Chest hair and irregular periods
Dear Dr Mitchell,
I would like to know if my condition can be treated. I have irregular periods. Sometimes for as much as six months I have no period. I grow a lot of facial hair which I don’t like and I constantly have to shave my chest and abdomen. I classify myself as unattractive. I am afraid to wear certain types of clothing. When I was 15 I didn’t see my period for four months and my mom took me to the doctor where I did a blood test and a pelvic ultrasound. When the results came back, the doctor said everything was OK. Now I’m 21 and I’m still experiencing these problems. Can my condition be treated so my menses will be regular and are there treatment that will slow down the growth of hair on my body, particularly my face? Will I be able to get pregnant?
The problem that you are experiencing with the irregular periods and the excessive hair growth on the face and the rest of the body is most likely due to a condition called polycystic ovarian disease. This is a condition in which you do not release an egg each month so the ovaries develop multiple follicles within it which are not released and so they become bigger with time. This results in an excessive production of the male hormone testosterone which causes the excessive hair growth in a similar manner to what occurs in men. This also results in acne, deepening of the voice, enlargement of the clitoris and irregular menstrual periods.
Polycystic ovarian disease or syndrome is sometimes associated with excessive weight gain and an increased tendency to develop diabetes mellitus because the body develops a resistant to insulin which is responsible for lowering the blood sugar. Women with polycystic ovarian syndrome have difficulty becoming pregnant because of the failure to release an egg every month. The condition, though distressing, can be treated. The main thing is to lose weight if you are overweight. You should try to achieve your ideal weight for height. This can be done by cutting back on the consumption of refined sugars and fried foods and consuming smaller, frequent meals with adequate servings of vegetables and fruits daily. It is useful to get help from a dietician as sometimes this can be difficult. A regular exercise programme is also important to help to burn some of the calories to lose the extra weight.
This has to be a lifestyle change for long term so it requires a lot of discipline. Weight loss helps to restore regular cycles, reduces the level of testosterone (male hormone) in the body and helps to control the excessive hair growth and improves fertility.
The excessive hair growth on the face may be controlled by shaving, using creams or by doing laser hair removal. In some women the use of a low dose birth control pill containing the medication Cyproterone Acetate helps to suppress the excessive facial and body hair over time. Preparations such as Dian 35 or Cypress help in this regard in addition to helping to establish regular, monthly menstrual periods. It also helps to control acne so your face will clean up and you will feel good about yourself.
Ovulation can be induced in women with polycystic ovaries by using the drugs Metformin and Clomid. Metformin helps with the weight loss in addition to reducing the risk of developing diabetes mellitus in women with polycystic ovaries. Clomid (Clomiphene Citrate) when used alone or with Metformin works well in establishing ovulation and will improve your chances of becoming pregnant. This in addition to weight loss is the mainstay in the management of women with polycystic ovaries who wish to become pregnant.
The fact that you did an early ultrasound that was normal does not rule out the diagnosis. You should repeat the pelvic ultrasound and the hormone profile which should include your testosterone level in the blood. A blood sugar test should also be done. The treatment of women with polycystic ovarian disease can be difficult since it requires discipline to stick with the diet exercise programme and the medications. The outcome is, however, good in the long term and you will be able to have many children.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@ jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025.
DISCLAIMER:
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor or other professional health care provider.
