PCOS – how Permanence can help

The PCOS induced hormone imbalance causing Hirsutism (male pattern hair growth in a female) is treatable via medication. However, medication cannot turn back the clock on hair that has already gone terminal before treatment takes effect. Permanence can help by eradicating this disfigurement.

 

hirsutism Polycystic Ovary Syndrome PCOS

 

At birth our bodies are covered in vellus hair (fine down-like hair) even on our heads but our skin already has all of the hair follicles it will ever have – some 5 million of them. At puberty, androgenic hair growth will cause areas of this vellus hair to convert to terminal hair (thick, long, pigmented hair) on our underarms and pubic region. In males, hormones will also cause terminal hair to grow on the face, chest and, to a lesser degree, on the arms, legs, and back.

Unfortunately, in females the remaining vellus hair is only waiting for the occasional presence of enough male-type hormone (androgen) to trigger terminal conversion and, once triggered, there is no going back.

The only permanent solution to unwanted terminal hair is to kill the hair follicle. Plucking, waxing and laser can only remove the hair stem and, in the case of laser, do some damage to the bulb from which it grows. In each case the hair will recover and grow back.

The galvanic electrolysis method used at Permanence is guaranteed to kill terminal hairs at the bulb, destroy the bulge from which it regenerates, and prevent regrowth. This is a guarantee we back in writing. The electrology equipment used by Permanence has been custom-designed for our clinic. It is fast, minimises pain and is safe. The fine control unique to our machines means minimal discomfort during the procedure and reduced recovery time for your skin.

Our therapists can put together a Permanence Treatment Plan that will see your beauty and confidence restored and banish this most visible symptom of PCOS permanently.

PCOS – the syndrome in detail

PCOS (Polycystic Ovary Syndrome) is the most common hormone disorder among women during their reproductive years. It affects 10% of women between the ages or 12 and 45 and is a leading cause of infertility. The underlying cause of the disease is unknown although there is strong evidence it may be genetic.

Regardless of its cause, the symptoms of PCOS are both treatable and reversible.

PCOS Polycystic Ovary Syndrome

As a syndrome with unknown causes PCOS cannot be diagnosed by a simple test. It must be diagnosed by the presence of a collection of symptoms. Since these symptoms can appear unrelated and relatively mild for many years, women can endure them for decades before they are either picked up during tests for other conditions or while being tested for infertility.

History

PCOS was first described in 1935 in the USA by Doctors Stein and Leventhal after whom it was initially named Stein-Leventhal Syndrome. Hippocrates described a collection of characteristics which appear to describe PCOS in 400BC but the earliest clear account describing the external symptoms of the syndrome dates to early 18th century Italy. Internally, the ovarian abnormalities associated with PCOS were first described 120 years later in 1844.

PCOS is also known as Hyperandrogenic Anovulation, Functional Ovarian Hyperandrogenism, Ovarian Hyperthecosis or Sclerocystic Ovary Syndrome.

Morbidity

The most life-threatening condition arising from PCOS is insulin resistance leading to heart disease and other conditions of obesity.

PCOS sufferers are at a higher risk of Endometrial Carcinoma (cancer of the uterus) and risk permanent infertility.

Symptoms

Menstrual Disorders – either oligomenorrhea (few or irregular periods) or amenorrhea (no periods)

Infertility – resulting directly from the irregular or lack of periods

High levels of masculinising hormones – elevated levels of testosterone result in hirsutism (male pattern hair growth in a female); acne and oily skin; male pattern baldness and hypermenorrhea (heavy and prolonged periods when they do occur)

Insulin Resistance – leading to abdominal obesity (apple shape weight distribution); cardiovascular disease and type 2 diabetes

PCOS Polycystic Ovary Syndrome ultrasound

PCOS Ultrasound

Cause

The cause of PCOS is thought to be genetic through a gene inherited from either parent. This leaves a child with a 50% chance of inheriting the disease but gives no indication of how severely the child, if female, will be affected. In males the same gene may express itself in early onset baldness and excessive hairiness over the rest of the body or the male may remain asymptomatic. The specific gene involved is yet to be identified.

Definition

A woman is defined as having PCOS if any 2 of the following 3 criteria are met and other factors are excluded that would also cause them:

• Few (oligoovulation) or no (anovulation) menstrual periods

• Excess male hormone (androgen) activity

• Polycystic ovaries

Diagnosis

Importantly, not all women with PCOS have polycystic ovaries. A pelvic ultrasound will be used to check for polycystic ovaries but a negative finding does not rule out PCOS.

In a normal menstrual cycle one egg is released from a ripe follicle on the ovary. The follicle then shrinks and disappears within 12 to 14 days. On an ovary affected by excess androgen, several follicles begin to ripen at once but their development is arrested and none reach ovulatory size.

In a pelvic ultrasound, the examiner is looking for a telltale “string of pearls” – a row of 12 to 25 partly ripened follicles to make the diagnosis of polycystic ovaries. It is important to remember that the name polycystic is a little misleading in that there are no actual cysts on the ovaries only that the many (poly) immature follicles (cysts) look like cysts on the surface of the ovaries. A simple blood test is taken to measure levels of androgens such as androstenedione and testosterone. While there are several ways of measuring androgen levels, free-testosterone level is thought to be the most reliable indicator.

A Glucose Tolerance Test measures insulin resistance by blood tests taken at intervals after a fixed amount of glucose is given to determine how quickly it is cleared from the blood.

Treatment

Although the cause of PCOS cannot be treated directly, its symptoms can.

The medications Metformin and Thiazolidinedione are often used to improve insulin sensitivity.

A low GI diet has been shown to be effective in reducing weight and increasing period regularity in PCOS patients. This distinction is significant as fat retention due to PCOS is predominantly visceral fat (packed between body organs) rather than subcutaneous fat (under the skin) and requires modification of diet content and not simply portion control to reduce it.

Clomiphene Citrate is a medication often prescribed to promote regular ovulation. In women not wishing to become pregnant a contraceptive pill is frequently effective in regularising periods.

A contraceptive pill containing cyproterone acetate is also effective as an anti-androgen to reduce the effects of hirsutism (male pattern hair growth). More powerful anti-androgens such as flutamine or spironolactone can also be prescribed.

While hirutism can be arrested by medication this will not reverse existing hair growth. This hair will need to be removed mechanically. Here Permanence can help by systematically and permanently removing unwanted hair caused by PCOS.