a pcos primer

Hello all! I can't believe I didn't blog yesterday. Are you ok? Did you freak out? I hope you made it through ok without my wise words of wiseness.

I thought for this entry I'd clue you in to the "basics" of PCOS and what it all means. So... here we go! (My comments are in GREEN.)

Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder, (woo hoo! It's common! Somehow, strangely, this does not make me feel better.) affecting approximately 5%-10% of all females. PCOS is a hormonal disorder that involves multiple organ systems within the body, and is believed to be fundamentally caused by insensitivity to the hormone insulin. However, it is not well understood enough to know for sure that this is the cause. It can be diagnosed in all phases of life - in girls as young as 8-9 years of age, up through post-menopause. Although PCOS is one of the leading causes of infertility, the reproductive aspects of the disorder are secondary. PCOS is not limited to women of reproductive age or potential.

Common symptoms of PCOS include (aka- the sexiest symptoms EVAH!):

• irregular or no menstrual periods (for women of reproductive age)
• irregular ovulation, with or without monthly bleeding
• acne
• excess hair growth on the face and body
• thinning scalp hair
• accumulation of unruptured follicles on the periphery of the ovaries (mislabeled as "cysts", often called polycystic ovaries)

It is not necessary to have all of these symptoms to have PCOS. In fact it is not necessary to have "polycystic ovaries" to have PCOS. PCOS manifests itself differently in each woman.

In addition to the above, approximately 60% of women with PCOS have weight management issues (stupid weight management issues. I spit on you. No fair.) which can lead to obesity with only normal caloric intake. (ok, this is the way sucky thing. I can watch my food intake like a HAWK- eating like 1200-1400 calories, and my weight won't budge.) Energy in the form of glucose (food) is stored right away as fat, instead of being made available for other functions within the body. This can lead to chronic fatigue and undernourishment, despite the fact that there is adequate food intake and even an appearance of over nourishment. (ha ha. over nourishment. That's a nice way to say "chubby".) However, it's important to note that 40% of women with PCOS are of normal weight, or even fall under a normal weight range. (I guess I'm one of the lucky 60% who have to battle with this.)

There is no cure for PCOS, but it can be successfully managed through diet, exercise, and in some cases medical intervention. Management of PCOS is essential, as unmanaged PCOS can progress to diabetes, and can also lead to certain forms of cancer if unaddressed. Proper management of PCOS often eliminates all symptoms. Some women with managed PCOS are among the healthiest within the population because of their lifestyle choices. (this is what I really want! And once I get there, I'll walk around going "I'm probably healthier than you! HA!)

PCOS has also been called Stein-Leventhal Syndrome, historically. The name "polycystic ovarian syndrome" or "polycystic ovary syndrome" is a poor descriptor of the condition, however attempts to arrive at a consensus on renaming the condition have failed so far.

Myths about PCOS:

Women with PCOS cannot have children. FALSE
Women who have had children cannot have PCOS. FALSE
Hysterectomy cures PCOS. FALSE
A woman must have polycystic ovaries to be diagnosed with PCOS. FALSE
A woman who has polycystic ovaries definitely has PCOS. FALSE
Birth control pills cure PCOS. FALSE
If a woman doesn't want to have children (or more children), she I doesn't have to worry about PCOS management. FALSE
If a woman passes a glucose tolerance test, she doesn't have insulin resistance or PCOS. FALSE

Women with PCOS also have higher rates of:

•Miscarriage
•Gestational diabetes
•Pregnancy-induced high blood pressure (preeclampsia)
•Premature delivery

___________________________

So, there you go! A very BASIC primer, but a little info for you. Also, this is a picture of an ultrasound of a polycystic ovary. It looks almost identical to the ultrasound I got in November. All the little black round dots are follicles that never ruptured.

Anyway, I keep reading different books/articles to see if I can learn more, but this is usually about as in depth as it gets. I hope it was at least mildly interesting for you! :)

~M

in a fog

I feel a bit like I'm in a fog today. Maybe it's because it's Monday and I'm just tired. Maybe it's because I'm in this sucky holding pattern- just waiting for this cycle to end. Who knows. My body feels quite wonky today- sluggish, bloated, and really nauseated. Blech.
No fun.

This weekend I started reading this book on holistic fertility. So far it's interesting. I plan on doing the yoga that it suggests- maybe it will help me relax a bit? We'll see. It's all very interesting, and hopefully it will be a good companion to my acupunture.

Also, today I was reading some other infertility blogs, and a couple of them also had PCOS. I have to say, it made me feel a bit behind the curve. Most of these women have already been to reproductive endocronologists and fertility doctors. Or- is that the same thing? I'll have to google that later. Anyway, it just made me think: should I have seen a specialist sooner? I was trying to be patient- but was I TOO patient? I mean, I've only been diagnosed with PCOS by my obgyn- should I have rushed out and gotten a 2nd opinion? I mean, I saw my ovaries on the sonogram- they look like classic polycystic ovaries- and I have many of the symptoms, so I really have no doubt, but I just wonder if I should have seen a specialist sooner. (Holy run-on sentence, Batman!)

It's really so hard in all walks of life NOT to compare yourself to others. Second guessing your choices when you see what others have done. I guess I will just have to trust what I've done so far (it's not like I can change it now!) and move forward-hoping my choices and instincts were the right ones.

~M

a weighty issue

My scale was not my friend this morning. Well, I guess it has never really been my friend. I knew I was retaining water this morning, and my pants felt a tiny bit snug, so I thought "hmm... I haven't weighed myself in a while, maybe I should just see where I am." Yeah. I kind of wish I hadn't done that. I realize I share a lot on this blog, but, dear readers, I will not be telling you my weight. I am TOO embarrassed by it. But, I have gained about 8 pounds this month. WHAT??? GAH.

I hate that it's so easy for me to gain weight and so difficult to lose it. When I first was diagnosed with PCOS, and read that one of the symptoms for many women was "difficulty losing weight" I was partially relieved to know that it wasn't my fault. But now I'm just mad. Really mad.

I hate that my weight is always on my mind. Every second; really- not an exaggeration. I'm so tired of thinking about it; it's exhausting. I feel like a broken record. But I know that it will never be something I can't focus on. It will be my lifelong struggle. And I realize that everyone has something like that, and I'm not unique in this regard. Everyone has a thing they perpetually struggle with.

Anyway, I've decided because of this, that I'm not going to do clomid this month. Instead, I'm going to use this month to just focus on losing some weight. I want to be as healthy as possible when I have my appointment with Dr. Sami David in May. This was a hard decision to make, because I was really looking forward to doing another round of clomid; hoping that it would really do what it was supposed to this time. The fact that I had a prescription for a higher dose just made me hopeful. But; it's more important that I'm healthy. So, this next cycle is just going to be all about trying to be healthier. Because baby or no baby, my health is vital. And I think it's time to take a little break from being so baby focused, and just focus on me. Because when baby Fraser DOES show up, I want to be a shining example of health and happiness for our little wee one.

~M

alright already!

Ok, so right now I'm at the eye Doctor- filling out forms. I'm participating in a contact lens study (don't worry- all lenses are FDA approved) for cash. That's right; I get to wear free contact lenses and they pay me. Anyway, there are a TON of forms you have to fill out, and I just had to initial like 5 pages saying I promised I was "not pregnant". Way to rub it in, eye doctor!

~M

discouraging

So, today I'm feeling discouraged. It's day 53 of my cycle. FIFTY THREE. It has been 5 days since I finished the progesterone, and nothing has happened. I was happy though, because for the last few days, my temperature had been dropping, which seems like for sure it meant things were coming to an end, but this morning it went back up again. Not SO high up that you'd think I ovulated, just high enough to be annoying and discouraging. Most girls don't wish for their periods to come, but I feel like I constantly am. You'd THINK I'd constantly be wishing to be pregnant, but so often, after I take a million tests and know I'm NOT pregnant- I'm just in a hurry to get my period so I can try again.

Anyway, so now I'm just waiting, and hoping that maybe with Murphy's law- because I'm mentioning it and all- I'll get my period soon so we can start again. I'm REALLY hoping!

Cross your fingers for me!

(this was an entirely not entertaining and way bummer of a post. Sorry 'bout that.)

~M

cake

So. Yesterday's birthday cake....It was sooooo good. :) yum. And at dinner? I broke every single dietary restriction, because, dammit, it was my birthday!! But it was super tasty and so fun, and my lovely husband gave me a wonderful birthday celebration.

Sadly though, it's back to reality today, and I feel SO sluggish and tired. Partly I think because I stayed up a little later than usual, but mostly, I think it's the diversion from my eating restrictions that did it. Anyway, back on the wagon today!

I think I'll do a long workout tonight to try and get my energy back up, and then early to bed for me!

I have to admit...I'm sort of at a loss these days about what to post here. I mean, I'm still just waiting waiting waiting for this cycle to end so I can start my new cycle of clomid. So, while I'm waiting... I guess you just get to hear about the cake I eat. Although, there won't really BE anymore cake being eaten...so...there goes THAT material. hmm. I better think about this before my 3 readers get bored and never come back! :)

~M

another year older

Well, it's my birthday! Another year gone by- it's crazy how quickly it goes. Usually I'm really excited about birthdays, but this year I feel odd about it. I couldn't quite put my finger on it until I started thinking about what is different. I'm not one of those people who gets sad that I'm aging; I mean, I don't LOVE aging, but I like birthdays and it's inevitable that we age, so, you know. But, I realized that at 33, I'm getting closer to the dreaded "35". 35 isn't old at ALL, but in fertility land, it's the cut off age where things change. For instance, they say in most instances, you should wait after you've been trying to get pregnant for about a year before going to a fertility doc; UNLESS you're 35. Then go right away. And if you're pregnant at 35? You're high risk. Yep. So, anyway, I'm well aware that I still have plenty of time, so I'm really not stressed about it; it's more of just an awareness that it's getting closer. Not a stress though. I know I'm still a spring chicken. ;)

Anyway, I'm looking forward to tonight, because my lovely husband is going to take me out to dinner and I will have some CAKE! Woo hoo! Yes, cake is verboten for me… but not on my birthday! Birthdays give you a "free pass" for stuff like that. ALSO, in a super lucky twist of fate (OR, maybe they just really love me) Starbucks had "free pastry day" today, and I redeemed mine! Yum. My free apple bran muffin was VERY tasty indeed. I will be having a salad for lunch to try and balance it out, but really, I'm not worried about it. It's my birthday.


So, I think in writing this post, by the time I reached the end, I've lost all my "weird" feelings about my birthday this year. I'm happy to be 33, and happy to be turning one year older. I'm blessed with lovely friends, a wonderful family, an incredible husband, a cute kitty, my health, a good job, and a roof over my head. Each year that passes it seems the more blessings I have, and the more people in my life there are to love. So, I am quite grateful for that. Happy Birthday, me.