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Re: New to PCOSFrom: jodi (anonymous@obgyn.net)Fri, 24 May 2002 09:57:20 -0500 (CDT)
Whoa... first I want to say PCOS must be the in thing this summer, we have so many "just-diagnoseds" on this board all of a sudden... Second, I want to say that yes there IS a point to losing weight... it CAN be hard for us (it usually IS hard for us) but there ARE ways to do it and there ARE benefits to doing it... For many of us, the only thing(s) that help with weight loss are Metformin and/or a PCOS friendly diet. By PCOS friendly diet, I cannot say one diet specifically... Some women here are serious low carbers. Some women here follow more of a modified approach, still eating a good portion of carbs a day BUT choosing those carbs sensibly. Read up on the "glycemic index." This is basically a rating given to a food telling you how much your blood sugar will rise if you ingest it. In this school of thought, carbs are not evil - but certain carby foods are worse/better for you than others, depending on the wholeness of their grain and what else has been added to them. Fat, fiber, and protein slow the relsease of blood sugar into your body, making foods with fiber, fat or protein lower on the glycemic index scale than carbs without them. For some examples... Whole grain rye has a very low GI rating. Many whole grains/starches are OK for you. Beans are fine. Certain grains/starches such as potatoes and corn are not so good for you. A glass of 2% milk has a lower GI rating than a glass of skim. And so on. I highly reccomend SugarBusters to get a good idea of this. I will admit that I personally bought SugarBusters and later gave it to Goodwill because, really, the info in it is QUITE simple and easy to hold on to, not something you have to refer to over and over. Unfortunately this book seems to yet be unavailable in softcover, and I really think the amount of info contained within is not worth the hardcover price... So see if you can find it used or at the library. It is a GREAT overview. Just has some shortcomings from a "This was good information but not worth the price" standpoint... You might also try the Zone or the Insulin Resistance Diet books... read a LOT. Pick and choose what works for you. The best diet in the world doesn't amount to a hill of beans if you personally can't stay on it so read read read and tailor to fit. Try to find a doc who will look in to prescribing metformin. It really helps a lot with the weight. Exercise! Even if you DON'T lose lots of weight, the improvements in insulin levels WILL help you. You can be THIN and have PCOS symptoms. You can be chubby and managing those symptoms. Try to find a doc who will address the depression! I am working on this myself... I have had depression off and on of varying severity since I was 12 or 13. I am now 25... and realise how much my depression has affected my life and my health, largely via my PCOS... I have been severely depressed these past two weeks and I understand all too well that no energy feeling! I was walking 25-30 miles a week and doing aerobics 2-3 times... eating well... I felt wonderful... but then BAM, one afternoon, my mood just went down, and has yet to come up. I'm now sleeping late every day and taking the bus to and from work and eating disgusting amounts of junk food. I feel like a fat slug. But I know eventually this mood will lift... it always does... but I know it will come back, so I am admitting finally that I have to deal with it... Just something to think about. Depression has a nasty way of undermining the best diet and exercise intentions... Women with PCOS CAN lose weight. We just need to try a different approach than joe-average consumer. Losing weight WILL help you. As for BCPs... I've been going on and on about them a lot lately. They are offered as "treatment" to so many women with PCOS by doctors who do not understand the condition... BCPs provide SYMPTOM RELIEF. They do not really "work" on the PCOS at all. Basically, they put your ovaries to sleep, which reduces both cyst formation and the horrendous outpouring of ovarian hormones. This reduces your hormonal symptoms, such as acne and excess hair. (Better luck on the acne than the hair, to be honest... though some women DO have success with the hair problem with BCPs...) By going off the pill every 3 weeks - this is essentially what you are doing when you take the dummy pills during the 4th week, or when you don't take them, which I don't, as I consider them an insult to a woman's intelligence - you have a regular withdrawal bleed, and this reduces your risk of endometrial cancer. I'm sure all of the above sound pretty good, right? Unfortunately, there are always some drawbacks. First, BCPs don't fix anything. They cover up the problem. So while they do provide symptom relief, they don't fix anything long-term, and all your problems will come back when you stop taking the BCPs. Now, in and of itself, this isn't a problem. But i think a LOT of women do not understand this fact and I think a lot of doctors need to do a better job of explaining things. (They also make it hard to tell what effect the insulin meds or diet are having on your cycles, skin, etc...) Second, BCPs do nothing - obviously! - to correct the infertility issues we have! It is sometimes possible, though, that after a year some time on the pill, hormone levels will benormalized long enough that ovulation will occur for a short while after stopping the pill, allowing a window of oppurtunity for getting preg before everything goes to the dogs again. Third, as you are well aware, BCPs have SIDE EFFECTS. This is why I do not take the pill. These can range from the strange and mildly annoying - such as contact lenses not feeling right for the first month or two - to the severe and debilitating - such as migraines or severe depression. Weight gain is another biggie. Some argue that the pill further worsens insulin resistance, thus resulting in weight gain... and thus POSSIBLY worsening PCOS. If taken with an insulin med, this effect is probably negligable - some even argue it's already negligable, given what's already going on in your body - but you should be aware of it. There is nothing wrong with taking the pill if you want symptom relief, find a pill that works for you without side effects, and understand that BCPs are not a cure for PCOS. Which pill were you on? I found ortho-novum 7/7/7 gave me severe migraines - I actually thought I had a brain tumor because I had never had a migraine in my life and all of a sudden I find myself with a throbbing headache and blind spots in my vision - so I quickly got off of THAT. I know know that tri-phasic pills - pills that have different doses of hormones throughout the pack - are horrible for PCOS. Go for a monophasic pill, if you want to use BCPs. Insulin meds and controlling your diet do not provide symptom relief quite as fast as BCPs... but they do address the root of the problem, insulin resistance. This is getting long, so I won't get into this now. Feel free to ask questions. The next thing I want to say is I did NOT like the first article you posted... I'm not saying this to make you feel bad, I'm saying this because I think you should pretend you never read it. I do not think PCOS should be considered a "birth defect." I do not think it is accurate to say that the uterine lining builds up and "hardens." (???) Thickens, yes... but if it HARDENED it would never come out! I have never heard of a hump on the back or adrenal hyperplasia being complications of PCOS. The hump on the back is something else... Cushings? Adrenal hyperplasia CAN be seen in women with PCOS... I believe it presents similar symptoms to PCOS... but I am not aware of either of these things being CAUSED by PCOS. I really do not think this woman did her research well at all. Delayed onset of periods is NOT a sign of PCOS. Women with PCOS can get their first period at any time. I got mine early - a few weeks before I turned 11. Some women here didn't get it till they turned 18. Some got it at about the "normal" time, 12-13 or so. I do not feel PCOS should be referred to as a "rare disorder..." Statistically, it seems to not affect THAT many women... but think about how many women have yet to be diagnosed. Think about how many women you personally know that show signs of PCOS or have really been diagnosed with it. I'm talking real life, not on line. I personally know four who were diagnosed and 4 or 5 I suspect have it. Unless we have something in the water around here, I'd say this is not an atypical experience! Seriously. I feel this is a terrible article and you should pretend you didn't read it. She doesn't even mention excess hair in it!!!!! You cannot write about PCOS and leave out excess hair. To me that would be like writing about September 11th and not mentioning the twin towers. The third article you posted is a great one. If you'd like some off-line studying of this, get Samuel Thatcher's book "PCOS: The Hidden Epidemic." Lastly - if you want a child, go for it. I don't think that that article saying "most women need infertility treatments" was quite on the ball. Yes, a lot of women with PCOS need fertility help. But a LOT of women don't even KNOW they have PCOS, have infrequent periods, and get pregnant. A LOT of women DO know they have PCOS, and are told they will never have a child, and then... they DO. A LOT of women have PCOS and find that metformin or low carb dieting or both regulate their periods and they get pregnant, no fertility help. I think that author should have said "Many" instead of most. Subtle change, but oh so meaningful. So if you truly want a child, do not let this stop you from trying. With metformin there is hope. With metformin PLUS clomid, if you need it, there is even MORE hope. I don't know... i can't express how much I dislike that article. It provides a bit of truth but with a slant I just don't like. I can't help but feel the women who wrote it does not have PCOS, is horrified at what an awful disordfer it is, and is gleeful to think SHE doesn't have to suffer with it... and it just making it out to be as nasty and unmanageable as she possibly can. May PCOS smite her! :-) - jodi
At Fri, 24 May 2002, Ann wrote:
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