Tuesday, July 27, 2010


Well after one month of testing the results are back. I am happy to say it is nothing auto immune like we had feared, but simply what we started with - PCOS. However, there is a difference in this diagnosis than the last. When the reproductive endocrinologist diagnosed me about a year or so ago, I wasn't what you would call his ideal patient. I.E. I wasn't there to spend $50k trying to get pregnant. So he wrote me a prescription for hormones (birth control) and sent me on my merry way. Well things just got worse. When I sought help from my primary care dr. she was kind enough to look into it further. She must have ran every test in the book. I came back with an estrogen level of 10. Normal for my age is 200-400. They also found more cysts in my ovaries than they could count. This means that I do not ovulate and when I do want to have kids I will have to have fertility treatments. Also the stabbing pain I sometimes get in my abdomen is actually cysts that have ruptured. But, PCOS is a lot more than a woman issue. There is a very strong link between PCOS and diabetes. My sugar levels were at 116. Full blown diabetes starts at 126. The main treatment for this is a drug called Metformin. I will be taking this drug 2x per day. This drug has been shown to stop the painful cysts in the ovaries. It also bring down the blood sugar levels and can aide in weight loss. They actually don't know what causes the cysts or what causes the diabetes, it is kind of a medical mystery. All they know is that the two go hand in hand, and unless you get properly medicated it is a vicious cycle that just gets worse and worse. I also will now be taking a drug called Spironolactone 1x per day. This drug actually has a few uses - it is used as a diuretic to treat swelling and fluid retention in patients with congestive heart failure, liver cirrhosis, or kidney problems; it can be used for the treatment of high blood pressure; it treats low potassium; but, in my case it is going to be used to treate excess secretion of the hormone aldosteron (testosterone) by the adrenal gland. I don't actually have an overactive adrenal gland, but since my estrogen level is a 10 there is nothing to counter act the testosterone that my body does produce. This testosterone imbalance is what is causing my hair to fall out. I am really hoping that this helps and that I can get my hair to grow back, or at least stop falling out. Lastly I have been switched to a different pill Ortho- Cyclen. This birth control has no testosterone in it, that way I am only getting the estrogen that my body is not producing. The good news is that there were no signs of arthritis in my blood work, no signs of thyroid problems or anything else - all my organs other than my ovaries looked perfectly healthy. I did ask the dr. about my arthritis symptoms. The way she put it - my body thinks it is 70 years old. I feel like a post menopausal woman. Also, the dramatic and quick weight gain put a lot of strain on my joints. As I level out my hormones, and lose weight, coupled with standard arthritis treatments of exercise, weight loss, and pain pills, I should feel better. The dr. describes this process kind of like a train. At first we are just trying to apply the breaks. Once we get the train to stop we then work on reversing the train. But a train is heavy and it takes a lot of time and effort to get a train to stop. I am optimistic now that I have a 100% diagnosis and now a relatively aggressive treatment.

More About PCOS- Poly-cystic Ovarian Syndrome

Polycystic Ovary Syndrome (PCOS) is one of the most common female endocrine disorders affecting approximately 5%-10% of women of reproductive age (12–45 years old) and is thought to be one of the leading causes of female infertility.

The principal features are obesity, anovulation (resulting in irregular menstruation) or amenorrhea, acne, and excessive amounts or effects of androgenic (masculinizing) hormones. The symptoms and severity of the syndrome vary greatly among women. While the causes are unknown, insulin resistance, diabetes, and obesity are all strongly correlated with PCOS.

Polycystic ovaries develop when the ovaries are stimulated to produce excessive amounts of male hormones (androgens), particularly testosterone, either through the release of excessive luteinizing hormone (LH) by the anterior pituitary gland or through high levels of insulin in the blood (hyperinsulinaemia) in women whose ovaries are sensitive to this stimulus.

The syndrome acquired its most widely used name due to the common sign on ultrasound examination of multiple (poly) ovarian cysts. These "cysts" are actually immature follicles, not cysts ("polyfollicular ovary syndrome" would have been a more accurate name). The follicles have developed from primordial follicles, but the development has stopped ("arrested") at an early antral stage due to the disturbed ovarian function. The follicles may be oriented along the ovarian periphery, appearing as a 'string of pearls' on ultrasound examination. The condition was first described in 1935 by Dr. Stein and Dr. Leventhal, hence its original name of Stein-Leventhal syndrome.

PCOS is characterized by a complex set of symptoms, and the cause cannot be determined for all patients. However, research to date suggests that insulin resistance could be a leading cause. PCOS may also have a genetic predisposition, and further research into this possibility is taking place. No specific gene has been identified, and it is thought that many genes could contribute to the development of PCOS.

A majority of patients with PCOS have insulin resistance and/or are obese. Their elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis that lead to PCOS.

Adipose tissue possesses aromatase, an enzyme that converts androstenedione to estrone and testosterone to estradiol. The excess of adipose tissue in obese patients creates the paradox of having both excess androgens (which are responsible for hirsutism and virilization) and estrogens (which inhibits FSH via negative feedback).[18]

Also, hyperinsulinemia increases GnRH pulse frequency, LH over FSH dominance, increased ovarian androgen production, decreased follicular maturation, and decreased SHBG binding; all these steps lead to the development of PCOS. Insulin resistance is a common finding among patients of normal weight as well as those overweight patients.

PCOS may be associated with chronic inflammation, with several investigators correlating inflammatory mediators with anovulation and other PCOS symptoms

Women with PCOS are at risk for the following:

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