Tag: Polycystic Ovary Syndrome

September is PCOS Awareness Month

Posted on by Evangeline

Here’s an article from RESOLVE that gives some good insights about PCOS–Polycystic Ovarian Syndrome.

Polycystic Ovary Syndrome: Causes, Diagnosis

and Treatment

By Jennifer Kulp Makarov, MD
Published in Resolve for the journey and beyond, Winter 2011

Polycystic ovary syndrome (PCOS) is a very common disorder that many women first learn about while seeking the cause of their infertility. PCOS affects 5-10% of women of reproductive age, making it one of the most common hormonal disorders in this age group. The exact cause of PCOS is not known. It is likely that a combination of factors leads to the development of PCOS. PCOS is thought to be a genetic trait and may run in families. Environmental factors such as the diet that one consumes are also thought to play a role in the development of PCOS.

Women with PCOS have three characteristic symptoms. Women are diagnosed with PCOS when they have at least two of these three symptoms:

  1. Irregular periods
  2. Excess androgens — either measured in the blood or seen through symptoms such as acne or excess hair growth
  3. Polycystic ovaries — seen on ultrasound

Women with PCOS may have irregular periods. They may have only 6 to 8 periods per year. They may get their period every month for a few months and then skip a month or two or they may go many months without having a period. Many women with PCOS will have infertility associated with their irregular menses. Also, when women with PCOS do become pregnant, they have an increased rate of miscarriage.

Another common symptom of PCOS is acne or oily skin. Acne may occur over the face but may also be found over the back or chest. This is due to relatively higher levels of testosterone circulating in the bloodstream.  Testosterone is a hormone that is found in much higher levels in men. Women with PCOS do not have male levels of testosterone but the levels of testosterone may be higher than expected for females. These higher levels of circulating testosterone can also cause excess facial hair on the chin or upper lip or excess hair growth on the chest and abdomen. The hormone imbalances seen in PCOS can also cause a type of hair thinning which occurs at the front of the scalp. Sometimes blood tests can show excess levels of testosterone in women with PCOS but other times they do not.

The third common feature of PCOS is what is called polycystic ovaries. This can be seen on a transvaginal ultrasound. This is actually a misnomer as the ovaries of women are not really full of cysts but rather ovarian follicles that each contains an egg. All women have these follicles in their ovaries and each month a group of follicles start to develop, with one going on to be the dominant follicle that ovulates the egg. The ovaries of women with PCOS may contain many small follicles that do not go on to ovulate an egg each month. These follicles fail to develop normally because of the hormonal imbalances in PCOS. Because the ovaries do not grow and ovulate an egg each month, women with PCOS may also experience difficulty getting pregnant.

Obesity is also common in women with PCOS. Up to 50-60% of women with PCOS are obese. Symptoms of PCOS such as those described above can be worsened by obesity. The hormonal imbalances found in women with PCOS may cause them to be more likely to gain weight and become obese. Women with PCOS are also prone to developing insulin resistance in which the body produces excess amounts of insulin. This is thought to be a precursor to Type II diabetes. Women with PCOS are at greater risk of developing diabetes and therefore all women with PCOS should be screened for insulin resistance.

Treating the Symptom of  PCOS

There are treatments available for women with PCOS. These treatments do not cure the disease but rather help improve the symptoms of PCOS. For women with PCOS who are obese, diet and exercise to maintain a normal body weight may alleviate many of the symptoms of PCOS. In fact, for obese women, losing even 5-10% of body weight may help. Oral contraceptive pills are often given to correct some of the hormonal imbalances found in PCOS and can help decrease acne and excess hair growth as well as regulate menstrual cycles. Acne can also be treated with topical ointments or antibiotic creams. Women with excess hair growth often find laser electrolysis helpful. Metformin is an oral medication that may be prescribed to women with PCOS who are insulin resistant.

Women who are having difficulties conceiving may take a medication called clomiphene citrate or clomid to help them ovulate regularly. In women with PCOS who take clomid, about 80% will ovulate in response to the medication and 30-40% will become pregnant. About half of women will ovulate when taking one pill a day (50 mg) on cycle days five through nine. The other 50% of women do not ovulate on this dose of clomid and may need a higher dose or another medication. Using clomid increases your chances of having a multiple pregnancy to 8-13%, with twins being the most common. If pregnancy does not occur after six cycles of clomid use, further evaluation or a change in therapy is recommended.

If you think you may be experiencing any or all of the symptoms of PCOS, it is important to see a doctor for diagnosis and treatment.

Dr. Jennifer Kulp Makarov practices at Genesis Fertility & Reproductive Medicine, both at Genesis’ main office as well as their new office, in Park Slope, Brooklyn, New York. Dr. Makarov graduated from Tufts University with a degree in Biology, earning her medical degree from the UMDNJ-Robert Wood Johnson Medical School. She completed her Obstetrics and Gynecology residency at Johns Hopkins University School of Medicine and her fellowship training in Reproductive Endocrinology and Infertility at Yale University School of Medicine. Dr. Makarov has a special interest in the care of patients with PCOS, those in need of PGD to prevent transmission of genetic disease and women desiring fertility preservation.

You might also want to take a look at this previous post that is written from a more personal view of experiencing PCOS. 

PCOS

Posted on by Evangeline

Here’s an excerpt from an email newsletter I received from  a friend, Dr. Nadia Brown of Doyenne Leadership Institute, regarding her struggles with Polycystic Ovary Syndrome (PCOS). 

I hope it encourages you in some way to know that you are not alone in the infertility journey. Keep your hope strong and focused!

Photo courtesy of Sura Nualpradid/ FreeDigitalPhotos.net
Photo courtesy of Sura Nualpradid/ FreeDigitalPhotos.net

My very concerned husband asked me if I were feeling okay after another night of me not sleeping well. During the conversation he asked the question “have you gained weight”?

Yikes! Did he really just ask me that? He has NEVER asked me that.

For those that don’t know my husband, he didn’t ask the question out of malice or ill-will, he was sincerely trying to analyze the situation so that he could fix it and I could sleep.

But did he have to ask me that question?

Yes, I’ve gained weight and it’s very noticeable… to me. My jeans don’t fit the way they used to and my hormones have been a raging hot mess. Despite my efforts of maintaining my eating regimen, it just was not paying off when it came to those lovely three digits on that scale.

It has been one of those weeks where you walk by the scale and give it the stank eye while secretly wishing you could just smash it all to pieces.

Several years ago, I was diagnosed with Polycystic Ovary Syndrome (PCOS), which is an endocrine disorder where a woman’s hormones are completely and utterly out of whack! (Dr. Nadia’s non-medical definition).

Some of the symptoms are infertility, acne, and weight gain especially around the middle.  Doctors often share the grim news that not only will it be difficult or impossible to get pregnant it may also be difficult (or impossible) to lose weight!

Why am I sharing this?

Because whether you want to admit it or not, the way you feel about yourself and your overall health impact your performance at work. It is even more frustrating when you feel like you are doing everything right and yet you’re still not seeing the results you want to see.

This week with getting back into the groove of business and working on my new project has been stressful in and of itself. Add in the fact that I’m not feeling my best and I don’t feel that I look my best added insult to injury.

It has been difficult to focus due to a lack of sleep and because of my type A personality I tend to just say “I need to work a little harder”. I just need to be more disciplined and it will get better.

That’s where my coach comes in. As we were talking, she could tell that something wasn’t right and instead of saying “Nothing” (the standard lie so many women tell when someone asks what’s wrong) I shared with her what was going on.

It’s not always easy to be vulnerable and share that not only is something wrong, but despite your best efforts you don’t seem to be able to fix it.

Her response was, “Be easy on yourself”.

It wasn’t a “get out of jail free” card that meant I no longer had to work hard and handle my business, but it was permission to admit that there are some things that are out of my control. It was permission to acknowledge that I won’t have all of the answers, but when I am physically, emotionally, and hormonally off it affects every single area of my life whether I like it or not.

Sometimes your support team isn’t there to help you do anything major except to remind you to give yourself a break. Everything isn’t going to be perfect and there are some things that are beyond your immediate control.

After our conversation, she forwarded me the contact information of someone who could relate to what I was going through in case I wanted to talk about it more. Not only could she relate, but she shared the findings of her personal research along with her story.

While reading the contact’s story detailing her journey with PCOS, her findings and her approach I began to not only feel better, but I began to see that I had options beyond 1) keep doing what I’ve been doing or 2) just give up altogether.

Three years ago when I decided to make some serious changes in my health, it paid off big. Not only did I lose weight and feel great, but was able to stop taking asthma and allergy medications after 20 years! It was nothing short of miraculous. So surely, if I just stayed the course it would help with this too, right?

Maybe not.

The former process just didn’t fit my life and my new hectic schedule. It not only no longer served me, but it frankly wasn’t working. Now I may have found another way. In reading her story and her research, I found an option that not only fits my lifestyle, but also fits my desire to take a more holistic approach to my health.

I had a choice to make. Was I going to sit there and whine about it or was I going to do something about it?

I could make the choice to continue doing things the way that I have been or I could try something new. By making minor shifts in my daily routine and actions, I could have a major impact on my mood, my health, and my waistline.**excerpt from Dr. Nadia’s soon to be released book ~ Leading Like a Lady: How to Shatter Your Inner Glass Ceiling

Note: This is not a fad diet. As a matter of fact, she recommends you throw out the word D-I-E-T! Can I get an “AMEN”?

What is going on in your world right now that you may need to evaluate? The definition for insanity is doing the same thing and expecting a different result. Even things that we deem good may no longer serve us for where we are and where we want to go.

Instead of beating yourself up about it, why not open up and see if there might be a better way? Be easy on yourself.