PCOS Review Newsletter #98

A free health newsletter for women with polycystic ovary syndrome or polycystic ovaries.   Issue #098      January 27, 2010

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TABLE OF CONTENTS

1) NAC Improves Fertility in PCOS Women

2) When Should Doctors Prescribe Metformin?

3) Just for Today…continued

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1) NAC Improves Fertility in PCOS Women

Another medical study has just been published to show that supplemental NAC is helpful for women with PCOS who are trying to conceive and want to reduce risk of miscarriage.

NAC is n-acetyl-cysteine, a derivative of the amino acid cysteine. It is a very important antioxidant and thus protects the body from damage. NAC is available as a nutritional supplement, and as a FDA-approved prescription drug.

In this new study from Assiut University in Egypt, 60 Clomid-resistant women with PCOS were treated. "Clomid resistant" means that the women took the drug Clomid to induce ovulation, but the Clomid treatment did not work.

They then received ovarian drilling. Ovarian drilling is a surgical procedure in which a laser fiber or electrosurgical needle punctures the ovary 4 to 10 times. This treatment may lower the level of male hormones such as testosterone.

After the ovarian drilling, the women were divided into two groups. One group took supplemental NAC while the other group took a placebo for 5 days starting at day 3 of the cycle, for 12 consecutive cycles.

By the end of the study, the NAC group had a significant increase in both ovulation and pregnancy rates vs. the placebo group.

Moreover, miscarriage rates were significantly lower and live birth rates were significantly higher in the NAC group.

This study confirms earlier studies indicating NAC is a supplement that has value for women who have polycystic ovary syndrome.

You can get high-quality NAC here.

You can also click here for more information about NAC.

Source:
Nasr A, Effect of N-acetyl-cysteine after ovarian drilling in clomiphene citrate-resistant PCOS women: a pilot study, Reprod Biomed Online. 2009 Dec 14. [Epub ahead of print]

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2) When Should Doctors Prescribe Metformin?

Two pharmaceuticals are almost always prescribed for treating PCOS: birth control pills and metformin (Glucophage).

There are dozens of studies that show metformin is effective in reducing PCOS-related problems.

So it's no surprise that metformin is very commonly prescribed (never mind its side effects!).

But…is there any situation where metformin should NOT be prescribed? Doctors may have different opinions as to when to use metformin. Here is the opinion of one group of medical researchers from the Saint Vincent de Paul hospital in Paris, France:

1. Metformin is not efficient enough to regulate menstrual cycles.

2.Metformin is not efficient enough to treat hyperandrogenism (excessive levels of male hormones).

3. Metformin should not be used as a first-line treatment to treat infertility. Clomiphene citrate (CC) should be the first treatment.

4. Metformin in addition to Clomid is not recommended as a second line treatment, after the failure of Clomid alone.

5. Metformin should not be used during pregnancy in non-diabetic women with PCOS for the purpose of preventing the risk of gestational diabetes.

6. Metformin should be prescribed to PCOS women when they are diabetic, in order to reduce cardiovascular risk, but after lifestyle modifications have been recommended.

7. Metformin should not be used in PCOS non-diabetic women in order to lose weight. Metformin should not be used in order to treat cholesterol or triglyceride problems in women with PCOS.

8. In PCOS women without diabetes, but with fasting hyperglycemia (high blood sugar) or carbohydrate intolerance, metformin should be prescribed if body mass index is greater than 35.

Metformin is not a miracle drug nor should it be used indiscriminately. If you plan to take metformin for a long time, make sure that you fully understand its possible side effects, including a vitamin B12 deficiency. Before taking any medication, always ask your doctor: "Why should I take this?" or "What exactly are the risks and benefits?"

Disclaimer: We are not giving you medical advice here. We are only reporting research information. Always consult with your physician about any pharmaceutical medication.

Sources:
Duranteau L et al, Should physicians prescribe metformin to women with polycystic ovary syndrome PCOS?, Ann Endocrinol (Paris). 2010 Jan 13. [Epub ahead of print]

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3) ) Just for Today…continued

Here are some thoughts for today:

In our last newsletter, we gave you thoughts "just for today". Here are some more thoughts to consider:

Just for today, I will try to improve my mind. I will not be a mental loafer. I will read something that requires effort, thought and concentration.

Just for today I will exercise my soul in three ways. I will do a good deed for someone without letting them know it. (If they find out I did it, it won’t count). I will do at least two good things that I know I should do but have been putting off. I will not show anyone that my feelings are hurt. They may be hurt, but today I will not show it.

Just for today, I will be agreeable. I will look as well as I can, dress becomingly, talk softly, act courteously, and speak ill of no one. Just for today I will seek to improve no one except myself.

Just for today I will have a plan. I may not follow it exactly but I will have it, thereby avoiding hurry and indecision.

Just for today I will take a quiet half hour to relax alone. During this time I will reflect on my behavior and will try to get a better perspective on my life.

Just for today I will be unafraid. I will gather the courage to do what is right and take the responsibility for my own actions. I will expect nothing from the world, but I will realize that as I give to the world, the world will give to me.

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Thought for Today: "Don't be afraid of the space between your dreams and reality. If you can dream it, you can make it so." -- Belva Davis

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