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Re: Please help! (long reply)From: jodi (anonymous@obgyn.net)Tue, 19 Nov 2002 13:08:36 -0600 (CST)
Hi Amanda Yes it is possible to get pregnant with PCOD/PCOS. It may not be EASY and it may not be certain but it is certainly possible. Since your diagnosis, have you been getting any treatment? Until the last few years, most doctors would do one (or both) of two things to a woman presenting with PCOS: tell her to lose weight and everything would be all right, or to take birth control pills and everything would be all right. Sometimes a doctor would prescribe spironalactone (Aldactone) to help deal with the excess body hair, acne, and other signs of excess androgens. But a lot of us have had to deal with doctors who either acted as if our problems were entirely our own fault, or no big deal. Things have changed for the better, although it is not always easy to find a doctor who realizes this! We still go through the mill. Since we moved 3,000 miles from my old doctor, I have an appt. with a new doc today and I am nervous as anything... Have you been doing any reading up on PCOS? (You say syndrome, I say disorder... it's the same crummy illness.) If not, get cracking! Do an internet search on "PCOS and insulin resistance" and/or check out some books. Samuel Thatcher's "PCOS:The Hidden Epidemic" is a good one for a medical overview - medical, but very readable. Colette Harris's "PCOS: A Woman's Guide to Dealing with Polycystic Ovary Syndrome" is a good one for making you feel that you CAN take steps to overcome this problem. A lot of people have torn this book apart in reviews on Amazon. It sort of dismisses medical treatment and it DOES contain a good deal of things I feel are hokie - aromatherapy, for example, and drinking filtered water and eating only organic, vegan foods (which is noble, but not too realistic, in my opinion) - but overall, I like the fact that it is written by a woman with PCOS who took control and won. I think it contains enough sensible advice and wonderful explanations of the problem to make it a great book. Avoid the Boss-Best book... it is VERY basic and you won't learn anything there you can't learn in Thatcher's book which is bigger and more complete (in my opinion... by the time I bought this book, it was a total waste of money, I knew everything and more!) So read and learn! In a nutshell, they think PCOS usually stems from an excess of insulin driving all of our other hormones haywire. Sometimes women with PCOS have adrenal problems instead of or in addition to the insulin problems. So you really need to find out what is causing your PCOS, because the treatment will differ. For most of us, it is insulin, and by using insulin lowering medications and/or diet (both is best in my opinion, but many women have success with just the diet) we can get our other hormones into line and aleviate many of our problems. A lot of us also take birth control pills. There are a lot of pros and cons to BCPs. A major pro is, they put your ovaries at rest, and can clear up a lot of the cysts that are on them pumping out all these excess hormones. (The cysts are a result of failed ovulations... our bodies can't quite complete the ovulation process, though they try. I think that our constantly high LH levels are indicative of this.) Because of this, some women have success with weight loss, body/facial hair reduction, head hair loss reduction, and acne clearing with BCPs. Of course, there are some drawbacks. Biggest, BCPs only provide symptom relief. The underlying problem - insulin production - is still there, so if you go off BCPs, your problems come back, often with interest. There is some speculation that BCPs can WORSEN our insulin problems, but I think this theory has recently been proven more or less false. (My old doctor told me yes they do worsen the problem, but nowhere near as bad as what you already have, and the worsening goes away when you stop the pill. I don't know.) If you are not trying to conceive, BCP AND addressing the insulin problems with meds or diet or both is a good way to go, if you choose to. If you are trying to conceive, some docs will prescribe a few months of the pill to clear up your ovaries and sort of give you a fresh slate, hormonally speaking. Some women who were previously not ovulating will ovulate for a while after stopping the pill. (SOME... not all. Before going on insulin meds, I didn't have periods at all for months after stopping the pill. AFter starting insulin meds, this is no longer true.) Another problem with BCPs, though, is they can have nasty side effects. I am now taking Yasmin, which doesn't seem to be affecting me adversely... but it is the 12th BCP I have tried! Others have caused migrains, weight gain, worse acne, spotting, and extreme suicidal depression. So it can take some experimenting to find the right pill for you. (I honestly don't think I have met anyone who has reacted so poorly to BCPs as I have, so don't let this scare you!) Now what you need to do is find a good doctor to treat you. A lot of us see an endocrinologist or a reproductive endocrinologist. I used to see an endocrinologist, today I have an appt. with a reproductive endocrinologist. Some of us, though, just see our regular doctor, or a ob/gyn. Any doctor can prescribe any med, so it really boils down to finding a doctor who is up on this and is willing to treat you seriously. It can be difficult. It takes many of us years to get diagnosed. Knowing the problem and knowing the treatment options before you go in is a great help. I wasted years saying "tell me what's wrong and fix me." Things got rolling a lot faster when I was able to say "Tell me if this is what's wrong and if it is, here is how to fix me." Ask when you make an appointment if the doctor treats PCOS with insulin lowering medications such as metformin. Even if the doctor chooses not to treat you with it, you'll know he or she is on the ball. Finally, if all else fails, there's clomid, an ovulation inducing drug. Women with PCOS have now been shown to respond much better to clomid when the insulin problem is addressed as well. Women who take metformin and clomid were much more likely to ovulate, conceive, and carry to term than women who take clomid alone. All right, I have said enough. Now get to reading, and welcome to the board. It's very comforting to know you are not alone in this, isn't it? - jodi
At Tue, 19 Nov 2002, Amanda wrote:
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