PCOS Part 2: Treatment

Source.

This is the second post in a series. Here is the link to Part 1.

It is estimated that 5 to 10% of women who are of child bearing age have PCOS. (Source) That means that if you don't have PCOS, you probably know someone who does, or multiple somebodies. Here are some of the normal symptoms (source, source, source, and I'm stopping there...) :

• Infrequent, irregular, or absent menstrual cycles
• Multiple small cysts on the ovaries, and sometimes elsewhere
• Pelvic pain
• Hormonal imbalance
• Anxiety or depression
• Fatigue
• Mood Swings
• Migraines
• Infertility due to irregular or absent ovulation
• Increased hair growth on face, neck, stomach, back, hands, and feet
• Acne, oily skin, dandruff - often cystic acne
• Weight gain/obesity - normally around the waist
• Type II diabetes
• High cholesterol
• High blood pressure
• Thinning hair
• Skin tags - usually on neck or armpit
• Dark or thick skin located on the neck, arms, thighs, or breasts
• Sleep apnea
• Uterine (or other reproductive) cancer

If you don't have PCOS and know someone who does, read through that list once in awhile, then become a little more understanding, should she be fighting the ovarian demons, on some days.

Source.

I was diagnosed with Polycystic Ovarian Disease in November 2006, at my own request. I had been suffering from symptoms since my early-onset puberty, but no one had bothered to tell me that these symptoms weren't normal, nor had any attempt been made to pinpoint their cause. As my previous post relates, I took the information to the doctor, then asked her to determine if this was my diagnosis. It was.

The doctor was just as laid back about my treatment plan as she was about my diagnosis, so I basically told her what I had learned was the common treatment, and she wrote the prescriptions. Common for the treatment of PCOS is the diabetes medication metformin (generic of Glucophage), combined with a birth control pill of the doctor's choosing (or one the patient tolerates). I was prescribed 500 mg, twice daily, of metformin, and a birth control pill that was strong enough to regulate my periods. No one ever discussed this with me, not the doctor then. Not any of the doctors I've seen since then, until the doctor I have now.

As I mentioned in my last Dukan Diet post, I went to the doctor after some episodes of low-blood sugar, which had been caused by the combination of the low-carb diet and my metformin. I am neither diabetic, nor insulin-resistant. Since my 20+ pound weight loss, my body didn't need as much of the metformin. Yahoo! I'm on my way to being med-free!

Anywhere I have looked for information (an example) about PCOS, I have seen that there is no medically-proven "cure" for PCOS. There are varying schools of thought about its treatment, but no one says that you can be cured of it. What you see, over and over, though, is that the better your overall health and well-being, the more the symptoms recede. One study I recently read about said that as little as 5% weight loss could contribute to the significant lessening of symptoms. Keys to living with PCOS are acquiring and maintaining a healthy weight, exercising regularly, eating healthfully, and not smoking. All, pretty much common sense, right?

Possible Cures

Here's something else. There are some health professionals that believe there are 2 ways to get rid of PCOS. One, is to go through menopause, which changes your hormonal balance and ceases the menstrual cycle that adds to the cyclical nature of the illness. The other thing that "cures" PCOS in some instances, is a full-term pregnancy. (I doubt you'd find that listed as a "cure" anywhere, per se, though. I have only seen it mentioned in a few places.) In some cases, women who suffer from PCOS find that the hormone slate gets wiped clean by pregnancy, and they have a system reset. Some women fail to re-develop the same issues when their post-pregnancy hormone levels change.

Sadly enough, though, that doesn't mean that getting pregnant fixes everything. Women with PCOS may be twice to up to 5 times more likely to miscarry than the average population (depending on source, and definition), and PCOS causes infertility in some women.

American Pregnancy Association states that "Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage." I'm seeing 45% rate of miscarriage in PCOS women commonly quoted, but I'm not finding the source of that percentage anywhere. Wikipedia says 30-50% (source). I've seen people "quoting" that the rate could be as low as 9% if metformin is continued through the first trimester, but I can't find the source of that, either. Wikipedia cites a two-thirds lowered risk with use of metformin (source), but goes on to say that "a 2006 review of metformin treatment in pregnancy found insufficient evidence of safety, however, and did not recommend routine treatment with the drug." (source)

A list of common treatments for PCOS (source, source, source, and I'm stopping there):

• Lose weight, eat healthfully, exercise regularly 
• Quit smoking
• Medication to lower insulin, combined with a fertility drug (if trying to conceive) or a birth control pill
• Hormone therapy, either with a birth control pill or other medications or injections
• Surgery such as ovarian drilling or an ovarian wedge resection (from what I can tell, neither is practiced regularly-- mostly used as a last-resort attempt when infertility is a factor)

Contrary to what you may have heard, even though you may not die from PCOS per se, you can die from what it causes. Cancer, heart disease, diabetes, etc., and when you add in the miscarriage rate? Most of the time PCOS is a pain. Sometimes, it's deadly. 

Who do you know that might benefit from a little more kindness, gentleness, and understanding?

My next post on this topic will be about living with PCOS.

Much love,
LL~