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 was a first. I don’t tol­er­ate noise well and I don’t make 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 oth­er possibilities. 

Short­ly after­ward, 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 fall­en into think­ing that it did­n’t real­ly mat­ter that I was­n’t under treat­ment for PCOS any­more. Obvi­ous­ly, I was wrong.

Poly­cys­tic Ovar­i­an Syn­drome (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 involved 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 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. 

The cur­rent thought is that PCOS may be caused by insulin resis­tance, which can lead to type II dia­betes. Thus, treat­ment with met­formin 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 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 of 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. 

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 sur­prised to find myself preg­nant. How­ev­er, I had five mis­car­riages when I tried to con­ceive again later.

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