During my pre-op sonogram we took a look at both my ovaries, and the technician was able to show me the cysts on both my right and left ovaries. By the second ovary, Brad was even able to point out the cysts that lined my right side. It was confirmed before Dr. Howard even opened me up that I was going to need to be treated for the PCOS along with the Endometriosis.
I had my initial consultation with Dr. Howard on my anniversary, so might as well have my PCO consultation the day before my birthday! I was able to meet with Dr. Howard today and learn more about what exactly is going on inside my body.
What is PCOS?
PCOS stands for Poly (or many)-Cystic-Ovary-Syndrome, simply meaning that many cysts line my ovaries. Dr. Howard was very quick to say that he wished the name would be changed because the cysts on the ovaries are merely a piece of the puzzle in what happens...it is not the cause. PCOS is a hormonal imbalance linked to the way the body processes insulin after insulin has been produced by the pancreas to regulate blood sugar (glucose). As a matter of fact, the moment I was born my body was already on track for PCO.
Our cells require two things - Oxygen (which we breath in) and Glucose (which our body makes by processing the food we eat). There is a "gate" in our cells that must be opened so that the glucose can enter the cell. This is done by insulin triggering a transmitter to open the gate, and then the glucose slides right in.
In patients that have diabetes, this transmitter is broken and the gate can't be opened. In patients with PCO, the message is sent to open the gate, but a false message is sent as well which uses more energy than the body knows should be required. Because of this, the body begins to store up extra insulin so that the message doesn't continue to process so slowly. (This can be seen in the picture below on the bottom left corner)
All that means is that as an infant, after my very first time to eat, my body realized that something was different than it should have been. The message in my cells was being sent to open the gate and let the glucose in, but it was doing so with too much energy required. So my body began to store up extra insulin to make up for the difference. This is known as insulin resistance.
Note: Insulin normally helps convert sugars and starches from foods into energy, but in cases where there is insulin resistance, the glucose will begin to build up in the bloodstream. These high insulin levels lead to excess levels of male hormones which translates to weight gain.
When I hit puberty, this introduced the issue with my ovaries. In a normal ovary, testosterone (male hormones) are turned into estrogen (female hormones). In the ovary of a patient with PCO, there is excess testosterone. This excess leads to damaging the egg because there isn't enough estrogen for the egg to fully mature and leaves only a sac of fluid behind. These sacs of fluid are the cysts that remain on the ovary, so you can see how the "string of pearls" (as they are sometimes called) or the multiple cysts lining the ovary are formed.
When testosterone is present in excessive levels, as found in PCO patients, it is converted to a much stronger dihydrotestosterone (DHT). This is responsible for thinning hair in women along with excessive hair growth in unwanted areas (especially on the face). The excess testosterone can also be responsible for excess fat and excess oils (oily hair and skin) which can lead to acne.
All of that combined - the way that my body is function and the fact that it leads to obesity - the likelihood of high blood pressure, heart disease, and diabetes are greatly increased in women like me with PCOS.
So what do you do?
It might seem like all of that is a little overwhelming...I know it was to me! But there are medicines to take and things to do in order to fight against what is going on.
1 - Prescription drugs. Metformin (as used in diabetic patients) and Flutomide (or Spironolactone) Metformin alone largely reduces the risk of developing heart disease and diabetes. These drugs are used to combat the oily skin/acne, excess hair, and excess fat that occurs in PCO patients.
I will be taking Spironolactone twice a day (breakfast and dinner) and I will be working my way up to taking Metformin twice a day.
Metformin has a 4 week introduction where you take half of a pill at dinner for the first week, half of a pill at breakfast and half at dinner for the second week, half at breakfast and a full pill at dinner for the third week, and a full pill at breakfast and dinner for the fourth week.
2 - Exercise. An obvious way to combat the excess fat and encourage health is by working out. My doctor encouraged me to work out 5 times a week, 30 minutes a day. During those 30 minutes, he suggests that his patients walk 2 miles. It doesn't seem like much, and it definitely doesn't seem difficult, but he has seen it to be very successful in his patients.
3 - Diet. The South Beach Diet is often recommended for PCOS patients because of the limits it has on Carbs as well as other guidelines that are followed to encourage and promote healthy eating. Weight loss is proven to improve insulin sensitivity.
I am excited to get started on all 3 steps and work towards a healthier me!
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