A discussion of Polycystic Ovarian Syndrome (PCOS).

>> Thursday, March 3, 2011

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PCOS is characterized by a series of hormonal imbalances which can cause abnormal bleeding patterns, irregular ovulation, and difficulty in getting pregnant. PCOS may also cause unwanted changes in the way you look. If it is not treated, over time it can lead to serious problems with your health, like diabetes or high blood pressure.

Hormones are chemical messengers that trigger many different processes, including growth and energy production. Often, the job of one hormone is to signal the release of another hormone. For reasons that are not well understood, in PCOS the hormones get out of balance. One hormone change triggers another, which changes another.

For example, the ovaries (the main source of female hormone production) make a tiny amount of male sex hormones called androgens. In PCOS, they start making slightly more androgens. This may cause you to stop ovulating, get acne, or grow extra facial and body hair - any of which can be distressing.

Physiologically, the body may have a problem using other hormones like insulin - which is called insulin resistance. When the body is unable to use insulin properly blood sugar levels go up. Over time, this increases your chance of developing diabetes. So even though PCOS is usually present during the teenage years, shortly after menarche, the symptoms tend to be few and mild at first. Some of the most common symptoms are acne, weight gain and trouble losing weight. These could be confused with normal changes in the teen years, and come on now girls, we all know how distressing it can be to do everything in your power to lose weight, only to gain more. Ughh! It’s painful, and so painful to watch your child suffer with it.

As time goes on, extra hair can appear on the face and body, and often women get thicker and darker facial hair and more hair on the chest, belly, and back. And if that’s not bad enough, the hair will begin to thin on the top of your head.

Often women with PCOS have fewer than nine periods a year. Some women have no periods. Others have very heavy bleeding. Periods can become incredibly unpredictable, which is why it can be so difficult to get pregnant with PCOS. But, if you have heard someone say, “Women with PCOS can’t get pregnant,” don’t believe it. The hormone imbalances, and irregular menses can be treated. As long as you have a functional uterus and ovaries, you can get pregnant. You may need a little help, but it can happen.

So, let’s discuss how to find out if you have PCOS and outline some of the treatments for the various symptoms. To diagnose PCOS, your doctor may send you for an ultrasound to examine your internal organs, and take a look at your uterus and ovaries. PCOS almost always shows a ring of small cysts on the ovaries, and that is where the name polycystic (or many cysts) comes from. The cysts are not harmful, but are a result of the hormone imbalances. PCOS seems to run in families, so your chance of having it is higher if other women in your family have PCOS, irregular periods, or diabetes. PCOS can be passed down from either your mother's or father's side.

Of course, it is important to get labs drawn to check for hormone imbalances and other abnormalities in your blood. Your doctor may order these tests: fasting insulin, fasting glucose, fasting lipid panel, thyroid panel, estrogen, progesterone, testosterone (free and bound), alpha hydroxyprogesterone, C-reactive protein, DHEA, DHEAS, and complete blood count. There are several other labs and hormones that can be checked .

After a PCOS diagnosis has been made, birth control pills are often given, because they can help your periods become regular and can reduce symptoms such as excess facial hair and acne. An androgen-lowering medicine, spironolactone, may be used with the birth control pills to help reduce symptoms even more. Some of the newer birth control pills have a progesterone in them that is chemically similar to spironolactone, like BeYaz, Yaz and Yasmin.
To treat insulin resistance and metabolic disorders, a diabetes medicine called metformin is used. The goal is generally to get blood sugar balanced and weight controlled, which in turn improves overall health and reduces the chances of other major health problems such as:
  • Type 2 diabetes
  • High blood pressure
  • Cholesterol abnormalities, such as high triglycerides or low high-density lipoprotein (HDL) cholesterol
  • Elevated levels of C-reactive protein, a cardiovascular disease marker
  • Metabolic syndrome, a cluster of signs and symptoms that indicate a significantly increased risk of cardiovascular disease
  • Nonalcoholic steato-hepatitis, a severe liver inflammation caused by fat accumulation in the liver
  • Sleep apnea
  • Abnormal uterine bleeding and endometrial cancer caused by exposure to continuous high levels of estrogen
So, it’s not hard to understand why this is more than a bleeding problem, and if left untreated can lead to many health problems. I hope this helped explain to you what is happening in your body, and also encourage you to see your doctor, Stop putting it off, your health is important.
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