PCOS: Dexamethasone As A Treatment?

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Anonymous (not verified)
PCOS: Dexamethasone As A Treatment?

Hi Dr. Amos,

My OB/GYN added dexamethasone to my metformin regimine in light of my DHEAS level being 566. Back then, it did the trick and we were pregnant within two cycles. I now have two children (ages 2 1/2 and 18 months) and we're again TTC.

I have a new OB/GYN, but he's admittedly not as up to date on PCOS treatment as he'd like to be. I had suggested at first that he prescribe metformin and dexamethasone, since it worked for the first time, but when my DHEAS level is low enough that it's likely not needed, or am I wrong?

Thank you,

Marcy

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Dr-Amos (not verified)

There is no "magic" treatment for PCOS and each woman needs to be treated differently. If the DHEAS level is elevated, the addition of dexamethasone has been shown to improve the response to clomiphene and/or metformin. With a normal DHEAS level most doctors will likely not intially give dexamethasone because it has some side effects that may make getting pregnant more difficult it not given for the right reasons.
Dexamethasone is a synthetic steroid and can worsen the body’s ability to metabolize sugar (promote glucose intolerance) and is not ideal for patients with insulin resistance.

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MomOfSuperheros (not verified)

My question was meant to be a little more specific to my DHEAS level of 182, and weather or not that warrants dex or not. Thanks for all the info though!

Anonymous's picture
Dr-Amos (not verified)

Sorry, I thought I mentioned that. The DHEAS levels are normally between 35-430 ug/dl so yours are normal and thus most doctors won't give dexamethasone.