Page 41 - Retail Pharmacy Assistants September 2020

index (BMI), the better number of embryos she’ll get,” Ms Georgeou said. “In addition to BMI, chronic inflammation can have an effect, once again making the consumption of fruit and vegetables and following a healthy lifestyle essential to increase ovarian reserve.
“Underlying thyroid conditions should also be diagnosed and seen to.”
Ms Georgeou says whenever she
has a patient looking to conceive,
it’s important that she looks at their micronutrient and macronutrient levels, their metabolic health levels and the nutritional deficiencies present in their blood, because just a low level of vitamin D could cause an endocrine disturbance.
“Vitamin B6, B12, iodine, iron, omega-3 fatty acids and vitamin D are essential among others, and some people might benefit from inositol to help regulate insulin production, as an example,”
she said.
“Dutch Cycle Mapping, which refers to
mapping out a woman’s hormonal pattern throughout her menstrual cycle, can
also be used to achieve pregnancy for women with PCOS and even decrease cancellation rates.”
Pharmacist intervention on
the ground
Ms Georgeou says pharmacists can help women with PCOS on the “lifestyle front” by informing them of interventions they can manage to avoid metabolic syndrome and type 2 diabetes,
among others, as well as being able
to play a role in optimising their drug therapy outcomes.
“Pharmacists should be aware that metformin and thiazolidinediones are prescribed for PCOS and therefore avoid providing information on type 2 diabetes when dispensing these medications
or dispensing certain antibiotics with contraceptives,” she said. “For patients being prescribed oral contraceptives, pharmacists can help by letting the patient know how important it is that they take their medication as indicated and what side effects they could experience from fluid retention and weight gain to breast tenderness.
“It’s important that pharmacists advise patients to have regular health checks in the interests of minimising the risk of developing health problems later in their life cycle.”
Ms Georgeou also points out that pharmacists should be aware that stress resulting from the Covid-19 crisis could worsen pre-existing hormonal imbalances or even trigger exacerbate underlying PCOS.
Mark Webster, owner of Stay Well Pharmacy in Christchurch, New Zealand, says the pharmacy encounters PCOS patients with negatively affected skin.
This, he says, is because hormonal conditions, including PCOS, can generate an oversupply of testosterone, which can result in a surge in sebum and skin cell production, with resultant hormonal acne. However, not everyone with hormonal acne has high androgen levels, as seen in blood sample tests.
Other factors that can cause hormones to become unbalanced and affect the skin include contraceptives, periods,
WOMEN’S HEALTH 39 anxiety, and stress, among others.
Alvin Narsey, owner of Priceline Pharmacy West Brunswick in Melbourne, says he treats mild to moderate acne with topical therapies, but emphasises that what is required is an underlying grasp of what’s going on with the patient, making a diagnosis of PCOS helpful.
This is because exterior treatments won’t be successful until the underlying conditions that cause the imbalance are resolved. At times this necessitates a full blood panel administered by a GP or relevant healthcare worker.
In addition to acne, women with PCOS may develop acanthosis nigricans, which are patches of dark, thickened, velvety skin that look like ‘skin tags’ that can appear behind the neck, on the thighs, or on the vulva.
Women with PCOS should also
be advised that they need to use contraception, contrary to common belief that this is unnecessary, according to a recent study: ‘The benefits and harms of receiving a PCOS diagnosis: A qualitative study of women’s experiences’. This is because, although some women with the condition may have trouble conceiving naturally, many women with PCOS do conceive naturally.
The study delves into how a dread around infertility results in long-lasting psychological turmoil. Women with the condition describe how they
felt pressure to conceive early and struggled to talk about it with their partners. Some had sex without contraceptive protection, a few ending up with unintended pregnancies.
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RETAIL PHARMACY ASSISTANTS • SEP 2020