PCOS - Polycystic Ovary Syndrome
Free Advice, Prescription Medication, Blood Tests
Dr Helen Webberley MBChB MRCGP MFSRH
GMC no 3657058
Polycystic ovary syndrome Clinic
What is polycystic ovary syndrome (PCOS)?
PCOS is a complicated disorder which can cause multiple medical problems in differing ways. It is sometimes referred to as Stein-Leventhal syndrome, named after the 2 American gynaecologists who first described it.
It occurs in women of menstrual age at an incidence of between 1 in 10 to 1 in 20 women and the incidence is similar across all ethnic groups. It is the commonest endocrine disorder in this age group. Many women who probably have PCOS have never been diagnosed and for this reason, WHO’s estimate of approximately 116 million women worldwide having it, is likely to be a gross underestimation.
Nobody really knows why PCOS occurs, there is certainly a genetic element to it, but it also frequently occurs in women in whom there is no apparent family history. A propensity to being overweight does however increase the likelihood of PCOS developing.
The most consistent features are the presence of multiple cysts on the ovaries and a hormonal imbalance with higher than expected circulating levels of the male hormone, testosterone. That is not to say that every woman with PCOS will have cysts, or that every woman with cysts will have PCOS!
The diagnosis is probably best made using the Rotterdam criteria which says that a woman is likely to have PCOS if she has at least 2 of the following criteria;
- Absent or very irregular ovulation, with very irregular, heavy or absent periods
- High levels of testosterone
- Multiple cysts on the ovaries on an ultrasound scan.
If you think that this may be you, then this clinic is dedicated to trying to help you overcome all the problems associated with PCOS.
Important medical problems associated with PCOS
Sadly many of the medical problems associated with PCOS are just the ones to make a woman feel really ‘unwomanly’ and this can lead to quite serious problems with confidence, self doubt and anxiety.
This is the only online PCOS clinic available that can help you try and address all of the problems associated with PCOS, with medical and dietary advice, prescriptions of medications, fertility treatment and skin and excess hair care management. We take a holistic approach to our service and use experts in different fields to help you regain your confidence and become the woman and mother you want to be.
Infertility and treatment of difficult periods
Because of the hormonal imbalances seen in PCOS, problems with periods and ovulation occur frequently. These can simply be irregular, absent or heavy periods, or more seriously, difficulties in conceiving and infertility.
We can provide blood tests to assess your hormone levels through your menstrual cycle, to give an accurate picture of what is going on and whether you are ovulating normally.
Based on the results of these blood tests, we can regularise your periods with hormones or even prescribe you Clomid to help you conceive. There is even evidence to suggest that a combination of metformin and clomid increases your chances even further of becoming pregnant.
Our nurses and doctors have years of expertise in this field and are available to help you with all your worries.
For more information on fertility please click here.
Diabetes and insulin resistance
Type II diabetes is common in women with PCOS. It is part of the ‘metabolic syndrome’ that is sometimes described as part of this condition. It is caused by insulin resistance at the surface membrane of cells. Insulin is needed to drive glucose from the bloodstream into cells to keep the blood levels low, at the same time as providing energy for the cells. In women with PCOS the cells seem to be resistant to this action and insulin levels rise, as do the levels of blood sugar, causing diabetes. It is helped by weight loss and exercise, but also by taking drugs such as metformin. Our medical team can give you advice regarding this as well as prescribing metformin for you as necessary.
It is a sad fact of life that many women who have PCOS also have problems with weight management. It has been shown that losing weight helps control diabetes as well as significantly increasing your chances of conceiving. This is particularly important when considering taking Clomid or even IVF.
We are able to help you with weight loss diets and support, and can prescribe medications such as orlistat to make the whole journey easier!
As with the hormonal imbalances that occur in and around puberty in adolescents, acne is also very common in women with PCOS. We are able to provide advice about acne management and can provide prescriptions for all kinds of creams and lotions as well as oral antibiotics for managing this unsightly condition.
Unsightly facial hair
This is a very distressing symptom for those women who experience this problem. We can provide advice about simple methods for managing this problem, such as the use of metformin tablets or vaniqa cream. We are able to prescribe these for you and if these do not provide the results you want, recommend other types of hair management techniques such as epilators, threading or even electrolysis.
At the end of the day, many of the problems seen in PCOS are associated with higher levels of circulating levels of testosterone, so medical interventions aimed at lowering testosterone to normal levels, can help greatly.
Use of the oral contraceptive pill increases levels of sex hormone binding globulin which in turn, soaks up any excess free testosterone floating around. Free testosterone is thought to be the main culprit!
Other anti-androgens such as spironolactone, have also been shown to reduce facial hair and 5-alpha reductase inhibitors such as finasteride have also been used as second line agents. However it is extremely important that adequate contraception is in place because of the risk of abnormalities in the foetus.
So as you can see, management of all the medical aspects of PCOS can be complex and certainly long term.
We would be very happy to……..
- Give free advice on all of the above
- Provide full blood work up including diabetes check, thyroid function, cortisol levels, hormones and testosterone
- Prescribe Orlistat (Xenical) for weight reduction
- Advise and prescribe contraceptive pill for regularising menstruation and periods
- Advise on diabetic diet and prescribe metformin for diabetes and weight reduction
- Advise and prescribe for treatment of acne
- Advise on management of facial hair and prescribe vaniqa
- Arrange ultrasound scans where necessary
- Advise on fertility and prescribe Clomid where necessary
- Provide ovulation kits including 21 day progesterone laboratory blood tests for greater accuracy
- Prescribe Norethisterone to induce your period prior to you commencing Clomid
- Prescribe letrozole and anastrozole if Clomid fails to help you conceive
- Where necessary, prescribe anti-testosterone agents such as finasteride
Dr. Helen Webberley in the news!
GP Dr Helen Webberley has treated many patients with the symptoms of carbon monoxide poisoning and warns of the damage that long-term exposure to the gas can lead to.
She said: “People should not think there is a safe level of poisoning, as exposure to the gas over time, even at a low level, can lead to brain damage.
“Everyone must be vigilant to symptoms which include dizziness, headaches, breathlessness and loss of consciousness.”
In the light of an A&E and wider NHS emergency, an innovative British doctor is merging healthcare and technology with the launch of a brand new online GP service. Based in the UK, My Web Doctor offers members exclusive access to expert doctor’s advice for just £12.99 per month. Affordable, professional and available on-demand, My Web Doctor is set to emerge as a must have resource for health conscious families and individuals across the UK and further afield.