Polycystic Ovarian Syndrome

from MedicineNet.com

 April 10 last year, I was diagnosed of having Polycystic Ovarian Syndrome (PCOS) also known as Stein-Leventhal syndrome (I prefer PCOS for I don’t even know how to pronounce the latter, haha). I was 19 y/o back then. 

   I searched for forums regarding PCOS in the Philippines and I was really surprised that quite many do have this condition. See here. you could really learn from their posts.

   It all started when I noticed that it was already 5 months since my last menstruation because I'm only used to having a month or two – interval, thinking that it was the  so called irregular menstruation. At first, my mother thought that maybe it was because of so much stress with school works, but my auntie suggested that I consult a doctor. And so we did. We went to my aunt's OB-GYNE in St. Luke's Medical Center, at first I was really hesitant or scared to go. It was such a shame that I would say to patients to consult a doctor regarding their health problems, but then I was the one who is hesitant now. Upon meeting the doctor, I really felt glad that she’s not like other scary to approach doctors (doctors somehow scare me even though I wanted to become a doctor when I was a kid); rather, she’s very nice and pleasant (you'll know that she cares). She made a request for some blood tests and a transrectal ultrasound, and it was that which confirmed that I do have Polycystic ovaries. She gave me prescriptions on medications to take and advised to lose some weight (maybe engaged to sports). She really explained to us everything that we need to know about PCOS in a very understandable manner, very informative! And shared other cases of PCOS she encountered. I was really inspired by her.

Okay, I'm overly talking about this PCOS stuff, but what is it anyway? 

     Normally a woman's ovaries have fluid-filled sacs called follicles/cysts which, when an egg matures, break and thus leads to ovulation (egg then goes to the womb for possible fertilization). In PCOS, the ovaries had build up a number of immature follicles because no egg matures. How does this happen? (I'll try my best to explain this as I've understood it). You see, the problem in PCOS is that of a so-called Peripheral Resistance to Insulin (PRI) and hormonal imbalance (Woman with PCOS, typically have high level of Androgen, let me explain further). In our body, we have this Pancreas which releases insulin which converts sugar into energy. With PRI, the body does not recognize insulin, therefore sugar is not converted to energy. On the other hand, females have the so-called Estrogen hormones in their bodies while males have Androgens (male hormones), but there is also a small amount of the other in our body (Small amount of Androgen for the females and Estrogen for the males). Our Androgens are brought through the blood into our ovaries and undergoes a chemical process called Esterification into which it would be converted to Estrogen. Again with PRI, this does not happen and so there would be build up of Androgens (making androgens > estrogen, which is the main reason for acne and excessive hair growth). And so, the ovaries can't do its job (on making a baby), since Estrogen is needed so that eggs will be matured-which is needed for ovulation especially if you want to get pregnant.

Symptoms of PCOS (these are only some of them): 

Acne (pimple, pinheads, comedo and such, I actually didn't noticed this, but I did have an acne problem when I was in my early teen, but so was my twin, so I actually thought that it was just the normal changes especially for adolescence.) 

Hirsutism (or growth of facial hair, or anywhere we females aren't supposed to usually, I did not actually think that it was a symptom because I grew believing that I was a "balbon"-hairy)

Obesity or Weight gain (But others would say that they are skinny. I'm actually overweight back then, I was about 140 lbs and I started to lose some weight making me 122 lbs now-people really noticed how I lost some weight and its because of this. Losing weight was the difficult part for me because I really do eat a lot and the only diet I'm in was on a seafood diet (I see food and I eat it. haha). Anyway, I went to the gym last summer but I really don't have someone to be with me regularly, so I did not really liked it, then I noticed that my appetite decreased, I think it was because of Metformin, but then it went back again. I'm actually eating a lot again and it really frustrates me. And so I realized that depriving myself with great tasting food is not really helping so I would just eat everything that I like just with minimal amount. Also, It's really helpful being in my dorm since I get lazy going down to have dinner so most of the time I just would not, which I believe really helps me lose some weight for I only eat biscuits, just to have something before drinking my medication.)

Cysts on the ovaries (this could be seen with an ultrasound-vaginal or rectal, my mother's friend which is a doctor advised us to have the same sonographer since it could somehow affect the interpretation of the requesting physician)

Missed or Irregular Menstruation (like I've said above I had 5 months without menstruating , this is because of the absence of progesterone in our body)

Treatments

   There is actually no cure for PCOS, but it could be managed to prevent further complications. First is lifestyle modification- healthy eating and regular exercise to lose some weight. Medications will also be given, I had Duphaston (a progesterone to start menstruating again), Yasmin to Diane (are hormone treatments/oral contraceptives that regulates menstruation and helps to decrease the abnormal hair growth and acne) and Metformin (usually prescribed for type 2 diabetic patients, but also prescribed for women with PCOS to help in the resistance to insulin problem and help in decreasing body mass.) Those were my medications before, we had a check-up yesterday and my Diane was changed  to Cerazette and still continue on with Metformin.

How can this affect ones life?

    Well aside from the fact that the treatment medications are pricely, the most common is that of the symptoms or effects of PCOS like Acne build up and Excessive hair growth (which could affect ones body image), and of course Infertility (for those wanting to have babies).   Also, they say that women who have PCOS is at greater risk from different health problems like Diabetes, Hypertension, Heart Attacks, Hyperlipidemia, Endometrial Cancer, etc. It is also said that woman could develop mental health conditions like Depression and Anxiety. (I sometimes feel depressed but I doubt that it's because of this). 

I just hope I (and others as well) could get better soon. We can do this! 

Please! I do want to have a baby someday! 

Here some of the sites you could browse to learn more about PCOS:

womenshealth

medicinenet

Be my reader! :)