Website of the week
Surprisingly, it took a long time to find some decent images of polycystic ovary syndrome (PCOS). There were plenty of ultrasounds, but mostly single low-resolution images that told you little.
This site is selling the services of an infertility clinic, but it has a collection of decent ultrasound images that are marked up so you can tell what you are looking at. It takes a few minutes to see the pictures and read about them, and you can ignore the rest. Why go there: see the ultrasound findings.
Downside: a commercial site.
Information from: Advanced Fertility Center of Chicago.
Guidelines on management
The parts of this article that are particularly helpful are those sections that deal with specific areas of management.
These include PCOS and cardiovascular disease, anovulation and amenorrhoea in women not attempting to conceive, disease prevention in women not attempting to conceive, ovulation induction in women attempting to conceive, and facts about weight loss, ovarian function and hirsutism.
You don’t have to read the whole article and the headings are clear as you scroll down.
Why go there: some important questions answered.
Downside: you have to pick them out.
Information from: American Family Physician.
This brief article is densely packed with information about insulin resistance in PCOS. It discusses the compensatory hyperinsulinaemia and the evidence that suggests that hyperinsulinaemia plays an important role in the pathogenesis of PCOS.
The ways in which hyperinsulinaemia produces hyperandrogenism in women with PCOS are considered, and the evidence is sufficient to justify the clinical use of agents such as metformin in the management of such women.
Why go there: to see the evidence.
Downside: not an easy read.
Information from: Virginia Commonwealth University.
PCOS and obesity
There are at least two good reasons to read this article. One is that it is written by the author of this week’s Clinical Review (page 36), and the other is that obesity is such a hot topic at the moment. This piece is about the impact of obesity on PCOS and reproductive health. With about 50 per cent of women with PCOS suffering from obesity, the links between the two conditions make this an important element of management.
It is known that even modest weight loss in women with PCOS improves the endocrine profile, menstrual cyclicity, rate of ovulation and likelihood of a healthy pregnancy.
Why go there: emphasise the importance of weight loss.
Information from: Royal College of Obstetricians and Gynaecologists.
Address: Please click here
I was rather surprised to discover that there appears to be only one charity in the UK involved with PCOS, and this is it.
Its website is not exactly ambitious, and its name — Verity — doesn’t give you much of a clue to its content, but it is backed by some highly respected professionals.
There is an excellent downloadable booklet explaining all about the condition. Another plus is that there is a section for health professionals.
I know this is a charity, but I was disappointed that you have to send for its patient packs — you cannot preview the contents online — and they cost from £30 to £43 for 100. Of course funds are bound to be limited, but the information on offer might reach those for whom it is intended more readily if the packs could be downloaded for printing out.
Why go there: the place to send patients.
Downside: site needs jazzing up a bit.
Information from: Verity.Address: www.verity-pcos. org.uk
Dr Barnard is a former GP in Fareham, Hampshire