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pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes, and contraception considerations during rapid weight loss.

14 questions · sorted by votes

42 votes 3 answers13k views
Nobody warned me fertility could return quickly. What are the contraception considerations?

Anovulatory for most of my adult life with PCOS, told repeatedly that conception would be difficult and would need assistance. Five months into treatment, having lost…

pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
tirzepatide
tirzepatide

A dual GIP and GLP-1 receptor agonist. Questions here cover the SURPASS and SURMOUNT programmes, the practical differences from a pure GLP-1…

162 questions
discontinuation
discontinuation

Stopping treatment: tapering versus abrupt cessation, what the trial withdrawal arms measured, clinically driven stops, and the practical planning…

21 questions
asked by tare_weight 47k · 30 days ago
37 votes5 answers49k views
What does the mechanism of cagrilintide predict that SURMOUNT-2 did not test?

Numbers first: cagrilintide · SURMOUNT-2. I suspect the usual explanation for this is wrong, or at least incomplete. I am aware this may have a boring answer. I would…

glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gip-receptor
gip-receptor

GIP receptor pharmacology, and the still-unsettled question of whether agonism or antagonism at GIPR is the metabolically useful direction.…

83 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by bounty_hunter_q 18k · 2.3 years ago
37 votes 3 answers20k views
How does insulin resistance link weight, androgens and anovulation in PCOS?

Diagnosed with PCOS at 24, now 31, BMI 34. I have been told for years that losing weight will improve my symptoms, and separately that insulin resistance is the…

pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
hormones
hormones

Endocrine changes accompanying substantial weight loss: sex hormone binding globulin, testosterone, oestradiol, cortisol and the reproductive…

14 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
asked by elke_brunner 14k · 2.0 years ago
33 votes 5 answers23k views
How do I convert the TRIUMPH-3 hazard ratio into an absolute risk reduction?

My laboratory results are from the same laboratory each time, drawn fasting, which I gather matters. I want the working, not the result — I need to be able to redo it…

cardiovascular
cardiovascular

Cardiovascular outcomes: the SELECT major-adverse-event result, SOUL, SUSTAIN 6 and REWIND, how to convert a hazard ratio into an absolute risk…

111 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by low_dead_space 42k · 17 months ago
31 votes3 answers8.9k views
My total testosterone fell 27% but my free androgen index fell 64%. Which is real?

Baseline, before starting treatment: total testosterone 2.6 nmol/L, SHBG 22 nmol/L. After eight months and 16 kg of weight loss: total testosterone 1.9 nmol/L, SHBG…

pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
hormones
hormones

Endocrine changes accompanying substantial weight loss: sex hormone binding globulin, testosterone, oestradiol, cortisol and the reproductive…

14 questions
bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

284 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by carys_meredith 17k · 10 months ago
27 votes 5 answers19k views
What ovulatory outcomes have actually been reported in PCOS?

I have three data points across nine months, which I hope is enough to see a trend. I can parse the result. I am less sure what it licenses me to conclude. I have…

pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
hormones
hormones

Endocrine changes accompanying substantial weight loss: sex hormone binding globulin, testosterone, oestradiol, cortisol and the reproductive…

14 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
asked by a_lindgren 46k · 12 months ago
25 votes 5 answers13k views
Does the FLOW population resemble anyone asking about semaglutide here?

For reference: FLOW · semaglutide. I want to understand what this actually establishes, as opposed to what it is being used to imply. My concern is that I am being…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by juliette_farnese 12k · 13 months ago
25 votes0 answers9.5k views
What does STEP 4 tell me about fatigue at the 5 mg dose?

Conditions: STEP 4 · fatigue · 5 mg. The figures are clear enough; the question is what they mean and what they do not. I can supply the numbers if the specifics…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
injection-site-reaction
injection-site-reaction

Local reactions: erythema, induration, pruritus and nodules. Their relationship to injection depth, diluent composition, benzyl alcohol…

14 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by cake_collapsed 13k · 13 months ago
17 votes 5 answers16k views
What does SOUL report at the 60 mg dose level?

For reference: SOUL · 60 mg. I have the document in front of me and I can read the numbers. What I cannot do is interpret them. I am reasonably comfortable with…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by aine_mulcahy 35k · 6 months ago
13 votes3 answers21k views
Does the PIONEER-1 population resemble anyone asking about cagrilintide here?

Stated plainly: PIONEER-1 · cagrilintide. I have read the primary source rather than the summary, which has left me with more questions. I understand the headline. I…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
semaglutide
semaglutide

A GLP-1 receptor agonist with a fatty-acid-acylated backbone and a roughly one-week half-life, marketed for type 2 diabetes and for weight…

360 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by void_volume 13k · 23 months ago
13 votes5 answers15k views
What is the reported incidence of nausea on a GLP-1 receptor agonist in STEP 8?

Stated plainly: nausea · a GLP-1 receptor agonist · STEP 8. I would like help reading this properly rather than being told what conclusion to reach. I have the full…

gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by wren_calloway 14k · 19 months ago
13 votes0 answers4.8k views
What interval makes sense for repeating eGFR on dulaglutide?

What I have: eGFR · dulaglutide. I would rather over-plan the first cycle and simplify later. I am prepared to do the work if someone can tell me which work matters.…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

284 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

108 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by void_volume 13k · 4 months ago
7 votes5 answers14k views
Is ALT worth drawing at baseline before starting a GLP-1 receptor agonist?

Setup, so nobody has to ask: ALT · a GLP-1 receptor agonist. I would like to set this up properly once, rather than adjust it repeatedly. My budget is real but not…

bloodwork
bloodwork

Laboratory monitoring: which panels are worth ordering, sensible intervals, reference-range versus optimal-range arguments, and how to read a…

284 questions
harm-reduction
harm-reduction

Reducing avoidable risk where a decision has already been made: independent verification before use, sterility practice, dose arithmetic checked…

445 questions
a1c
a1c

Glycated haemoglobin as a ninety-day glycaemic average: what a change of half a point means, why it lags, and the conditions under which it…

108 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by one_ml_bac 12k · 13 months ago
6 votes0 answers1.4k views
What did the placebo arm of SUSTAIN-6 report for early satiety?

The particulars: SUSTAIN-6 · early satiety. I have the document in front of me and I can read the numbers. What I cannot do is interpret them. I am reasonably…

clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
pcos
pcos

Polycystic ovary syndrome: insulin resistance as the shared mechanism, ovulatory and menstrual outcomes reported on treatment, androgen changes,…

14 questions
asked by hana_petrikova 19k · 5 months ago
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