The doctor just told me yesterday that I have a large cyst on my ovaries. It seems like every week I find out something else. Last week I found out that I have PCOS and they put me on glucophage. Now I have a cyst on my ovary. I am really sad and I need some encouragement from others that have this.

PLM

btw

I am so happy and grateful for all of the new preg. to the board and I am also grateful for all of the warnings and past info that helped me to go to the doc. and know what to ask.

plm

Hi PLM - sorry about your cyst. I have PCOS and endo AND a stupid paratubal cyst (which will never go away). Maybe b/c pills will help your cyst subside.

hope things get better. http://www.healthboards.com/ubb/smile.gif

hey pml, cheer up! http://www.healthboards.com/ubb/smile.gif Glucophage is gonna work like a miracle for you! http://www.healthboards.com/ubb/smile.gif When I was dx´ed in 2001, I was feeling awful, had mood swing, was overwheight, had irregular and anovulatory cycles.. http://www.healthboards.com/ubb/tongue.gif Now, after a 1 on glucophage XR I feel WONDERFUL and got pregnant twice (m/c probably b/c of low progesterone and high levels of antibodies)!!! For someone that didn´t even ovulate on its own, it was a great progress!! http://www.healthboards.com/ubb/smile.gif Besides that, almost all PCOS symptoms have disappeared! no polycists on my ovaries! http://www.healthboards.com/ubb/smile.gif u/s looks good!

It will happen to you! http://www.healthboards.com/ubb/smile.gif GOOD LUCK!! http://www.healthboards.com/ubb/smile.gif

------------------
Minouche
PCOSer - dx in Sep. 2001
TTC - 4 years
DH - internet miracle

PLM**I had 3 cysts on my ovaries and my both my ovaries are attached to my utterus. My RE put me on BCPs for a couple of weeks and when I had my u/s the cysts were gone! So don't get down**when there is a will there is a way.

Thanks everyone. Do the cysts just ho away, or will the glucophage help to make them go away because the doc said it was really large and the will either put me on pills or remove it but I have to go to a specialist. How long will it take for them to leave. I really feel worried and scared.

I was referring to the policysts of the policystic ovary...glucophage got rid of all of them...

What exactly will the glucophage do, as far as results, I know that their is no cure for PCOS but will the meds help all of the symptoms or what? Will the glucophage help me to become pregnant? I wish my doc, would have been more thorough. And why am I not on clomid everyone else is talking about it. My other doc said it was wierd for a person who has PCOS to receive glucophage so I am really confussed.

I hope this helps.. http://www.healthboards.com/ubb/smile.gif

Polycystic Ovary Syndrome...
Treatment with Insulin Lowering Medications

INTRODUCTION:
Polycystic ovary syndrome is characterized by anovulation (irregular or absent menstrual periods) and hyperandrogenism (elevated serum testosterone and androstenedione). Patients with this syndrome may complain of abnormal bleeding, infertility, obesity, excess hair growth, hair loss and acne. In addition to the clinical and hormonal changes associated with this condition, vaginal ultrasound shows enlarged ovaries with an increased number of small (6-10mm) follicles around the periphery (Polycystic Appearing Ovaries or PAO). While ultrasound reveals that polycystic appearing ovaries are commonly seen in up to 20% of women in the reproductive age range, PolyCystic Ovary Syndrome (PCOS) is a estimated to affect about half as many or approximately 6-10% of women. The condition appears to have a genetic component and those effected often have both male and female relatives with adult-onset diabetes, obesity, elevated blood triglycerides, high blood pressure and female relatives with infertility, hirsutism and menstrual problems.

HYPERINSULIN & PCOS?
As of yet, we do not understand why one woman who demonstrates polycystic appearing ovaries on ultrasound has regular menstrual cycles and no signs of excess androgens while another develops PCOS. One of the major biochemical features of polycystic ovary syndrome is insulin resistance accompanied by compensatory hyperinsulinemia (elevated fasting blood insulin levels). There is increasing data that hyperinsulinemia produces the hyperandrogenism of polycystic ovary syndrome by increasing ovarian androgen production, particularly testosterone and androstenedione and by decreasing the serum sex hormone binding globulin concentration. The high levels of androgenic hormones interfere with the pituitary ovarian axis, leading to increased LH levels, anovulation, amenorrhea, and infertility. Hyperinsulinemia has also been associated high blood pressure and increased clot formation and appears to be a major risk factor for the development of heart disease, stroke and type II diabetes.

DIAGNOSIS
There is little agreement when it comes to how PCOS is diagnosed. Most physicians will consider this diagnosis after making sure you do not have other conditions such as Cushing's disease (overactive adrenal gland), thyroid problems, congenital adrenal hyperplasia or increased prolactin production by the pituitary gland. TSH, 17-hydroxyprogesterone, prolactin and a dexamethasone suppression test may be advisable. After reviewing your medical history, your physicians will determine which tests are necessary. If you have irregular or absent menstrual periods, clues from the physical exam will be considered next. Your height and weight will be noted along with any increase facial or body hair or loss of scalp hair, acne and acanthosis nigricans (a discoloration of the skin under the arms, breasts and in the groin). Elevated androgen levels (male hormones) androstenedione, DHEAS or testosterone confirm the diagnosis. A fasting insulin and glucose level will be obtained. Many physicians tell their patients that insulin values are normal, when in fact the value indicates that insulin may be playing a role in stimulating the development of PCOS. Most labs report levels less than 25-30 miu/ml as normal, while in fact, levels over 10miu/ml on a fasting blood sample suggests that PCOS may be related to hyperinsulinism. As women with polycystic ovary syndrome may be a greater risk for other medical conditions, testing for blood lipids, diabetes and PAI-1 (a blood factor that promotes abnormal clotting).

NEWER METHODS OF TREATMENT
Traditional treatments have been difficult, expensive and have limited success when used alone. Infertility treatments include weight loss diets, ovulation medications (clomiphene, follistim, Gonal-F), ovarian drilling surgery and IVF. Other symptoms have been managed by anti-androgen medication (birth control pills, spironolactone, flutamide or finasteride).

Ovarian drilling can be performed at the time of laparoscopy. A laser fibre or electrosurgical needle is used to puncture the ovary 10-12 times. This treatment results in a dramatic lowering of male hormones within days. Studies have shown that up to 80% will benefit from such treatment. Many who failed to ovulate with clomiphene or metformin therapy will respond when rechallenged with these medications after ovarian drilling. Interestingly, women in these studies who are smokers, rarely responded to the drilling procedure. Side effects are rare, but may result in adhesion formation or ovarian failure if the procedure is performed by an inexperienced surgeon.

But recently promising new treatment options have become available. Drs. Velazquez, Nestler and Dunaif have shown that lowering serum insulin concentrations with metformin (Glucophage 1500 mg a day) or troglitazone (troglitazone, Rezulin has recently been withdrawn from the market because of lifethreatening side effects) ameliorates hyperandrogenism, by reduction of ovarian enzyme activity that results in male hormone production.

For women in the reproductive age range, polycystic ovary syndrome is a serious, common cause of infertility, because of the endocrine abnormalities which accompany elevated insulin levels. There is increasing evidence that this endocrine abnormality can be reversed by treatment with widely available standard medications which are leading medicines used in this country for the treatment of adult onset diabetes, metformin (Glucophage 500 or 850 mg three times per day or 1000mg twice daily with meals), pioglitazone (Actos 15-30 mg once a day), rosiglitazone (Avandia 4-8 mg once daily) or a combination of these medications. These medications have been shown to reverse the endocrine abnormalities seen with polycystic ovary syndrome within two or three months. They can result in decreased hair loss, diminished facial and body hair growth, normalization of elevated blood pressure, regulation or menses, weight loss and normal fertility. We have seen pregnancies result in less than two months in woman who conceived in their very first ovulatory menstrual cycle. By six months over 90% of women treated with insulin-lowering agents will resume regular menses.

The medical literature suggests that the endocrinopathy in most patients with polycystic ovary syndrome can be resolved with insulin lowering therapy. This is clinically very important because the therapy reduces hirsutism, obesity, blood pressure, triglyceride levels, elevated blood clotting factors and facilitates reestablishment of the normal pituitary*ovarian cycle, thus often allowing resumption of normal ovulatory cycles and pregnancy. We know the polycystic ovary disease is associated with increased risk of heart attack and stroke because of the associated heart attack and stroke risk factors, hypertension, obesity, hyperandrogenism, hypertriglyceridemia, and these are to a large degree resolved by therapy with these medications.

ARE THESE MEDICATIONS SAFE?
Side effects are rare. Although metformin, rosiglitazone and troglitazone lower elevated blood sugar levels in diabetics, when given to non*diabetic patients, they only lower insulin levels. Blood sugar levels will not change. In fact, episodes of "hypoglycemic attacks" appear to be reduced.

METFORMIN (Glucophage):
When first starting this medication, people will often experience upset stomach or diarrhea which usually resolves after the first week. This side effect can be minimized by taking metformin with a meal and starting with a low dose. I recommend that our patients start with one 500 mg pill daily the first week and increase to twice a day during the second week. If after the second week GI side effects are minimal, the dose is increased to 850 mg twice daily. Patients with reduced renal function (creatinine >1.5 or creatinine clearance <60%) are at a higher risk for a rare side effect of metformin therapy called lactic acidosis, and the drug should be given cautiously, if at all, to such patients. Patients taking metformin should notify their physician and discontinue the medication:

48 hours before surgery
48 hours before an IVP Xray study or other Xrays where an intravenous dye is administered
If you experience shortness of breath, severe muscle weakness or chest pain
If you use alcohol excessively

Thanks this information did help. I also hope that their is a medicine that will help with the large cyst is my ovary and I don't have to go into surgery for it.