Polycystic Ovarian Syndrome. I was diagnosed just over three years ago. My father had just died. After he spent a month in an out of the hospital. I was a mess and keeping everything together with scotch tape so my family could stay afloat. But I was slowly falling apart. My biggest cause for concern? I had been spotting EVERY DAY FOR OVER A MONTH. And I don’t mean, wipe and you see a bit of blood. I mean contemplating whether or not a panty liner/ pad or tampon is necessary spotting.
Every. Day. For. A. Month.
I couldn’t even tell you when my last period was. So, I went to the GYN. She did a pelvic exam, and said it was more than likely stress, but just in case ordered an ultrasound and some hormonal blood tests. To this day I’m grateful she took my concern seriously. I remember the ultrasound tech showing me what she saw, explaining my anatomy (I thought it was so fucking cool. I’ve always loved science). But don’t remember anything particularly striking from that appointment (it was over 3 years ago).
I go in for a consult with the doctor and she asks if I have ever suffered from obesity, excess facial hair or acne. No, no, yes when I was about 22.
She explains that I have PCOS. Both of my ovaries are full of small cysts, what they classify as “string of pearl” ovaries. They literally look like someone shoved a pearl necklace into each ovary. My testosterone is slightly elevated, which is probably why I had acne. The rest of my hormones, she says, look good. However, the reason for my spotting was probably just stress.
So then she starts asking me a bunch of questions about my period.
Do you have them? Are they irregular? How far apart are they?
Yes. Yes. 30-45 days. So my PCOS isn’t too bad.
Are you trying for a baby? (me at 25/26) What? No!
Well PCOS can be managed by taking birth control pills or metformin. I declined both. I was on a huge all natural kick (still am, but am much less strict). I asked for any natural ways to help manage the symptoms, she says low carb diets and leafy greens are shown to help, as well as regular exercise. Thank god she was a competent OB.
Since that consult I’ve done a lot of research on PCOS. I don’t have many of the “normal” symptoms. I’m fairly thin, no excess hair. What I do have, are the cysts, high Anti-Mullerian Hormone (AMH), slightly elevated glucose levels, and benign cysts on my breasts (I learned about that one at a different OB’s office last year).
PCOS is not a disease, it’s a syndrome, so it presents itself differently in pretty much everyone. Hell, you don’t even need cysts in your ovaries to be have the syndrome. PCOS is an endocrine syndrome first and foremost. It affects your hormones, which in turn effects how your ovaries mature an egg for ovulation. Some women with PCOS don’t ovulate at all, known as annovulation. Others, like me, ovulate late into their cycle, causing “late”/ long cycles.
According to the Mayo Clinic the exact cause of PCOS isn’t known. However, below are some factors that their website their website says might play a role include:
- Excess insulin.Insulin is the hormone produced in the pancreas that allows cells to use sugar, your body’s primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin. Excess insulin might increase androgen production, causing difficulty with ovulation.
- Low-grade inflammation.This term is used to describe white blood cells’ production of substances to fight infection. Research has shown that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens, which can lead to heart and blood vessel problems.
- Research suggests that certain genes might be linked to PCOS.
- Excess androgen.The ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne.
According to the Mayo Clinic some of the complications of PCOS can include:
- Gestational diabetes or pregnancy-induced high blood pressure
- Miscarriage or premature birth
- Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
- Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
- Type 2 diabetes or prediabetes
- Sleep apnea
- Depression, anxiety and eating disorders
- Abnormal uterine bleeding
- Cancer of the uterine lining (endometrial cancer)
- Obesity is associated with PCOS and can worsen complications of the disorder.
So, as someone who wasn’t looking to have a baby, and didn’t have to many symptoms, I did what the doctor ordered. I tried to eat healthy. I tried to maintain a schedule to workout. If nothing else, it helped me stay slim. Now that I’ve actually started trying to have a baby, and done COPIOUS amounts of research (I still didn’t want to be on metformin) I’ve started a regime of a supplement Myo-Inositol. My doctor supports me taking the supplement, and it doesn’t come with any of the side effects associated with metformin. I’ll add the links to some of the studies I’ve found down below.
Genazzani AD, Prati A, Santagni S, et al. Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients. Gynecol Endocrinol.2012;28(12):969-973.