops while asleep

Why do women with polycystic ovary syndrome (PCOS) have trouble with their
menstrual cycle?

Normal Ovary and Polycystic Ovary

The ovaries are two small organs, one on each side of a woman's uterus. A woman's
ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These
sacs also are called cysts. Each month about 20 eggs start to mature, but usually
only one matures fully. As this one egg grows, the follicle accumulates fluid in it.
When that egg matures, the follicle breaks open to release it. The egg then travels
through the fallopian tube for fertilization. When the single egg leaves the follicle,
ovulation takes place.

In women with PCOS, the ovary doesn't make all of the hormones it needs for any of
the eggs to fully mature. Follicles may start to grow and build up fluid. But no one
follicle becomes large enough. Instead, some follicles may remain as cysts. Since no
follicle becomes large enough and no egg matures or is released, ovulation does not
occur and the hormone progesterone is not made. Without progesterone, a woman's
menstrual cycle is irregular or absent. Plus, the cysts make male hormones, which
also prevent ovulation.

Does polycystic ovary syndrome (PCOS) change at menopause?

Yes and no. Because PCOS affects many systems in the body, many symptoms
persist even though ovarian function and hormone levels change as a woman nears
menopause. For instance, excessive hair growth continues, and male pattern
baldness or thinning hair gets worse after menopause. Also, the risks of
complications from PCOS, such as heart attack, stroke and diabetes, increase as a
woman gets older.

What tests are used to diagnose polycystic ovary syndrome (PCOS)?

There is no single test to diagnose PCOS. Your doctor will take a medical history,
perform a physical exam, and possibly take some tests to rule out other causes of
your symptoms. During the physical exam the doctor will want to measure your
blood pressure, body mass index (BMI), and waist size. He or she also will check out
the areas of increased hair growth, so try to allow the natural hair growth for a few
days before the visit. Your doctor might want to do a pelvic exam to see if your
ovaries are enlarged or swollen by the increased number of small cysts. A vaginal
ultrasound also might be used to examine the ovaries for cysts and check out the
endometrium, the lining of the uterus. The uterine lining may become thicker if your
periods are not regular. You also might have blood taken to check your hormone
levels and to measure glucose (sugar) levels.

How is polycystic ovary syndrome (PCOS) treated?

Because there is no cure for PCOS, it needs to be managed to prevent problems.

Treatment goals are based on your symptoms, whether or not you want to become
pregnant, and lowering your chances of getting heart disease and diabetes. Many
women will need a combination of treatments to meet these goals. Some treatments
for PCOS include:

Birth control pills. For women who don't want to become pregnant, birth control pills
can control menstrual cycles, reduce male hormone levels, and help to clear acne.
However, the menstrual cycle will become abnormal again if the pill is stopped.
Women may also think about taking a pill that only has progesterone, like Provera®,
to control the menstrual cycle and reduce the risk of endometrial cancer. (See Does
polycystic ovary syndrome (PCOS) put women at risk for other health problems?)
But progesterone alone does not help reduce acne and hair growth.

Diabetes medications. The medicine metformin (Glucophage®) is used to treat type

2 diabetes. It also has been found to help with PCOS symptoms, although it is not
FDA-approved for this use. Metformin affects the way insulin controls blood glucose
(sugar) and lowers testosterone production. Abnormal hair growth will slow down,
and ovulation may return after a few months of use. Recent research has shown
metformin to have other positive effects, such as decreased body mass and
improved cholesterol levels. Metformin will not cause a person to become diabetic.
Fertility medications. Lack of ovulation is usually the reason for fertility problems in
women with PCOS. Several medications that stimulate ovulation can help women
with PCOS become pregnant. Even so, other reasons for infertility in both the woman
and man should be ruled out before fertility medications are used. Also, there is an
increased risk for multiple births (twins, triplets) with fertility medications. For most
patients, clomiphene citrate (Clomid®, Serophene®) is the first choice therapy to
stimulate ovulation. If this fails, metformin taken with clomiphene is usually tried.
When metformin is taken along with fertility medications, it may help women with
PCOS ovulate on lower doses of medication. Gonadotropins (goe-NAD-oh-troe-pins)
also can be used to stimulate ovulation. These are given as shots. But gonadotropins
are more expensive and there are greater chances of multiple births compared to
clomiphene. Another option is in vitro fertilization (IVF). IVF offers the best chance of
becoming pregnant in any one cycle and gives doctors better control over the chance
of multiple births. But, IVF is very costly.

Medicine for increased hair growth or extra male hormones. Medicines called anti-
androgens may reduce hair growth and clear acne. Spironolactone (speer-on-oh-lak-
tone) (Aldactone®), first used to treat high blood pressure, has been shown to
reduce the impact of male hormones on hair growth in women. Finasteride
(Propecia®), a medicine taken by men for hair loss, has the same effect. Anti-
androgens often are combined with oral contraceptives.

Before taking Aldactone®, tell your doctor if you are pregnant or plan to become
pregnant. Do not breastfeed while taking this medicine. Women who may become
pregnant should not handle Propecia®.

Vaniqa® cream also reduces facial hair in some women. Other treatments such as
laser hair removal or electrolysis work well at getting rid of hair in some women. A
woman with PCOS can also take hormonal treatment to keep new hair from growing.

Surgery. "Ovarian drilling" is a surgery that brings on ovulation. It is sometimes used

when a woman does not respond to fertility medicines. The doctor makes a very
small cut above or below the navel and inserts a small tool that acts like a telescope
into the abdomen. This is called laparoscopy. The doctor then punctures the ovary
with a small needle carrying an electric current to destroy a small portion of the
ovary. This procedure carries a risk of developing scar tissue on the ovary. This
surgery can lower male hormone levels and help with ovulation. But these effects
may only last a few months. This treatment doesn't help with loss of scalp hair and
increased hair growth on other parts of the body.

Lifestyle modification. Keeping a healthy weight by eating healthy foods and

exercising is another way women can help manage PCOS. Many women with PCOS
are overweight or obese. Eat fewer processed foods and foods with added sugars and
more whole-grain products, fruits, vegetables, and lean meats to help lower blood
sugar (glucose) levels, improve the body's use of insulin, and normalize hormone
levels in your body. Even a 10 percent loss in body weight can restore a normal
period and make a woman's cycle more regular.[Return to Top]How does polycystic
ovary syndrome (PCOS) affect a woman while pregnant?

There appears to be higher rates of miscarriage, gestational diabetes, pregnancy-

induced high blood pressure (pre-eclampsia), and premature delivery in women with
PCOS. Researchers are studying how the diabetes medicine metformin can prevent
or reduce the chances of having these problems while pregnant. Metformin also
lowers male hormone levels and limits weight gain in women who are obese when
they get pregnant.

Metformin is a FDA pregnancy category B drug. It does not appear to cause major
birth defects or other problems in pregnant women. But, there have been no studies
of metformin on pregnant women to confirm its safety. Talk to your doctor about
taking metformin during pregnancy or if you are trying to become pregnant. Also,
metformin is passed through milk in breastfeeding mothers. Talk with your doctor
about metformin use if you are a nursing mother.[Return to Top]Does polycystic
ovary syndrome (PCOS) put women at risk for other health problems?

Women with PCOS have greater chances of developing several serious, life-
threatening diseases, including type 2 diabetes, cardiovascular disease (CVD), and
cancer. Recent studies found that:

* More than 50 percent of women with PCOS will have diabetes or pre-diabetes
(impaired glucose tolerance) before the age of 40. * Women with PCOS have a four
to seven times higher risk of heart attack than women of the same age without
PCOS. * Women with PCOS are at greater risk of having high blood pressure. *
Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL
(good) cholesterol.

The chance of getting endometrial cancer is another concern for women with PCOS.
Irregular menstrual periods and the absence of ovulation cause women to produce
the hormone estrogen, but not the hormone progesterone. Progesterone causes the
endometrium to shed its lining each month as a menstrual period. Without
progesterone, the endometrium becomes thick, which can cause heavy bleeding or
irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the
lining grows too much, and cancer.

I have PCOS. What can I do to prevent complications?

Getting your symptoms under control at an earlier age can help to reduce your
chances of having complications like diabetes and heart disease. Talk to your doctor
about treating all your symptoms, rather than focusing on just one aspect of your
PCOS, such as problems getting pregnant. Also, talk to our doctor about getting
tested for diabetes regularly. Eating right, exercising, and not smoking also will help
to reduce your chances of having other health problems.

How can I cope with the emotional effects of PCOS?

Having PCOS can be difficult. Many women are embarrassed by their appearance.
Others may worry about being able to get pregnant. Some women with PCOS might
get depressed. Getting treatment for PCOS can help with these concerns and help
boost a woman's self-esteem. Support groups located across the United States and
on-line also can help women with PCOS deal with the emotional affects.
Polycystic ovary syndrome
Polycystic ovary syndrome is one of the more common hormonal disorders that affect
women who are capable of reproduction. The syndrome involves the ovaries becoming
enlarged and the formation of a number of small cysts all around their outer edges. This
can lead to a number of different issues, including irregular menstrual periods, and it can
also make it very difficult for the woman to become pregnant. While treating the
condition, especially if caught early, can help reduce the risk of some complications, it
may not be possible to completely cure polycystic ovary syndrome.

The reproductive cycle is not actually controlled by the ovaries; instead, the pituitary
gland begins releasing specific hormones that tell the reproductive system to begin
growing an egg and then later tell it when to release the egg. The ovaries then secrete
estrogen and progesterone that tell the uterus to prepare its inner lining for the egg. If no
pregnancy occurs, the ovaries stop secreting these hormones and the uterus sheds its
lining during the menstrual cycle.

However, in polycystic ovary syndrome, this chain of events does not occur in the way it
should. Instead, the pituitary gland starts to secrete too much luteinizing hormone. This
hormone tells the ovaries to create androgen, which is actually a male hormone.
Androgen is produced during the menstrual cycle, and it’s perfectly normal for a
woman’s ovaries to make a small amount of this male hormone. However, the increased
luteinizing hormone stimulates the ovaries to produce too much androgen. This causes
the menstrual cycle to become irregular and can lead to other symptoms.

Unfortunately, doctors do not know the exact reason why the pituitary gland starts to
secrete so much of this hormone, but they have identified two factors that are connected
to it. One is heredity—it’s possible that a specific mutated gene is connected to
polycystic ovary syndrome and that a woman is more likely to have the syndrome if her
mother or one of her sisters does.

Another factor is the production of excess insulin. Insulin is produced by the pancreas
and is what allows the body to break down and use glucose (sugar). If your body
becomes insulin resistant, it can’t use insulin as effectively, and the pancreas has to create
more and more insulin to achieve the same affect. The extra insulin may possibly cause
the ovaries to produce more androgen. More study on both of these two risk factors needs
to be done, however, before any conclusion can be reached.

Symptoms of polycystic ovary syndrome usually appear after a girl has her first period,
although it is possible for the syndrome to develop later on in life. This can happen due to
changes in your body—for example, gaining a good amount of weight can bring on
polycystic ovary syndrome. The symptoms may vary in severity, and not all women will
experience the same. However, to be diagnosed with polycystic ovary syndrome, a
woman must have two of the following three symptoms.
The most common symptom is abnormal menstruation. This can include intervals of
more than 35 days, few menstrual cycles, not menstruating for four months, or very light
or very heavy periods. Elevated androgen levels are another sign and can actually cause
your body to grow facial hair or excess body hair. You may also experience adult acne.
The third symptom is polycystic ovaries. Having enlarged ovaries with cysts in them does
not necessarily mean you have polycystic ovary syndrome, however—you have to have
one of the other two symptoms. In some cases, the cysts are caused by something else
while in other cases, women are diagnosed with polycystic ovary syndrome by do not
have polycystic ovaries.

DUPHASTON 10 mg TABLETS
Solvay
Pharmaceuticals

SCHEDULING STATUS:
S4

PROPRIETARY NAME
(and dosage form):

DUPHASTON 10 mg TABLETS

COMPOSITION
1 tablet contains dydrogesterone (9beta,10alpha-pregna-4,6-diene-3,20-dione) 10 mg.

PHARMACOLOGICAL CLASSIFICATION
A. 21.8.2 Progesterones without estrogens.

PHARMACOLOGICAL ACTION
Dydrogesterone is an orally active progestogen which acts directly on the uterus, producing a complete
secretory endometrium in an estrogen-primed uterus.
At therapeutic levels, dydrogesterone has no contraceptive effect as it does not inhibit or interfere with
ovulation or the corpus luteum.
Furthermore, Duphaston is non-androgenic, non-estrogenic, non-corticoid, non-anabolic and is not excreted
as pregnanediol.

INDICATIONS
Irregular duration of cycles and irregular occurrence and duration of periods caused by progesterone
deficiency.
Combined with an estrogenic substance, Duphaston can be applied in secondary amenorrhoea,
dysfunctional uterine bleeding and post-menopausal complaints where endogenous progesterone deficiency
is implicated.

CONTRA-INDICATIONS
Duphaston should not be given to patients with undiagnosed vaginal bleeding nor to those with a history of
thromboembolic disorders.
DOSAGE AND DIRECTIONS FOR USE
In general
The dosage schemes below are meant as general recommendations. For optimal therapeutic effect, the
dosages are to be adapted to the nature and severity of the disorder.
In irregular cycles due to endogenous progesterone deficiency
Duphaston 5 to 10 mg is recommended especially in irregular cycles due to shortened luteal phase (ie pre-
menopause). Treatment should be repeated for several cycles.
In secondary amenorrhoea
Administration of Duphaston in combination with an estrogen is usually recommended as in these
conditions endogenous progesterone deficiency is nearly always accompanied by estrogen deficiency.
0,05 mg ethinylestradiol is administered each day from the 1st to the 25th day of the cycle, and 5 mg
Duphaston is added twice daily from the 11th to the 25th day. Five days after the subsequent withdrawal
bleeding, the same is repeated to imitate a natural cycle.
In dysfunctional uterine bleeding
The symptomatic treatment is aimed at stopping the bleeding and including a subsequent withdrawal
bleeding.
- To stop bleeding:
Duphaston 10 mg together with 0,10 mg ethinylestradiol twice daily for 5 to 7 days.
- To prevent heavy bleedings:
Duphaston 5 mg twice daily from day 11 to day 25 of the cycle, if necessary, combined with an estrogen
during the first half of the cycle.
In post-menopausal complaints
If for the symptomatic treatment of post-menopausal complaints estrogens are used (hormone replacement
therapy - HRT), Duphaston 10 mg is used to counteract the effects of unopposed estrogens on the
endometrium. A subsequent withdrawal bleeding is induced.
- If on continuous estrogen therapy:
Duphaston 10 mg twice daily during the first 12 to 14 days of each calendar
month.
- If on cyclic estrogen therapy:
Duphaston 10 mg twice daily during the last 12 to 14 days of the treatment.

SIDE EFFECTS AND SPECIAL PRECAUTIONS

Side effects of Duphaston may include gastro-intestinal disturbances, allergic skin rashes or urticaria,
changes in libido, acne, fluid retention, mass gain, mental depression and breast changes, which may
include discomfort or gynaecomastia. Alterations in liver function tests have been reported and less
frequently jaundice.
In a small percentage of the treated cases, breakthrough bleeding may occur, which can be prevented by
increasing the dosage. During the clinical application of Duphaston, no virilising side effects were
observed.
Duphaston should be used with caution in patients with cardiovascular, renal or hepatic impairment,
diabetes mellitus, asthma, epilepsy and migraine. It should be used with care in persons with a history of
mental depression.

KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT

See "Side effects and special precautions". Treatment is symptomatic and supportive.

IDENTIFICATION
Round, flat, white tablets with bevelled edges, one side with an inscription “S”, the other side with “155”on
either side of the break mark.