My Doctor Online The Permanente Medical Group
Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Overview
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Polycystic ovary syndrome (PCOS) describes a set of symptoms that can include menstrual irregularities, excessive facial hair, and even infertility in women. Skin blemishes, unwanted body hair, and weight gain are also symptoms of PCOS.
In healthy women, the ovaries produce a very small amount of male hormones, or androgens. In women with PCOS, the ovaries produce too many androgens and do not produce a sufficient amount of the female hormone progesterone.
Symptoms often begin shortly after puberty or the first period (menstruation), though they usually appear gradually. Typically, the diagnosis is made in 20- to 30-year-old women.
As a result of hormone imbalances, a woman with PCOS may develop metabolic problems such as diabetes, cholesterol abnormalities, heart disease, or sleep apnea.
Though there is no cure for PCOS, all or most symptoms can be successfully managed with lifestyle modifications and treatment.
Symptoms
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Common symptoms of PCOS include:
- Irregular, infrequent, and/or heavy menstrual periods
- Excessive dark facial and body hair
- Infertility or difficulty getting pregnant
- Numerous small ovarian cysts
- Sleep apnea (breathing problems during sleep)
- Pelvic and/or lower abdominal pain
- Acne or skin discolorations
- Thinning scalp hair
- Weight gain and obesity
Other common symptoms of PCOS include high blood sugar or diabetes, low HDL (good cholesterol) levels, high LDL (bad cholesterol) levels, high triglycerides (blood fat), and high blood pressure. If you have PCOS, you may also be at risk for depression and anxiety.
Diagnosis
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Because there is no single diagnostic test for PCOS, the process involves a series of examinations and tests, such as:
- A physical examination, during which we may find symptoms of PCOS such as excessive body hair and high blood pressure
- A pelvic ultrasound examination, which may reveal ovarian cysts
- Blood tests to check your various hormone levels, cholesterol levels, and blood sugar
We may ask you about your medical history, including your menstrual cycle, as well as any family history of PCOS, diabetes, cholesterol problems, or other hormone disorders.
Treatment
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Although PCOS cannot be cured, its various symptoms can be treated. PCOS symptoms can be treated with lifestyle modifications and medications.
Lifestyle modifications
The primary lifestyle changes recommended for PCOS include getting regular exercise, improving your diet, quitting smoking if you smoke, and managing your weight. These lifestyle adjustments can have tremendous benefit, relieving many or even all symptoms of PCOS.
In addition, noninvasive hair removal options such as electrolysis, laser treatments, or hair removal creams can help manage unwanted hair growth.
Medication
Several types of medications may be used to treat the different symptoms of PCOS, including:
- Birth control pills, which limit your body's production of androgens (male hormones). They can help regulate your menstrual cycle, reduce hair growth, and clear up acne.
- Progesterone helps regulate your menstrual cycles and protects against endometrial cancer.
- Fertility medications. If you are trying to become pregnant, fertility medications such as clomiphene citrate (Clomid, Serophene) can stimulate ovulation. Other options for fertility may be considered.
- Metformin (Glucophage) is a diabetes medication that helps the body respond to insulin. It can also help restore ovulation and fertility in women with PCOS.
- Anti-androgens such as spironolactone can help with excess hair.
- Acne and skin medications, prescription or over-the-counter, can help clear acne and other skin blemishes.
Additional References:
- Birth Control and Risk of Pregnancy: How Does Your Method Compare?
- External Link to The Hormone Foundation
- External Link to Polycystic Ovarian Syndrome Association
- External Link to Womenshealth.gov
Your Care with Me
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If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.
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If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.
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Coordinating Your Care
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Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
If you call the Appointment and Advice line
- Our call centers are open every day of the year around the clock. If you need advice, we will transfer you to one of our skilled advice nurses (RNs). They can help you determine when you need to be seen and in what location.
- The advice nurse can often start your treatment by telephone depending on the situation and has access to your electronic medical record.
If you come to an office visit
- At the beginning of your visit, you will receive information about when you are due for your next test, screening or immunization. We can discuss and schedule any preventive tests that you need.
- At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
- To help you prepare for your visit, please see additional details under Office Visit.
If I prescribe medications
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
- Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
- Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures we will schedule an appointment with the radiology department. When the results are ready I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If I refer you to another specialty colleague
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
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If surgery or a procedure is a treatment option
I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
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Convenient Resources for You
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As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
Manage your care securely
- View and compose secure e-mail messages.
- Manage your prescriptions.
- View your past visits and test results.
- View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
- Read about causes, symptoms, treatments, and procedures.
- Find interactive health tools, videos, and podcasts to help you manage your condition.
- View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
- Locate health education classes and support groups offered at every medical center.
- Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
- View your Preventive Services to see whether you are due for a routine screening or updated immunization.
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Related Health Tools:
Interactive Programs
- Taking the First Steps to Regular Exercise Taking the First Steps to Regular Exercise
- Get a good night's sleep with Overcoming™ Insomnia Get a good night's sleep with Overcoming™ Insomnia
Podcasts
- Exercise Lite Exercise Lite
- Exercise Smart Exercise Smart
- Healthy Pregnancy and Successful Childbirth Healthy Pregnancy and Successful Childbirth
- Mastering Menopause Mastering Menopause
- Ready to Lose Weight Ready to Lose Weight
- Stress Management for Medical Conditions Stress Management for Medical Conditions
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.