PCOS

MORE DETAILS ON PCOS

klik http://www.jarrettfertility.com/PCOS%20patient%20handout.pdf

-----

Taken from: http://home.hamidarshat.com/SakitPuan.htm

Polycystic Ovary(PCO) mengancam kesuburan wanita Malaysia

Wanita yang gemuk, pusingan haidnya tidak teratur dan tumbuh rambut pada kaki, badan atau muka berwaspadalah mungkin anda mengalami masalah kilang ovary bengkak atau ‘polycystic ovary’. saya tidak lah gemok dan tiada rambut sgt tumbuh di kaki badan atau muka. tetapi pusingan haid saya mmg tidak teratur.

Polycystic ovary atau PCO adalah suatu keadaan di mana kilang telur atau ovari pada seseorang wanita menjadi bengkak oleh sebab benih-benih telah terperangkap dalam ovari dan tidak boleh menetas pada waktu subur.    Maka apabila berlaku keadaan seperti ini lama-kelamaan ovari akan membengkak dan menimbulkan berbagai jenis masalah pada wanita tersebut. oh, patot la kdg2 rasa sakit.

Kejadian penyakit ini kian meningkat di kalangan wanita-wanita Malaysia ke taraf yang membimbangkan kerana ia menjejaskan kesuburan dan keupayaan mereka untuk hamil dan melahirkan anak.
Apakah tanda tanda penyakit Polycystic Ovary?

TIDAK SUBUR ATAU MANDUL. shit. mandul is not the word yet. and i dont like the word.

Kebanyakan dari pesakit-pesakit PCO datang berjumpa doktor pakar sakitpuan sebab sukar hendak hamil walaupun telah lama mencuba. Ada yang telah beberapa tahun berkahwin tetapi masih belum medapat zuriat. Ada yang berjaya mendapat anak pertama dan gagal untuk hamil lagi selepas itu. Mereka ini mudah meningkat berat badan mereka dan seringkali peningkatan ini  berlaku secara mendadak.

I.Haid tidak teratur.

Tanda yang biasa ialah haid yang tidak teratur, biasanya lambat datang haid dan kadang- kadang jarak antara haid  menjadi begitu jauh sekali sampai hingga 3 atau 6 bulan barulah datang haid yang berikutnya.    Ada setengah wanita pula sampai setahun tidak datang haid.

II.Gemuk

Tanda lain ialah peningkatan berat badan menyebabkan wanita itu gemuk atau obese.     Seringkali peningkatan berat badan ini berlaku secara mendadak selepas ia berkahwin dan pada ketika itu pusingan haid pun menjadi lebih tidak teratur dan kesuburan mereka sangat kurang ataupun langsung tidak subur kerana telur tidak dapat menetas. oh, begitu.tapi saya tidak obese, masih jugak terkena.

III.Darah haid sikit atau/dan berpanjangan.

Wanita pula mengalami selain daripada pusingan haid yang begitu panjang jangka waktunya, ialah perdarahan haid yang mungkin berlaku dengan sedikit sekali, tidak seperti biasa haid akan keluar dengan sederhana selama seminggu.   Tetapi wanita yang mengidap penyakit polycystic ovary akan mengalami haid yang sangat sedikit hanya menitis selama 2 atau 3 hari. -betol betol betol. Ada juga dikalangan mereka yang mengalami perdarahan yang berpanjangan sampai 15 hari ataupun 30 hari tanpa berhenti.-yang ini pernah mase mule2 period je dulu. skang takpernah.

IV.Tumbuh rambut.

Setengah wanita pula tanda-tanda lain ialah tumbuh rambut pada kaki, tumbuh misai dan janggut dan juga tumbuh rambut pada bahagian tangan dan ada kalanya di bahagian dada.    Ini menandakan peningkatan dalam hormon lelaki dalam darah wanita tersebut.   Iaitu satu keadaan yang sering berlaku dikalangan pengidap penyakit polycystic ovary.-alhamdulillah saya tidak terkena symptom ini.

V.Apakah puncanya ?.

Sebenarnya punca bagi penyakit ini tidak diketahui. Mungkin satu keadaan semulajadi di mana terdapat kelainan atau gangguan pada enzyme yang mengawal pembentukan hormon. -ok no doctors ever told me this. take note. Oleh itu biasanya jika dikaji paras hormon dalam darah, kita dapati wanita tersebut terganggu dalam hormon kesuburan mereka iaitu tahap hormon FSH (normal), LH – tinggi, hormon estrongen – tinggi, hormon progesterone – rendah, hormon progesterone – rendah, hormon testosterone (iaitu hormon lelaki) – meningkat tinggi.     Adalah dipercayai bahawa peningkatan berat badan ada kaitan dengan peningkatan hormon testosterone dengan estrogen dalam darah wanita tersebut.-ooo la yeke.

Mungkin ada ciri atau pengaruh kebakaan atau keturunan dalam penyakit ini. Walau demikian faktor pemakanan iaitu dari segi tabiat dan jenis makanan yang mengandungi banyak karbohidrat dan gula, perisa dan pengawet makan mungkin mempunyai peranan penting dalam kejadian penyakit PCO.

Faktor stress atau tekanan fizikal dan mental yang timbul dari suasana tegang dalam perkerjaan dan rumah, pergeseran dan konflik dikalangan keluarga atau saudara-mara dan dalam kenderaan ketika memandu mungkin juga ada memainkan peranan dalam kejadian penaykit ini.-mcm mana konflik dlm kenderaan pon ade kaitan. adoi camni kene byk bersabar betol kalau drive. aku mmg sgt slalu membebel maki2 org bile drive. adoi.

Ciri ovari dalam ultrasound.

Jika doktor pakar sakitpuan membuat pemeriksaan ‘vaginal ultrasound’ ia akan mendapati kedua-dua belah ovari bengkak dan membesar sampai dua atau tiga kali ganda dari saiz biasa. Kelihatan ovari itu seolah-olah  mengandungi bintik-bintik hitam iaitu apa yang digelar “honeycomb appearance”.   Bintik-bintik hitam inilah sebenarnya telur atau benih wanita yang telah terperangkap.
Rawatan

i. Tujuan rawatan polycystic ovary ialah pertama untuk meningkatkan kesuburan kerana sebahagian besar daripada mereka berjumpa doktor dengan tujuan untuk mendapatkan anak dan kerana mereka mengalami ketidaksuburan ataupun kemandulan.   dont use ayat kemandulan jika masih ada harapan utk mengandung boleh tak! hish. bukan mandul tu maksodnye mmg takboleh and takde chance lansong utk mengandung ke? kalau dah buang rahim or buang ovary ke, baru la leh gune term mandul! choy!

ii. Tujuan kedua ialah untuk membetulkan pusingan haid supaya jarak antara satu haid supaya jarak antara satu haid dengan yang lainnya lebih kerap ataupun normal iaitu 30 hari.

Cara cara untuk mengawal kegemukan (obesity)

Dalam merawat pesakit perkara yang terpenting sekali bagi pesakit berkenaan ialah ketabahan ,disiplin serta keazaman diri untuk mengurangkan berat badan.     Kebanyakan daripada mereka mungkin melebihi 70 kg dan berat badan yang sebaiknya bagi wanita yang ukuran tinggi 5 kaki 2 inci ialah kurang daripada 60 kg.

Untuk mengurangkan berat badan memang memerlukan ketabahan, kegigihan dan disiplin yang kuat kerana sebenarnya orang orang yang obese atau gemuk mengalami masalah tabiat makan.    Oleh itu ia memerlukan rawatan mental supaya ia lebih tabah dan disiplin lagi dalam mengawal pemakanan mereka.    Di samping mengawal pemakanan yang mungkin berlebihan dalam kabohidret dan gula, ialah mereka perlu membuat riadah atau exercise yang sewajar. -saya dah start jogging every sunday dah skg.heee

Meningkatkan kesuburan wanita.

Dari segi merawat kesuburan terdapat banyak kaedah rawatan yang sering dicuba oleh pakar-pakar sakitpuan.   Diantaranya ialah ubat-ubat seperti berikut.

Ubat subur Clomiphene

Biasanya ubat subur Clomiphene atau clomid akan diberikan dalam dos yang tinggi mungkin sampai ke tahap 250 mg atau lima biji sehari untuk selama 5 hari hingga 7 hari mulai daripada hari kedua atau ketiga dari hari mula keluar haid.    Tujuan rawatan ini ialah untuk merangsang ovari yang polycystic ini untuk mengeluarkan telur.-alamak. nak kena up sampai 250mg ke..adoi...5 bijik tu!sehari!

Respons yang positif dengan adanya pengeluaran telur mungkin berlaku hanya di kalangan sebahagian pesakit sahaja, mungkin separuh daripada mereka tidak akan menunjukkan kesan positif dari segi pengeluaran telur.-itulah.

Walau demikian setiap wanita yang menjalani rawatan kesuburan memerlukan pengawasan dan ujian yang teliti oleh pakar sakitpuan kerana jika terlalu banyak telur dikeluarkan pada satu masa dan ini boleh membahayakan kesihatan menyebabkan kandungan yang berganda-ganda.-tapi kalau dapat kembar dgn clomid ni, bestnya! :P

Ubat kesuburan yang lain daripada Clomiphene ialah ubat suntikan hormon Gonadotrophin yang juga diberikan mulai hari kedua haid selama lima hari berturut-turut.    Bahayanya ubat ini ialah rangsangan telur yang berlebihan menyebabkan terlalu banyak telur keluar dan ini boleh menjejaskan kesihatan dan menyebabkan kehamilan berganda.

Ubat Metformine

Sekarang ini ubat Metformine yang biasa digunakan untuk merawat kencing manis digunakan dalam jangka masa enam bulan berturut dan dos yang digunakan ialah antara 1 gm hingga 2.5 gm setiap hari sampai enam bulan.    Mengikut kajian 60 peratus daripada wanita yang memakan ubat ini akan menetas telurnya dan sebahagian besar juga akan akhirnya mengandung.

Rawatan laparoscopy dan ovarian drilling

Ini adalah satu kaedah baru dimana pesakit “polycystic ovary” akan menjalani pembedahan kecil yang memerlukan bius am.     Teropong laparoscopy untuk melihat ovari dan seterusnya laser drilling akan dilakukan dengan menggunakan elektrik cautery ataupun laser cautery.    Kaedah rawatan ini juga menghasilkan kehamilan dalam lingkungan 50 hingga 60 peratus.

-------------------------------------------------------------------------------------------------------------------

PCOS FAQ.

Taken from http://www.youngwomenshealth.org/pcosinfo.html

PCOS is a common problem among teen girls and young women. In fact, almost 1 out of 10 women has PCOS. This guide was created to help you understand PCOS by answering the most commonly asked questions.

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne. PCOS begins during a girl’s teen years and can be mild or severe.

What are the signs of PCOS?

Teen girls and young women with PCOS commonly have one or more signs. Some of the most common signs include:

• Irregular periods that come every few months, not at all, or too frequently
• Extra hair on your face or other parts of your body, called hirsutism (her-suit-is-em)
• Acne
• Weight gain and/or trouble losing weight
• Patches of dark skin on the back of your neck and other areas, called acanthosis nigricans (a-can-tho-sis ni-gri-cans)

Could I have PCOS?

If you have some or all of the above signs, you might have PCOS. There can be other reasons why you might have one or more of these signs. Only your health care provider can tell for sure. If you do have PCOS, you'll want to know what causes it and how to treat it.

What causes PCOS?

PCOS is caused by an imbalance in the hormones (chemical messengers) in your brain and your ovaries. Many girls also have higher than normal levels of insulin from the pancreas. PCOS usually happens when a hormone called LH or levels of insulin are too high, which results in extra testosterone production by the ovary.

For a more detailed explanation, take a look at the figure below:

1. The pituitary (pi-tu-i-tary) gland in your brain makes the hormones luteinizing (lu-tin-iz-ing) hormone and follicle (fall-i-call) stimulating hormone (LH and FSH).
2. After getting the signal from the hormones LH and FSH, the ovaries make estrogen (es-tro-gen) and progesterone (pro-ges-ter-one), the female sex hormones.
3. All normal ovaries also make a little bit of the androgen testosterone (an-dro-gen tes-tos-ter-own), a male sex hormone. The pancreas (pang-cre-us) is an organ that makes the hormone insulin. High levels of insulin can also cause the ovaries to make more of the hormone testosterone.

Why are my periods so irregular?

Having PCOS means that your ovaries are not getting the right hormonal signals from your pituitary gland. Without these signals you will not ovulate (make eggs). Your period may be irregular or you may not have a period at all.

Let's review a regular menstrual cycle.

1. The menstrual cycle starts when the brain sends LH and FSH to the ovaries. A big surge of LH is the signal that tells the ovaries to ovulate, or release an egg.
2. The egg travels down the fallopian tube and into the uterus. Progesterone from the ovary tells the lining of the uterus to thicken.
3. If the egg isn't fertilized, the lining of the uterus is shed. This is a menstrual period.
4. After the menstrual period, the cycle begins all over again.

The regular menstrual cycle diagram shows a normal menstrual cycle. The PCOS cycle diagram shows a PCOS cycle which stops just before ovulation. As a result, girls with PCOS may ovulate occasionally or not at all, so periods may be too close together, or more commonly too far apart. Some girls may not get a period at all.

Now, let's look at what happens during a menstrual cycle with PCOS.

1. With PCOS, LH levels are often high when the menstrual cycle starts. The levels of LH are also higher than FSH levels.
2. Because the LH levels are already quite high, there is no LH surge. Without this LH surge, ovulation does not occur, and periods are irregular.

What types of tests will my health care provider do to diagnose PCOS?

Your health care provider will ask you a lot of questions about your menstrual cycle and your general health and then do a complete physical examination. You will most likely need to have a blood test to check your hormone levels, blood sugar, and cholesterol. Your health care provider may also want you to have an ultrasound test. This is a test that uses sound waves to make a picture of your reproductive organs (ovaries and uterus) and bladder (where your urine is stored). In girls with PCOS, the ovaries may be slightly larger and have tiny cysts.

Does PCOS mean I have cysts on my ovaries?

The term "polycystic ovaries" means that there are lots of tiny cysts, or bumps, inside of the ovaries. Some young women with PCOS have these cysts; others only have a few. Even if you do have lots of them, they are not harmful and do not need to be removed.

Why do I get acne and/or extra hair on my body?

Acne and extra hair on your face and body can happen if your body is making too much testosterone. All women make testosterone, but if you have PCOS, your ovaries make a little bit more testosterone than they are supposed to. Skin cells and hair follicles are extremely sensitive to the small increases in testosterone found in young women with PCOS.

Why do I have patches of dark skin?

Many adolescents with PCOS have higher levels of the hormone insulin in their blood. Higher levels of insulin can sometimes cause patches of darkened skin on the back of your neck, under your arms, and in your groin area (inside upper thighs).

Will PCOS affect my ability to have children some day?

Women with PCOS have a normal uterus and healthy eggs. Many women with PCOS have trouble getting pregnant, but some women have no trouble at all. If you are concerned about your fertility (ability to get pregnant) in the future, talk to your health care provider about all the new options available, including medications to lower your insulin levels or to help you ovulate each month.

What can I do about having PCOS?

A healthy lifestyle that includes healthy eating and daily exercise is the important part of treating PCOS. There are also excellent medications to help you manage irregular periods, hair growth, and acne. Ask your health care provider about the various options.

What is the treatment for PCOS?

The most common form of treatment for PCOS is the birth control pill; however, other kinds of hormonal therapy may include the "vaginal ring" and "the patch". Even if you are not sexually active, birth control pills may be prescribed by your health care provider because they contain the hormones that your body needs to treat your PCOS. By taking the birth control pill either continuously or in cycles you can:

• Correct the hormone imbalance
• Lower the level of testosterone (which will improve acne and lessen hair growth)
• Regulate your menstrual periods
• Lower the risk of endometrial cancer (which is slightly higher in young women who don't ovulate regularly)
• Prevent an unplanned pregnancy if you are sexually active

Is there any other medicine to treat PCOS?

A medicine which helps the body lower the insulin level is called Metformin. It is particularly helpful in girls who have high levels of insulin, or have pre-diabetes or diabetes. Some girls are treated with both Metformin and birth control pills at the same time.

Ask your health care provider about treating hair growth.

Only you and your health care provider can decide which treatment is right for you. Options may include bleaching, waxing, depilatories, Spironolactone (spi-ro-no-lac-tone), electrolysis, and laser treatment. Spironolactone is a prescription medicine that can decrease hair growth and make hair lighter and finer. However, it can take up to 6-8 months to see an improvement.

Ask your health care provider about treatment for acne.

There are various ways to treat acne, including the birth control pill, topical creams, oral antibiotics, and other medications.

Ask your health care provider about a weight loss plan.

If you are overweight, losing weight may reduce some of the symptoms of PCOS. Talk to your health care provider or nutritionist about healthy ways to lose weight such as increasing exercise and following a nutrition plan that helps manage insulin levels. Healthy eating can also keep your heart healthy and lower your risk of developing diabetes.

Weight Management Tips:

• Choose nutritious, high-fiber carbohydrates instead of sugary or refined carbohydrates
• Balance carbohydrates with protein and healthy fats
• Eat small meals and snacks throughout the day instead of large meals
• Exercise regularly to help manage insulin levels and your weight

What if I have worries about having PCOS?

If you have been told you have PCOS, you may feel frustrated or sad. You may also feel relieved that at last there is a reason and treatment for the problems you have been having, especially if you have had a hard time keeping a normal weight, or you have excess body hair, acne, or irregular periods. Having a diagnosis without an easy cure can be difficult. However, it is important for girls with PCOS to know they are not alone. Finding a health care provider who knows a lot about PCOS and is someone you feel comfortable talking to is very important. Keeping a positive attitude and working on a healthy lifestyle even when results seem to take a long time is very important, too! Many girls with PCOS tell us that talking with a counselor about their concerns can be very helpful. Other girls recommend internet chats. The Center for Young Women's Health offers a monthly chat for girls and young women with PCOS. To learn more about it, visit our chat page.

What else do I need to know?

It is important to follow-up regularly with your health care provider and make sure you take all the medications prescribed to regulate your periods and lessen your chance of getting diabetes or other health problems. Because you have a slightly higher chance of developing diabetes, your health care provider may suggest that you have your blood sugar tested once a year, or have a glucose challenge test every few years. Quitting smoking (or never starting) will also improve your overall health.