Re: BCP Question for Dr. Sam
From: =?iso-8859-2?q?Zalányi Sámuel ?= (anonymous@obgyn.net)
Tue, 12 Jun 2001 22:00:54 +0200
Dear Mel,
Let me correct you on some points. You are wrong that research hase only recently been done on PCOS. The condition was correctly described by two US doctors in the 1930s (weight excess, hair growth, menstrual irregularities and infertility). We were reading on this condition as 3rd year medical students and later too. Asl ong as 30 y ago we were familiar with the fact that PCOSers tend to turn diabetics later in their life. It was also correctly described that androgen excess is a main feature of the syndrome and this was the point where cyproterone acetate came into the picture. Later the imbalance between LH/FSH and high prolactin was also recognised. These were all correctly established as parts of the PCOS syndrome. Some 10 y ago it was recognised that PCOSers have higher than normal insulin levels (insulin resistance, remember the diabetes tendency) and this proved to be the basis of all the other symptoms. The faulty gene has been described too.
Now coming back to your problems. If you really have PCOS (it wasnt diagnosed by me) then insulin sensitizers are improving your condition, even if you do not test positive for IR. BCPs are contraindicated in case of manifest diabetes, would you then prescribe them to somebody who is prediabetic (IR).
Besides BCPs cause weight gain and tend to increase your blood pressure. Neither is desirable in persons who tend to have these problems already. Spironolactone is not a very specific antiandrogen (it is mostly prescribed in the US because cyprot.ac. is not available, although Finasteride is...)
I would not like to go into discussion with any doctors on any other boards (or offices) but I have seen very curious Dxs and Rxs here...
I keep my opinion which seems to be quite up to date and well informed on PCOS.
For you better understanding
Sam
>
> I would be willing to bet that every one of you is as frustrated as I
> am from trying to live with PCOS. Not only is it just an incredibly
> frustrating condition, one that affects nearly all aspects of our
> health, but it's also a condition that has only recently had anyone do
> any research on. There is no definitive answer. Everyone disagrees.
> And because we're all so desperate for any kind of help, we'll grab at
> anything.
>
> I don't mean to discredit Dr. Sam or anyone else with info on this
> list, but it just about drives me insane to see how many conflicting
> opinions I get about PCOS. How can I know which ones are valid and
> which aren't?
>
> People here cultishly insist that if you're not seeing a Reproductive
> Endocrinologist, then you're not getting correct info. Well, I was on
> another PCOS board the other day, and they were having a live chat with
> their "official doctor-type person". This doctor was an RE and the
> chat was about infertility. Since Dr. Sam never answered my long
> explanation about my problems with Metformin, I asked this RE. He
> didn't understand why I'd take Metformin if the BCPs and Spiro weren't
> bothering me, and said that BCPs were fine. He also agreed that if I
> had the kind of reaction to Metformin that I had, I shouldn't take any
> more of it.
>
> Now, I've read the studies about Metformin, so I know it does work for
> most people. But the point I'm trying to make is that everyone seems
> to be certain that *their* info is the *correct* info. If I were a
> regular reader of that other PCOS board, maybe I'd side with that
> doctor, and maybe if I came over here, I'd think everyone here was
> crazy. I'm not saying I do think that, I'm pointing out that there is
> great controversy over this issue and "home loyalty" seems to only
> confuse it even more.
>
> My frustration reached a breaking point, so I made an appointment to
> talk to my own doctor about the whole thing. My doc is familiar with
> Metformin therapy for PCOS, as she is the one who suggested I try it
> over a year ago. I asked her if she thought BCPs were going to make my
> IR worse and if I should go off them. She told me that since I
> couldn't take Metformin, and since my glucose and insulin readings
> always come up okay, she didn't think it should be a problem for me.
> She went and phoned an OB/GYN she knows, to make sure she was on-track,
> and the OB/GYN said the same thing.
>
> So, maybe someday we'll all be proved wrong, and my pancreas will shut
> down. But it seems to me like my only option is to wait until the next
> miracle breakthrough treatment comes down the pike (will it be D-chiro
> inositol? Who knows?), because I cannot take Metformin. In the
> meantime the BCP/Spiro combination allows me to feel like a normal
> person, and I try to control my insulin as best I can by how I eat and
> exercise.
>
> --Mel
>
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