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<title>Maddy&apos;s PCOS Diary</title>
<link rel="alternate" type="text/html" href="http://www.healthdiaries.com/women/pcos/maddy/" />
<modified>2007-08-27T10:18:38Z</modified>
<tagline>Polycystic Ovarian Syndrome</tagline>
<id>tag:www.healthdiaries.com,2007:/women/pcos/maddy//182</id>
<generator url="http://www.movabletype.org/" version="3.33">Movable Type</generator>
<copyright>Copyright (c) 2007, Maddy</copyright>
<entry>
<title>Taking an &quot;all natural&quot; approach to PCOS</title>
<link rel="alternate" type="text/html" href="http://www.healthdiaries.com/women/pcos/maddy/archives/2007/08/taking_an_all_natural_approach_to_pcos.html" />
<modified>2007-08-27T10:18:38Z</modified>
<issued>2007-08-27T10:14:02Z</issued>
<id>tag:www.healthdiaries.com,2007:/women/pcos/maddy//182.6645</id>
<created>2007-08-27T10:14:02Z</created>
<summary type="text/plain">Well. I&apos;ve been having a look around on the internet - I can find literally hundreds of suggestions for herbs et al to help with PCOS - but I know I just can&apos;t take that many. So I&apos;m starting with...</summary>
<author>
<name>Maddy</name>

<email>mandyjanew@blueyonder.co.uk</email>
</author>

<content type="text/html" mode="escaped" xml:lang="en" xml:base="http://www.healthdiaries.com/women/pcos/maddy/">
<![CDATA[<p>Well.  I've been having a look around on the internet - I can find literally hundreds of suggestions for herbs et al to help with PCOS - but I know I just can't take that many.</p>

<p>So I'm starting with taking some.</p>

<p>Licorice<br />
Kelp<br />
Chromium GTF and<br />
Vitex</p>

<p>I'll see how I go on these before I worry about adding anything else in.</p>

<p>I'm also going to include 16 teaspoons of vinegar to my diet a day (not sure how yet, lol) and 1 teaspoon cinnamon.</p>

<p>I'm going to try the "standard" advice for my weight loss - eat natural fats; lower carbs; eat sufficient protein and fibre and follow a calorie restricted diet.</p>

<p>For exercise I'm going to start with walking - I'm going to aim for 25-50 miles per week and I'm also going to try to fit in 30 minutes of exercise before breakfast every day.</p>

<p>Also, as far as exercise goes I know I need to be more committed to being organised at home and keeping my house clean - so I'm mostly going to aim for being active for 2 hours per day - if I don't get "formal" exercise in but I do 2 hours of housework I'll be happy.  Sometimes you just can't do everything and putting dance music on and dancing while doing housework is exercise.</p>

<p>Okay so in the last 3 weeks I've lost 4lbs - so I'm here now at 182lbs.</p>

<p>There are 17 weeks to Christmas - so can this work for me?  Time will tell.............</p>]]>

</content>
</entry>
<entry>
<title>Friday 17 August 2007</title>
<link rel="alternate" type="text/html" href="http://www.healthdiaries.com/women/pcos/maddy/archives/2007/08/friday_17_august_2007.html" />
<modified>2007-08-17T08:13:07Z</modified>
<issued>2007-08-17T08:07:50Z</issued>
<id>tag:www.healthdiaries.com,2007:/women/pcos/maddy//182.6634</id>
<created>2007-08-17T08:07:50Z</created>
<summary type="text/plain">Well I&apos;m back! My weight loss journey so far has been very up and down. I&apos;ve been addicted to trying fast weight loss techniques to lose weight as quickly as possible with the result that I lose weight quickly, drop...</summary>
<author>
<name>Maddy</name>

<email>mandyjanew@blueyonder.co.uk</email>
</author>

<content type="text/html" mode="escaped" xml:lang="en" xml:base="http://www.healthdiaries.com/women/pcos/maddy/">
<![CDATA[<p>Well I'm back!  My weight loss journey so far has been very up and down.  </p>

<p>I've been addicted to trying fast weight loss techniques to lose weight as quickly as possible with the result that I lose weight quickly, drop off the wagon, regain the weight plus some more and stay off the wagon because I just can't face that type of diet again!</p>

<p>I've also had some personal difficulties to deal with so I've been sidetracked.</p>

<p>No more.  I have decided that enough is enough.  I really need to tackle my weight problem - I started again two weeks ago and so far I've lost 3lbs.  I'm aiming to lose 35lbs by Christmas.</p>

<p>My current weight is 13 stone 1.</p>

<p>I'm starting right back at the beginning again and making small changes along the way.</p>

<p>My first goals are:-</p>

<p>to eat no more than 1500 calories per day<br />
to exercise for 40-45 minutes pre breakfast and 40-60 minutes each evening<br />
to take my Kelp tablets and Licorice</p>

<p>That's it.  I'm going to do this for the next week and then make another change.</p>

<p>Here's to being a healthier me as a Christmas present to myself.  </p>

<p>P.S. I've noticed I have a lot of comments - thank you.  I shall come back later to answer everyone!</p>]]>

</content>
</entry>
<entry>
<title>Insulin Sensitivity</title>
<link rel="alternate" type="text/html" href="http://www.healthdiaries.com/women/pcos/maddy/archives/2006/01/insulin_sensitivity.html" />
<modified>2006-01-08T10:14:49Z</modified>
<issued>2006-01-08T10:13:48Z</issued>
<id>tag:www.healthdiaries.com,2006:/women/pcos/maddy//182.4237</id>
<created>2006-01-08T10:13:48Z</created>
<summary type="text/plain">The problem with PCOS and weight gain is caused by too much insulin. So to lose weight we need to restore our body&apos;s insulin sensitivity again. How do we do this? I&apos;ve been googling a bit today and found a...</summary>
<author>
<name>Maddy</name>

<email>mandyjanew@blueyonder.co.uk</email>
</author>

<content type="text/html" mode="escaped" xml:lang="en" xml:base="http://www.healthdiaries.com/women/pcos/maddy/">
<![CDATA[<p>The problem with PCOS and weight gain is caused by too much insulin.</p>

<p>So to lose weight we need to restore our body's insulin sensitivity again.</p>

<p>How do we do this?  I've been googling a bit today and found a great article from Joseph Mercola</p>

<p>Here it is</p>]]>
<![CDATA[<p>Can Insulin Sensitivity Be Restored?</p>

<p>Insulin sensitivity can be restored to its original state, well, perhaps not to its original state, but you can restore it to the state of about a 10-year-old. </p>

<p>One of my first experiences with this, I had a patient who literally had sugars over 300. He was taking over 200 units of insulin, and he was a bad cardiovascular patient, so I put him on a low-carbohydrate diet. </p>

<p>He was an exceptional case, after one month to six weeks he was totally off of insulin. He had been on over 200 units of insulin for 25 years. He was so insulin resistant, but one thing good about it is that when you lower that insulin, that insulin is having such little effect on him that you can massively lower the insulin and its not going to have much of an effect on his blood sugar. Two hundred units of insulin is not going to lower your sugar any more that 300 mg/deciliter. </p>

<p>You know that the insulin is not doing much, so we could rapidly take him off the insulin and he was actually cured of his diabetes in a matter of weeks. He became sensitive enough and was still producing a lot of insulin on his own. Then we were able to measure his own insulin. It was still elevated, and it took a long time, maybe six months or longer, to bring that insulin down. </p>

<p>It will probably never get to the point of the sensitivity of a 10-year-old, but yes, your number of insulin receptors increases and the activity of the receptors, the chemical reactions that occur beyond the receptor, occur more efficiently. </p>

<p>How to Increase Insulin Sensitivity</p>

<p>You can increase sensitivity by diet, which is one of the major reasons to take omega-3 oils. We think of circulation as that which flows through arteries and veins, and that is not a minor part of our circulation, but it might not even be the major part. The major part of circulation is what goes in and out of the cell. </p>

<p>The cell membrane is a fluid mosaic. The major part of our circulation is determined by what goes in and out. It doesn't make any difference what gets to that cell if it can't get into the cell. We know that one of the major ways that you can affect cellular circulation is by modulating the kinds of fatty acids that you eat. So you can increase receptor sensitivity by increasing the fluidity of the cell membrane, which means increasing the omega-3 content, because most people are very deficient. </p>

<p>They say that you are what you eat and that mostly pertains to fat because the fatty acids that you eat are the ones that will generally get incorporated into the cell membrane. The cell membranes are going to be a reflection of your dietary fat and that will determine the fluidity of your cell membrane. You can actually make them over fluid. </p>

<p>If you eat too much and you incorporate too many omega-3 oils then they will become highly oxidizable (so you have to eat Vitamin E and monounsaturates as well). </p>

<p>There was an interesting study pertaining to this where they had a breed of rat that was genetically susceptible to cancer. Researchers fed them a high-omega-3 diet, plus iron, without any extra Vitamin E and they were able to almost shrink down the tumors to nothing because tumors are rapidly dividing. This is like a form of chemotherapy, and the membranes that were being formed in these tumor cells were very high in omega-3 oils. The iron acted as a catalyst for that oxidation, and the cells were exploding from getting oxidized so rapidly. So omega-3 oils can be a double-edged sword. In fact, most food is a double-edged sword. </p>

<p>Like oxygen and glucose, food keeps us alive and kills us. Eating is the biggest stress we put on our body and that is why in caloric restriction experiments you can extend life as long as you maintain nutrition. This is the only proven way of actually reducing the rate of aging, not just the mortality rate but the actual rate of aging.</p>

<p>It has actually been shown by quite a number of papers that resistance training for insulin resistance is better than aerobic training. There are a variety of other reasons too. Resistance training is referring to muscular exercises. If you just do a bicep curl, you immediately increase the insulin sensitivity of your bicep. Just by exercising you are increasing the blood flow to that muscle, and one of the factors that determines insulin sensitivity is how blood can get there. It has been shown conclusively that resistance training will increase insulin sensitivity.</p>

<p>Protein’s Role</p>

<p>Now, back to the macronutrients. As I said before, you don't want very much in the way of non-fiber carbs, but fiber carbs are great. You are going to get some non-fiber carbs though. Even if you just eat broccoli you are going to get some non-fiber carbs. That is OK since for the most part you are getting something that is really pretty good for you. </p>

<p>Protein is an essential nutrient. You want to use it as a building block because your body requires protein to repair damage and replenish enzymes. All of the encoded instructions from your DNA are to encode for proteins. That is all the DNA encodes for. You need protein, but you want to use it as a building block. I don't believe in going over and above the protein that you need to use for maintenance, repair and building blocks.</p>

<p>I don't think you should be using protein as a primary fuel source, though your body can use protein very well as a fuel source. It is good to lose weight while using it as a fuel source because it is an inefficient fuel source. Protein is very thermogenic, meaning it produces a lot of heat, which means that less of it is going into stored energy and more is being dissipated--just like throwing a log into a fireplace. Your primary fuel should be coming from fat. </p>

<p>You can calculate the amount of protein a person requires or at least estimate it by their activity level. The book "Protein Power" actually went very well in to this. You have to calculate how much protein is required by activity level and lean body mass. There is still some gray area as to how many grams per kilogram of lean body mass, depending on the activity that person requires. </p>

<p>It can range anywhere from one to two grams of protein per kilogram of lean body mass, maybe even a little bit higher if someone is really active. You don't want to go under that amount for very long. It is better to go over than to go under that amount for very long. </p>

<p>If you can cure a diabetic of diabetes, you can do the same thing to a so-called non-diabetic person and still improve that person. I want to improve my insulin sensitivity just as much as I do my diabetics because insulin sensitivity is going to determine, for the most part, how long you are going to live and how healthy you are going to be. It determines the rate of aging more so than anything else we know right now.</p>

<p>Supplements</p>

<p>What about supplements such as Chromium?</p>

<p>All of my diabetics go on 1,000 mcg of chromium, some a little bit more if they are really big people. The amount is usually 500 mcg for a non-diabetic, though it depends on their insulin levels. </p>

<p>I use a lot of supplements. What you really want to do is to try to convert the person back into being an efficient burner of fat. Earlier we talked about when you are very insulin resistant and you are waking up in the morning with an insulin level that is elevated, you cannot burn fat but instead are burning sugar. </p>

<p>One of the reasons that sugar goes up so high is because that is what your cell is needing to burn, but if it is so insulin resistant it requires a blood sugar of 300 so that just by mass action some can get into the cell and be used as fuel. If you eliminate that need to burn sugar, you don't need such high levels of sugar even if you are insulin resistant.</p>

<p>You want to increase the ability of the cells in the body to burn fat and make that glucose burner into a fat burner. You want to make a gasoline-burning car into a diesel-burning car. Did anyone ever look at the molecular structure of diesel fuel in your spare time? It looks almost identical to a fatty acid. There is a company right now that can tell you how to alter vegetable oil to use in your Mercedes. It's just a matter of thinning it out a little bit. It is a very efficient fuel. </p>

<p>Triglycerides</p>

<p>You can look at other variables that will give you some idea too, such as triglycerides. If people are very sensitive to high levels of insulin, they come in with insulin levels of 14 and they have triglycerides of 1000. You would treat them just as you would if they had an insulin level of 50. It gives you some idea of the effect of the hyperinsulinemia on the body. </p>

<p>You can use triglycerides as a gauge, which I often do. The objective is to try to get the insulin level just as low as you possibly can. There is no limit. They classify diabetes now as a fasting blood sugar of 126 or higher. A few months ago it might have been 140. It is just an arbitrary number. Does that mean that someone with a blood sugar of 125 is non-diabetic and fine? If you have a blood sugar of 125 you are worse than if you had a blood sugar of 124--same with insulin. If you have a fasting insulin of 10, you are worse off than if you had an insulin of 9. You want to get it just as low as you can.</p>

<p>Does This Apply to Athletes? </p>

<p>With athletes, think about the effect of carbohydrate loading before an event. What happens if you eat a bowl of pasta before you have to run a marathon? What does that bowl of pasta do? It raises your insulin. What is the instruction of insulin to your body? </p>

<p>To store energy and not burn it. I see a fair amount of athletes and this is what I tell them, you want everybody, athletes especially, to be able to burn fat efficiently. So when they train, they are on a very low-carbohydrate diet. The night before their event, they can stock up on sugar and load their glycogen if they would like. </p>

<p>They are not going to become insulin resistant in one day. Just enough to make sure, it has been shown that if you eat a big carbohydrate meal that you will increase your glycogen stores, that is true and that is what you want. But you don't want to train that way because if you do you won't be able to burn fat, you can only burn sugar, and if you are an athlete you want to be able to burn both. </p>

<p>Few people have problems burning sugar if they are athletes, but they have lots of problems burning fat, so they hit the wall. And for certain events, like sprinting, it is less important, truthfully for their health it is very important to be able to burn fat, but a sprinter will go right into burning sugar. If you are a 50-yard dash person, whether you can burn fat or not is not going to make a huge difference in your final performance. </p>

<p>Beyond your athletic years, if you don't want to become a diabetic, and don't want to die of heart disease and don't want to age quickly, it is certainly not going to do you any harm to be able to burn fat efficiently in addition to sugar.</p>

<p>Vanadyl Sulfate</p>

<p>Vanadyl Sulfate is an insulin mimic, so that it can basically do what insulin does by a different mechanism. If it went through the same insulin receptors, then it wouldn't offer any benefit, but it doesn't, it actually has been shown to go through a different mechanism to lower blood sugar, so it spares insulin and then it can help improve insulin sensitivity. To really lower a person’s insulin, I give 25 mg 3 times a day temporarily.</p>

<p>Glutamine Powder</p>

<p>I also put people on glutamine powder. Glutamine can act as a brain fuel, so it helps eliminate carbohydrate cravings while they are in that transition period. I like to give it to them at night, and I tell them to use it whenever they feel they are craving carbohydrates. They can put several grams into a little water and drink it and it helps eliminate carbohydrate cravings between meals.</p>

<p>A high-protein diet will increase an acid load in the body, but not necessarily a high-fat diet. Vegetables and greens are alkalinizing, so if you are eating a lot of vegetables along with your protein it equalizes the acidifying effect of the protein. I don't recommend a high-protein diet; I recommend an adequate protein diet. </p>

<p>Fat in the Diet</p>

<p>I think you should be using fat as your primary energy source, and fat is kind of neutral when it comes to acidifying or alkalinizing. In general, over 50 percent of the calories should come from fat, but not from saturated fat. When we get to fat, the carbohydrates are clear-cut. No scientist out there is really going to dispute what I've said about carbohydrates. </p>

<p>There is the science behind it. You can't dispute it. There is a little bit of a dispute as to how much protein a person requires. When you get to fat, there is a big gray area as to which fat a person requires. We just have one name for fat, we call it fat or oil. Eskimos have dozens of names for snow and east Indians have dozens of names for curry. We should have dozens of names for fat because they do many different things. And how much of which fat to take is still open to a lot of investigation and controversy. </p>

<p>My take on fat is that if I am treating a patient who is generally hyperinsulinemic or overweight, I want them on a low-saturated-fat diet, because most of the fat they are storing is saturated fat. When their insulin goes down and they are able to start releasing triglycerides to burn as fat, what they are going to be releasing mostly is saturated fat. So you don't want them to take anymore orally. There is a ration of fatty acids that is desirable if you took them from the moment you were born, but we don't. We are dealing with an imbalance here that we are trying to correct as rapidly as we can. </p>

<p>Most of us here have enough saturated fat to last the rest of our life. Truthfully. Your cell membranes require a balance of saturated and poly-unsaturated fat, and it is that balance that determines the fluidity. As I mentioned, your cells can become over-fluid if they don't have any saturated fat. </p>

<p>Saturated fat is a hard fat. We can get the fats from foods to come mostly from nuts. Nuts are a great food because it is mostly mono-unsaturated. Your primary energy source ideally would come mostly from mono-unsaturated fat. It's a good compromise. It is not an essential fat, but it is a more fluid fat. Your body can utilize it very well as an energy source.</p>

<p>Grain-Fed Animals are not Healthy</p>

<p>Animal proteins are good for you, but not the ones that are fed grains. </p>

<p>Grain-fed animals are going to make saturated fat out of the grains. Saturated fat in nature occurs to a very tiny degree. In the wild there is very little saturated fat out there. If you talk about the Paleolithic diet, we didn't eat a saturated fat diet. Saturated fat diets are new to mankind. We manufactured a saturated fat diet by feeding animals grains. You can consider saturated fat to be second-generation carbohydrates. We eat the saturated fats that other animals produce from carbohydrates. </p>

<p>Zone was a good diet compared to the American diet. Is it an optimal diet? No. Is it optimal for what is known today about nutrition? It is not. Initially the author spoke about how it made no difference if you got your carbohydrate from candy or vegetables. </p>

<p>What he is doing now is changing his recipes so that the 40 percent carbohydrates are coming primarily from vegetables, and the carbohydrates are going way down because he knows that if they don't, it's not as good a diet. </p>

<p>I recommend 20 percent of calories from carbs, depending on the size of the person, 25 percent to 30 percent of calories from protein, and 60 percent to 65 percent from fat. You can get beef that is not grain-fed.</p>

<p>Insulin is Not the Only Cause of Disease </p>

<p>There are other considerations in disease, such as iron. We know that high iron levels are bad for you. If a person's ferritin is high, red meat is out for a while until the level goes down. </p>

<p>There is a great deal of difference between a non-grain-fed cow and a grain-fed cow. </p>

<p>Non-grain fed will have only 10 percent or less saturated fat. Grain-fed can have over 50 percent. </p>

<p>Also, a non-grain-fed cow will actually be high in omega-3 oils. Plants have a pretty high percentage of omega-3, and if you accumulate it by eating it all day, every day for most of your life, your fat gets a pretty high proportion of omega-3. I would try for 50 percent oleic fat, and the other fats would depend on the individual, but about 25 percent of the other two. </p>

<p>In a heavy diabetic I would probably go down on the saturated fat and go 60 percent oleic, and 1 to 1 on the omega-6 to 3 ratio--that would be therapeutic. The maintenance ratio would be about 2.5 to 1 for the omega-6 to 3 ratio. I would try to do most of this through diet. There are some practicalities involved. I would ask the person if they like fish and if they practically puke in front of me they are going on a tablespoon of cod liver oil, the best brand is made by Carlson, which doesn't taste fishy at all. </p>

<p>Most people end up going on a supplement of omega-3 oils because they are not going to eat enough fish to get an adequate amount. It is a little hard to get that much entirely from diet.</p>

<p>Sardines are a very good therapeutic food. They are baby fish so they haven't had time to accumulate a bunch of metal. They are smoked so they are not cooked and the oil is not spoiled in them. You have to eat the whole thing, not the boneless and skinless. You need to eat all the organs as they are high in vitamins and magnesium.</p>

<p>DNA Glycates</p>

<p>If people are worried about chromosomal damage from chromium, what they should really be worried about instead is high blood sugar. DNA repair enzymes glycate as well. Insulin is by far your biggest poison. They disproved that study that was against chromium many times. They showed that it only happens if you put cells in a petrie dish with chromium but in vivo studies prove otherwise. The lowering of insulin is going to be better than any possible detriment of any of the therapies you are using. Insulin is associated with cancer, everything.</p>

<p>Insulin should be tested on everybody repeatedly. It isn’t strictly because there haven't been drugs until recently that could effect insulin, so there is no way to make money off of it. Fasting insulin is one way to look at it, not necessarily the best way, but it is a way that everybody could get it done. Any family doctor can measure a fasting insulin. </p>

<p>There are other ways to measure insulin sensitivity that are more complex. We use intravenous insulin and watch how rapidly the blood sugar crashes in a fasting state in 15 minutes, and that assesses insulin sensitivity. Then you give them dextrose to make sure they don't crash any further. There are other ways that are utilized to directly assess insulin sensitivity, but you can get a pretty good idea just by doing a fasting insulin.</p>

<p>Designs for Health Institute<br />
</p>]]>
</content>
</entry>
<entry>
<title>WHAT IS PCOS?  WHY IS IT DIFFICULT TO LOSE WEIGHT?</title>
<link rel="alternate" type="text/html" href="http://www.healthdiaries.com/women/pcos/maddy/archives/2005/08/what_is_pcos_why_is_it_difficult_to_lose_weight.html" />
<modified>2005-12-01T11:44:14Z</modified>
<issued>2005-08-30T00:49:00Z</issued>
<id>tag:www.healthdiaries.com,2005:/women/pcos/maddy//182.3563</id>
<created>2005-08-30T00:49:00Z</created>
<summary type="text/plain">What is Polycystic Ovarian Syndrome (PCOS)? PCOS is a health problem that can affect a woman’s menstrual cycle, fertility, hormones, insulin production, heart, blood vessels, and appearance. Women with PCOS have these characteristics: high levels of male hormones, also called...</summary>
<author>
<name>Maddy</name>

<email>mandyjanew@blueyonder.co.uk</email>
</author>

<content type="text/html" mode="escaped" xml:lang="en" xml:base="http://www.healthdiaries.com/women/pcos/maddy/">
<![CDATA[<p>What is Polycystic Ovarian Syndrome (PCOS)? <br />
PCOS is a health problem that can affect a woman’s menstrual cycle, fertility, hormones, insulin production, heart, blood vessels, and appearance. Women with PCOS have these characteristics:</p>

<p>high levels of male hormones, also called androgens <br />
an irregular or no menstrual cycle <br />
may or may not have many small cysts in their ovaries. Cysts are fluid-filled sacs. <br />
PCOS is the most common hormonal reproductive problem in women of childbearing age.</p>

<p>How many women have Polycystic Ovarian Syndrome (PCOS)?<br />
An estimated five to 10 percent of women of childbearing age have PCOS.</p>

<p>What causes Polycystic Ovarian Syndrome (PCOS)?<br />
No one knows the exact cause of PCOS. Women with PCOS frequently have a mother or sister with PCOS. But there is not yet enough evidence to say there is a genetic link to this disorder. Many women with PCOS have a weight problem. So researchers are looking at the relationship between PCOS and the body’s ability to make insulin. Insulin is a hormone that regulates the change of sugar, starches, and other food into energy for the body’s use or for storage. Since some women with PCOS make too much insulin, it’s possible that the ovaries react by making too many male hormones, called androgens. This can lead to acne, excessive hair growth, weight gain, and ovulation problems.</p>

<p>Why do women with Polycystic Ovarian Syndrome (PCOS) have trouble with their menstrual cycle?<br />
The ovaries are two small organs, one on each side of a woman's uterus. A woman's ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These sacs are also called cysts. Each month about 20 eggs start to mature, but usually only one becomes dominant. As the one egg grows, the follicle accumulates fluid in it. When that egg matures, the follicle breaks open to release the egg so it can travel through the fallopian tube for fertilization. When the single egg leaves the follicle, ovulation takes place. </p>

<p>In women with PCOS, the ovary doesn't make all of the hormones it needs for any of the eggs to fully mature. They may start to grow and accumulate fluid. But no one egg becomes large enough. Instead, some may remain as cysts. Since no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman’s menstrual cycle is irregular or absent. Also, the cysts produce male hormones, which continue to prevent ovulation. </p>

<p>What are the symptoms of Polycystic Ovarian Syndrome (PCOS)? <br />
These are some of the symptoms of PCOS: </p>

<p>infrequent menstrual periods, no menstrual periods, and/or irregular bleeding <br />
infertility or inability to get pregnant because of not ovulating <br />
increased growth of hair on the face, chest, stomach, back, thumbs, or toes <br />
acne, oily skin, or dandruff <br />
pelvic pain <br />
weight gain or obesity, usually carrying extra weight around the waist <br />
type 2 diabetes <br />
high cholesterol <br />
high blood pressure <br />
male-pattern baldness or thinning hair <br />
patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs <br />
skin tags, or tiny excess flaps of skin in the armpits or neck area <br />
sleep apnea―excessive snoring and breathing stops at times while asleep <br />
What tests are used to diagnose Polycystic Ovarian Syndrome (PCOS)?<br />
There is no single test to diagnose PCOS. Your doctor will take a medical history, perform a physical exam—possibly including an ultrasound, check your hormone levels, and measure glucose, or sugar levels, in the blood. If you are producing too many male hormones, the doctor will make sure it’s from PCOS. At the physical exam the doctor will want to evaluate the areas of increased hair growth, so try to allow the natural hair growth for a few days before the visit. During a pelvic exam, the ovaries may be enlarged or swollen by the increased number of small cysts. This can be seen more easily by vaginal ultrasound, or screening, to examine the ovaries for cysts and the endometrium. The endometrium is the lining of the uterus. The uterine lining may become thicker if there has not been a regular period. </p>

<p>How is Polycystic Ovarian Syndrome (PCOS) treated?<br />
Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatments are based on the symptoms each patient is having and whether she wants to conceive or needs contraception. Below are descriptions of treatments used for PCOS.</p>

<p>Birth control pills. For women who don’t want to become pregnant, birth control pills can regulate menstrual cycles, reduce male hormone levels, and help to clear acne. However, the birth control pill does not cure PCOS. The menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone, like Provera, to regulate the menstrual cycle and prevent endometrial problems. But progesterone alone does not help reduce acne and hair growth. </p>

<p>Diabetes Medications. The medicine, Metformin, also called Glucophage, which is used to treat type 2 diabetes, also helps with PCOS symptoms. Metformin affects the way insulin regulates glucose and decreases the testosterone production. Abnormal hair growth will slow down and ovulation may return after a few months of use. These medications will not cause a person to become diabetic. </p>

<p>Fertility Medications. The main fertility problem for women with PCOS is the lack of ovulation. Even so, her husband’s sperm count should be checked and her tubes checked to make sure they are open before fertility medications are used. Clomiphene (pills) and Gonadotropins (shots) can be used to stimulate the ovary to ovulate. PCOS patients are at increased risk for multiple births when using these medications. In vitro Fertilization (IVF) is sometimes recommended to control the chance of having triplets or more. Metformin can be taken with fertility medications and helps to make PCOS women ovulate on lower doses of medication. </p>

<p>Medicine for increased hair growth or extra male hormones. If a woman is not trying to get pregnant there are some other medicines that may reduce hair growth. Spironolactone is a blood pressure medicine that has been shown to decrease the male hormone’s effect on hair. Propecia, a medicine taken by men for hair loss, is another medication that blocks this effect. Both of these medicines can affect the development of a male fetus and should not be taken if pregnancy is possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at getting rid of hair. A woman with PCOS can also take hormonal treatment to keep new hair from growing.</p>

<p>Surgery. Although it is not recommended as the first course of treatment, surgery called ovarian drilling is available to induce ovulation. The doctor makes a very small incision above or below the navel, and inserts a small instrument that acts like a telescope into the abdomen. This is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these effects may only last a few months. This treatment doesn't help with increased hair growth and loss of scalp hair. </p>

<p>A healthy weight. Maintaining a healthy weight is another way women can help manage PCOS. Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy weight, which will help the body lower glucose levels, use insulin more efficiently, and may help restore a normal period. Even loss of 10% of her body weight can help make a woman's cycle more regular. </p>

<p>How does Polycystic Ovarian Syndrome (PCOS) affect a woman while pregnant?<br />
There appears to be a higher rate of miscarriage, gestational diabetes, pregnancy-induced high blood pressure, and premature delivery in women with PCOS. Researchers are studying how the medicine, metformin, prevents or reduces the chances of having these problems while pregnant, in addition to looking at how the drug lowers male hormone levels and limits weight gain in women who are obese when they get pregnant.</p>

<p>No one yet knows if metformin is safe for pregnant women. Because the drug crosses the placenta, doctors are concerned that the baby could be affected by the drug. Research is ongoing. </p>

<p><br />
Does Polycystic Ovarian Syndrome (PCOS) put women at risk for other conditions?<br />
Women with PCOS can be at an increased risk for developing several other conditions. Irregular menstrual periods and the absence of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Without progesterone, which causes the endometrium to shed each month as a menstrual period, the endometrium becomes thick, which can cause heavy bleeding or irregular bleeding. Eventually, this can lead to endometrial hyperplasia or cancer. Women with PCOS are also at higher risk for diabetes, high cholesterol, high blood pressure, and heart disease. Getting the symptoms under control at an earlier age may help to reduce this risk.</p>

<p>Does Polycystic Ovarian Syndrome (PCOS) change at menopause?<br />
Researchers are looking at how male hormone levels change as women with PCOS grow older. They think that as women reach menopause, ovarian function changes and the menstrual cycle may become more normal. But even with falling male hormone levels, excessive hair growth continues, and male pattern baldness or thinning hair gets worse after menopause.</p>

<p>For More Information...<br />
You can find out more about PCOS by contacting the National Women's Health Information Center (NWHIC) at 800-994-WOMAN (9662) or the following organizations: </p>

<p>National Institute of Child Health and Human Development (NICHD), NIH, HHS<br />
Phone: (800) 370-2943<br />
Internet Address: http://www.nichd.nih.gov/womenshealth</p>

<p>American Association of Clinical Endocrinologists (AACE)<br />
Phone: (904) 353-7878<br />
Internet Address: http://www.aace.com</p>

<p>American Society for Reproductive Medicine (ASRM)<br />
Phone: (205) 978-5000<br />
Internet Address: http://www.asrm.org</p>

<p>Center for Applied Reproductive Science (CARS)<br />
Phone: (423) 461-8880<br />
Internet Address: http://www.ivf-et.com</p>

<p>InterNational Council on Infertility Information Dissemination, Inc. (INCIID)<br />
Phone: (703) 379-9178<br />
Internet Address: http://www.inciid.org</p>

<p>PolyCystic Ovarian Syndrome Association, Inc. (PCOSA)<br />
Phone: (877) 775-7267<br />
Internet Address: http://www.pcosupport.org</p>

<p>The Hormone Foundation<br />
Phone: (800) 467-6663<br />
Internet Address: http://www.hormone.org</p>]]>

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</entry>
<entry>
<title>Symptoms of PCOS</title>
<link rel="alternate" type="text/html" href="http://www.healthdiaries.com/women/pcos/maddy/archives/2005/04/symptoms_of_pcos.html" />
<modified>2005-12-01T11:44:28Z</modified>
<issued>2005-04-30T20:19:45Z</issued>
<id>tag:www.healthdiaries.com,2005:/women/pcos/maddy//182.2908</id>
<created>2005-04-30T20:19:45Z</created>
<summary type="text/plain">Firstly I&apos;ll reply to my journal comment! I found out I had PCOS in 2001 though now I recognise I have always had it. When I was a young teenager I used to spend hours in the bath scrubbing away...</summary>
<author>
<name>Maddy</name>

<email>mandyjanew@blueyonder.co.uk</email>
</author>

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<![CDATA[<p>Firstly I'll reply to my journal comment!</p>

<p>I found out I had PCOS in 2001 though now I recognise I have always had it.<br />
When I was a young teenager I used to spend hours in the bath scrubbing away at darker patches of skin which used to look "dirty" (now I realise it's caused by insulin resistance)<br />
I was always sporty and a bit of a tomboy and never had a problem with my weight.  I loved sports at school.  When I reached 16 I started to gain weight quite rapidly and took up weight training and dieting.  I have been dieting ever since.<br />
Over time the weight loss has become harder and harder.  After having my son when I was 24 the weight seemed to jump on me quite rapidly.  I spent a few years on a "healthy diet" of low fat, high carbs only to gain more weight and start sprouting extra hair!<br />
I visited my Dr over the course of weeks and months never really getting anywhere until I read an article on PCOS and asked for the tests to find I do have it.<br />
PCOS is where small cysts form all over the ovaries; your body becomes resistant to insulin and produces extra to compensate; too much sugar in the blood causes fatigue and general aches and pains and fat gain.  Fat gain causes more hormonal imbalances and that coupled with insulin resistance causes the body to produce too much testosterone which in return can cause male hair pattern baldness; excess body and even facial hair; lack of periods and more cysts.  And so the cycle goes on.<br />
I will collate some better information than that to post in my journal.  After all, if this is a journal about PCOS I should include some information on the syndrome right?  But it's quite ironic that today I have decided to stop focussing on PCOS!</p>]]>

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