PCOS: Another thing wrong with me

In the epic saga that was my "road to cancer" story, I mentioned another issue we found called Polycystic Ovarian Syndrome. I had never heard of it, and really, PCOS is kind of one of those mystery disorders that has a core group of symptoms, but not everyone has the same issues. I figured it may do someone some good to know about it, so here you go. 

There are a ton of symptoms that can indicate PCOS, but in order to receive an official diagnosis, your physician will need to run blood tests and likely an ultrasound, and they must find 2 of these 3 factors:
1. Follicles or cysts on the ovaries
2. High levels of male hormones
3. Irregular periods

Some of us lucky ladies hit the trifecta. From the first time Aunt Flow paid me a visit, my periods have been all over the place. Uber heavy and terrible cramps, all the way to nonexistent for months. When my initial blood tests came in, my nurse practitioner confirmed my testosterone levels were super high, despite my taking hormonal birth control. Apparently, if I hadn't been taking those sweet little pills, I'd have been shaving twice a day. My face. More on that later. And, of course, the ultrasound showed a bunch of follicles larger than they should have been on my ovaries. 

So, in practical terms, what does this diagnosis mean for the "sufferer?" A bunch of things. In my case, the high testosterone caused some breakouts, and some people get pretty awful acne. On some women, it causes serious facial hair. Not just that little mustache that can be waxed monthly. We're talking full on bearded ladies if they don't shave. Body hair can be impacted, too. Some women also get thinning hair or even the equivalent of male pattern baldness, so basically a receding hairline. 

There's not really a known cause for PCOS, but there are some chicken/egg scenarios and there's a chance it's hereditary. In my case, I also have insulin resistance. My pancreas works fine. I make insulin like I should, but my cells don't actually use the insulin to absorb sugar and use it for fuel. The result is I end up storing all that sugary goodness...mostly on my belly. Some women end up with almost-pregnant looking stomachs--which is a cruel twist of fate, since PCOS can make conception harder. The chicken and egg scenario comes in because the belly fat can also store estrogen, often triggering androgen production (male hormone). They don't seem to know if insulin resistance stores the estrogen and triggers the hormone imbalance with PCOS, or vice versa. 

PCOS goes undiagnosed a lot, since gynecologists don't treat it frequently. Often, an endocrinologist is your best bet. Some women get bounced from doctor to doctor before being diagnosed. I got lucky in that my nurse practitioner is a specialist. 

Treatment depends on your specific symptoms. For some, birth control regulates menstrual cycles. That was helpful for me until my cervix was overrun with cancer. I take Metformin, which is a type 2 diabetes drug, but causes my cells to use the insulin I'm producing, and keeps the belly fat at bay. Some don't react as well to it, but I've lost 20 lbs in 2 months. Some could be due to the cancer, but it didn't start until I started medication. I also take Spironolactone to slow the androgens impact on my skin. 

There are complications, as with any health issue. Anxiety and depression are common. I joined a PCOS support group on Facebook, and those with facial hair, acne, baldness, etc. seemed to be impacted the most. If insulin resistance is present and not treated, type 2 diabetes may develop. Long term exposure to estrogen can also lead to endometrial cancer. 

At the end of the day, it's not curable, but PCOS is manageable, and now I know why I haven't been able to lose any weight for the past couple years, regardless of diet and exercise. It's nice to at least have a diagnosis.