DEAR DR. DONOHUE: I have a granddaughter who has polycystic ovary syndrome. I cannot find much information on this illness. Is there medication for it? – M.B.

ANSWER: When Drs. Stein and Leventhal first described this condition in 1935, they proposed removing a wedge-shaped piece of the ovary as a treatment for polycystic ovary disease, and the operation worked for many women. At that time, the syndrome was known as Stein-Leventhal syndrome, and you might find more information by looking using that name.

Early on, obesity, infertility, menstrual irregularities and enlarged ovaries studded with cysts were considered the salient features of this condition. They still are for some women, but now the important signs of it are an overproduction of male hormone and a decrease in the number of monthly ovulations. With 5 percent to 10 percent of women in their childbearing years having polycystic ovary syndrome, it is anything but a rare occurrence.

Treatments are many. Women decide which features of the syndrome they most wish to eliminate. If a woman is overweight, simple weight reduction can often bring a cure. If infertility is the most vexing problem, then a medicine like clomiphene is chosen. Birth-control pills can restore normal menstrual periods. When facial hair and acne cause consternation, a medicine directed to blunting the effect of male hormones is prescribed. Since it has been discovered that an upset in blood sugar control is often a feature of the syndrome, diabetes medicine has been used in treatment, and it can often take care of many of the other signs of the syndrome. Metformin is the medicine most often chosen.

DEAR DR. DONOHUE: I read the letter about herpes-1 virus, which causes cold sores. A friend told me that cold sores are caused by stress. She also said if you have a cold sore and have oral sex, you can transmit it as genital herpes. My boyfriend and another good friend have never heard of this. Who is right? Can you give someone a cold sore via kissing? – D.D.

ANSWER: The herpes-1 virus is the common cause of cold sores, also called fever blisters. The herpes-2 virus is the common cause of genital herpes. However, the herpes-1 virus can be transferred to the genitals and cause an outbreak of genital herpes, and the herpes-2 virus can be transferred to the lips and cause a cold sore.

Stress doesn’t cause a cold sore, but it can bring on a recurrence of it. The herpes virus stays with a person for life once the person becomes infected. It takes up permanent residence in nerve cells. From time to time, it leaves the nerve cell home and produces a cold sore outbreak. Not only can stress bring on a reappearance of a cold sore, but so can sunlight, fever and menstruation.

You can give a person the virus by kissing, most often when you have a visible sore.

DEAR DR. DONOHUE: What is diabetic ketoacidosis? – E.M.

ANSWER: When a type-1 diabetic – one requiring insulin shots – doesn’t inject enough insulin, then all sorts of metabolic disasters take place. The usual story is that the diabetic comes down with an infection and the stress requires more insulin than usually taken. Without sufficient insulin, sugar (glucose) doesn’t enter body cells. The cells turn to fats for their energy source. Metabolism of fats produces ketones. Ketones, in turn, throw off body chemistry. The body’s acid-base balance goes out of kilter, and the blood turns acidic.

All of these changes, if not corrected, lead to lethargy and eventually to a coma. Death is possible. Quick action with insulin and fluids corrects the situation.

The diabetes story is recounted in the booklet on that topic. Readers can obtain a copy by writing: Dr. Donohue – No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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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