Polycystic Ovarian Syndrome (POS)

>> Thursday, January 5, 2012

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So Shelly’s labs and ultrasound came back and just as predicted, the uterus was normal. The ovaries showed the small immature cysts that border the ovary. This is classically seen in PCOs or polycystic ovarian syndrome. It’s interesting to go see the radiologist and have them show you this. What happens is that the follicles begin to mature but the process just stops and freezes at a certain point. These cysts or follicles are resistant to the message (hormonal ) that tells them to complete the process to ovulation.

Why does this happen? PCOs is the most common hormonal dysfunction we see today in young women, so the blood work tells the rest of the story. There are usually abnormalities in testosterone levels, fasting insulin levels, FSH and LH ratios that are the messengers from the brain to orchestrate the hormone releases for ovulation. Many times estrogen and progesterone will be normal. These imbalances can cause abnormal facial hair growth, tummy and chest hair in some women, and abnormal weight gain due to the high insulin levels. But it is the anovulation, or lack of ovulation that creates the menstrual irregularities.

Our bodies are fearfully and wonderfully made and it’s amazing that they function so perfectly most of the time. PCOs can be corrected but the first symptom was irregular cycles. Many women use their cycles as a way to measure their health, right? If cycles are OK, I must be OK, if cycles are changing or irregular something must be wrong, and they are right. It is very important to go see your doctor so a full evaluation can be done, if needed.

Ciara had a different situation. It turns out that her ultrasound did show that she had a 2 cm fibroid inside her uterus. There were a few smaller fibroids within the body of the uterus. All of her blood work was normal.

Ciara and I went over everything and all the possibilities for treatment. Because of the severe cramping the intrauterine fibroid was causing and her desire to have more children, she wanted to have it removed surgically. It is common to see women with fibroids have erratic, irregular bleeding and spotting. Some women will bleed after sex, every time they use the restroom, and because the fibroid is inside the uterus, the uterus will contract or cramp to try to get it out. Since she wants to have more children, the small fibroids within the uterus can be left alone and monitored as they are benign and should not interfere with pregnancy.

Isn’t amazing how both these women came in with the same complaint but have totally different problems in their bodies. Just take care of yourself, and have regular checkups with a doctor you trust; if something goes wrong you can get it resolved quickly.

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