Polycystic Ovarian Syndrome

I spent most of Valentine’s Day 2004 in the emer­gency room. I was scream­ing when I arrived in the ambu­lance, and that’s some­thing. I sel­dom make any loud noises! I couldn’t help it, though. I was in some of the worst pain of my life because an ovar­ian cyst had burst. The doc­tors couldn’t really do any­thing but pump me full of painkillers and put me through lots of tests to rule out more seri­ous problems.

Shortly after­wards, I learned that I could have bled to death had that cyst been right at a blood ves­sel. I’d never been warned of that, and had falled into think­ing that it didn’t really mat­ter that I wasn’t under treat­ment for PCOS any more. Obvi­ously, I was wrong.

Poly­cys­tic Over­ian Syn­drome, or PCOS, is more a col­lec­tion of prob­lems with a com­mon root than a sin­gle ill­ness. The symp­toms can, in fact, be so diverse that many physi­cians do not tie them together to see the over­all pic­ture. The main symp­tom is that women with PCOS do not ovu­late nor­mally, but form ovar­ian cysts that can lead to other prob­lems. They usu­ally suf­fer from amen­hor­rhea (fail­ure to men­stru­ate) or dys­men­or­rhea (irreg­u­lar or painful men­stru­a­tion), infer­til­ity, and in some cases dys­pare­u­nia (pain dur­ing sex). The hor­monal imbal­ance can lead to weight gain, hir­sutism, acne and other prob­lems. There is a very high inci­dence of depres­sion in PCOS suf­fer­ers, as well. In some cases, women who gain a lot of weight may develop PCOS as a result of their weight gain. In most, though, it seems that the imbal­ance causes the weight gain. In my case, I was quite thin when the PCOS started, and after finally get­ting treat­ment for it I started los­ing weight with­out dieting.

Cur­rent thought is that PCOS may be caused by insulin resis­tance, which can lead to type II dia­betes. Thus, treat­ment with Met­formin (glu­cophage) is some­times help­ful. Doc­tors have long used birth con­trol pills in an effort to mod­er­ate the hor­monal imbal­ance that is an impor­tant fac­tor in PCOS. There are actu­ally two kinds of birth con­trol pills, though — those that increase the lev­els of andro­gens, and those that use estrogen/​progesterone. For years I was given the andro­gen pills, which unfor­tu­nately increase the level of the hor­mones that are already too high. Switch­ing to an estrogen/​progesterone pill gave far bet­ter results.

Women with PCOS have a much higher risk for heart dis­ease, dia­betes, and some forms of can­cer. Endometrio­sis, mis­car­riages and infer­til­ity are more com­mon among women with PCOS than among those with nor­mal hor­mone lev­els. It is, there­fore, very impor­tant for women who think they may have PCOS to seek treat­ment even if they aren’t wor­ried about hav­ing chil­dren and are not both­ered by the overt symp­toms. PCO­Sup­port is the best resource I’ve found for infor­ma­tion about PCOS.

Katie is my mir­a­cle baby. I was told by sev­eral doc­tors that I would never bear a child with­out fer­til­ity treat­ments, as I’d never ovu­lated reg­u­larly. About a year after hav­ing surgery to remove a great many ovar­ian cysts, though, I was suprised to find myself preg­nant. Since then I’ve had two mis­car­riages, and I’m some­what reluc­tant to try car­ry­ing a child again. Hope springs eter­nal, though!



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