For anyone who's too lazy to do the searches, but wants to know, this is interesting:
PCOS
"Polycystic Ovarian Syndrome (PCOS) is also known as:
polycystic ovaries; sclerocystic ovarian disease; polycystic
ovarian disease (PCOD); Stein-Leventhal Syndrome. PCOS
stands for Polycystic Ovarian Syndrome. PCOS is actually a
misnomer, because it onlyrefers to one of many symptoms
associated with this disorder. It affects between 5 to 10%of all
women and is one of the leading causes of infertility.
WHAT ARE THE SYMPTOMS?
Symptoms can be mild or severe, and can vary widely from
woman to woman. This is part of the reason doctors often miss
the diagnosis. Someone with PCOS may have one or all of the
following symptoms in varying degrees:
- irregular periods: abnormal, irregular, heavy or scanty
(oligomenorrhea)
- absent periods (amenorrhea)
- ovarian cysts
- hirsutism (excess facial and/or body hair)
- alopecia (male-pattern hair loss)
- obesity
- acne
- skin tags
- acanthosis nigricans (brown skin patches, often found on the
nape of the neck)
- high cholesterol levels
- high blood pressure
- exhaustion and/or lack of mental alertness
- decreased sex drive
- excess "male" hormones, such as androgens, DHEAS, or
testosterone
- infertility
- decreased breast size
- enlarged clitoris(rare)
- enlarged ovaries
- enlarged uterus
Note that symptoms can worsen over time or with weight gain.
I THINK I HAVE PCOS - WHAT NOW?
Go straight to an endocrinologist. They specialize in glandular
disorders; in this case, the gland in question is the pancreas, which
is overproducing insulin. Seeing an OB/GYN is only really useful
if you are trying to get pregnant and, even then, a reproductive
endocrinologist would probably be better informed.
TESTING FOR PCOS
There is no *one* truly definitive test yet, but rather a set
of tests can be used to diagnose PCOS:
1. A glucose tolerance test (GTT). Note that for the GTT
you should have about 200g of carbs daily for the three to
four days leading up to the test -- but of course fasting
for 10 to 12 hours right before the test! -- otherwise the
results will not be accurate. Also, smoking or exercise for 8
hours before or during the test can affect results.
2. Cholesterol Levels. Not just total cholesterol, but also
triglycerides, HDL cholesterol, LDL cholesterol.
3. Testosterone, LH, FSH, and androstenedione levels.
Some doctors will advocate more or fewer tests, but the
ones listed above are the most common. Other tests may
include urine 17-ketosteroids, laparoscopy, ovarian biopsy,
serum HCG (pregnancy test), and basal fasting insulin.
In addition, some physicians will also suggest an ultrasound
to check for ovarian cysts, which is of course what the
syndrome is actually named after. However, some women
with PCOS do *not* have ovarian cysts and some women
who do not have PCOS do, so an ultrasound alone is not
enough for a firm diagnosis.
WHAT CAUSES PCOS?
The root of PCOS is an inability to respond properly to insulin,
the hormone produced in the pancreas that allows your body's
cells to absorb energy from the food you eat. This means your
cells don't respond to the normal amount of insulin, so the
pancreas pumps out even more. That's what insulin resistance is
and it happens when the body turns carbohydrates, both simple
and complex, into glucose that surges into the bloodstream.
Insulin travels to the muscle cells, telling them to take glucose from
the bloodstream and store it in the liver. As
insulin levels in the blood increase, glucose levels in the blood
decrease. When blood glucose falls below a certain level, the
brain, which needs glucose to function, calls out for more by
telling you to eat again. If it doesn't get glucose, the result is
drowsiness or lack of mental alertness. This glucose shortage is
also known as low blood sugar or hypoglycemia. When
hypoglycemia strikes, the liver is unable to replenish bloodglucose
from its stored supply because eating a carbohydrate-rich meal or
drinking a sugary beverage creates an exaggerated
insulin response that prevents delivery of the glucose. So, insulin
remains in the bloodstream,sending messages to store more body
fat and preventing the release of already-stored fat, and glucose
remains in the liver instead of going to the brain. In addition, the
high levels of insulin stimulate the ovaries to produce large
amounts of the male hormone testosterone, which may prevent
the ovaries from releasing an egg each month, causing infertility.
High testosterone levels in women also cause acne, male-pattern
baldness, and excess hair growth. Last but not least, it is the
insulin problem that puts us at increased risk for diabetes as well
as heart disease.
WHAT IF I HAVE PCOS?
If you are currently overweight, the first step is to lose the excess
pounds, because many symptoms of PCOS improve or even
disappear entirely at normal weight. Since the cause of all the
problems is insulin resistance, the key seems to lie in restricting
carbohydrates and exercising regularly, for physical activity also
helps regulate insulin production. The most popular of the
low-carb diets are 'Dr Atkins' New Diet Revolution' by Robert
Atkins and 'Protein Power' by Michael and Mary Eades. Another
popular approach is the 'Carbohydrate Addicts Diet' by Rachel
and Richard Heller. Even at normal weight, it is still critical to
moderate
carbohydrate intake as well as exercise. This is simply going to
have to be a way of life, since PCOS cannot be cured, only held
in check. Although many women have reported great success
through low-carbing and exercise alone, a growing number of
women with PCOS are now being treated with so-called diabetic
drugs, such as Metformin (AKA Glucophage). There have been
several studies reporting good results in treating PCOS with
Metformin. However - and this is very important! - Metformin is
only meant to be taken temporarily. The goal is to use
Metformin in conjunction with diet and exercise to lose excess
weight. "
And from the post further above that:
SHBG
What is Sex Hormone Binding Globulin?
Hormone molecules are bound to proteins in the blood. Bound hormone molecules are inactive
until they are released and become free. The main protein produced by the liver and released into
the blood is albumin, which is similar to the egg white of a chicken egg. Sex hormone-binding
globulin (SHBG) is one of the proteins produced by the liver. The binding capacity of this protein
for testosterone is 30,000 times greater than that of albumin. During their reproductive years,
women have double the concentration of SHBG when compared to men as oestrogens encourage
SHBG production. Androgens, such as testosterone, suppress SHBG production. Women with
hirsutism (excess body hair Q 8.6) associated with hyperandrogenism have relatively low SHBG
levels resulting in increased levels of free, actively available, androgens.
And also something about testosterone - something I've never thought to read much about:
"Approximately 97 to 99 percent of
testosterone is transported in the blood bound to plasma proteins such as sex hormone binding globulin (SHBG) and albumin. The
remaining 1 to 3% is the biologically active, free testosterone. Testosterone circulates in the blood approximately 15 to 30 minutes
until it is either bound to receptors or metabolized into inactive products by the liver and subsequently excreted through the urine. "
What else is associated with naturally higher test levels? Circusgirl said aggression and competitiveness. But what about body hair, the ability to read a map, lol, and refusal to ask directions? Ha ha - just kidding, but it's going to be 6 months before I can go and get a test test, and I'm kind of interested to know if there are any other signs. Depression - no - I don't have that.