Polycycistic ovary syndrome

[firecat88]

So...next Friday, I get to go to the doctor. For a while, I've suspected that I most-likely have PCOS (poly-cystic ovary syndrome). I have quite a few of the signs and symptoms of it, if Wikipedia is to be believed. However, until now, I've never really done anything about it. On Friday, though, I'm finally being formally, officially tested for it. I'm not at all sure what this entails, though. Has anyone else here had the procedure done?

[Seshat]

When I was tested, they covered three things.

1. A fasting blood sugar test. (To determine my level of insulin resistance, I believe.)
2. A lower abdomen ultrasound, to look at my ovaries and see if they were polycystic. Also to rule out endometriosis, uterine fibroids, and other lower abdomen anomalies.
3. Checking whether I had the other problems: eg, the tendency to put on belly weight rather than hip/thigh weight, the tendency to hairiness, the totally wonky periods.

I think they also did a urine dipstick test (the diabetes check, among others). They may also test how your body reacts to glucose - I've never had that done, but it would make sense to me for them to test it.

The fasting blood sugar test is annoying, but minor. You eat nothing after 10pm the night before, go in to a path lab first thing the next morning, confirm to the nurse that you're having a fasting blood sugar test and have had nothing but water, and you and the four or five others having a fasting test get to be processed first.
It's just a standard blood sample. Definitely do it at a path lab, preferably one you've used before and where you know the nurses are good at getting blood samples.


The lower abdominal ultrasound is more annoying. They use a transvaginal probe, and yes, that does mean what it sounds like. They stick a probe up your vagina and waggle it around while watching the ultrasound monitor.
As long as you get a good tech, it's all very mechanical and medical and gentle. And they use plenty of lube, and a condom.
Take a friend to hold your hand if you want to.
They also use another scanner, this one across your belly. It's a lot less (ahem) intrusive.
They do the scan twice, once with you with a full bladder, and once empty. They ask you to drink a certain amount of water however-many-hours before coming in. Sorry I can't be more precise, mine were done years ago.


As for the rest: keep a menstruation diary for a few months. If you can manage to, do without shaving (or waxing or whatever) for several weeks so you can show your doctor your natural level of hairiness. The rest of the signs are pretty visible to a doctor who knows what he/she is looking for.


Solutions for PCOS:
PCOS is a disorder of both the digestive and the reproductive hormones, with each side making the other worse. You can attack it from either side.

From the digestive side: diabetes medications like metformin (eg diabex) are helpful. Note that you don't need insulin if you have PCOS but not diabetes.

A low glycaemic index or low glycaemic load diet is extremely helpful.
It will feel very odd and 'wrong' to start with! You're used to your blood sugar spiking and dropping off suddenly, and probably used to constantly having small amounts of something sugary so you have a lot of small spikes during the day. Self-medicating with sugar!
This is actually a sensible approach when you don't know what's going on - it works, and minimises the intense lows of a sugar drop. But in the long term, it will overload your pancreas and probably end up giving you diabetes and/or heart disease.

A low glycaemic load diet is a better solution in the long term. With this, you don't ever spike - instead, you have a slooow climb followed by a slooow fall, and you cycle around the natural ideal-point. It mimics what a normal, non-insulin-resistant person's blood sugar does.

It took me two or three weeks to adjust to the different way my body felt, and still (years later) I find myself craving sugar highs - and sometimes give in. But the majority of my diet is now low GI.

BTW: adjust it slowly if you need to. Switch from white bread to multigrain, but change nothing else for two weeks. Then change the type of fruit you eat. Two weeks. Then....

Exercise is another key factor. It reduces the insulin resistance, increases the number of muscle cells in your body and reduces the number of active fat cells. This helps both the digestive and repro hormones!
If you've been reading my advice here, you'll know I advocate starting exercise slowly, and building up only as you feel comfortable. Also, finding a place and time to exercise which suits you, and a type of exercise which suits you.


Lastly, you can attack PCOS through the reproductive hormones. Usually this involves the pill, the patch, implanon, depo-provera, or some other form of synthetic hormone.
It's never worked for me. This doesn't mean it might not for you - some people find it works beautifully for them.

[Miss_Stress]

I echo Seshat. I can't add anything about the procedure, as Seshat has covered it marvellously. I have the syndrome myself and had to go through all those procedures. They provided me with the pill and so far it has worked, so there's hope it will work for you and you must drink a pint of water an hour before the scan. Take someone with you if possible, as Seshat says.

Lastly, if you need to talk, PM me because I understand all too well

[Seshat]

As, of course, do I.

Edit to add: the diet+exercise+metformin attack is working on my case. So between Miss_Stress and I, you have evidence of both strategies being worthwhile. It's just an issue of which works for you.

I would recommend adjusting to a low GI (or low GL) diet regardless of which strategy you attempt, however. Mostly, I think, because it works for me, and it makes sense to me. And no, it doesn't matter one bit if you have that slice of cake, or pig out on those biscuits. Just go ahead and pick up again afterwards.

As for exercise... well, buy a frisbee and take your family to the park.

(What? I'm serious. Exercise doesn't mean going to the gym and wearing yourself out. It means throwing frisbees, or playing badminton without a net and without any rules, or walking the dog, or.....)

[blondemarmot]

I have that too! When I finally got a doctor who would take me somewhat seriously about my "little" issues I got the fasting test and they tested for androgens. That was it. Androgens were a little high (didn't hear about the fasting test) but with the hirsutism and ridiculous periods they confirmed it. Then went through a couple more asshole doctors.
"If you just lose weight all your problems will go away," my ass. Direct quote.

[pitmonkey]

I have this also. It does run in families, daughter, sis and I have it. One of the ideas about pcos is that the body is making more insulin to combat the Resistance of the cells using it. the execs is broke down in to different hormones. That intern sets off other unbalances.
I am coming into peri-menopause which has its own ste of isues. Having a cycle that is regular for the first time. Pcos does not stop when the overies do.
Also you need to look at heart health with this. High blood pressure is one of the things that happens with pcos. With the high male hormones, come some of the same risks for heart problems.
sorry for the rambling, there is so much to say about this that it is hard to keep on a single track. do a google search and see what you find.

[42_42_42]

I didn't have any tests done when I was diagnosed, but probably because my doctor knew my history so well. My husband is actually the one who figured out what I had, back when we were dating. He looked up all the symptoms that were giving me trouble and presto they all added up to PCOS. I mentioned that to the doc I was seeing at the time and she refused to even consider it, despite me having had those symptoms plague me since I was 15 and she'd been my doc treating me for all those symptoms the entire time! Finally, after I got married and got my new awesome doc, I went over my whole history and she said, yeah, just as I suspected, you've got PCOS. She put me on metformin (which Publix nicely provides free of charge) which I'll have to take for the rest of my life even though I no longer have ovaries (they were removed due to benign tumors, which were entirely unrelated to the PCOS -- I just got luckly and had 2 things wrong w/ my reproductive organs). Since the surgery, things have improved a lot for me, but they started getting better as soon as I was on the metformin. http://www.soulcysters.com/ is a great online support community for anyone with PCOS.

[Seshat]

"If you just lose weight all your problems will go away,"

Weeeeelllll..... yes and no.

Fewer active fat cells & a greater number of active muscle cells does reduce the insulin resistance, and if I recall correctly, active fat cells do something funky with reproductive hormones as well.

But with PCOS, it's never "just lose weight". A PCOS patient's body is actively trying to store energy - ie, to add fat!

<points to treatment info above>
PCOS patients need help to lose weight.

Depending on the severity, the treatment team might include any or all of:
* General practitioner (family doctor, primary care provider, whatever)
* Counsellor/behavioural specialist (can help provide alternatives to comfort eating, can help make it easier for you to find ways to exercise that suit you, etc.)
* Nutritionist/Dietitician
* Physiotherapist or exercise specialist
* Digestive endocrinologist
* Reproductive endocrinologist (yes, these are two separate sub-specialties!)
* Maybe other digestive or reproductive specialists, as needed.
* Maybe a PCOS specialist, if any exist yet.

[Seshat]

.... why does it seem that the end of a PCOS post is always one of my messages?

Surely someone else has something to say?

[teh_blumchenkinder]

Nope! Not from me, anyway... I seem not to be 'blessed' with such. It doesn't sound fun.

[blondemarmot]

Oh, it's loads of fun. Suprise periods or going a year and half without one (that was actually nice during the summer) and having to tell people not to touch me under the chin without telling them its because of stubble.

[Sapphire Silk]

* Maybe a PCOS specialist, if any exist yet.

Probably a GYN, since it involves the reproductive organs. Or an endocrinologist.

Seshat really nailed it with her suggestions and info

[Seshat]

Thank you, Panacea.

Unfortunately, it's due to personal knowledge. And yes, I would imagine that PCOS specialisation would come from either gynacology or endocrinology, since those are the fields it most affects.

[firecat88]

Oh, it's loads of fun. Suprise periods or going a year and half without one (that was actually nice during the summer) and having to tell people not to touch me under the chin without telling them its because of stubble.

Oh yes, I've got both the random periods and the weird under-my-chin hair. I'm constantly (read: every other day) checking the mirror to make sure I don't have any before I go anywhere. And sometimes those things get long.

[blondemarmot]

It would be nice if they would just stay contained but I'll be doing makeup and then all of a sudden I'm just "what the hell? A loner decides to grow out the middle of my cheek?!"

I "know" I should lose weight. But on the other hand...I'm not gaining. I'm at my high school weight, still. I've been thinner only during a horrible break up. And that wasn't a healthy weight loss. The thing that pissed me off about that doctor was that I've had PCOS issues since I had started my cycle at 13, maybe an inch or two shorter and 30+ pounds lighter. She made it sound as if all the problems were my fault and my fault alone. She then prescribed spironolactone because a side effect was hair growth slowing or stoppage. It's main usage is for lowering blood pressure (i think) and I already have a lower than normal pressure. I haven't taken any in years because it made me sick and feel like I was going to faint when I stood up. She was...a know-it-all-listen-to-none kind of person.