DEAR DR. DONOHUE: I am 26, have no children and have been diagnosed with polycystic ovary syndrome. I think it started with my first period, because I was always irregular. A specialist found cysts on my ovaries and gave me birth-control pills, and they gave me regular periods. Is there a possibility that this is self-correcting? I am depressed about never being able to have children. Could I become pregnant without taking fertility drugs? – C.H.
ANSWER: Somewhere between 3 percent and 6 percent of women suffer from polycystic ovary syndrome. An increased level of male hormone and a decreased number or absence of menstrual periods are its trademark signs. An array of other symptoms and signs are also found in some women with it. Facial and chest hair are frequent signs. So is acne. Obesity is present in about 40 percent of affected women. Large ovaries studded with cysts are another common finding. Infertility is usual. A recent addition to the list of signs and symptoms is a poor response to insulin, with disturbance of blood sugar. Your observation of its early start is valid. It often makes itself known right from the first menstrual period.
The diagnosis is confirmed in many ways. Affected women have an elevation of male hormone in their blood, and there’s a change in the ratio of two pituitary hormones. An ultrasound of the ovary discloses their enlargement and the cysts.
Polycystic ovary syndrome doesn’t self-correct.
Treatment focuses on the sign or symptom that is most troublesome to the individual woman. For someone who wants to become pregnant, fertility drugs like Clomid are usually turned to. Are you worried about multiple births from their use? That happens, but the chances are only 6 percent.
If you are overweight, weight loss can sometimes suppress symptoms and enhance fertility. If your blood sugar is higher than normal, treatment with the oral diabetes drug metformin brings it down and often promotes fertility.
DEAR DR. DONOHUE: My landlord fell and hit his head. He began to forget conversations and incidents that recently took place. One of his health care providers turned him in to the state in order to void his driver’s license. He drives very well. I am in the car with him all the time. Not having a license is a death sentence for him. He cannot get around. What would you do in this situation? – L.T.
ANSWER: I would get the opinion of a neurologist, who could act as a qualified referee in this dispute. Depriving a person of a driver’s license is a major obstacle to functioning in this world. Allowing an unfit driver to drive is a danger to the driver and to the public.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com
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