DEAR DR. DONOHUE: I am writing in regard to the letter from the woman diagnosed with polycystic ovary syndrome.

I was diagnosed with Stein-Leventhal syndrome after many futile fertility treatments. My doctor performed an ovarian wedge surgery, and six months later I was pregnant. I conceived a second child 21 months after that. I think polycystic ovary syndrome and Stein-Leventhal syndrome are the same. Why don’t I ever read about the ovarian wedge surgery for infertile women with polycystic ovary syndrome? – L.F.

ANSWER: Doctors Stein and Leventhal first described polycystic ovarian syndrome in 1937, and the name became Stein-Leventhal syndrome. Now it’s most often called polycystic ovary syndrome. Those two doctors pointed out the salient features of the syndrome: enlarged ovaries studded with cysts, loss of menstrual periods, and obesity. Infertility was another common feature. Doctors Stein and Leventhal also championed the surgical treatment of this syndrome – removal of a wedge of the ovary. The operation worked for some reason, but that reason wasn’t appreciated until more recently. Removing the wedge decreased the production of male hormone, which is the basis of the syndrome.

Now that new information has shown that an overproduction of male hormone is the important cause of the syndrome, there are many medicines that can be used to treat it. The wedge removal isn’t necessary. For one thing, it almost always caused only a transitory drop in male hormone production. For two, it was often associated with the formation of adhesions.

Taking medicines is much easier than having surgery and is a more reliable way to treat this illness, which now is known to have many features that were unrecognized in bygone years. One of those features is insensitivity to the action of insulin.

DEAR DR. DONOHUE: My wife is 66. She went to an orthopedic surgeon, who had her take an MRI and X-rays of her hip and pelvis. The MRI showed cysts on her ovary, some of which are just over 1 centimeter. The radiologist recommended a vaginal ultrasound. The orthopedist said we should follow up with a gynecologist. We did.

The gynecologist reviewed the MRI and did a Pap smear. He indicated that cysts of this sort are always benign. We found an article that said: “Cysts are more often cancerous after menopause. Your doctor may recommend surgery to remove the ovary.” We are now concerned. What are the implications of a cyst in women after menopause? – F.W.

ANSWER: In a postmenopausal woman with an asymptomatic ovarian cyst, if the cyst is small (less than 5 cm in diameter), if it is unilocular and thin-walled, and if the woman has a normal CA-125 blood test, the risk of cancer is very small and can be followed without surgery. “Unilocular” indicates no partitions in the cyst. CA-125 is a blood test not used to detect ovarian cancer in most cases, but useful in this situation. Follow-up scans or ultrasounds are recommended.

If the issue worries your wife and you, why not get a second opinion? That always clears the air and reassures patients.

DEAR DR. DONOHUE: I have never, in my more than 60 years, seen anyone recommend low-sodium V8 juice as one of the best sources of potassium. An 8-ounce glass has about 900 mg and is only 50 calories.

A banana, always recommended for its potassium, has less than half the potassium in the V8 juice and is high in calories. – G.P.

ANSWER: Thanks, G.P. Now people (and I) know of a good potassium source.

A banana has 450 mg of potassium with about 109 calories, not a diet-breaker.

A baked potato with skin has 844 mg of potassium and 173 calories. It’s not a challenge to a weight-loss diet either, if you’re careful about what you put on it.

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. Readers may also order health newsletters from www.rbmamall.com

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