QuestionQUESTION: Hi Dr.,
I am 29y/o,my menarche was when i was 16 y/o and since then it has been irregular ,it comes every 45 days or 35 days,but it happens sometimes even to skip,i went 4 years ago to gynecologist and she did an US to me and said i have multicystic ovaries.she said nothing to worry but if i need to regulate my cycle i have to get COCP,but i refused to get it as we have family history of breast cancer,and i did another US 2 months ago and they said everythings appears normal and they didnot say i have that multicystic ovaries?
my question is multicystic ovaries same as PCOS??i am skinny don't have acne,but i do have some little hair growth in my chin.
p.s i did hormonal assay 5 years ago and everything was normal!
thanks
ANSWER: Hello Stacy from the U.S.,
I presume that the term "multicystic" that your doctor used is the same as PCO. Multicystic is the description and PCO is the disorder. For example and ultrasonographer reading the ultrasound would say that the ovaries are "multicystic" in appearance and consistent with PCO-type ovaries. PCO itself is an ovarian dysfunction disorder. The problem is not the "cysts" but ovaries that have this description tend to have the dysfunction. By dysfunction I mean that the ovaries are not working correctly. As a result, ovulation does not occur or is erratic and the female hormones in your system are out of balance.
The treatment for this is to use the birth control pill if you are not trying for pregnancy. If you are trying for pregnancy you will need to use a fertility medication to correct the ovarian function. There has been absolutely no study or proof that birth control pills increase the risk of breast cancer so you don't have to worry about that.
Patients that have PCO don't have to have ALL the findings in PCOS. There are variations. It only requires that you have two characteristics to make the diagnosis. For instance, one requirement is an ovulatory dysfunction, which causes irregular menstrual cycles. The other would be characteristic ovaries found on ultrasound or increased facial hair growth or abnormal glucose metabolism or increased insulin levels or an elevated LH/FSH ratio, etc. Any of these would suffice and there are others. You seem to have two of the findings, so unless there were another explanation for your irregular cycles, the diagnosis would be PCO. Hormonal testing levels would be normal (based on the lab ranges), but the characteristic is that the LH level is higher than the FSH level. Also this assay needs to be done on the second or third day of your cycle otherwise it is not valid to interpretation.
I have written extensively on this subject on my blog. I would recommend that you give it a look.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
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QUESTION: Thanks Dr,
i actually miswrote the word they told me i have "multifollicular ovaries" not multicystic ovaries!is there any difference?another thing why the second ultrasound that i had 2 months ago was normal?they told me everything is normal!
thanks
AnswerHello Again,
I understood what you meant and "multicystic, polycystic and multifollicular" are all describing the same thing ultrasonographically. The reason why this description is made is because this finding can be a characteristic of PCOD.
I don't know why they called the second ultrasound normal but I suspect because "multifollicular" is not a clinic diagnosis and technically a normal finding, they decided not to make anything of it. However, if you need to know why the second one was different from the first one, then you need to as your doctor or the radiologist that read the ultrasound. Anything I tell you is purely conjecture.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
