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Category: Birth control

PolyCystic Ovarian Syndrome PCOS

September 04, 2018 9:58 am

PolyCystic Ovarian Syndrome PCOS is a complex condition. The exact cause of PCOS is unknown however, it involves hormones imbalance and multiple ovarian cysts, irregular menses, and infertility.  In some cases, PCOS can be compounded by diabetes, hypertension and other metabolic conditions. PCOS has been shown to effect approximately 10% of women of childbearing age with symptoms of menstrual abnormalities, poly cystic ovaries, and excess androgen (male sex hormone). PCOS should be diagnosed by ensuring there are no other underlying endocrine issues. There are several associated disease processes that seem to be related to PCOS. These related disease processes are Type 2 Diabetes, higher depression and anxiety, increased cardiovascular risks, stroke, hyperlipidemia, sleep apnea, overall inflammation, and endometrial cancer.

Anatomically, numerous cysts are found on the ovaries. These are usually diagnosed by ultrasound, blood levels of hormones, and symptoms described above.

Poly Cystic Ovarian Syndrome
Examples of Poly Cystic Ovarian Syndrome

Bariatric Surgery and PolyCystic Ovarian Syndrome PCOS

Bariatric Surgery can improve PCOS in those individuals with Type 2 Diabetes Mellitus. Further information on weight loss surgery and its effect on PCOS here. 

“Depo” Shot and Weight Gain

September 16, 2013 4:14 pm

Female patients having weight loss surgery should use two forms of Birth control  for 18 months after weight loss surgery. Depo shots are suppose to prevent ovulation for a prolonged period of time. An attractive aspect of it is once a patient get the injection, there is not need to worry about birth control till the next injection is due. There have been a number of studies that have associated Depo shots with weight gain. Below are three citations from pubmed and the ACOG website.
depo-provera-3
Weight Gain
Women tend to gain weight while on therapy with Depo-Provera CI. From an initial average body weight of 136 lb, women who completed 1 year of therapy with Depo-Provera CI gained an average of 5.4 lb. Women who completed 2 years of therapy gained an average of 8.1 lb. Women who completed 4 years gained an average of 13.8 lb. Women who completed 6 years gained an average of 16.5 lb. Two percent of women withdrew from a large-scale clinical trial because of excessive weight gain
Validity of perceived weight gain in women using long-acting reversible contraception and depot medroxyprogesterone acetate.
Source
Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
Abstract
OBJECTIVE:
The objective of the study was to evaluate perceived weight gain in women using contraception and determine the validity of self-reported weight gain.
STUDY DESIGN:
We analyzed data from new contraceptive method users who self-reported a weight change at 3, 6, and 12 months after enrollment. We examined a subgroup of participants with objective weight measurements at baseline and 12 months to test the validity of self-reported weight gain.
RESULTS:
Thirty-four percent of participants (1407 of 4133) perceived weight gain. Compared with copper intrauterine device users, implant users (relative risk, 1.29; 95% confidence interval, 1.10-1.51) and depot medroxyprogesterone acetate users (relative risk, 1.37; 95% confidence interval, 1.14-1.64) were more likely to report perceived weight gain. Women who perceived weight gain experienced a mean weight gain of 10.3 pounds. The sensitivity and specificity of perceived weight gain were 74.6% and 84.4%, respectively.
CONCLUSION:
In most women, perceived weight gain represents true weight gain. Implant and depot medroxyprogesterone acetate users are more likely to perceive weight gain among contraception users.
The Danger of Depo
 The American Journal of Obstetrics and Gynecology reports that the worst offender is Depo-Provera, the contraceptive shot. Depo contains a synthetic hormone that keeps estrogen levels low, preventing the release of eggs. Women who used it were twice as likely as those who used nonhormonal contraceptives to become obese over three years, even after accounting for exercise and eating habits.
 
 
It is because of the above and other published reports that I recommend agains Depo shot as a means of birth control for patient who have or area considering weight loss surgery.