Weight fluctuations, facial hair and infertility.

Dear Ask The Doctor: Good day, I have often have pain during intercourse with my husband, and I seem to be prone to getting urinary infections, my weight fluctuates and I seem to be getting terrible facial hair specially on chin, My periods are iregular 90 % of the time. I went to see the doc and they suggested I have a sonar which I did and they couldn't find anything wrong it all seemed normal. As there seems to be nothing showing up on my sonar I didn't think to go back to the doctor. Unfortunately my medical aid doesn't cover specialists etc... What should I do? We have been trying to conviece for a year now.

Dear Janene: The symptoms that you have mentioned, weight fluctuations, facial hair and irregular periods all suggest of polycystic ovarian syndrome (PCOS). This is caused by an imbalance in the female sex hormones. PCOS occurs in 5 - 10% of women and is the commonest cause of infertility.

The diagnosis of PCOS is made on the basis of clinical signs and symptoms. Your doctor may also have to rule out other illnesses that have similar features such as hypothyroidism and hyperprolactinemia.

Treatment will involve losing weight, birth control pills to regulate the menstrual cycle and metformin to increase the body's sensitivity to insulin. In certain cases, treatment with clomiphen citrate may be needed to stimulate ovulation. You may have to discuss treatment options with your doctor.