I could not find a health category in this forum. Hope, I did put some information in this right category.
WHAT ARE THE SYMPTOMS?
Symptoms can be mild or severe, and can vary widely from woman to woman. This is part of the reason doctors often miss the diagnosis. Someone with PCOS may have one or all of the following symptoms in varying degrees:
- irregular periods: abnormal, irregular, heavy or scanty (oligomenorrhea)
- absent periods (amenorrhea)
- ovarian cysts
- hirsutism (excess facial and/or body hair)
- alopecia (male-pattern hair loss)
- obesity
- acne
- skin tags
- acanthosis nigricans (brown skin patches, often found on the nape of the neck)
- high cholesterol levels
- high blood pressure
- exhaustion and/or lack of mental alertness
- decreased sex drive
- excess "male" hormones, such as androgens, DHEAS, or testosterone
- infertility
- decreased breast size
- enlarged clitoris(rare)
- enlarged ovaries
- enlarged uterus
Note that symptoms can worsen over time or with weight gain.
I THINK I HAVE PCOS - WHAT NOW?
Go straight to an endocrinologist. They specialize in glandular disorders; in this case, the gland in question is the pancreas, which is overproducing insulin. Seeing an OB/GYN is only really useful if you are trying to get pregnant and, even then, a reproductive endocrinologist would probably be better informed.
TESTING FOR PCOS
There is no *one* truly definitive test yet, but rather a set of tests can be used to diagnose PCOS:
1. A glucose tolerance test (GTT). Note that for the GTT you should have about 200g of carbs daily for the three to four days leading up to the test -- but of course fasting for 10 to 12 hours right before the test! -- otherwise the results will not be accurate. Also, smoking or exercise for 8 hours before or during the test can affect results.
2. Cholesterol Levels. Not just total cholesterol, but also triglycerides, HDL cholesterol, LDL cholesterol.
3. Testosterone, LH, FSH, and androstenedione levels. Some doctors will advocate more or fewer tests, but the ones listed above are the most common. Other tests may include urine 17-ketosteroids, laparoscopy, ovarian biopsy, serum HCG (pregnancy test), and basal fasting insulin.
In addition, some physicians will also suggest an ultrasound to check for ovarian cysts, which is of course what the syndrome is actually named after. However, some women with PCOS do *not* have ovarian cysts and some women who do not have PCOS do, so an ultrasound alone is not enough for a firm diagnosis.
WHAT CAUSES PCOS?
The root of PCOS is an inability to respond properly to insulin, the hormone produced in the pancreas that allows your body's cells to absorb energy from the food you eat. This means your cells don't respond to the normal amount of insulin, so the pancreas pumps out even more. That's what insulin resistance is and it happens when the body turns carbohydrates, both simple and complex, into glucose that surges into the bloodstream. Insulin travels to the muscle cells, telling them to take glucose from the bloodstream and store it in the liver. As insulin levels in the blood increase, glucose levels in the blood decrease. When blood glucose falls below a certain level, the brain, which needs glucose to function, calls out for more by telling you to eat again. If it doesn't get glucose, the result is drowsiness or lack of mental alertness. This glucose shortage is also known as low blood sugar or hypoglycemia. When hypoglycemia strikes, the liver is unable to replenish bloodglucose from its stored supply because eating a carbohydrate-rich meal or drinking a sugary beverage creates an exaggerated insulin response that prevents delivery of the glucose. So, insulin remains in the bloodstream,sending messages to store more body fat and preventing the release of already-stored fat, and glucose remains in the liver instead of going to the brain. In addition, the high levels of insulin stimulate the ovaries to produce large amounts of the male hormone testosterone, which may prevent the ovaries from releasing an egg each month, causing infertility. High testosterone levels in women also cause acne, male-pattern baldness, and excess hair growth. Last but not least, it is the insulin problem that puts us at increased risk for diabetes as well as heart disease.
WHAT IF I HAVE PCOS?
If you are currently overweight, the first step is to lose the excess pounds, because many symptoms of PCOS improve or even disappear entirely at normal weight. Since the cause of all the problems is insulin resistance, the key seems to lie in restricting carbohydrates and exercising regularly, for physical activity also helps regulate insulin production. The most popular of the low-carb diets are 'Dr Atkins' New Diet Revolution' by Robert Atkins and 'Protein Power' by Michael and Mary Eades. Another popular approach is the 'Carbohydrate Addicts Diet' by Rachel and Richard Heller. Even at normal weight, it is still critical to moderate carbohydrate intake as well as exercise. This is simply going to have to be a way of life, since PCOS cannot be cured, only held in check. Although many women have reported great success through low-carbing and exercise alone, a growing number of women with PCOS are now being treated with so-called diabetic drugs, such as Metformin (AKA Glucophage). There have been several studies reporting good results in treating PCOS with Metformin. However - and this is very important! - Metformin is only meant to be taken temporarily. The goal is to use Metformin in conjunction with diet and exercise to lose excess weight.
WHAT ARE THE SYMPTOMS?
Symptoms can be mild or severe, and can vary widely from woman to woman. This is part of the reason doctors often miss the diagnosis. Someone with PCOS may have one or all of the following symptoms in varying degrees:
- irregular periods: abnormal, irregular, heavy or scanty (oligomenorrhea)
- absent periods (amenorrhea)
- ovarian cysts
- hirsutism (excess facial and/or body hair)
- alopecia (male-pattern hair loss)
- obesity
- acne
- skin tags
- acanthosis nigricans (brown skin patches, often found on the nape of the neck)
- high cholesterol levels
- high blood pressure
- exhaustion and/or lack of mental alertness
- decreased sex drive
- excess "male" hormones, such as androgens, DHEAS, or testosterone
- infertility
- decreased breast size
- enlarged clitoris(rare)
- enlarged ovaries
- enlarged uterus
Note that symptoms can worsen over time or with weight gain.
I THINK I HAVE PCOS - WHAT NOW?
Go straight to an endocrinologist. They specialize in glandular disorders; in this case, the gland in question is the pancreas, which is overproducing insulin. Seeing an OB/GYN is only really useful if you are trying to get pregnant and, even then, a reproductive endocrinologist would probably be better informed.
TESTING FOR PCOS
There is no *one* truly definitive test yet, but rather a set of tests can be used to diagnose PCOS:
1. A glucose tolerance test (GTT). Note that for the GTT you should have about 200g of carbs daily for the three to four days leading up to the test -- but of course fasting for 10 to 12 hours right before the test! -- otherwise the results will not be accurate. Also, smoking or exercise for 8 hours before or during the test can affect results.
2. Cholesterol Levels. Not just total cholesterol, but also triglycerides, HDL cholesterol, LDL cholesterol.
3. Testosterone, LH, FSH, and androstenedione levels. Some doctors will advocate more or fewer tests, but the ones listed above are the most common. Other tests may include urine 17-ketosteroids, laparoscopy, ovarian biopsy, serum HCG (pregnancy test), and basal fasting insulin.
In addition, some physicians will also suggest an ultrasound to check for ovarian cysts, which is of course what the syndrome is actually named after. However, some women with PCOS do *not* have ovarian cysts and some women who do not have PCOS do, so an ultrasound alone is not enough for a firm diagnosis.
WHAT CAUSES PCOS?
The root of PCOS is an inability to respond properly to insulin, the hormone produced in the pancreas that allows your body's cells to absorb energy from the food you eat. This means your cells don't respond to the normal amount of insulin, so the pancreas pumps out even more. That's what insulin resistance is and it happens when the body turns carbohydrates, both simple and complex, into glucose that surges into the bloodstream. Insulin travels to the muscle cells, telling them to take glucose from the bloodstream and store it in the liver. As insulin levels in the blood increase, glucose levels in the blood decrease. When blood glucose falls below a certain level, the brain, which needs glucose to function, calls out for more by telling you to eat again. If it doesn't get glucose, the result is drowsiness or lack of mental alertness. This glucose shortage is also known as low blood sugar or hypoglycemia. When hypoglycemia strikes, the liver is unable to replenish bloodglucose from its stored supply because eating a carbohydrate-rich meal or drinking a sugary beverage creates an exaggerated insulin response that prevents delivery of the glucose. So, insulin remains in the bloodstream,sending messages to store more body fat and preventing the release of already-stored fat, and glucose remains in the liver instead of going to the brain. In addition, the high levels of insulin stimulate the ovaries to produce large amounts of the male hormone testosterone, which may prevent the ovaries from releasing an egg each month, causing infertility. High testosterone levels in women also cause acne, male-pattern baldness, and excess hair growth. Last but not least, it is the insulin problem that puts us at increased risk for diabetes as well as heart disease.
WHAT IF I HAVE PCOS?
If you are currently overweight, the first step is to lose the excess pounds, because many symptoms of PCOS improve or even disappear entirely at normal weight. Since the cause of all the problems is insulin resistance, the key seems to lie in restricting carbohydrates and exercising regularly, for physical activity also helps regulate insulin production. The most popular of the low-carb diets are 'Dr Atkins' New Diet Revolution' by Robert Atkins and 'Protein Power' by Michael and Mary Eades. Another popular approach is the 'Carbohydrate Addicts Diet' by Rachel and Richard Heller. Even at normal weight, it is still critical to moderate carbohydrate intake as well as exercise. This is simply going to have to be a way of life, since PCOS cannot be cured, only held in check. Although many women have reported great success through low-carbing and exercise alone, a growing number of women with PCOS are now being treated with so-called diabetic drugs, such as Metformin (AKA Glucophage). There have been several studies reporting good results in treating PCOS with Metformin. However - and this is very important! - Metformin is only meant to be taken temporarily. The goal is to use Metformin in conjunction with diet and exercise to lose excess weight.