I must whole heartly agree with Dr. Erika, this is my thinking all along. It does however fall on the sholders of the woman with PCOS to stick with the diet. You can follow many low fat, low processed carb diets to acheive the same results.
Wednesday, December 26, 2007 PCOS - Polycystic Ovary Syndrome
The scariest part about PCOS is the diagnosis. Too many young women with their mothers come to see me scared out of their wits by doctors who tell them their daughters, once glibly diagnosed with PCOS will in time become diabetic, infertile and possibly even victims of possible cancer. In my personal experience PCOS is a typical example of how a disease label translate into an unfounded and dangerous amount of stigma and fear. Over the course of the past ten years I have seen too many young women who have been cavalierly diagnosed with PCOS scaring them and their mothers into a state of panic without providing them with healthy solutions and hope.
The good news is that there is plenty of hope and knowledge and the young woman at the receiving end of this diagnosis need never become a disease!
What is PCOS?
Polycystic ovary syndrome is a hormonal disorder caused by an imbalance in the pituitary-hypothalamic-ovarian system that is defined by a constellation of some or all of the symptoms of:
- irregular menstrual cycles,
- stopping of ovulation,
- testosterone excess,
- weight gain,
- hair thinning on the head
- increased facial, arm and leg hair
- Insulin resistance
- sugar cravings
The diagnosis of PCOS has become the diagnosis du jour for conventional medicine at a loss for reasons why our teens may have irregular periods, become overweight, suffer with acne and become too hairy. Practically every pelvic ultrasound performed on a young woman with irregular periods and any of the above symptoms (and most have at least one) that shows cysts on the ovary becomes a quick excuse to throw in the PCOS label.
This situation creates a slew of possibly unnecessary treatment and testing choices for too many teens and their parents leading them to embark on a course of action that may not be helpful at all.
I don't want to appear glib when addressing symptoms of weight gain, acne, hair issues. They are all valid and worrisome symptoms that have become too prevalent in our teens. I want to eliminate the stigma and put the whole issue of PCOS into perspective for both moms and young women because I find that fear and intimidation make terrible partners if you want to get and stay healthy.
Here is a quick checklist of what to do and what you need to know when dealing with the "potential" or definitive" diagnosis of PCOS:
-Not all PCOS is the same. Since every person is different, PCOS is just a diagnosis and while in some cases, the whole constellation of symptoms associated with the syndrome is apparent, in most cases it is not. Make sure you take a realistic and honest look at what is really bothering your daughters. Don't let the doctors tell you what the symptoms are. Look, listen and speak with your daughter.
-Since we are all alive, the only sure thing is that things will change. In the case of PCOS that means that if you have cysts on your ovaries today, they may very well be gone by tomorrow or next month without any help from the doctor. Most cysts are a normal part of the female cycle and they grow when we ovulate and go away a few days or weeks later. Having the ultrasound done in mid cycle (if you know your cycle) does usually show cysts which are just part of ovulation. Most cysts do not require a knee-jerk reaction; they are not cancer or in danger of bursting and causing terrible trouble.
-Before accepting a diagnosis of PCOS as fact, have follow-up ultrasounds and also follow the recommendations I make here for a few months.
-Conventional medicine treats people diagnosed with diseases with medications. I am a conventional physician and have treated many patients with the recommended medications over the course of my early years in practice. I can assuredly tell you the medications recommended for PCOS are dangerous and of no proven help to the individual symptoms or the overall problem. And worst of all, there are no long term studies to show any beneficial effects or proven safety for their use over the long haul.
-The medications used are:
o Birth control pills to regulate the irregular periods,
o Glucophage, an anti diabetic drug used on adults with insulin resistance and also frequently used off label for weight loss, a
o Various hair growth and removal medications
o Cholesterol lowering drugs.
o Their side-effects include but are not limited to:
-liver function impairment,
Scientific speculation about the massive increase in the PCOS diagnostic label includes genetics as a predisposing factor, while diet and lifestyle seem to take second place while common sense and my experience tells us they are the culprits.
The increase in the diagnosis of PCOS appears indelibly connected to our teens' and twenty-something's' poor eating habits, specifically foods filled with hormones and chemicals, sedentary living habits, and increasing stress levels.
To me, the most likely hypothesis is that the diagnosis is more frequent with the conventional frenzy for more testing, more diagnosing and more medications to treat variations on normal.
If common sense and desire to keep the patient healthy and empowered comes first, the treatment for "potential" or "possible" PCOS must be much simpler and far less dangerous. Making conscious choices about way of life, honestly deciding if conventional medical treatments are the best way to go or diet, exercise, lifestyle and stress management are more desirable are all individual decisions that start at home in the family setting and get transferred onto our young women.
Dr.Erika's Treatment for PCOS
Here is the treatment I provide to my patients with a high level of success and NO negative side-effects:
1. Diet: Hormone healthy foods: i.e.- fruit, vegetables, nuts, beans, lean cuts of meat, fish and whole grains. No junk foods (no saturated fats, no trans fats, no processed foods, no soda, NO sugar substitutes, no or certainly limited amounts of alcohol).
2. Exercise: A minimum of 30 minutes a day, 3-5 days a week as individually appropriate. Starting slowly and build up kindly and gently to a serious level of activity. It will strengthen the young woman and help her build significant self-confidence along with help with weight and improvement in the balance of hormones
3. The age appropriate vitamins and minerals on a daily basis.
4. Natural Progesterone. Since many of the symptoms are caused by hormonal imbalances prevalent in teens adding progesterone gently helps the young woman's hormonal balance and often eliminates most of the problems. For my patients I use Pro-Cream Formulaevery evening in three week cycles for up to six months.
5 Thyroid function evaluation and treatment. In my experience I find that often thyroid function is overlooked as a possible ingredient for the problems because the blood tests used to diagnose low thyroid don't really reflect the true status of the thyroid and thyroid is not considered a part of PCOS. I believe it should be and find that treatment with appropriate thyroid medication often brings about significant improvement in the overall picture.
Try this regimen along with caring, support that stirs clear of intimidation, fear and doom and gloom of a potential problem that may never really exist.
Interesting article. I googled the Pro-Cream Formula progesterone cream. I've heard of this type of product, and was just curious about it. What is your opinion of progesterone cream, Debra? When/for whom might it be useful?
The progesterone cream would be very helpful for any woman who doesn't ovulate or form the corpus luteum from the release of an egg. I'm actually considering talking to my ObGyn about it next time I see her in two weeks. (perimenopause on my part)
The corpus luteum is what produces the progesterone in the luteal phase. One of the problems in PCOS is low progesterone which can cause PMS symptoms. Women with PCOS don't ovulate all the time, due to high testosterone levels. PCOS is a one of the most common reasons for infertility in young women.
I'll tell you right now. It's people like Dr. Erika that provide us PCOS sufferers with absolutely NO help whatsoever. She's from the "old school" train of thought that "just lose weight" will fix all the problems.
I have a question for Dr. Erika. What about all the thin women who suffer from the SAME problems as us overweight PCOS women???
And what studies is she looking at that show that the meds are not working??? I know of several people that Metformin (aka Glucophage) has worked wonders for. It has helped them become regular in their cycles, helped them to ovulate, and even helped them to conceive.
It's arrogance and ignorance like that that keeps PCOS from being researched any further. It's a REAL syndrome and not just in our heads. It's not about just losing weight for a PCOS sufferer.
I agree that each woman expresses different symptoms of PCOS, but just because she expresses only a couple of key traits, it doesn't mean you dismiss her from having it. And I also agree that birth control pills are not a recommended method of treatment; it only masks the effects of PCOS rather than treating it. In order to stimulate a period, Provera and Prometrium are recommended for PCOSers.
Finally, I'm glad mothers are bringing their daughters in now to be tested for PCOS when they suspect they may have it. At least they're nipping this in the bud now rather than allowing their daughters to face this when they get married and discover they can't have children as easily as a normal person. I commend these mothers.
I think the jest of the article is not all PCOS sufferers are at the upper spectrum of the syndrome and not to panic , it doesn't have to be a "medical emergency" just as you yourself have found that going the natural route is healthier. And those who are at the lower end of the spectrum may be fine with dietary adjustments for control.
Once PCOS progresses into Type 2 diabetes or severe insulin resistance than medications are life saving to say the least. But then again most women with PCOS aren't diagnosed until they want to start a family and now these day that might be at 30 years old..... by this time they may have accumulated some unwanted symptoms like high LDL, early stages of atherosclerosis and early stages of heart disease.
:D not everyone agrees with Dr. Swartz, she's a bit out there sometimes.