How do you treat Poly-cystic Ovary Syndrome (PCOS) and/or find a specialist?

I have been seeing a doctor (or several doctors) for a period of 8 years. I have changed them frequently and have finally gotten to a point where I can't stand. Amongst the normal treatment with BC and some other medications, nothing seems to be happening.





It has only been in the last 2 years that weight gain and skin problems have gotten really bad. Nothing seems to be working. Are there any resources and/or registry where I can find a specialized doctor to assist? While my Primary Care Provider is a good doctor, I am in search of more aggressive treatment and or someone who might understand the problem from a different medical perspective.





I also want to know where I can find the criteria for allowing a patient with PCOS to use metformin? Do they have to have diabetes to do so? Any info you could provide would be greatly appreciated. Thanks!

How do you treat Poly-cystic Ovary Syndrome (PCOS) and/or find a specialist?
I agree, Soulcysters is GREAT.





Generally speaking, many physicians prescribe metformin to their PCOS patients without doing any tests.





However, the primary indication for using metformin in PCOS is insulin resistance.





Your doctor should test you for insulin resistance and put you on metformin if you have it.





Insulin resistance can be diagnosed in a few ways. The easiest is the fasting insulin value. If the value is above the normal limit, but blood glucose is normal or low, you have insulin resistance. If your fasting blood sugar is high, you may have diabetes. Either way, metformin would help. A glucose tolerance test may also provide clues. During this test, you fast the night before and then chug this awful glucose-rich drink. They then measure your blood glucose levels over a few hours.





I'm on metformin. I hated it at first because of the AWFUL diarrhea it gave me, but I've adjusted now, I'm ovulating again, and I could not be happier (well, unless I was pregnant!).





Metformin, rather than treating the symptoms like birth control does, gets at the root and helps your body level out its own hormones rather than adding hormones to mask the ones you're already making. From what I understand, the symptoms of PCOS are caused by the fact that high levels of insulin cause the ovaries to make testosterone instead of estrogen, which leads to all kinds of problems including acne and infertility.





One other thing I'd suggest is low-carbing. Carbs cause fluctuations in blood sugar which can lead to insulin fluctuations. You may find a lot of improvements in your symptoms on a low-carb diet.





Good luck on your journey, and do stop by SoulCysters. The ladies there are full of beautiful advice!
Reply:Please check out www.soulcysters.com There is a weath of information there and a message board full of wonderful and informed women who can help you with any questions you may have. It's a great site.
Reply:Another great site is the PCOS message boards at www.ivillage.com The best type of doctor to see is a reproductive endocrinologist. He/she can prescribe metformin. There is no specific guidelines for this (you dont have to have diabetes). Generally a dose of 1500-2500mg is your goal. There are some bad GI side effects, so usually you increase slowly. PCOS is usually diagnosed with blood tests combined with your symptoms. It is common for people to test OK with insulin resistance and the other blood tests but still respond positively to metformin. I highly recommend it. Check out the message boards to have more questions answered about PCOS.