Health tit bits PCOS

What is polycystic ovary syndrome (PCOS)?

Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman's:

• Menstrual cycle       What is one of them? I have gone for 3 years with out a bleed
• Ability to have children       I  am not able to have children 
• Hormones                           Mine are all over the place think pre puberty all the time. 
• Heart
• Blood vessels
• Appearance                 Will tell you more about this later on but yes very much so. 

With PCOS, women typically have:

• High levels of androgens (AN-druh-junz). These are sometimes called male hormones, though females also make them.
• Missed or irregular periods (monthly bleeding)
• Many small cysts (sists) (fluid-filled sacs) in their ovaries

What causes PCOS?

The cause of PCOS is unknown. But most experts think that several factors, including genetics, could play a role. Women with PCOS are more likely to have a mother or sister with PCOS.

A main underlying problem with PCOS is a hormonal imbalance. In women with PCOS, the ovaries make more androgens than normal. Androgens are male hormones that females also make. High levels of these hormones affect the development and release of eggs during ovulation.

Researchers also think insulin may be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. Many women with PCOS have too much insulin in their bodies because they have problems using it. Excess insulin appears to increase production of androgen. High androgen levels can lead to:

• Acne                                        Thankfully I do not suffer with acne.
• Excessive hair growth            Oh yes on my face, chest and arms.
• Weight gain                            Yes ALOT which is what is leading towards my weight loss surgery.
• Problems with ovulation         I have a serious problem with ovulation. 

What are the symptoms of PCOS?

The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:

• Infertility (not able to get pregnant) because of not ovulating. In fact, PCOS is the most common cause of female infertility.
• Infrequent, absent, and/or irregular menstrual periods
• Hirsutism (HER-suh-tiz-um) — increased hair growth on the face, chest, stomach, back, thumbs, or toes
• Cysts on the ovaries
• Acne, oily skin, or dandruff
• Weight gain or obesity, usually with extra weight around the waist
• Male-pattern baldness or thinning hair
• Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black
• Skin tags — excess flaps of skin in the armpits or neck area
• Pelvic pain
• Anxiety or depression
• Sleep apnea — when breathing stops for short periods of time while asleep

For me the worst effects of the PCOS is the infertility. The hair growth although a depressing aspect can be managed with a razor. Even if this does bring about it's own problems like a shaving rash, most days I can deal with it. 

The weight gain, skin tags and darker skin is all unsightly but I have learnt to just get on with it. My body is what it is. 

Now please dont misunderstand me. I have my days I do not want to go out my front door and I don't. I am ashamed when meeting new people. Humans are very judgemental by nature. No amount of make up or feminine clothes can make me feel like a woman. I may have the body of a female but it is rebelling against me. Facial hair, legs and face need to be shaved every 24 hours. I have a new understanding of a 5 oclock shadow, and i am blonde and fair skinned so what colour are they  . . . yep dark almost black. My arm hair is slightly darker and thicker than most but the sun bleaches them so in the summer it is not to bad. 

How is PCOS treated?

Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, whether or not you want to become pregnant, and lowering your chances of getting heart disease and diabetes. Many women will need a combination of treatments to meet these goals.

Personally I find the fact there is no cure to be very frustrating. In the past 10 years alone I have tried different methods to try to help control my symptoms. With not much luck. Thankfully in the 15 years I have been receiving treatment it has changed as more studies are done and it keeps changing all the time with new recommendations, which yes i will try. 

 Some treatments for PCOS include:

Lifestyle modification. Many women with PCOS are overweight or obese, which can cause health problems. You can help manage your PCOS by eating healthy and exercising to keep your weight at a healthy level. Healthy eating tips include:

• Limiting processed foods and foods with added sugars
• Adding more whole-grain products, fruits, vegetables, and lean meats to your diet

This helps to lower blood glucose (sugar) levels, improve the body's use of insulin, and normalize hormone levels in your body. Even a 10 percent loss in body weight can restore a normal period and make your cycle more regular.

At one time i spent 3 years on a strict no carb and 1000 calorie a day diet, for me this did not help with my weight gain even with exercise and metformin. 

Birth control pills. For women who don't want to get pregnant, birth control pills can:

• Control menstrual cycles
• Reduce male hormone levels
• Help to clear acne

Keep in mind that the menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone (proh-JES-tuh-rohn), like Provera, to control the menstrual cycle and reduce the risk of endometrial cancer . But, progesterone alone does not help reduce acne and hair growth.

Not an option for me. 

Diabetes medications. The medicine metformin (Glucophage) is used to treat type 2 diabetes. It has also been found to help with PCOS symptoms, though it isn’t approved by the U.S Food and Drug Administration (FDA) for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production. It slows the growth of abnormal hair and, after a few months of use, may help ovulation to return. Recent research has shown metformin to have other positive effects, such as decreased body mass and improved cholesterol levels. Metformin will not cause a person to become diabetic.

Personally I did not have any improvement with the weight or hair growth while taking metformin. I still take it to this day. 

Fertility medications. Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used. Also, some fertility medications increase the risk for multiple births (twins, triplets). Treatment options include:

• Clomiphene (KLOHM-uh-feen) (Clomid, Serophene) — the first choice therapy to stimulate ovulation for most patients.
• Metformin taken with clomiphene — may be tried if clomiphene alone fails. The combination may help women with PCOS ovulate on lower doses of medication.
• Gonadotropins (goe-NAD-oh-troe-pins) — given as shots, but are more expensive and raise the risk of multiple births compared to clomiphene.

Another option is in vitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any given cycle. It also gives doctors better control over the chance of multiple births. But, IVF is very costly.

Surgery. "Ovarian drilling" is a surgery that may increase the chance of ovulation. It’s sometimes used when a woman does not respond to fertility medicines. The doctor makes a very small cut above or below the navel (belly button) and inserts a small tool that acts like a telescope into the abdomen (stomach). This is called laparoscopy (lap-uh-RAHS-kuh-pee). The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But, these effects may only last a few months. This treatment doesn't help with loss of scalp hair or increased hair growth on other parts of the body.

Medicine for increased hair growth or extra male hormones. Medicines called anti-androgens may reduce hair growth and clear acne. Spironolactone (speer-on-oh-LAK-tone) (Aldactone), first used to treat high blood pressure, has been shown to reduce the impact of male hormones on hair growth in women. Finasteride (fin-AST-uhr-yd) (Propecia), a medicine taken by men for hair loss, has the same effect. Anti-androgens are often combined with birth control pills.  These medications should not be taken if you are trying to become pregnant.

Before taking Aldactone, tell your doctor if you are pregnant or plan to become pregnant. Do not breastfeed while taking this medicine. Women who may become pregnant should not handle Propecia.

Other options include:

• Vaniqa (van-ik-uh) cream to reduce facial hair
• Laser hair removal or electrolysis to remove hair
• Hormonal treatment to keep new hair from growing

Other treatments. Some research has shown that bariatric (weight loss) surgery may be effective in resolving PCOS in morbidly obese women. Morbid obesity means having a BMI of more than 40, or a BMI of 35 to 40 with an obesity-related disease. The drug troglitazone (troh-GLIT-uh-zohn) was shown to help women with PCOS. But, it was taken off the market because it caused liver problems. Similar drugs without the same side effect are being tested in small trials.

I am due to have weight loss surgery this spring, which i am very excited about. I will keep you updated as to my journey with my attempts to loose weight, increase my fertility and control some of my other PCOS effects. 

I would like to share aletter I used to try to explain how infertiltity makes me feel, check out the page titled heartfelt letter.