1 post tagged “polycystic ovarian syndrome”

By John Morgan, Spotlight Health

With medical adviser Stephen A. Shoop, M.D.

	Kat Carney.

For millions of young women, "being late" doesn't mean they have poor time-management skills. A late or missed menstrual cycle can cause panic. But aside from a possible pregnancy, a missed period may actually be a sign of polycystic ovarian syndrome (PCOS), the most common hormonal problem among women of reproductive age. When Kat Carney, host of Discovery Health Channel's The Body Invaders, learned she had an ovarian cyst, she had never even heard of PCOS. Unfortunately, neither had her doctor. Or if he did, he failed to recognize her classic PCOS symptoms. "I didn't realize I had any problem because these symptoms were too easily attributed to other causes," shares Carney.

"My weight gain was because I didn't exercise enough. A few facial hairs and irregular periods were just wacky hormones. My doctor wasn't concerned with the cyst, so neither was I."

But her body began to tell her otherwise.

Over the next six years Carney's symptoms only got worse. She started losing the hair on her head while the facial hair increased, and she ballooned to 220 pounds. Desperate, Carney turned to another doctor, who ran some blood tests and did a sonogram which revealed that each of her ovaries had 30 cysts. It was only then that she learned she had PCOS.

PCOS basics

Kat Carney's frustration with the medical community is all too familiar to the millions of women who have PCOS. Very little is understood about the syndrome. Doctors don't know why an estimated 6-10% of reproductive age women contract the syndrome, although there seems to be a genetic predisposition that may be as high as 50% for daughters whose mothers are afflicted.

"Onset of the syndrome appears to be around puberty and tends to diminish with age, with ovulation starting again around 35," states Dr. Sam Thatcher, director of the Center for Applied Reproductive Science in Johnson City, Tenn.

An extensive Dutch study found that young women whose periods occur over 40 days apart don't get regular. "They don't grow out of it. And these girls are often at risk for PCOS," says Thatcher, author of PCOS: The Hidden Epidemic.

Thatcher advises that a young woman who has not had a period by age 16 should be evaluated because PCOS is one of the leading causes of infertility.

Symptoms of PCOS include:

• Ovarian cysts
• Irregular or absent monthly cycle
• Obesity or weight gain centered in the midsection
• Facial hirsutism (excessive hair growth)
• High blood pressure
• Acne
• Insulin resistance, elevated insulin, or diabetes
• Thinning of the scalp hair
• Infertility

According to Thatcher, PCOS is difficult for many doctors to diagnose because there are so many symptoms and not all women have all the warning signs. The three main forms of diagnosis are:

• Clinical diagnosis with the clinical triad of obesity, irregular cycle, and hair and skin problems associated with high androgen levels.

• Hormonal testing, including insulin and lipid panels.

• Ultrasound scan of the ovaries.

While the syndrome does not generally shorten a woman's lifespan, the many symptoms can seriously erode quality of life.

"Many women suffer intense feelings of isolation which lead to depression and eating disorders," details Thatcher, who is donating the proceeds of his book to PCOS advocacy and education groups. "PCOS threatens all things female. You get overweight. You have to shave. You get acne. And you can be infertile."

Heal thyself

The good news is there are effective treatments for PCOS. Most women are placed on birth control pills to regulate their hormones and anti-androgen medications to control the hirsutism. Fertility therapy typically includes the use of Clomid.

"My doctor put me on birth control pills and aldactone, an anti-androgen medication to combat the hirsutism," recalls Carney. "He said I'd have to take them until I was ready to try and have children."

But instead of feeling better, within weeks Carney was gaining more weight, losing more hair, and feeling more depressed. He explained she was gaining weight from eating fatty foods. Her depression was because she was obese, and the profuse sweating that she complained of was simply "hot weather."

Eight doctors later, Carney weighed 240 pounds and had had enough with "the exact same" diagnoses. Her depression was increasing, and her mood swings had intensified. She felt terrible, and she was determined to find out why.

So she turned to the Internet.

"I didn't have a choice. My doctors weren't giving me any other options," states Carney, who has started a Web site to help other women with PCOS. "I became a fanatic. I looked up every thing. I read every thing I could find, and I became my own advocate."

What Carney found was that the birth control pills were causing her weight gain, depression, and hot flashes. She stopped taking her prescribed medications and asked her doctor for Eulexin, a drug used successfully in Europe to treat excess body hair and PCOS. Because the medication wasn't FDA-approved for PCOS, her doctor refused.

Carney finally found a doctor who agreed to prescribe Eulexin as long as she came in for regular liver testing. She immediately began to feel better.

Eulexin worked for Carney, but Thatcher cautions it doesn't work for everyone, and that patients should always consult a physician. "Every patient is different with different symptoms. We need to tailor treatment to the individual needs of each patient."

Modern medicine

And Thatcher cautions that people should not assume PCOS is an illness associated solely with the ovaries and female hormones. In actuality, PCOS is a disorder of the entire endocrine system — the brain, pituitary gland, pancreas, liver, fat, and ovaries — which is responsible for maintaining homeostasis in the body.

"The most important advance in PCOS has been linking the syndrome to insulin resistance," explains Thatcher. "For some reason, the body seems to become deaf to the actions of insulin, so the pancreas speaks louder, making more insulin, which disrupts the body's equilibrium."

Recent studies indicate that as many as 50% of women with PCOS have insulin resistance and are at high risk for Type 2 diabetes. Because of the link to insulin resistance, many experts now advocate the American Diabetes Association's guidelines for a 250-500 reduction in calories. Exercise is also highly recommended.

"I read all the literature on the insulin connection. I knew I had to get my body well," explains Carney. "So I eliminated all refined carbohydrates and started going to the gym every morning and every night."

Six weeks later, the weight that she could never lose before began coming off. And her symptoms were remitting.

Over the next 14 months, Carney lost 90 pounds and eventually needed no medication at all.

"I feel better than ever. My weight has never been better, and I have no cysts," reports Carney. "My blood work indicates I don't have PCOS."

But if Carney gets stressed, skips working out, or eats poorly, her symptoms return.

Promising treatment

Another medication being used to successfully treat PCOS symptoms is Metformin, an insulin-altering drug that sensitizes the body to insulin and inhibits glucose production without risk of hypoglycemia. One of the side effects of Metformin is weight loss caused by gastrointestinal upsets.

"Metformin is an important medication for some, but not for all," advises Thatcher. "It got very popular on the Internet. Yet some women don't tolerate it well."

While PCOS cannot be cured, once properly diagnosed, it can usually be effectively managed. Even for infertility, Thatcher's clinic reports a fertility success rate of 90%.

"Just because you have PCOS, it doesn't mean you can't have children," says the 31-year-old Kat Carney. "Many can. I ovulate very regularly now."

As for children in her future, Carney says it's nice to know she has a choice. "The hardest thing has been getting used to being thinner," jokes Carney, who now weighs 150 pounds, yet still finds herself asking for a size 16. "I remember noticing men notice me for the first time. I ran home."

This is one race she might want to lose.