DEAR DR. DONOHUE: I am a 22-year-old female who was told by my doctor that I have polycystic ovarian syndrome. Will I ever be able to have kids? Can it be treated? – J.F.

ANSWER:
Since the 1930s, when Drs. Stein and Leventhal pieced together the puzzling picture of women with large, cyst-filled ovaries, knowledge of the syndrome has become clearer and treatment more effective. Because so many symptoms have become associated with it through the years, these two pioneering doctors would be hard-pressed to recognize the illness that they first described and that often bears their names — Stein-Leventhal syndrome.

Women with polycystic ovarian syndrome usually have scanty menstrual periods, or their periods stop altogether. They frequently have facial and chest hair. Acne can persists far beyond the teen years. Their ovaries are larger than normal and are studded with cysts. Infertility is the rule. Type 2 diabetes, the kind that can usually be controlled with diet and oral medicine, is another feature. So is obesity.

An increased production of male hormones is the prime malfunction that accounts for these signs and symptoms. Treatment, therefore, centers on restoring the normal female-to-male hormone environment.

Birth control pills can often establish that goal. So can other hormones involved in keeping the female-to-male hormone ratio in balance.

If a woman with the syndrome is overweight, weight loss can often straighten matters out.

Medicines that nurture the development and release of healthy ova are available for those wishing to have children.

Polycystic ovarian syndrome is not life-threatening, but if untreated, it does slightly raise the risk for cancer of the uterus and ovaries, and it raises the risk of coming down with heart disease later in life.

DEAR DR. DONOHUE: I am 78 years old and do a lot of work in my house, and I also help others with their housework. Lately I notice that every time I hit my arm or wrist, I get a lot of redness under the skin. It goes away in time. I started taking Zocor and Toprol at about the same time this started. Is it the medicines? – Anon.

ANSWER:
The redness, I am sure, is bruising. With aging, skin thins and much of its padding goes away. Blood vessels in the arms and hands, therefore, are subject to breaking. Furthermore, blood vessels become fragile with age, and that adds to their vulnerability.

Having said that, I still want you to see your doctor about the multitude of illnesses that feature bruising. A drop-off in the number of platelets is one example. Platelets are the tiny blood cells that stick to each other to seal breaks in injured vessels. A low platelet count, therefore, is an important cause of bruising.

I looked for bruising as a side effect of your medicines. I was surprised. Bruising is listed as a possible side effect for Toprol. Don’t stop taking it. Speak to your doctor. Suddenly stopping the medicine could create serious problems.

DEAR DR. DONOHUE: Could I have your opinion on EECP treatment for angina? It’s an electronic method of clearing arteries. My doctor wants me to begin soon. Do you think it is worthwhile? – C.B.

ANSWER:
“EECP” stands for “enhanced external counterpulsation,” a novel treatment for clogged heart arteries that cause the chest pain of angina.

Cuffs similar to the ones used for taking blood pressure are wrapped around the calves, the lower thighs just above the knees and the upper thighs. Inflation of the cuffs is timed to a particular point in the heart’s pumping cycle. Cuff inflation increases the supply of blood to the heart muscle, the very thing needed to combat angina. The cuffs also diminish the stress on the heart that comes from pumping blood, an additional plus for someone with angina.

Treatments are generally given one hour a day, five days a week for seven weeks.

My opinion is that this is an excellent way to treat angina, particularly for those who are not candidates for bypass surgery or whose artery blockage does not lend itself to the balloon dilation of angioplasty.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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