Reduced fertility
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The benefits of weight loss for fertility
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Many women who have PCOS are overweight and this adds to their insulin resistance. Weight loss will help with symptoms and will also decrease the risk of long term complications. Several studies in overweight women with infertility due to ovulation difficulties have shown the return of normal ovarian function with even small amounts of weight loss. Even without weight loss, symptoms are often improved by becoming healthier.
Realistically aiming to reduce weight by five to ten percent at about ½ to 1 kilo every week or two has been shown to be enough to reduce symptoms and to be sustainable long term. Women can be fit, well and healthy at a wide range of shapes and sizes, so weight alone is not the only guide to success. Other changes to look for include reducing waist measurements, clothes fitting better, symptoms improving or better changes on blood tests.
Weight loss can be best achieved by a program of healthy eating and exercise as outlined in this booklet. Usually there is no need for very restrictive dietary plans however women often find guidelines and nutritional advice from a health professional such as a dietitian helpful. Discuss with your doctor the best choices available for weight loss if needed.
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Medications for reduced fertility
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If your ovulation is not regular, modest weight loss and lifestyle changes can help but in some women medications may be required to induce ovulation. Medications include Clomiphene, Metformin, or FSH. Careful monitoring is required when using medication to induce ovulation in women with PCOS to avoid possible overstimulation of the ovary. It may be necessary to proceed to assisted reproduction techniques including IVF.
Fertility treatments are more effective for women who have undertaken lifestyle change first.
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Big Girls Group
| Weight loss and lifestyle programs such as the BGG provide education and support for women wishing to optimize their reproductive and gynaecological health. For more information see the back of this booklet.
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Smoking
| Apart from other health risks, smoking increases insulin resistance. If you are trying to get pregnant or you are already pregnant, smoking can be detrimental to the health of your fetus. If you can’t give up on your own contact the Quitline. If you are concerned that you might put on weight if you give up smoking, speak to a dietitian for support and advice.
| Quitline 13 78 48
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Period problems
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To regulate periods and avoid overgrowth of the lining of the uterus, the oral contraceptive pill (OCP - such as Diane, Brenda or Juliet) is widely used. Sometimes progesterone-like hormones may be given as an alternative.
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Acne and excessive hair
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Medications
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Several medications have been shown to improve excess hair growth. These include the OCP, Cyproterone acetate and Spironolactone. Medication usually needs to be continued for six months before an effect is seen and cannot be used if trying to conceive or during pregnancy.
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Bleaching, waxing, depilatories, electrolysis and laser treatments
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A mixture of bleaching, waxing and depilatories may be required for hair problems.
Methods such as laser and electrolysis can be expensive and may not work as well when hormones are causing more re-growth. Also the skin on the face is sensitive and the skill of the operator is important to prevent scarring and damage. Seeking advice from a dermatologist is recommended.
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Disclaimer
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The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this booklet or incorporated into it by reference.
We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy.
Women are encouraged to discuss their health needs with a health practitioner.
If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.
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Published June 2008
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