Pamela: Welcome Dr. Grazi!!!! We are so glad that you are here! The room is already filling up and we have many questions for you!!!
Lynn: Dr Grazi: I've been trying to get pregnant for a year and a half. I have PCOS. What is the best fertility treatments for PCOS for a woman that wants to have a baby?
Liz: Thanks William
drgrazi: Hi,folks. Sorry I'm late. Thisi is Dr Grazi
shana: Amanda
Maybe you don't have PCOS. The adrenal hyperplasia can cause irregular cycles, ance, and hair growth.
Julie2: hi taly
yvette43: Hi
this is yvette43
Mae: Hi,
I was wondering what diet do you suggest a person with PCOS should follow?
Carolyn: Just recently diagnosed with PCOS January of this year. Have gone through two cycles of Clomid, then shots of Repronex... am waiting a few more days for blood test to see if I'm pregnant. First cycle was quick and smooth... no pain. Second cycle was twice as long and had abdominal pain (ovaries) for a week..., ugh! My question is... what is the best long-term treatment for those of us with PCOS after we have achieved pregnancy? I am 26 years old and took birth control for 8 years masking the PCOS symptoms. The infertility treatment that I have been doing has worked with minimal side effects, I'm just now starting to worry about long term PCOS?!?! Pleas respond!!
EllenB: Thanks Jennifer. It took me 5 1/2 years to get pregnant and if by talking about PCOS on tv, I can make it easier for someone else to conceive, I will.
Pamela: Dr. Grazi, just begin answering!!
Liz: Dr. Grazi: I am 26 years old and just found out on Friday for sure although my doctor say's that I don't need to have an ultrasound since it is not necessary since I am not trying to have children now. I should go on Provera if my cycle does not start by the 27th to bring it on so I can start Alesse to regualte my hormones. I have requested a sonogram a few times. Should I have a sonogram to fully diagnos?
spanish23: i am 14 years old & i have been haveing all of the symptoms
Veronica: Dr. Grazi,
What type of injection should I be taking since I have PCOS. I am suppose to start my second round of humegon next week? Do want that additional LH?
amanda: Hello Apple, I also take spirnolactone for the male-like effects of PCOS, I don;t know that I see much of a difference and it's been about 9 months. I know I have some side effects though.
drgrazi: OK. Pam: There are lots of good questions. Where do I start?
William: Room FAQ:
1. The room scrolls by very quickly so change the "Messages" number, just to the left of the Log Out button, to a larger number than 20.
2. When the MD and Pam's other volunteers arrive, give them a chance to get oriented. Don't throw out all your questions at once because they'll just scroll by.
3. Best to type your question on a notepad or into a MS-Word document on the side, then cut+paste it into the message box here when you are ready to ask it. That way if it isn't answered the first time you can paste it in again later.
4. If your answer scrolls by and you cannot find it, e-mail or and the entire transcript will be mailed to you in a few days.
Let's remember, the MD and volunteers can handle only one question at a time, so if they don't see yours please be patient and ask again.
51 of us here now, good lord this is going to to be a packed house!
Jennifer: Dr, I was hoping you could let us know why so many doctors (OB/GYN's) are so insistant that the ONLY treatment for those of us with PCOS trying to conceive is Clomid, especially when Clomid rarely works in PCOS women and when it does, 20% miscarry.
spanish23: Can i have PCOS??
yvette43: Is someone there to answer some questions about pcos
Keri: Dear Dr. Is there anything else you can suggest I should do besides taking birth control pills to better myself and this disease? What is the first step I should take when I am ready to get pregnant?
shana: EllenB
I am currently seeing an OB/GYN that specializes in infertility. He has done tons of blood work and an HSG so far. All tests have come out fine. I got pg once on 50mg of clomid, but m/c at 6 wks. I am now back on the clomid, 100mg, and we are trying again.
Apple: amanda: what kind of side effects? are you on anything else?
victoria: Hi. Is the meeting going on now?
William: Hi, Dr. G, you can't make a mistake here, just grab a question and give an answer. We understand things will scroll by quickly so take a moment to get settled in.
I recommend single-malt, think I'll pour me some Isle of Jura and get comfy :o)
Pamela: Just pick and Start!!
Myrna: Welcome Dr. Grazi
Jennifer: Ellen, I'm glad you're here, I was looking for a way to contact you when I first saw your story. My email address is , please everyone feel free to email me. Always looking for more cysters to befriend and share experiences with.
melodee405: hi dr.grazi i have a 14y/o daughter who has most of the symptoms of pcos what can i do or where should i go to help in the diagnosis?
CarolC: Hi - I have just started Metformin - was wondering if there was any added benefit in adjusting my diet to watch sugar intake??
Julie2: Jennifer, that is a great question! thanks for asking it
EllenB: Diet wise, I think that most people agree that a low carbohydrate diet makes sense for women with PCOS because it helps with the hyperinsulinemia. And there are studies that show that a weight loss of even 5 to 10% of body weight can restore ovulation. I know that this is true in my case.
trybal2: hi dr., i have had irregular periods since i am 16, i am now 27. i bleed for months at a time, with no stopping in between. i am trying so hard to get pregnant, and i have pcos, but i dont know what kind of a dr., i should see.?
drgrazi: Let's go to the issue of sonograms for the diagnosis of PCOS... Not necessary. Generally speaking, we can make the diagnosis on clinical findings alone. Blood tests are also useful.
Pamela: Ellen, feel free to just help out and answer as well...Dr. Grazi know that you and Beth are here to help.
tracy: tracy, iwould like to know if you are not the right medications for pcos and you have ivf can you have a miscarraige.?what medications do you recommend for a woman who has pcos and is going for ivf to be on?
Mich: Is treatment for PCOS long term or is it taken care of after a time of being treated. How is one treated for PCO? I had 2 failed IVFs and no treatment for PCO.
lori: Hi, I have not been diagnosed with PCOS but I feel I have many of the symptoms. I am 36 and had an internal ultrasound 6 years ago. It didn't show anything but I still feel I may have it. It is possible to have missed it on the ultrasound?
lori: Hi, I have not been diagnosed with PCOS but I feel I have many of the symptoms. I am 36 and had an internal ultrasound 6 years ago. It didn't show anything but I still feel I may have it. It is possible to have missed it on the ultrasound?
victoria: Dr. Grazi, what is your best opinion on getting doctors to
treat us if we aren't trying to conceive?
William: Pam, so you know I'm going to be quiet here and let your folks have center stage. I'll post my room FAQ every few minutes.
There's already 60 people here, that might be capacity.
Dee: Dr. Grazi, I've been diagnosed with PCOS for some years, I always have cysts on my ovaries, and fibrocystic breasts. My two problems are digestive related-colitis, and I'm very underweight. Does any of this go along with the PCOS. I'm on no birth control now, most of them make me sick to stomach. No fertility drugs either. But, when I take nothing, I get ruptured cysts.
amanda: Taking Prednisone at 5mg a day for a lifetime, how bad is that for the rest of your body? I've heard it's not a good drug to be on. They came to the conclusion that I have adrenal hyperplasia because even after being on the pill, my DHEA was extreemly high. What do you think? HELP!!
drgrazi: With regard to a 14 y/o with signs of PCOS, let's be careful. The last thing you want to worry her about is future fertility. If she is overweight, then that is the first problem to address.
EllenB: Jennifer: You can contact me at Also look for me on the AIA PCOS message board.
kerry: Doctor, I have been trying to get pregnant for about two years, unsuccessfully. I've been dating my husband for 5 years. My weight has been normal until I met my husband (I was 22 yrs old). Since then I have gained alot of weight (was size 14, now 24), my period has been so abnormal and I have hair growth on my face. Does this sound like pcos?
Julie2: Ellen, so weight loss helped you? Gosh, I wish it would have helped me. I lost 50lbs about 4 and a half years ago. and although my cycles were a little more regular..I still wasnt getting more the 1 in three months. I havent ovulated in over 5 years
Pamela: The floor boards are creaking!! I really appreciate you repost the FAQs.
cherra: Thank you Ellen
bak19: a diet low in carbs is also very helpful when taking metformin - it seems to keep the gi side effects under control
Lynn: Dr.: I have PCOS and I am very overweight. I am presently trying Weight Watchers to help lose weight. what is the best way to lose weight? I am determined to try to get pregnant even at the weight of 239. What do you think?
joanneseth: Hi Dr. Grazi, are there are any
stats on incidences of autism in one
of a twin pair when fertility drugs
are involved?
LEE: cAN YOU HAVE PCO WITH JUST THE SYMTOMS OF EXCESSIVE FACIAL HAIR??
William: Room FAQ:
1. The room scrolls by very quickly so change the "Messages" number, just to the left of the Log Out button, to a larger number than 20.
2. When the MD and Pam's other volunteers arrive, give them a chance to get oriented. Don't throw out all your questions at once because they'll just scroll by.
3. Best to type your question on a notepad or into a MS-Word document on the side, then cut+paste it into the message box here when you are ready to ask it. That way if it isn't answered the first time you can paste it in again later.
4. If your answer scrolls by and you cannot find it, e-mail or and the entire transcript will be mailed to you in a few days.
Let's remember, the MD and volunteers can handle only one question at a time, so if they don't see yours please be patient and ask again.
62 of us here now, good lord this is going to to be a packed house!
drgrazi: Here's one thing I'd like to make perfectly clear: Polycystic ovaries has nothing to do with cysts on the ovaries. It is a confusing point that we docs have to struggle with all the time, but they are totally different things. In PCOS, there really are not cysts, just lots of egg follicles.
gailygirl: I am taking glucophoge for my symptons, but the facial hair and weight gain still progress
lauren: Is there any information about taking clomid and prednisone to help in achieving pregnancy in someone that has borderline PCOS. My re said no but have you ever heard of this protocol and what do you think?
Carolyn: General question: Will all of the questions and answers given be posted on the AIA site so we can review everything? I am finding it hard to access more than about 25 questions/answers at a time? Please do so!! Thank you, thank you, thank you...
nikgot: I was have PCOS and just did 5 rounds of clomid treatment. On my 1st 3 tries I produced a normal follicle and had HCG, but did not get pregnant. On my 4th and 5th try, I produced many small follicle, but non were mature enough to proceed with a shot and insemination. Is there any explanation for this?
wintrysun: about long-term PCOS...I took clomid to get pregnant 20 years ago, and I have had normal regular cycles ever since. Good luck! Also,
gemini: hello all
amanda: HOw likely is it that you will end up with diabeties or heart problems when you have PCOS?
Jennifer: Dr. I hope you get a chance to address Clomid and PCOS and how it does not often work as the only treatment.
bessie: Dr, Grazi, Being diagnosed with PCOS and delivering a baby 12/99...Is there a chance that i can conceive without use of meds (Gonal F). I am trying to conceive right away.
yvette43: I don't know anything about pcos and don't know if I have them but for the past year I have been haveing some problems and I just heard this morning about the symtoms of pcos and it sounds like me. I'm wondering if this pco can cause alot of menstrual pain before and after. I've just been diagnosed with diabetes.
Pamela: Carolyn-you will be able to read the entire transcript on our site tomorrow!
drgrazi: The typical fertility drugs used to treat PCOS have been around - in one form or another - for over thirty years, and I am not aware that any has been linked to autism.
melln: can you be born with pcos, or does it have an onset at a particular age?
spanish23: I am 14 years old i have some of the symtoms, where do i begin could i have PCOS
EllenB: Julie2: I have been on a modified version of Atkins (I eat lots of vegetables and some fruits but no bread, pasta, potatos or refined sugars)for two months and have lost 10 pounds (25 to 30 to go) and have had two ovulatory cycles.
William: Yes, questions will be reposted on the AIA website
Veronica: Doctor, was is your thoughts about additional Lh in fertility injections? My doctors wants me to try a second month of Humegon.
evj313: I have suffered many yrs w infertility. only recently was i informed of PCOS.I suffer from all symptoms described. need advice where to follow up.live in bklyn.is your center taking new pts?where is it located?
Susan: What is PCO Syndrome? I seen something on tv this a.m. and I have 4 of the 5 symptoms.
faithann: Q: how and why one gets pco's
rvaipree: can someone tell me whats going on in the chat room
Liz: Dr. Grazi, I had blood work done and that is how my doctor diagnosed me. What is the best way to treat this since I am not trying to have children at the moment but want to have them one day. I have a family history of infertility problems and I was put on Provera 2 times already to get my cycle started now I have to wait till the 27th and if it does not come by then, I will have to go on the Provera again, is there any other medication that I can take since Provera makes me have serious mood swings?
jen430: I don't know if I have PCOS, I have been trying to get pregnant for about 2 years
shana: Dr. Grazi
I am 27 yr. old with a history of irregular cycles. I have some facial hair and acne. My cycles are irregular. I was put on clomid and got pg month 3 of 50mg. I m/c at 6 wks. I am now on the clomid, 100mg. All bloodwork has been within normal range and the u/s showed "healthy ovaries". I fear I may be suffering from PCOS. Any suggestions or comments.
Julie2: Ellen, you are very lucky! *sigh*
Apple: Dr.: For those women not looking to get pregnant presently, what would you recommend to reduce the symptoms of facial hair, and are there best practices for diminishing the condition?
EllenB: melln: There is a piece on the PCOS page of the AIA website that responds to your question about the onset of PCOS. It is my summary of Dr. Rogerio Lobo's talk on PCOS at the AIA PCOS conference in October 1999. Check it out. It's actually quite interesting.
drgrazi: Nikgot: you ask a nice question, but getting pregnant is about more than just ovulating and having sperm around at the right time. There are many reasons why you may not have conceived, including that Clomid is a complicated drug.
bak19: pcos is a genetic disorder and yes you are born with it. some women have polycystic appearing ovaries but do not end up with the full blown syndrome.
Erika: Hi there! My RE has me trying Clomid agin ( for the 8th cycle) but this time he has me on it for 8 days at 100mg/day. Is this something new? Will it help a womean with PCO? What days are best to take the Clomid?
Thanks!
rvaipree: is there help for females with PCOS
MG: What sems to be going on is that a lot of people are asking questions but Dr has not answered many or am I missing something
melln: Is there anything I can do to prevent m/c? I have had 5 m/cs in four years and I am feeling like I willl never carry. I was dx with PCOS 2 years ago and am on met.
William: Just to follow up on the autism question (William has a PhD in psychology with an emphasis on child psychopathology), it is very difficult to demonstrate what causes autism because it is so rare. Best evidence points toward a biological basis rather than family environment effect, but it is almost impossible to link any drug to autism since the base rate of autism is so low.
ba: Dr. Grazi, Do you know the possible side effects of taking provera 10mg x days before knowing you are pregnant(the firdt few weeks of conception)?
Mae: Can you tell me what if anything can be done for hairloss for people with PCOS? Will it ever come back with the right diet/medications?
gemini: i am 29y/o female that was diagnosed with PCO. I was told that after my first child that i would have a haard time getting pregnant. fortunately I was lucky 5yrs after my first child I was blessed with Girl/Boy twins. To all in distress hang in there.
rvaipree: i don't think i understand how this chat room works
Livvy1: What kind of treatment is there to eliminate the superfluous facial hair?
drgrazi: Hooray for evj313. Yes we do take new patients. Incidentally, PCOS is the most common reason that a woman will walk through our doors. I think this is typical of most fertility specialist.
evj313: I have suffered many yrs w infertility. only recently was i informed of PCOS.I suffer from all symptoms described. need advice where to follow up.live in bklyn.is your center taking new pts?where is it located?
Myrna: Dr. Grazi, I'm 28 yrs old and believe I have PCOS. My doctor has never diagnosed me for this but until this year I had never heard of PCOS. I haven't had my menstral in over 2 yrs. And since I got it at age 10 I've only had it maybe 7 times. I've tried to get pregnant and did 2 yrs ago but miscarried at 2 months. My doctor says that I don't get my menstral due to overweight and high male testorone. I have excess facial hair (chin) and body hair. My weight goes up but mainly in the midsection area. Could you help me with more information.
yvette43: I haven't used birth control for the past 6 years and I haven't gotten pregnant. I wanted to before but now I'm not looking for it to happen. I just want to know if treatment for pcos would help me with other problems I have
William: Room FAQ:
1. The room scrolls by very quickly so change the "Messages" number, just to the left of the Log Out button, to a larger number like 99.
2. Best to type your question on a notepad or into a MS-Word document on the side, then cut+paste it into the message box here when you are ready to ask it. That way if it isn't answered the first time you can paste it in again later.
3. If your answer scrolls by and you cannot find it, e-mail or and the entire transcript will be mailed to you in a few days.
Let's remember, the MD and volunteers can handle only one question at a time, so if they don't see yours please be patient and ask again.
73 of us here now, good lord this is going to to be a packed house!
Ivette: Hi, I have recently been diagnosed with PCOS, I'm not overweight, no acne, no facial hair, just an irregular menstrual cycle. What type of diet should I be on? How serious is this?
EllenB: Erika: You say that you are on your 8th cycle of clomid. I'm not a doctor but I think the current wisdom among reproductive endocrinologists is to do no more than 4 or 5 cycles of clomid and then move on to either injectibles or a combination of clomid and metformin. There is a percentage of women with PCOS (@25%) who are "clomid resistant" so you may want to talk to your doctor about this. Ellen
maureen: Could pcos prevent fertilization to occur? I have had 2 IVF cycles on the first i produced 12 eggs - no fertilization and the 2nd i produced 17 eggs - 7 of which we left to their own devices again no fertilizaion.
Jennifer: Doctor, can you PLEASE address Clomid and why women are subjected to so many cycles before their doctors opt for an insulin treatment medication?
jen430: My menstrual cycle is very irregular. Is there hope?
drgrazi: Superfluous facial hair that is a result of PCOS is best treated by a course of oral contraceptive pills, followed by traditional hair removal. Generally, you need to wait at least 6 months to see the hair growth stabilize, then have it removed.
Pamela: Dr. Grazi....People are concerned whether weight for hold them back from getting pregnant..Can you address that?
spanish23: all my blood work was done all wa fine but i have all of these symtoms what should i do?
Apple: Dr, what medications/lifestyles get to the root of the PCOS problem? My doctor put me on the pill but that only brings on the periods
nikgot: Is there a reason that my body responded by producing a normal follicle the first 3 rounds of clomid, but not the last 2. Are my ovaries getting worse? And, is this decreasing my chances of conceiving?
wintrysun: Dr., can you tell me about Glucophage as treatment? My daughter is 17.Which "pill" is best?
Myrna: Dr. Grazi, I live in the Bronx. You said you clinic takes new patients, so what type of medical coverage do you take?
Charlene: Dr. Grazi, I'm 34 years old. Have one son, age 7. I concieved him after going right off the pill. Want another child. Just diagnosed with PCOS (probably had it all along). Tried 2 cycles of clomid (high doses). Did not even ovulate. Where do I go from here?
drgrazi: Fertilization failure in PCOS patients undergoing IVF is unusual. I would need more specifics to give you good advice.
AmyG: Is there any success taking Metformin for PCOS? Can this help achieve pregnancy
Veronica: Doctor, was is your thoughts about additional Lh in fertility injections? My doctors wants me to try a second month of Humegon.
EllenB: melln: I'm so sorry to hear of your miscarriages. Have they determined the cause? Have you seen a high risk pregnancy group? Ellen
pamels: Hello, my name is nadine I saw this on the new this morning and was wondering if I may havePCOS. I'm 44 yrs of age and have not seen a menustral in over 4 0r 5 years, I have put on a lot of weight. My husband and I tried to have a child but we couldn't. Please help any advise?
yvette43: Is someone out the hearing me?
Jessic678: I have internal sonograms performed everytime I go my GYN doctor and the results are always me having multiple cysts on my overies. I had a laporoscopy performed on me last summer and then put on the birth control pill but nothing seems to help me my doctor seems to give me no answers but tells me that I have POS. Can you please help me.
spanish23: i am 14 is it possable to have PCOS
Lynn: I don't get this.... The dr has only spoken once according to my screen! Are you guys getting your answers??
shana: Dr. Grazi
I have not been diagnosised with PCOC, but feel I may have it. All bloodwork and u/s have been normal. I have acne, irregular cycles, and facial hair. I got pg on 50mg of clomid, but m/c at 6 wks. I am back on the clomid, 100mg and we are trying again. Any suggestion?
Pamela: Dr. Grazi could you address Jennifer's question....
Doctor, can you PLEASE address Clomid and why women are subjected to so many cycles before their doctors opt for an insulin
treatment medication?
Jennifer: Lynn, more than once, but not answering the important questions
Julie2: yvette, yes we all see your messages
drgrazi: Glucophage for the treatment of PCOS is all the rage right now, but I think we need to wait for more data till it becomes the standard. Certainly, in a young woman who is KNOWN TO HAVE insulin resistance, it makes sense to use this if there are bothersome symptoms. Be careful, though - this will not be as effective, especially with hair loss, as the oral contraceptive.
William: Room FAQ:
1. The room scrolls by very quickly so change the "Messages" number, just to the left of the Log Out button, to a larger number like 99.
2. Best to type your question on a notepad or into a MS-Word document on the side, then cut+paste it into the message box here when you are ready to ask it. That way if it isn't answered the first time you can paste it in again later.
3. If your answer scrolls by and you cannot find it, e-mail or and the entire transcript will be mailed to you in a few days.
Let's remember, the MD and volunteers can handle only one question at a time, so if they don't see yours please be patient and ask again.
73 of us here now, good lord this is going to to be a packed house!
EllenB: AmyG: The research studies on metformin and PCOS are actually quite promising. One study in particular showed an 89% ovulation rate for women who were previously clomid resistant who took metformin and clomid at the same time.
caroline: I have PCOS after 8 years of trying. I had children without having fertility treatment (I had actually given up fertility treatment). I actually left it to god to get pregnant. I am currently on Spironolactone for the facial hair. I'm wondering if there is another way to go that will help me? I heard weight gain is part of the problem and I am a little overweight. Can I get some help?
gigi: I have changed my diet and cut out all sugar and refined carbohydrates. After doing so my cycle came back and I now have a 31 day cycle with ovulation on day 15. My question is do I still have pcos? Also, I have done a few saliva hormone assays and know that my progesterone is still very low. I have been using progesterone cream for several months and wonder what is a normal level of progesterone? I know I'm not there yet because I have pms like crazy. Gigi
Candace: Dr. Grazi
I am 21 years old. I was diagnosed with PCOS 3 years ago. I spent 2 years on Aldactone with some success, and then I was switched to Metformin after having irregular and heavy periods, which did nothing for me. Now, my weight is completely out of control, while my facial hair has somewhat subsided and my periods are normal on their own. What is the next step?
jen430: Hi, My name is Jennie, I am 31, overwieght, I have very irregular menstrual periods and I am trying to have another child. Are there any answers?
amanda: Is anyone getting questions answered?
amanda: Is anyone getting questions answered?
AmyG: Can a person who ovulates regularly and has a fairly normal menstral cycle and has PCOS become pregnant and not miscarry
alice: what are the current treatments for pco - specifically regulation of menstrual cycle and control of excess facial hair?
drgrazi: PCOS is generally not an indication to have laparoscopy done, except for certain cases where the cysts are vaporized or cauterized. We generally use this for women who cannot take medications for some reason. It is important to remember that even then, it is never a "cure."
Erika: Ellen: I'm trying Met this time so the doctor thought it was worth the try. He won't do injectibles while I'm on met.
tesca: I only found out about this disorder this morning Iam 27 and have had all these symptoms since I began mensturating I have gained 20lbs in under 2wks I am now 190lbs up from 120lbs and have been diagnosed with anovulation I don't even know if i can ever get pregnant I don't get a period unless I am on medication I have undergone several tests and spent several thousand dollars I just want to understand what is going on with my body.
bak19: if you are hyperinsuliemic your doctor may perscribe metformin. for many women it does help regulate cycles by lowering insulin levels. Metformin is not a cure all for PCOS and does come with side effects but right now it is one of the best medications available for some women with PCOS
Pamela: Dr. Grazi is typing as fast as he can..he is answering questions...Ellen B and Beth are also here and they are aia pcos coordinators. They are helping answer questions!
Jennifer: I think there must be some pre-fab answers here and that's why we're not getting our specific questions answered.
kerry: Doctor, one thing I haven't mentioned is that I had a large cyst removed from my left ovary and my doctor says my hormones are out of wack. I have to high estrogen and now being overweight does not help the cause. But I feel like where did this weight come from? I don't know! I gain weight very easy, my body does not have any mercy. I have not been diagnosed with anything and I actually made an appointment with you on April 13th. I hope you can help me.
shana: Dr. Grazi
Would I be a good choice for the Met. I have acne, irregular cycles, and slight facial hair. I got pg on 50mg of clomid, but m/c at 6 wks. (My dr. feels the m/c was caused by a lack of progestron, b/c at 6 wks my level was only 13.1. I m/c 5 days later. I am back on the clomid, 100mg. I seem to respond well to the clomid, but wonder if Met might be a better choice.
T30: HOW CAN WE G0ET IN CHAT ROOM?
melln: EllenB- Unfortunately we don't have any groups for high risk pg. Now I'm on metformin and have lost 60 pounds and still I cannot carry. The dr hasn't even done anything to find out why. I am getting very frustrated.
drgrazi: Folks: you can't believe how quickly your questions are flying past my screen. SOrry I can't answer everyone, despite my significant typing skills.
Lynn: Dr Grazi: Do you feel that glucophage will regulate my periods along with Clomid for ovulation?
Pamela: Beth is Bak19!!!!
Julie2: caroline, I have left it to God also. But he isnt answering my prayers. Glad he did for you
Pamela: T30..you are here!!!
wintrysun: Glucophage or "the Pill" for a 17-year-old? Which pill? Please advise.
ba: Dr. Grazi, I am not sure if you recieved my message, Do you know of any possible side effects of taking provera 10mg x 10 days before you knew you were pregnant (about 1-2 weeks after conception)?
Pamela: No Jennifer...no prefab answers!
Veronica: Doctor, was is your thoughts about additional Lh in fertility injections? My doctors wants me to try a second month of Humegon.
drgrazi: A 31 y/o overweight woman with PCOS has many options. The first step is to see your doctor and implement a wt loss program. At some point in time, however, ovulation induction with medications will likely be necessary. While you are doing all that, please also don't forget to have your husband checked out. It takes two to Tango!
Jennifer: Dr. Grazi,can you please answer why so many women are subjected to such high and dangerous doses of Clomid when it usually does NOT work for PCOS women and they end up with the heartbreak of miscarriage frequently when they DO conceive????
Liz: What medical insurances does your office accept, I need to get referrals to see a specialist, I have Aetna U.S. HeathCare? Can I get a referral to see you?
EraDee: What exactly are the symptoms of POS?
LEE: WHAT dR CAN i GO TO TO HAVE THIS CHECKED? A REG DR. OR A GYNO ?? ANYBODY WHOS BEEN DIAGNOSED CAN ANSWER, THANKS
sunflower: Hi. I am 26 years old and very overweight.
I have been diagnosed as having PCOS. I
have almost non-existent periods. Although
I know I need to lose weight not only to
control PCOS but for my general health,
would I be able to get pregnant with
treatment without losing weight?
would I be able to
Mae: I have hairloss on the crown of my head I believe due to me having PCOS. I went off the pill because I felt it was contributing to my hairloss. Do you have any suggestions? I need to lose 50 lbs, would that maybe help my hair problem? Do I need to follow a certain diet? I have acne and bad skin on my arms, is this due to PCOS? Thanks, Mae
amanda: Is anyone answering questions? Please advise.
maureen: I have regular periods and i suspect regular ovulation. I have responded well to fertinex not as well to pergonal and clomid. My blood test for the pcos was negative. How accurate are the blood tests? I have many of the other symptoms, overweight, facial hair, inability to conceive and then this lack of fertilization.
bak19: excess hair can be treated by laser hair removal, electrolosis, and sometimes with a medication called spirnolactone. Tweezing is not great - shaving is better.
AmyG: Ellen B. I do ovulate on my own and have a regular cycle. I am overweight but have a big sweet tooth. I am now on weight watchers. I also have some facial hair. I would like to avoid taking Clomid I was wondering if Metformin would help
drgrazi: regarding exposure to Provera in pregnancy, the data seem to be reassuring. I would get a detailed sonogram during the midtrimester, but expect a good outcome!
Julie2: lee, I was finally diagnosed by a gynecologist/fertiltiy specialist
cherra: Dr. Grazzi PLease your opinion on low-carb diets and PCOS and infertility GOOD BAD???
EllenB: Alice: The treatments for PCOS are, in general, either symptom based (such as spironolactone for excess facial hair and acne) and birth control pills to regulate the menstrual cycle or fertility medications to induce ovulation or targeted at the underlying metabolic condition such as metformin (glucophage) which treats the insulin resistance that some women with PCOS have but according to research studies, also restores ovulation. In terms of facial hair, there is either spironolactone which suppresses new hair growth but doesn't target existing hair and electrolysis and other hair removal methods and there is supposedly a new product coming out this year that will be topical and take care of the hair. ellen
bessie: Dr. Grazi, Im on day 14 with Gonal F, multiple folicles measuring 15/13, estradial 1097, how high can the estradial go before having to stop cycle
Candace: Dr. Grazi
I am 21 years old. I was diagnosed with PCOS 3 years ago. I spent 2 years on Aldactone with some success, and then I was switched to Metformin after having irregular and heavy periods, which did nothing for me. Now, my weight is completely out of control, while my facial hair has somewhat subsided and my periods are normal on their own. What is the next step?
Pamela: Dr. Grazi, Ellen B. and Bak19 are answering questions.
Devans: My doctor has prescribed Chlomid for me what are the chances that this medication will be successful in becoming pregnant? what are the statistics of women who develop cancer of the uterus by not treating pcos.
drgrazi: Generally, you know when you have PCOS if you have irregular or absent cycles, and have signs of excessive male hormones such as acne or hirsutism.
shana: Dr. Grazi
Would I be a good choice for Met? I am 27, have irregular cycles (30=50 days), acne, and facil hair. I am not at all overweight. All blood work and u/s have come back normal. I got pg on 50mg of clomid, but m/c at 6 wks. The dr. thinks the m/c might have been caused by a lack of progestrone. I am now on 100mg of clomid, and we are trying again.
maureen: I should add to my post -- I conceived 4 years ago with iui and pergonal. The pregnancy came after a 20 pound weightloss
Jessic678: Is anyone there to respond to my question?
amanda: Hi Lee, I go to a reproductive endocronologist for treatment.
Jessic678: Is anyone there to respond to my question?
William: I'll take the insurance question but I'm sure Dr. Grazi may also reply. My hunch is that AETNA is accepted at his office since AETNA is one of the larger health insurers. However, you need to understand that not every AETNA policy has the same coverage for infertility. You may be able to get coverage for PCOS, but they may refuse to cover anything that is designed to get you pregnant. I know, it sounds stupid, but that's they way a lot of health insurance policies are writted. Treatment of the underlying cause of infertility may be permitted, but not something like IVF that is designed to overcome the infertility and lead directly to a pregnancy.
1939: Dr. Grazi my dtr is 41yrs old has been through 3 cycles of clomid/folistim and told that one ovary is not producing follicles and this last cycle she had 2 eggs that did not mature and disappeared..saw the program this am on TV..and she did have wt gain and hair loss prior to beginning the cycles...what to look for please help us
Julie2: cherra, although I am not a DR I have heard great things about low carb diets...
Lynn: Please answer my question. I'm on glucophage to help regulate my periods. What do you think of this treatment? I'm going on Clomid at the end of the month. Do you recommend this treatment?
caroline: I had a laporoscopy done (for cysts in the ovaries). I've been on clomid. I have irregular cycles. I've been on birth control to regulate my cycle. I have facial hair. I even had an DNC because I had heavy bleeding at one point never got pregnant and like I said before after trying for 8 years. I had given up on everything and left it to God. I have 2 beautiful children. But, I am currently on spironolactone for my face and I'm wondering is there something out there that can help me with my weight gain?
LEE: THANKS JULIE, I AM OVERWEIGHT AND HAD FACIAL HAIR GROWTH BUT NEVER HAD A PROBLEM W/ GETTING PREGNANT OR PERIODS, I HAVE 3 KIDS AND THIS FACIAL HAIR & ACNE STARTED AFTER MY LAST PREGNANCY, COULD THIS BE PCOS?
cherra: Hello
yvette43: Dr. In the past year I ballooned to 190 lbs having alot of skin problems, irregular menstrual cycles, serious pain with my period, I was diagnosed with diabetes and taking glucophage. I have lost 30 lbs in the last 5 months. My period are still coming with servere pain, I'm growing a mustache. What are pcos and how do I know If I have them.
evj313: Dr. Grazi, where is your office center located? Is it @ Bklyn Hospital, in downtown Bklyn? I work in the Health Care field,w over 38 Primary Care Phys.Quite often the response to my infertility questions is ,you must lose weight,when my diet is not the problem.Most likely PCOS.Why are so many Physicians quick to solve everything w weight loss.Also this will be valuable info for patients seen in our office which i can pass on to the Physicians. Please advise.The anguish of being motherless is almost unbearble
cherra: Thanks Julie
Jennifer: How many of us have to ask about Clomid before it is addressed?
EllenB: Just a reminder. If your questions do not get answered tonight, please come to the AIA PCOS message board (it's a separate message board). Two doctors have been helping to moderate the board and answer questions. Ellen
Liz: I am on Weight watchers now, I have lost 20 lbs already and I am losing more as I go by eating healthy, I have had weight problems for many years and I also have experienced large amounts of facial hair due to this disorder. Is electrolysis a good thing? Will insurance cover this since it is for a medical condition and will they pay for the birth control pills as well since this is treatment for the disorder?
EraDee: Could POS be genetic? I haven't had my period up to six months at a time. My mother told me that the females in my family have some sort of horomone problem, but she was not specific? Could this be it?
drgrazi: Let me make a general comment to those out there who are struggling with wt loss. In general, MDs do not like to treat if you are very overweight, as this puts the pregnancy in some jeopardy even if the treatment succeeds. That is why you should try your best to avoid carbohydrates and EXERCISE!. When all else fails, however, ovulation induction is usually successful. You may need need to try a variety of medications before you succeed.
lauren: Can you still have PCOS with very regular periods (every 30 days exactly)
yvette43: I'm doing everything I can for the acne which I have never had and nothing is working.
dpj: Ellen, is the AIA message board the same as the bulletin board for PCOS?
William: Jennifer, please repost the question and Dr. Grazi or one of Pam's other volunteers will get to it. Please keep in mind, there are 75 people online in this room right now.
taracrash9: Hi, I have had irregular periods since I am 16, I am now 27. I bleed for months at a time, and then stop for a few weeks, and again my period comes back. Over the past couple of years I have grown facial hair and I am more over weight then ever, I am trying VERY hard to get pregnant, for the past 6 years and nothing. PLEASE tell me what kind of dr., I can see to help me, my GYN and all GYNs always want to give me birth control, but I have a HIGH Cancer rate in my family and dont want to do that, please tell me what DOCOTR I need to see !!!!!
drgrazi: Shana: Metformin might work, but if you succeeded with Clomid already, that is likely to work again. Just make sure that this time you are carefully monitored during your cycle BEFORE you ovulate, and consider adding in progesterone just after you ovulate.
Pamela: Jennifer--ask your clomid question again!!!
spanish: i am 14years old i have excess hair growth,weight gain,ance,irregular periods could i have PCOS my mother & I want to know
bak19: for general questions on PCOS after the chat visit the pcos center on the aia website. As far as diet goes many women feel much better and do drop pounds on a diet that restricts carbohydrates. There are books available by Dr. Atkins, Dr. Richard and Dr. Rachael Heller and by Dr. Sears that will help
Julie2: lee, you are very blessed to have 3 children. If only everyone was that lucky...
kls: I am a 28 year old woman with no interest right now in having a child. However, my endocrinologist says I do have PCOS - I almost never get my period but I get PMS, it is really uncomfortable and I'm worried about infertility in the future. I am not overweight, I have been on a low-carb diet, and I'm in excellent health. I HATE the pill, and have tried aldactone and glucophage which worked for awhile but don't anymore. I'm at my wits end, any suggestions?
Jennifer: My question is why so many women are subjected to high and dangerous levels of Clomid before their doctors even consider giving an insulin sensitizing drug. Why are doctors to ill informed?
wintrysun: Dr. Thank you for Glucophage info.Which oral contraceptive do you recommend?
drgrazi: Some women with regular periods have ovaries that appear polycystic on ultrasound, but they do not have the PCO SYNDROME.
Veronica: Doctor, was is your thoughts about additional Lh in fertility injections? My doctors wants me to try a second month of Humegon.
PLEASE RESPOND...I DON'T WANT TO WASTE ANOTHER CYCLE!
Tonie: What causes PCOS and how can I prevent it.
Candace: Dr. Grazi
I am 21 years old. I was diagnosed with PCOS 3 years ago. I spent 2 years on Aldactone with some success, and then I was switched to Metformin after having irregular and heavy periods, which did nothing for me. Now, my weight is completely out of control, while my facial hair has somewhat subsided and my periods are normal on their own. What is the next step?
drgrazi: The best treatment for PCOS-related acne is oral contraceptives.
Dee: Dr. Grazi. Everyone seems to complain of being overweight. I have been struggling with being underweight throughout all this. I weight 90 lbs and can't gain at all. Does this contribute to the PCOS or maybe another underlying problem?
Jennifer: Oh, and that Clomid does not usually work as the sole treatment for infertility in PCOS women, and that when it does end up in conception, that 20% miscarry
alice: Are hot flashes part of the symptom profile? What are some of the long term complications of untreated pco(i.e., diabetes)?
cherra: THANK YOU DR. GRAZZI, I KNOW WE ARE BOMBARDING YOU WITH QUESTIONS.
EllenB: To get to AIA's PCOS message board, go to the AIA homepage (americaninfertility.org) and then click on PCOS or PCOS Message Board.
shana: EllenB
You seem to know alot about PCOS? Are you a nurse or a dr.? Would you mind trying to help me with my question. I got pg on 50mg of clomid, but m/c at 6 wks. I am now on 100mg of clomid. I have acne, irregular cycles, and facial hair. When I am on the pill, everything is fine. I am not at all overweight, and my dr. seems to think that is a big indicator of PCOS. All blood work and u/s have come back normal. I was wondering if I should continue on the clomid, or try the Met. I haven't talked to my dr. about it yet. I am currently in the 2ww, but trying not to get my hopes up. Any suggestions?
drgrazi: Any oral contraceptive will be effective with PCOS. The one that has been specifically marketed and approved for treatment of acne is Ortho Tricyclen.
ba: Dr. Grazi, Thank you for your time!!! Do you know if there is a greater chance of miscarriage with PCOS patients? I just found out that I am pregnant, took blood test todat and HCG was about 2200, what does this mean, and should I have it done again?
bak19: even if fertility is not your concern seeing a reproductive endocronoligist is a good way to find a doctor who treats PCOS they are also called RE's
greenacres929: Dr. Grazi
I am 35 years old, I have facial hair, I'm over weight, I'm also losing hair on my head and I was diagnosed with diabets when I was 17 years old, and my menstral cycle runs anywhere from 35 to 40 days (instead of 28 days) and very heavy, could I have PCO.
Ivette: I just recently started using clomid 50mg. I ovulated and had a regular menstrual on a 32 day cycle. Why did my doctor put me on a higher dosage?
William: Jennifer, I'm not an expert on this but we have many here. I have read medical journal articles stating that long-term use of clomid is related to ovarian cancer. However, more recent studies that have used better statistical controls have failed to show this relation. I'm no expert when it comes to other side effects associated with high clomid dosages, though.
susan: I just heard about pcos this a.m. Can you tell me what it means. From what I heard I have 4 of the 5 symptons
yvette43: I have been asking questions for 20 minutes and have not gotten one answer yet.
amanda: Please let me know about Prednisone and treatment of PCOS/adrenal hyperplasia. I take 5mg a day
lpk: I have been dx with pcos. I do not ovulate at all. Gonal f has been successful at low doses ( I tend to hyperstimulate easily). Ijust had my 3rd iui fail. Only started met 2 months ago. Also just had lap. Question? How many iuis should I give it before considering ivf? No male factor. Only prob according to re is annovulation.
tracy: if your an ivf patient can it be possible that you can have a miscarraige if your on the wrong medication? what medications do you recommend for pcos?
EllenB: taracrash: If you have been trying to get pregnant unsuccessfully for 6 years, you should see a reproductive endocrinologist (or RE) if you have not done so already. An RE is an obstetrician/gynecologist who has gone on to do additional training (a fellowship) in infertility and other reproductive and hormonal disorders.
sonata565: what treatment is best for hirsutism?
Livvy1: Liz, electrolysis is scary and painful. I am going to try laser hair removal.
Lynn: I HAVE PCOS AND WEIGH 239. IS IT DANGEROUS TO GET PREGNANT. i CANT SEEM TO LOSE THE WEIGHT.
drgrazi: Jennifer: a complicated question, and a pet peeve of mine. You are right that clomiphene is an abused drug. The reason for this is that it has a wide window of safety, is cheap, is effective in some women, etc. But I agree wholeheartedly that it should not be used until a specific diagnosis is arrived at. You are wrong to assume, however, that treatment with insulin sensitizing agents are always preferred. There are some downsides to them, too. Also, making the diagnosis of insulin resistance is not straight-forward.
melln: are you born with pcos, or does it have an onset at a particular age?
spanish: doc, i have the irregular period the excess hair growth the & whole nine what should i do is there any other way to tell that i have it
MG: DR. How much extra weight is weight enough to be come a problem. Also how long should a first child be weanec before starting another round of IVF and is there anyway to induce a period after wweaning so that I can begin another try for an IVF baby
Livvy1: Ditto to you Sonata.
drgrazi: Greenacres: Yes.
nikgot: Is there a higher rate of miscarriages on gonadotrophins, like follistim? If so, why?
Jennifer: Thank you for answering my question Dr. Grazi
Candace: Dr. Grazi
I am 21 years old. I was diagnosed with PCOS 3 years ago. I spent 2 years on Aldactone with some success, and then I was switched to Metformin after having irregular and heavy periods, which did nothing for me. Now, my weight is completely out of control, while my facial hair has somewhat subsided and my periods are normal on their own. However, over the past few months I have become extremely tired/exhausted easily.. is this part of PCOS? What is the next step in a case like mine, drug-wise?
shana: Some people are being very rude. Dr. Grazi is gracious enough to give up his/her time, and is trying hard to answer all the questions. Please refrain from making rude comments! He will get around to the clomid question in just a minute.
Barbara: Hi,I am a 38 year old mom. I strongly suspect I have PCOS...I am trying very hard to have another child but have not conceived in almost 7 years....I would like to know where in Brooklyn the Doctor is located and what hospital he is associated with
LEE: my acne has been diagnosed as rosacea, can this be considered the "acne associated with the pcos?
Jennifer: What are the downsides to the insulin sensitizing medications?
drgrazi: ivette: I would not dare to answer for your doctor. An ovulation is an ovulation. Unless you were diagnosed with an ovulatory abnormality while on the lower dose, I would stick with it.
spanish: doc, i have the irregular period the excess hair growth the & whole nine what should i do is there any other way to tell that i have it

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MG: Yvette - have you been hitting send after you write the question, if not you have to do that
William: Room FAQ:
1. The room scrolls by very quickly so change the "Messages" number, just to the left of the Log Out button, to a larger number like 99.
2. Best to type your question on a notepad or into a MS-Word document on the side, then cut+paste it into the message box here when you are ready to ask it. That way if it isn't answered the first time you can paste it in again later.
3. If your answer scrolls by and you cannot find it, e-mail or and the entire transcript will be mailed to you in a few days.
Let's remember, the MD and volunteers can handle only one question at a time, so if they don't see yours please be patient and ask again.
Julie2: lynn, again I am no DR, but I have been made aware that having PCOS and being over wieght is like a catch 22...Some people say being overwiehgt causes PCOS and others say having PCOS can cause you to be overweight..it really sucks...
Liz: William, if I call Dr. Grazi office will they be able to tell me whether they accept the insurance. My doctor now seems reluctant to do anything for me but put me on Provera to bring on my cycles and then Birth Control (Alesse) Should I see another doctor for a second opinion? What are my options here since I do have the Aetna US Healthcare HMO?
Rosina22: I have PCO and was able to get pregnant after 3 cycles of clomid, IUIs then 2 cycles of follistim and IUIs. I lost the baby at 19 weeks. After I lost the baby,I've done my 3rd cycle of follistim and IUIs and will find out the results this Friday. If it doesn't work, should I move on to IVF or stick to IUIs?
EllenB: Women with PCOS do have a higher rate of miscarriage (as high as two times that of other women according to some studies) but it's not clear what the precise cause is. Some have speculated that it is the higher than normal LH to FSH ratio. Obesity itself is a cause of miscarriages as is diabetes so there may be many factors involved.
sonata565: what treatment is best for hirsutism?
yvette43: Hello, can anyone answer my questions.
drgrazi: Women with PCOS do have a higher incidence of miscarriage. The reasons for this may largely be due to weight, as it is known that being overweight increases the risk, independent of ovulation problems. There also is probably a higher risk of miscarriage with use of fertility drugs, particularly clomiphene, because of its antiestrogenic effects on the uterine lining.
caroline: hello! Are we conversating
Jennifer: I have had great success with electrolysis. It's not that bad once you get used to it, and it is permanent.
nikgot: Thank you for your help.
lucy: DR, I am 32, diagnosed with PCOS through u/s. I also
have symptoms like very irregular period,
overweitght (5'4", 140lb), facial hair.
I took clomid for 4 cycles, one ov,
no pg. I suggested metformin to my OB/GYN.
However he doesn't think it would work for
me because blood test shows that my
fasting insulin and glucose level are normal.
Should there be other test to determine insulin resistant.
You mentioned in your previous answer that IR itself
is hard to determine. What does that mean? Thanks.
cherra: Thank you again Dr. Grazzi for taking the time to answer ALL these questions.
Candace: I have had success with electrolysis as well. The pain is worth it!
drgrazi: Spanish: a history and physical exam by a qualified MD will likely confirm the diagnosis of PCOS.
wintrysun: Ellen b and Beth, canyou recommend an endocrinologist in NYCity or Westchester County, NY?
Julie2: EllenB, excuse me if I am wrong and I am not trying to be rude but having PCOS, being overweight and having diabetes can all cause M/c's? Then I am doomed all around..I have all of those...it all seems hopeless
Ivette: What type of diet should I be on to control/prevent symptoms?
Liz: Thanks Livvyl, did your insurance company pay for the electrolysis, I am on a low budget and it is hard since my docto's do not seem very cooperative with me on this. Part of the reason I am here is because all was not exlained to me.
nikgot: I'm concerned about hyperstimulation on follistim. Can you comment on the best way to proceed with this treatment for the PCOS patient?
spanish: i went to see a docotr & he noticed the hair on my upper lip & on the sides of my head & alot of hair on my arms he said it was strange for me to have it there
Erika: IS taking Clomid for 8 days at 100mg OK? Is this a new regiment? Wil it be beneficial for a woman with PCO?
drgrazi: The downside of Rezulin, which was once widely advocated (and very successful at inducing ovulation), is liver failure and, in some cases, deaths occurred. (Pretty serious complication.) With Metformin, you can get a condition called lactic acidosis. This is preventable if you are properly forewarned. Also,Metformin cannot be used in women with kidney disease.
spanish: thanx doc
EraDee: Can POS be genetic and be considered
as a horomone imbalance??
Jennifer: My insurance company did not pay for electroysis,I doubt that one would. If you find a compassionate professional electrolygist, they will usually give you a break on the price. Mine did, and she is great.
William: Liz, yes if you call his office you can find out if they accept AETNA. However, that doesn't mean that your AETNA policy necessarily covers you at Dr. Grazi's office. I know this sounds bizarre, but there are too many factors involved; geographic location, your employer's preferences in what policy they purchased from AETNA, and most important, what level of infertility coverage you have with the AETNA policy. Not all AETNA policies have good infertility coverage. HOwever, one thing I have learned from women who push for coverage, the more noise you make in demanding coverage from yoru insurer, the more likely it is you will get treatment covered. Also, remember it is not in Dr. Grazi's hands; he'd love to accept your insurance, but AETNA may limit what they'll pay for Dr. Grazi's services, espeically when it comes to things like injectible medications and IVF.
Barbara: Hi,I am a 38 year old mom. I strongly suspect I have PCOS...I am trying very hard to have another child but have not conceived in almost 7 years....I would like to know where in Brooklyn the Doctor is located and what hospital he is associated with
Mae: could you tell me what if anything can be done for hair loss on the crown of the head, and acne? Any solutions besides the pill? Tks Mae
yvette43: I haven't been to see my gyn in about 2 months. My reason is because I did'nt feel they were doing anything to help me. they didn't seen to know what was wrong with me
sonata565: what is the best treatment for hirsutism?
bak19: insulin sensitizing meds cause some unpleasant side effects. These can sometimes be avoided by starting the medication very slowly - a quarter pill for a week then a half for a week and work up the dosage very very slowly. Eating with the med helps but try to restrict carbos
Veronica: Doctor, was is your thoughts about additional Lh in fertility injections? My doctors wants me to try a second month of Humegon.
PLEASE TRY TO RESPOND...THANK YOU
drgrazi: Candace: Get rid of the carbohydrates and get on the treadmill. I don't mean to sound insensitive. This is very hard work and I know it, but that is the most effective way to treat your condition at this point.
Jennifer: Thanks Dr. I knew about those side effects. I'm on Metformin now, just struggling with the stomach upset and loss of appetite, but at least I'm losing a few pounds.
Lonneda: I was just diagnosed with PCOS today and my doctor prescribed spironolactone. I am afraid of taking the pill because I am 32, obese, and smoke. Has anyone heard of this medicine and does it work?
lori: I had electrolysis on my arms - all the hair is back ... My luck was not so great - but it really isn't that painful.
tammy: Hello, I have just found out that I have PCOS. Right now I have just finished taking Provera. Still waiting on my cycle. How long does it take?
drgrazi: Lee: Not sure.
MG: Jeifer, where are you located. If in the NYC area I would love the name of your electroysis person
Julie2: mae, thats a great question! I have been experiencing male pattern balding for over a year now..
Pamela: I want to let everyone know that if they are new to AIA, we have pcos support groups in the NY area and a wonderful monthly newsletter. If you want to get an information packet to learn more about everything we can offer you please send me an email at
Candace: Dr. Grazi
Thank you for answering. Since I am having regular periods, do I even need to be on medication, though?
Jennifer: I'm on Long Island, she treats a lot of women with PCOS
266: Hi everyone and dr. grazzi. I am a 33 yr old diagnosed with pco 9 months ago after 2 miscarriages.I failed clomid-4 cycles and today i had a hysterosalpingogram that showed possible tubal damage or adhesion.i am scheduled for laporoscopy next month and am scared to death.Dr. also said my uterus was twice the normal size.What does this mean and where do i go from here?
faithann: JULIE I HEAR THAT SAME HEAR AND ITS KILLING ME
Livvy1: Liz, electrolysis is almost always considered a beauty treatment, but insurance companies might cover laser hair removal if a doctor refers you to dermatologist who performs it. Candace, how did you get used to electrolysis?
drgrazi: Barbara:I am the Director of Brooklyn IVF. We have offices in Brooklyn, Staten Island and Hewlett, Long Island. Our main phone # is .
amanda: Can someone tell me about PRednisone and PCOS. I take 5mg a day.
William: Insurance will pay for electrolysis only in cases of severe hirsutism, and even then you have to work the system in most cases. Some cosmetic treatments are covered, but only when the level of problem is severe.
pamels: Hello again I was just wondering if anyone has recieved my first question and will it be answered. I'll ask again I'mm 44 I have not seen a menstrual for 4 or 5 years I have gainedalot of weight since then. My husband and I tried to have a child be we could not. Is it possible I may have PCOS? Pleae Help
lml: dr. what medications are now prescribed for pcos.
MG: Jennifer, thanx for answereing
Jennifer: I'm on Long Island, she treats a lot of women with PCOS
taracrash9: Hi, I have had irregular periods since I am 16, I am now 27. I bleed for months at a time, and then stop for a few weeks, and again my period comes back. Over the past couple of years I have grown facial hair and I am more over weight then ever, I am trying VERY hard to get pregnant, for the past 6 years and nothing. PLEASE tell me what kind of dr., I can see to help me, my GYN and all GYNs always want to give me birth control, but I have a HIGH Cancer rate in my family and dont want to do that, please tell me what DOCOTR I need to see !!!!!
bessie: Do you suggest taking glucophage with a normal insulin level pbut diagnosed with PCOS?
Erika: How do we prevent lactic asidosi from hapening while on met?
Julie2: DR Grazi, this is my first question I am asking. What do you recommend for a patient that has tried Metformin, clomid, lossing weight, and actos with none working?
Candace: Livvyl
Just a high tolerance for pain, I guess... I had a LOT of hair on my neck/sides of face and that was the worst part. There is also a cream that you can use (prescription only) called EMLA.
EllenB: Jennifer: Good question re: the downside of insulin sensitizing medications. As Dr. Grazi correctly said, these are all the rage in PCOS treatment these days and the studies do look promising but there are problems as well. First, none of these medications have been FDA approved for non-diabetic women with PCOS so any use of them is "off label." One of the insulin sensitizing agents, Rezulin (troglitazone), has been linked to something like 50 deaths and major liver damage so anyone using this drug should at the very least be monitored carefully by their physician. While metformin does not appear to have such serious side effects (except for lactic acidosis in a very small number of cases) and has been used as a treatment for diabetes in Europe for well over a decade, there are gastrointestinal side effects (nausea, diarrhea, etc.). A very interesting drug called d-chiro-inositol is still in the clinical trial phase but is being targeted specifically at PCOS. The preliminary data on this medication are encouraging. But, as Dr. Grazi, said, the jury is still out on these drugs.
drgrazi: Lonneda: Spironolactone has been used for the treatment of hirsutism for many years. It is generally safe. It works by blocking the androgen (male hormone) receptor at the level of the hair follicle, thus reducing hair growth. Possible side effects include low blood pressure and potassium loss.
Liz: Thanks again William, I will try and give the insurance company a call again, now I just need to get my doctor's to write the referral for me to Dr. Grazi..
Jennifer: Again, my email address is and I'm always looking for other women with PCOS to share information and experience with. Feel free to email me at your convenience with any questions, comments, etc.! :-)
Christine: Greetings to the Doctors. I have a question about PCO and miscarriage. I've had 3, and am currently pg now. I am very scared of mc again. What can I do, if anything to prevent it?
Lynn: Dr, please tell us about glucophage more. i do crave sugar more since on it. Is my sugar level going too low?
lori: Dr. - what is your opinion of "The Carbohydrate Addicts Diet"? I have been reading this book and it seems like it may be a way to go. It seems as though carbs are a big pain for many of us....
1939: Dr. Graze, My question is my dtr had 2 cycles of lupron/follistim/humegon and only 2 follicles .6cm were produced and disappeard..ques. how can I find out if I have PCOS. I am seeing a physician in NYC for infertility..
AmyG: I have PCOS, with facial hair, overweight, hairloss. I have regular periods and suspect that I ovulate. What are my chances of becoming pregnant with diet changes and no medication
lee: jennifer, What DR on long island are you referring to?
spanish: doctor noticed hair on the side of my face on my upper lip & that i had alot of hair on my arms he said that is was werid for me to have here in those places
drgrazi: Veronica: generally, women with PCOS have high LH levels, so use of FSH alone is equally effective. There may, however, be a specific reason your doctor wants you to use an LH containing medication. I don't think it can hurt.
jen430: My name is Jennie. I am 31 yrs old, very irregular periods, some facial hair, overweight and I am trying to have another child and I would like to know what kind of help is there. My GYN has never mentioned PCOS. HELP
Julie2: EllenB, excuse me if I am wrong and I am not trying to be rude but having PCOS, being overweight and having diabetes can all cause M/c's? Then I am doomed all around..I have all of those...it all seems hopeless
Jennifer: Dr. Steven Brenner in Lake Success
yvette43: Yvette 43 here reaching out to someone. Please can I get some help
drgrazi: Julie2: If pregnancy is the goal, gonadotropins (such as Gonal F, Follistim, Repronex, etc) are the answer.
266: Hi everyone and dr. grazzi. I am a 33 yr old diagnosed with pco 9 months ago after 2 miscarriages.I failed clomid-4 cycles and today i had a hysterosalpingogram that showed possible tubal damage or adhesion.i am scheduled for laporoscopy next month and am scared to death.Dr. also said my uterus was twice the normal size.What does this mean and where do i go from here?
EllenB: Jennifer: Good question re: the downside of insulin sensitizing medications. As Dr. Grazi correctly said, these are all the rage in PCOS treatment these days and the studies do look promising but there are problems as well. First, none of these medications have been FDA approved for non-diabetic women with PCOS so any use of them is "off label." One of the insulin sensitizing agents, Rezulin (troglitazone), has been linked to something like 50 deaths and major liver damage so anyone using this drug should at the very least be monitored carefully by their physician. While metformin does not appear to have such serious side effects (except for lactic acidosis in a very small number of cases) and has been used as a treatment for diabetes in Europe for well over a decade, there are gastrointestinal side effects (nausea, diarrhea, etc.). A very interesting drug called d-chiro-inositol is still in the clinical trial phase but is being targeted specifically at PCOS. The preliminary data on this medication are encouraging. But, as Dr. Grazi, said, the jury is still out on these drugs.
maureen: My blood work for pcos came back negative. Having said that my dr. sees some irregularities in the ovaries, i have developed facial hair, am unable to lose weight and have been ttc for 5 yrs. Did have one pregnancy after a 20 pd weight loss which resulted in miscarriage. 2 subsequent Ivf cycles resulted in no fertilization. Is this pcos?
Myrna: Dr. Grazi I'm 28 yrs. overweight by at least 60lbs. Menstraul cycle has been absent (7 times in entire life). My doctor did all the blood test and sonograms and he said I had high male testosterone but everything else was ok. I went on birth control pills for about 4 months and then got off due to side effects. About 2 yrs. ago I got pregnant and miscarriad at 2 months. I have excess body hair/facial (chin area) and dark blemishes on the back of my neck and mid chest area and gain weight at times excessive but mainly in midsection. I believe I have PCOS, could confirm by these symptoms. Thank you.
wintrysun: Dr., Ellen, Beth or anyone...which oral contraceptive is most effective treatment of PCOS?
drgrazi: Pamels: Make sure you are not in menopause! If not, you are going to need gonadotropins. Don't forget that age is a big factor with fertility, so get moving with this soon.
lpk: I have dx of pcos. I have one failed ivf (due to hperstimulation of iui cycle). 3 failed iui's. I am totally annovulatory with absolutely no cycles. Gonal f works inlow doses. I have only been on Met 2 months. Question: When do I move on to IVF again.
melln: What is lactic acidosis? I've been on met for 2 years and my dr didn't say anything about this.
caroline: Is there a Doctor that you can recommend in New Jersey to see? I live in New Jersey and I have PCOS. I have children but, I would like to get rid of some of the other problems I have facial hair, overweight etc. Do you have someone to refer to me that would put me on treatment?
spanish: doctor noticed hair on the side of my face on my upper lip & that i had alot of hair on my arms he said that is was werid for me to have here in those places
Julie2: DR grazi, thank you very much for answering me..I appreciate it. I will be trying me second injectable cycle hopefully soon. On my first one I hyperstimed and got two blood clots in my lungs as a result
carole: taking Glucophase, does this help with excess facial hair growth?
kerry: doctor, my father is a diabetic. He has had problems with his weight ever since I know. Could this be the factor in pcos? I am not diagnosed with anything, I am trying to learn more about what is happening to me.
spanish: doctor noticed hair on the side of my face on my upper lip & that i had alot of hair on my arms he said that is was werid for me to have here in those places
indi: Is there help for PCOS
rachelle: help. I'm really scared, i've had 2 miscarriages in the past 4 months. I'm 38 years old and trying to get pregnant for the first I have been diagnosed with pcos and both pregnancies ended in the 7th week! Is it more likely genetics, or hormonal? I am really scared!!!
mich: I have been diagnosed with PCOS for about 2 years now, just to let everyone know there is help available for all who suffer. For severe hair growth, which I had, the medicine aldactone has worked miracles.
drgrazi: Maureen: PCOS or not, someone with two failed fertilization cycles at IVF needs to seriously consider other options. Was ICSI done? If not, do it.
William: Room FAQ:
1. The room scrolls by very quickly so change the "Messages" number, just to the left of the Log Out button, to a larger number like 99.
2. Best to type your question on a notepad or into a MS-Word document on the side, then cut+paste it into the message box here when you are ready to ask it. That way if it isn't answered the first time you can paste it in again later.
3. If your answer scrolls by and you cannot find it, e-mail or and the entire transcript will be mailed to you in a few days.
Let's remember, the MD and volunteers can handle only one question at a time, so if they don't see yours please be patient and ask again.
EllenB: Julie2: But there are many of us who have PCOS and are overweight and/or have diabetes who have successfully conceived and carried a pregnancy to term. The important thing is to see a doctor who is familiar with all of these conditions so that you are treated and monitored appropriately.
Mae: could you tell me what if anything can be done for hair loss on the crown of the head, and acne? Any solutions besides the pill? Tks Mae
alice: what is the best method to regulate my cycle without the use of birth control pills. I recently stopped taking them and wish to start a family in the near future.
Veronica: Dr. Grazi,
Thank you for answering my question. My doctor put me on Humegon because my insurance will not pay and therefore it is out of my pocket. My RE feels that the LH can't hurt either. My question is...wouldn't additional LH distrupt me getting pregnant? I have heard from people to avoid extra LH at all cost! Many thanks!
Charlene: Dr. Grazi, What is the best way to get pregnant when you have PCOS? Would you recommend in-vetro? Or is there something easier. Clomid did nothing.
Pamela: How many are in here Bill?
Carolyn: What is the best long-term treatment for PCOS after conception of a child? I am trying to concieve using a variety of infertility drugs: provera, clomid, repronex, and pregnyl... I am just nervous about long-term side effects, diseases, etc...
khaki: I was diag. with PCOS but have normal andrgen levels, and am very thin. so far clomid (up to 100) hasn't worked...i think i have hypothal. amennorrhea...?
drgrazi: Lactic acidosis is metabolic abnormality that can come as a result of the combination of dehydration and use of Metformin. Please read the package insert and speak with your doctor about this. (And don't worry. You would have known if you had it.)
bak19: many women with pcos have done well with the carbohydrate addicts diet books - although they restrict carbos you are still allowed to have them once a day making this a life plan instead of a diet - Dr. Rachael Heller the author also has pcos and understands the insulin connection very well
Jennifer: Should I be drinking more water on Metformin?
Julie2: EllenB, I certainly hope you are right. I see two seperate DR's because there arent RE's here so I see a Endocinologist and a Fertiltiy Specialist and they work together
Brandie: Can you please recommend an alternative method other than birth control pills to regulate my cycle.
mich: Dr. Grazzi, what is the likelihood that I will be able to conceive a child. I have relied on ortho-cyclen to have regular cycles and I am unsure whether or not I would have a cycle without it. Before the medicine I did not have one for 7 months.
drgrazi: Charlene: When clomiphene has failed, the most effective therapy is gonadotropins. Just be careful that you do not hyper-respond (typical with PCOS) by producing too many eggs. You don't want to have your whole family at once!
yvette43: Time is almost up and I haven't gotten one answer for all the questions I've asked. If no one can help me here please at least tell me where I can get some answers before I have to go to my doctor and pay.
EllenB: An important point that Dr. Grazi may have made already for those of you who are going down the gonadotropin road: Those of us with PCOS, in general, do much better on a low dose protocol of these medications -- one amp a day or even half an amp a day to start rather than 2 or 3 amps. Of course, every patient is different but the research supports the "low and slow" protocol for women with PCOS.
melln: I am now having reg cycles but I have not been able to conceive. We have tried clomid and the blood tests say that I am ov every month. What can I do?
Jennifer: Yvette, ask your question
William: 78 chatters in the room, over 700 people on FertileThoughts right now!
snfranqui: Dear Dr. I'm 24 yrs. old and I've always had irregular periods. Last year I missed my period for almost 8 months. I read the symptoms of pcos and it seems that I have some of those symptoms. What do you think I should do?
felicia: I've been diagnosed with PCO since I was 21yrs old and my condition seems
to be getting worse. when I tell the
doctor that I have PCO they look at me like I do not know what I am talking about. I would like to know
is there any type of relief for this
problem.
cherra: yvette,your question was answered as best he could without having examined you himor herself
drgrazi: Rachel: Let's remember that miscarriages are common in many women without PCOS. SO don't assume the two are related. At least half of all miscarriages are due to genetic factors. You need a proper workup before attempting another pregnancy.
katie: I was diagnosed with PCOS about 6 months ago by an endocrinologist. I don't feel like he is the best practitioner for me, he really told me nothing about the condition and just habded me some birth control pills without even explaining them to me. Do you know of any doctors in Maine who specilaze in this condition, or at least know more about it?
spanish: a doctor noticed hair on my lip side of my head & alot on my arms he said that was werid....should i have any reson to think that i might have PCOS
maureen: Dr Grazi -- i should clarify that with the 2nd cycle we had 17 eggs -- we left 7 on their own to see what happened and the other 10 we icsi'd. The 7 left alone did not fertilize. of the 10 5 reached blastocyst level. I have also been diagnosed with antiphospholipid antibodies and now need to take heparin as well. My doctor wanted me to try the glucophage for the suspected pcos. Just wanted your opinion.
Julie2: yvette, you will need to see a DR to diagnose PCOS and to treat it...
Mae: could you tell me what if anything can be done for hair loss on the crown of the head, and acne? Any solutions besides the pill? Tks Mae
evj313: Alice,i had regulated my periods for three yrs by using an herbal supplement called Lydia Pinkham after using the pill for many years and fearing the side effects.Speak w your MD,maybe this can be good for you. It's found in many pharmacys
faithann: I THOUGHT THIS CHAT WILL HELP ME UNDERSTAND ABOUT PCO AND TO GET PREG. BUT IT HASN'T...........
266: Please tell me what I can do?
Liz: I live in Staten Island, does anyone know of a good OB/GYN or endocrinologist that I can see here? I also work in downtown Manhatten?
anna: Dr. What medication would be best to help with the sympton of hair loss on the crown of my head as well as facial/body hair? I know I have pcos
Charlene: Dr. Grazi, If you have PCOS and not trying to have a child - do you have to be on some type of birth control for hormone sake? That's what my doctor told me.
lucy: DR Grazi,
I am 32, diagnosed with PCOS through u/s. I also
have symptoms like very irregular period,
overweitght (5'4", 140lb), facial hair.
I took clomid for 4 cycles(up to 100mg), one ov,
no pg. I suggested metformin to my OB/GYN.
However he doesn't think it would work for
me because blood test shows that my
fasting insulin and glucose level are normal.
Should there be other test to determine insulin resistant.
You mentioned in your previous answer that IR itself
is hard to determine. What does that mean? Thanks.
Brandie: Why are most ob/gyn reluctant to diagnosed their patients with PCOS?
carole: Taking Glucophase to help with weight loss, it doesn't seem to be helping get rid of the excess hair, will this help? thanks
alcurran: Dr. Grazi:
I have been to see a gyn. about my frequently missed menstrual cycle and certain months I spot for 3-4 weeks straight. Not heavy just slight spotting. He indicated that I was not ovulating due to weight gain. Once I saw your show this morning on GDNY I thought that I may have the PCOS Symptom. What do you think?
Any advice would be greatly appreciated.
gigi: Is is possible to control pcos with diet only. So far so good. Also, can horomones come back into balance this way? Gigi
Lisa: Dear Dr.,
I found out in October after my first m/c that I have PCOS. My symptoms include weight gain, and lack of ovulation. My Dr. put me on clomid and followed with folicle students and an injection of Profasi, HCG! I did become pregnant in January and I am finishing my first trimester!!!
My question is what effect could PCOS have on my current pregnancy? Will this increase my chances of Gestational Diabetes? and What should I do after I give birth to control PCOS? I know I will be anxious to lose weight and get my body back on track.
Thanks.
Lisa
drgrazi: Carolyn: Difficult question to answer. If pregnancy is not the issue, oral contraceptives prevent lots of female cancers and are the best course. Insulin sensitizers may turn out to prevent other problems, like diabetes, but have not been used long enough to really know. Incidentally, there is a lot of fear about the long term effects of fertility drugs. Most of it is hype. Look at a recent AIA newsletter for more info.
jen430: I live in NY, can anyone answer my questions. I still don't understand what PCOS is
William: faithann, what is your question, we have 3 experts here ready to help :o)
caroline: Dr. Grazi can you refer me to a Dr in New Jersey? That can treat my condition?
Mich: is treatment for PCO short term and then it's gone? Should PCO be treated before IVF. I had 2 failed IVFs. Now RE saids to treat PCO I need to stop trying to get pregnant before treatment for PCO. Is this true?
Candace: If I am having regular periods, do I need to be on medication for PCOS, even though I still technically have it?
drgrazi: Alcurran: Looks like a good chance s/he is right.
spanish: a doctor noticed hair on my lip side of my head & alot on my arms he said that was werid....should i have any reson to think that i might have PCOS
MG: If I might make a suggetstion - perhaps in the future - questions could be posted before the chat time -- It appears impossible for the Dr. to read let alone answer these very specific scenarios - And it seems like there are alot of very frustrated people out there
melln: Thank you Dr. I must not b/c I have been on met for 2 years now and Ihave reg cycles, have lost 60 pounds and my headaches are gone although they are not a common symptom I had them very often before met. I have not even experienced gi upset at all.
Ivette: It seem like most of the women diagnosed with PCOS are overweight and have facial hair. Is this true?
faithann: WHY DO YOU GET DIEABETS WHEN YOU HAVE PCO
266: I agree with you Faihann
drgrazi: Lucy: I think the fasting glu:insulin ratio is a good criteria, and if it is normal you are likely not IR. You can do a two hour glucose challenge test to be more specific.
Jennifer: I'm leaving, thanks Dr. Grazi and everyone else. Take care and good luck.
cherra: William, Ellen , Pamela and other people helping the DR. THANK YOU
joni8049: What kinds of tests should one have to test to see if they are insulin resistant. Can one use over the counter glucose strips?
DrJay: Several of my patients with Pcos and Unwanted Hair have responded dramatically to my treating them with Epilight. Please visit www.HAIRREMOVALMD.COM for info+ before and after photos.
spanish: doc thanx for the help u gave me
drgrazi: Mae: Make sure this is due to excessive androgens, because frequently there are other factors involved.
spanish: doc thanx for the help u gave me
faithann: ITS NOT LIKE WE HAVE ANY OTHER PROBLEMS WITH HAVING A BABY
Christine: Hi Spanish, I am just another chatter here in the room, but my un-professional opinion is that the presence of hair on your face and arms does not mean that you have PCO. I know it is considered a symptom. But there are other symptoms too. Also, the hair could be due to your heritage. Part of my hair problem is because I am decendent of the Middle East. It's in the genes!
lucy: thanks, doc
William: spanish, I think you said you are 14? IF that's the case, your doctor may be hesistant to diagnose PCOS just because you are young. Doctors may figure that since you are not old enough to where you should be getting pregnant, there shouldn't be a need to diagnose PCOS. However, it will take a doctor to do the diagnosis. Have you had your first OB/GYN exam?
nikgot: thank you for your help and time.
EllenB: Lisa: Congratulations on your pregnancy. In terms of gestational diabetes, Dr. Grazi may be able to answer your question in terms of statistics. I can tell you that in my case, I had no problem with gestational diabetes during my pregnancy (I didn't even have to re-take the GTT unlike many of my non=PCOS pregnant friends). After I gave birth, I breast fed for a year and actually had five or six normal cycles starting when my daughter was seven months old. My advice to you is to try to get back into an exercise program and a balanced but low carbish diet as soon as you can. Ellen
Veronica: Ellen B,
Why is it better to go down the "low and slow" road when taking gonotrophins? It is because PCOS patients may "hyper" easier? If you are taking 2 amps and the results were good, should you stay on that route? Thanks!
Lynn: Dr: I feel that PCOS is a very severe condition with many unfortunate side effects. I was looking forward to help because now I am trying to conceive. If you are not trying to conceive PCOS is tolerable, but not pleasant. Now since I want children I am at a loss becuase like usual, my questions have not been addressed. If you ever do something like this like this online again, i would read all the questions and answer the question you find REPEATED most often. I now have a headache and feel more frustrated than ever because I am on Glucophage which i was told was right to take and you are against it. Why did they put me on it if it might not be safe, and not fda approved for NON-diabetics.
drgrazi: Faith Ann: It is not true that having PCOS gives you diabetes. We currently think that women with PCOS are AT RISK. There is a difference. The point is that the same problems that can cause diabetes - resistance to insulin (this is not the most common cause) - can also cause PCOS.
amy: Hello all! Just saw notice on PCOS board. Hope everyone is well.
EraDee: Can PSOC run in the family?
William: DrJay, thank you for advertising on FertileThoughts, where should I send the bill to? :o)
lori: I think you all are doing a great job in here. I really appreciate the help and info.... It's really nice of you to share your knowledge and time in this kind of forum.
joni8049: Can pcos be diagnosed through symptoms alone?
Maggie: Dr.,Ellen,Beth,William, which oral contraceptive is best for teenage girl with PCOS symptoms. HELP!
lucy: Can low carb diet alone control pcos?
drgrazi: Mitch: PCOS is not curable! You treat is simultaneously with giving fertility therapy.
One thing to note: In some women, especially LEAN women with PCOS, the condition does seem to go away after a full term pregnancy.
Brandie: Can I take any weight loss pills, while taking birth control pills?
faithann: HAVE PO'S FOR 15 YEARS NOW HAVE DIEABETS FOR THE LAST 5 MONTHS JUST SHOT ME
yvette43: I think I saw and answer flash but it didn't stay long enough for me to catch one letter of the alphabet
spanish: no i didn't have thoose exams done why? i also have been have irregular periods since i was 11 or 12
Lynn: Dr. Grazi: one word answers are not helpful because I cant track what question you have answered.
Maggie: Who is DrJay? Near NYCity or Westchester County NY?
spanish: i am 14...thanx doc
dana: I was diagonsed with PCO and my GYN gave me PROVERA and CLOMID. I am on my 2nd cycle of CLOMID without Provera. Do you think I can get pregnant by this method??? My GYN said that I do not have the normal symptoms, just an elevated LH level. thanks!
drgrazi: Lynn: Glucophage is safe, but must be taken under supervision. In some women, it is a very appropriate modality of therapy. I wish medicine were more black and white - if you have A take B - but it is not that way (which is why some of us still need doctors).
yvette43: Is someone there to answer some questions or is it too late
William: Maggie, I'll let the others handle that one, my wife hasn't been on the pill in about 8 years, and I'm scheduled to get 'snip-snip' myself **legs crossing unconsciously**
drgrazi: Randie: yes. Under MD supervision.
Lisa: Thanks Ellen B!! The support makes all the difference in the world.
Lisa
drgrazi: Maggie: any low dose contraceptive pill will do. These include LoEstrin, Alesse, Desogen and many more.
Lisa: Thanks Ellen B!! The support makes all the difference in the world.
Lisa
Charlene: Maggie - Abstinence!! You'll be dying to have a child later on. Just read.
William: spanish, I'm not a doctor, just know something about how doctors sometimes don't pursue diagnostic work on women before they are actively seeking a pregnancy. When you have an GYN exam (you know, a pelvic exam) you should ask the doc about PCOS.
faithann: SHOOT ME BECAUSE IT'S KILLING ME NOT TO BE A MOTHER
yvette43: I have symtoms. How do I know if it is pcos
EllenB: Veronica: Women with PCOS tend to "over respond" to gondadotropins leading to a risk of hyperstimulation and high order multiples. The goal of the "low and slow" protocol is to get one or two mature follicles instead of 8, 14 or 20 follicles. And research studies out of England and Israel show higher pregnancy rates. But certainly, if you have responded well
to two amps, there may be no reason to try another protocol. I know that in my own case, I did numerous cycles on the standard (two amp) protocol and had many, many follicles but no pregnancy. When I switched doctors and did a low dose protocol, I got pregnant on my first cycle. Ellen
Brandie: What are some of the causes of PCOS?
drgrazi: Dana: you certainly don't need to take Provera before every clomid cycle, especially if you ovulated and menstruated from the previous course of therapy.
taracrash9: Hi, I have had irregular periods since I am 16, I am now 27. I bleed for months at a time, and then stop for a few weeks, and again my period comes back. Over the past couple of years I have grown facial hair and I am more over weight then ever, I am trying VERY hard to get pregnant, for the past 6 years and nothing. PLEASE tell me what kind of dr., I can see to help me, my GYN and all GYNs always want to give me birth control, but I have a HIGH Cancer rate in my family and dont want to do that, please tell me what DOCTOR I need to see !!!!!
cherra: Dr. Grazzi, Which low-carb diets do you personally reccomend for infertility and PCOS?
alice: thank you evj313. My doctor suggested Provera but I was uncomfortable with that suggestion since it could be harmful if I became pregnant while taking it. Also, are increased PMS symptoms part of the symptom profile? Since I stopped taking the pill my PMS symptoms have worsened.
lpk: IF one has pcos and annovuation (absolutly no cycles) not overweight. Gonal f works in low doses (had one cycle of hyperstimulation that was converted to ivf). is it acceptable to do up to 6 iui's before considereing ivf. Or should I move to ivf sooner.
jen430: Since I can't get my question answered here, can anyone direct me to the right place, I want to know what is PCOS. I may have it and I am a little concerned.
spanish: thank you very much
Lynn: Dear Dr. Grazi, this is a fertility chat, answering a 14 yr olds questions is not helpful becuase she is obviously not trying to conceive... her questions were given much too much attention, I thought this was a fertility seminar.
drgrazi: yvette43: I already reviewed the main symptoms of PCOS. The diagnosis can be confirmed on physical exam and hormonal testing.
EllenB: Another reminder: For those of you with unanswered questions or who have follow up questions, go to AIA's PCOS Message Board. Go to AIA's homepage (americaninfertility.org) and click on PCOS or PCOS Message Board. Ellen
lori: faithann - trust me many of us want to be Mom's too - I am 36 and am jealous every time I hear someone else is pregnant. It's tough but keep talking with your doctor(s).
cherra: Thanks again for your time Dr. Grazzi
drgrazi: Taracrash9: Sounds like a typical case of PCOS. Many women consult with medical endocrinologist or gynecologists, and this would be OK if you get satisfaction. Reproductive endocrinologists have special expertise in treating this type of disorder.
yvette43: SOMEONE, PLEASE HELP ME!
bak19: PCOS is a genetic disorder. It effects the reproductive and metabolic systems. Once a woman gets the proper treatment living with PCOS is manageable. For those with weight problems low carbing does help. Visit the AIA website and the PCOS center for information and join AIA We have support groups for PCOS and a monthly newsletter, conferences, and continue to add information to the website. By joining AIA you will realize that living with PCOS can get better and that you are not alone
dana: Dr Grazzi, I realize that I did not need the PROVERIA the 2nd time, but my question is: IS MY CHANCES OF GETTING PREGNANT WITH CLOMID POSSIBLE WITH PCO??
alcurran: Dr. Grazi:
I have been to see a gyn. about my frequently missed menstrual cycle and certain months I spot for 3-4 weeks straight. Not heavy just slight spotting. He indicated that I was not ovulating due to weight gain. Once I saw your show this morning on GDNY I thought that I may have the PCOS Symptom. What do you think?
Any advice would be greatly appreciated.
BTom: Is there anyone out there to answer questions regarding PCO?
cherra: Dr. Grazzi, Which low-carb diets do you personally reccomend for infertility and PCOS?
faithann: I KNOW BUT I JUST KEEP GETTING THE RUN AROUND THESE DAYS
drgrazi: jen430: If you read all that folks have written tonight, you will get a pretty good idea of what PCOS is about: excessive wt (but not always), excessive hair, acne (but not always) and irregular/absent menstrual periods. Because women with PCOS do not ovulate or do so only infrequently, they are also almost always infertile.
Veronica: Thank you for your help Ellen and Dr. Grazi.
nikgot: Maybe if we had gotten answers to these important questions at 14, we wouldn't have the problems that we have today.
Liz: Jen430, I agree with you, I was just diagnosed as well I am trying to learn as much as I can too. I have read a lot of articles on the subject and I am looking for more answers as well, my OB/GYN doesn't make this out to be a big deal but from what I am seeing here there definately are things to worry about. I am on AOL and my e-mail is , I would love to talk about this and maybe we can help each other out
EllenB: Although many of us suffer from PCOS related infertility, it is important to remember that PCOS is not just an infertility issue. It is a lifelong metabolic disorder that can have a devastating emotional impact on adolescents dealing with excess hair, weight and acne and serious long term health implications (diabetes, cardiovascular disease and endometrial cancer, among others) for all women who suffer from it, regardless of age. Ellen
Julie2: Thank you so much Dr and the Dr's helpers... : )
drgrazi: #1PK: Both are acceptable. Depends on your age and any other infertility factors.
William: Lynn, remember, it's not easy being a 14 year old with hairy arms and legs and hair on the lip. Besides, I handled most of her questions and I'm not the doc here.
In general FertileThoughts is for people 18 and older, but I'm sorta happy that someone who is 14 who is concerned would come online and try to find help. Much better than going through adolescence thinking you're body is horrible and not finding information that is useful.
jen430: Thank you Dr. Grazi, any suggestions?
drgrazi: Cherra: any low carb diet will do. Fat Busters, Atkins are both good. Remember that not much will be accomplished without adding (ugh!) exercise.
Maggie: Thanks,Doctor!Could the "pill" make me gain weight?
EllenB: For those of you with general questions about PCOS, in addition to AIA's message board, we have several articles about PCOS on our PCOS page. Again, go to the AIA homepage (americaninfertility.org), then click on PCOS and then scroll down and click on the title/summary of the article you are interested in. Ellen
Maggie: Dr.,Ellen,Beth,anyone...could the pill make a PCOS teen gain weight?
Julie2: Just a reminder, I have a PCOS chat going on in the PCOS chatroom at Fertile Thoughts..no Dr's just us patients...hope to see some of you there.
Bye
yvette43: DRGRAZI I HAVE MOST OF THE SYMTOMS: DIABETES, FACIAL HAIRS, IRREGULAR MENSTRUAL CYCLES, I ALSO HAVE VERY SEVERE PAIN WITH MY PERIODS AND AFTER.
drgrazi: Dana: Of course you can get pregnant with clomid, but only if it is inducing ovulation predictably. Does this answer your question? (Incidentally, PCOS is the most common indication for use of clomiphene.)
drgrazi: yvett43: What is your question?
jen430: Thank you Liz, I would like that, my e-mail is
William: Plus, exercise will strengthen the heart and improve your whole outlook on life.
Pamela: the questions are slowing up...anymore out there????
drgrazi: glucophage will likely not reverse facial hair growth unless it is used for a very extended period of time. If hair growth is the main complaint, I would not use glucophage.
Pamela: Bill how many people are still here..
faithann: YEA
cherra: Thank you for answering my question Dr. Grazzi. I have the exercise thing already going on. Again thank you for your time.
AmyG: I have seen a doctor since age 14. Was on birth control for cancer preventive measures for many years. Then with the help of a great doctor became pregnant after laser laporoscopy. Am now working on conceiving again. Would like to do it without operation of medication. I think it will happen. There is hope for us all with the right doctor. Find one that works for you.
Erika: IS taking Clomid for 8 days at 100mg OK? Is this a new regiment? Wil it be beneficial for a woman with PCO?
drgrazi: For anyone who cares to know: "the pill" can cause mild weight gain. MILD. As in 4-5 lbs.
joni8049: What would you suggest?
>>>If hair growth is the main complaint, I would not use glucophage.>>>
William: Before everyone leaves I want to thank Pam for organizing this chat; we had over 75 people in the room at one time. Going forward, we're going to work on some sort of program where questions will be posted one at a time in order of entry, and then everyone can sign up for e-mail distribution of the entire chat transcript.
Charlene: I don't think mine was answered. Do you have to be on birth control if you have PCOS and not planning children?
Liz: Jen430, do you have instant messenger as well, I will add you to my buddy list and I hope you do the same that way when we are both on we can talk in real time. Thanks to you as well
Maggie: William, thanks for being sympathetic to teens.PCOS is a nightmare for us.
lynn: I was recently diagnosed with PCOS, and
my doctor said it was no big deal, but if
I wanted to get my period he would put
me on birth control pills. Now I have
stumbled across the PCOS support group
on-line and have found out that it *is*
a big deal. Should I switch doctors? I
have started losing weight on low-carb. Can
I stop taking birth control pills, or
do they actually help. I don't like them.
evj313: Thanks to ALL for the info and thoughts.i didn't know there were so many women suffering out there just like ME!!!I hope all our prayers will be answered one day!!!!!!!!
Betsy: Dr. Grazi, I saw the piece this morning on Good Day New York...I am very much interested in whatever help i can get...since i have been unable to get any assistance from my present doctors...
greenacres929: no one answered me, I would like to make an appointment with the Dr. if possible.
phleb: I live in GA and I would like to know how to find a physician that specializes in infertility and PCOS
Lynn: Dr: Under my endocrinologist's supervision I'm taking Glucophage to regulate my periods, which I know now is safe. My gyn is putting me on Clomid to ovulate, and Provera to get periods. Do you think with this treatment i can become pregnant?
William: We're down to a managable 50 people now :o)
leave it to Pam, she always knows how to fill up a room!
drgrazi: Charlene: you don't have to be on birth control pills, but it is probably the best thing you can do to preserve good health and decrease your risks of developing problems later on. Seriously!
Mae: Dr., I was diagnosed with Alpecia when I was 17, and @ 20 with PCOS. Do you think I was misdiagnosed with Alopecia? My gradfather is a diabetic. Is this playing a role in my problems? I am very concerned about hair loss
jen430: Yes Liz I do and I will add you to my buddy list
drgrazi: Erika: Clomid at 100mg is not an unusually high dose. Please make sure you are being monitored in some way during your treatment.
dana: Doc, you answered my question. Thanks! I have one more for you. I am NOT overweight, I have NO acne, and NO excessivwefacial or body hair. My LH level is 3 times my FSH. SHOULD I EXPECT TO GET ANY OF THESE IN THE FUTURE??
William: Maggie, when I was in college I dated a woman who was teased in high school because she had "gorilla arms"; in college she was on the pill for irregular periods, and she had real bad PMS, acne, etc. Probably had PCOS. So I know how it is, that wasn't any fun for her as she was growing up.
Charlene: You suggested gonadotropins. What is that?
Erika: Dr. Grazi: it wasn't really the dose I was worried about it was the 8 days as opposed to 4.
Liz: Dr. Grazi: My doctors don't seem to be of much help except for the fact that they diagnosed me and I am worried there is high risk of cancer, diabetes, and infertility in my family. What can I do from here? I was diagnosed last week and I am trying to learn more each day. Any suggestions?
drgrazi: Mae: There are many causes of alopecia, and generally it is not a symptom of PCOS. I would also not make a connection to your grandfather's diabetes, although anything is possible.
William: Dr. Grazi is at IVF BROOKLYN; he'll post his office's phone number again before leaving for the night, or you can contact Pam at to get his phone number.
I betcha it's listed in the yellow pages for Brooklyn.
drgrazi: Dana: No. I would not make the diagnosis of PCOS on the basis of one abnormal lab value. Repeat it and you may be surprised that it is normal!
joni8049: Is anxiety one of the symptoms of pcos?
EllenB: Lynn: The reason to consider taking birth control pills is that they ensure a regular shedding of the lining of the uterus. I'm not a doctor but my understanding is that the reason that women with PCOS are at higher risk for endometrial cancer is that we do have regular cycles and therefore don't have this periodic shedding of the uterine lining. Another way to accomplish this would be to take provera every other month or so. If you are having regular ovulatory cycles, then neither may be necessary.
Maggie: Dr, can you recommend an endocrinologist in Westchester County, Ny?I'd like to see you, but Brooklyn is far for me. HELP!
Pamela: liz,
You need to see a endocrinologist. Call our help line at and we can give you a referral. Call between 10 am and 3 pm. Go to our pcos center after the chat...there is a lot to read about pcos there!!!
drgrazi: erika: There is a history of clomid use at the 100 mg level for up to 10 days, for women who have failed with higher doses. It is sometimes effective, but if not you will likely need to move on to gonadotropins.
Charlene: Are people with PCOS likely to get diabetes and/or heart disease? What other lovely things do we have to look forward to? Isn't this enough : )
Liz: Does Provera make anyone very anxious, every time I have taken it I find that I am very moody and I don't even want to talk to anyone?
EllenB: phleb: E-mail me at for the name of a doctor in Georgia. Ellen
Erika: Thank you very much, Dr. Grazi!
faithann: CHARLENE THAT IS LIFE. I'VE LEARNED
drgrazi: Joanie: Anxiety is not a symptom but rather a RESULT of having PCOS. When infertility is also the problem, everyone gets anxiety.
michele: I was treating pcos systems with spironolactone(100mg) and trilevelen. Both worked well in controlling hirsutism and weight control. However after 8 years I suffered tinnitus and hearing loss from the spironolactone. I have seen info that finasteride and flutamide are good substitutes. Can anyone give any info as to if they really work well and possible dangers. PDR info looks scary. Thanks
Liz: Thank you Pamela - I will call tomorrow morning
drgrazi: Cahrlene: Probably. It may, however, turn out that the excess estrogen levels typical in PCOS mitigate the effects of excess insulin on the heart. We won't really know till some years pass.
EllenB: Maggie: E-mail me at and I will get you the name of someone in Westchester County. Ellen
cherra: EllenB could you possibly recommend someone in the Raleigh/Durham NC area
drgrazi: Provera definitely can make you moody. So go ahead - - blame it on the drugs!
jen430: Dr. Grazi, I just realized my Dr. prescribed Clomid-50mg, but has never mentiond PCOS, should I be concerned?
Charlene: Dr. Grazi, again, what is GONADOTROPINS? Does that involve in-vetro fertilization?
deja489: Hi I was just diagnosed with PCOS, but I have a period every month, am I still at risk for uterine cancer??
EllenB: Charlene: On the issues of diabetes and heart disease, check out the articles at AIA's PCOS Center. Several of them deal with those topics. Ellen
faithann: HOW ABOUT A DR. IN ORLANDO FL
drgrazi: Michelle: There is a vast literature on the successful use of these meds. Personally, I do not use them because most of my patients are trying to conceive.
Liz: Dr. Grazi, Thanks I was not sure if it was me or the drugs and I was not sure if it was the best thing for me or if there are any other options for me now besides the Provera and Alesse
Maggie: thanks, eLLEN! i'LL e-mail you soon.
phleb: DR...My Dr had me taking Clomid monthly for over a year when I was trying to get pregnant..should I be concerned about the length of time on clomid or this Dr's treatment of my infertility?
Liz: Dr. Grazi, Thanks I was not sure if it was me or the drugs and I was not sure if it was the best thing for me or if there are any other options for me now besides the Provera and Alesse
Charlene: EllenB - THANKS. I WILL.
Pamela: Folks..this was a lot of work tonight...we can't give everyone all the answers in one chat! Please read the PCOS Center and please call our 888 number for referrals and please become a member so that you will get our monthly newsletter and up to date information about pcos and infertility!
drgrazi: deja489: if you have a period every month, you are likely ovulating, so I question the diagnosis. Generally, women with regular cycles are not at increased risk for uterine cancer.
EllenB: Gonadotropins are hormones in the form of injectible fertility drugs -- either purified FSH (follicle stimulating hormone) or a combination FSH and LH (lutenizing hormone). You can take these drugs and then do an IUI (intrauterine insemination)or you can take them in preparation for an IVF cycle. Either way, they are very powerful (and expensive) drugs and should be taken under the careful supervision (and monitoring) of an experienced reproductive endocrinologist. Ellen
yvette43: DRGRAZI, MY SYMPTOMS ARE FACIAL HAIRS, BALDNESS, IRREGULAR PERIODS, DIABETES, ACNE, I HAVE HAD A CYCT REMOVED FROM ONE OF MY OVARIES, HAVE BEEN TOLD THAT I HAVE ENDOMETRIOSIS INSIDE AND OUTSIDE OF MY UTERUS.
drgrazi: phleb: NO MORE CLOMID. While I would not lose sleep over the long term risks (in the paper that got us all worried, the data on use for a year or less was encouraging), almost all pregnancies with clomid will have occurred within 6 months of treatment, so there is simply no use in continuing.
EllenB: Several upcoming issues of the AIA Newsletter -- another reason to join.
Pamela: Ellen Bender Please get off line!! The today show producer is trying to get you!!!!
yvette43: One thing that tells me I may not have pcos is even though there are many weeks between my periods sometimes the doctors consider that i get one each month. But sometimes I do skip to the next month.
tracy: if you can't my question tonight than can you please e-mail me at ?my question is,if you have pcos is it possible that it could cause miscarraiges?I have had ivf done three times and have had three miscarraiges,and i show all the symtoms of having pcos.The doctors tell me that i should keep doing the ivf that eventually it will take without having a miscarraige.
Liz: When will the next conference be on PCOS, I would like to attend?
drgrazi: yvette43: endometriosis can only occur outside of the uterus (although there is a condition called adenomyosis, which may be what your doctor was referring to). If pregnancy is the goal, you need to be thinking about IVF.
EllenB: I'm gone folks. Sorry Pam. Ellen
William: hehehe...Today Show!!!...
Maggie: Dr., Ellen, Beth, Does weight loss alleviate other PCOS symtoms?
William: Thanks for helping out EllenB!
266: dr.Grazzi I have pco with 4-failed clomid cycles and had hsg today and was told there is possible tubal damage-need to have laporoscopy. The dye went to the first quarter of the tubes-that's it.What does this mean?
drgrazi: tracy: If you are overweight, lose it before doing IVF again. In either case, you must have an evaluation for recurrent miscarriages prior to doing IVF again. This would include checking for antibodies (immunological testing), anatomical abnormalities of your uterus (hysteroscopy would be a good idea) and having a genetic test.
Charlene: Does anyone know what GONADOTROPINS is/are?
William: DrGrazi, thanks for helping out with this chat, it was our largest yet!
Folks, if you didn't get your question answered tonight, go to Pam's website; you'll be sent there automatically when you hit the "Log Out" button. She has a PCOS bulletin board and you can post your questions there.
drgrazi: 266: Not uncommon for the doc to assume that PCOS is your only problem, and then to find that you have something else happening, like tubal disease. Now that the problem has been found, you are going to need that laparoscopy, unless the damage is considered so severe, in which case IVF should also be considered.
Liz: I had a miscarriage about 7 year ago, could this have been caused by PCOS? This was prior to being diagnosed about a week ago
deja489: is anybody still there??
William: Gonadotropins are a class of fertility medications (I think, I'm not the expert on this stuff)
drgrazi: Folks: It's been a real intense 90 minutes for me. Thanks for keeping me on my toes. Hope we can do it again sometime. Good luck to all of you.
Pamela: Dr. Grazi is going to finish up now....he has stayed late and we really need to let him go!! Thanks Dr. Grazi!! Everyone is welcome to stay and chat! You will be able to read the transcript of the chat on aia web site tomorrow! If you want more information on pcos go to our web site at https://americaninfertility.org
go to the pcos center or call us at !!!
Thanks for coming!!!