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TOPIC TITLE: polycystic ovarian syndrome
Created On 4/7/05 5:58 PM
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BH613
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4/7/05 5:58 PM
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I have PCOS and have been struggling wit hweight loss issues as well as hirsutism. Has anyone successfully lost weight and kept it off with PCOS?
Any ideas?
Miriam
 
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chanieF
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4/26/05 12:10 AM
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since insulin levels are the underlying issue in pcos (even in those who are non-IR with a GTT), metformin (usually up to 2000 mg daily) works great, along with an atkins type/low carb/diabetes type (contant blood sugar levels) diet.
for lots of info from others, check out atime.org
hatzlacha!
 
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chanieF
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4/26/05 12:13 AM
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one more thing..not sure what stage of life you are at, but met+BCP works even better re hormone levels. the best pill for pcos is yasmin, since it is the only pilll with no androgenic potency at all! in addiiton, it is a low estrogen pill so this also makes it a great option with little to no side effects.
 
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msy
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4/27/05 3:38 PM
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I have pcos, but i do not have a problem with excess weight gain. My periods became less and less regular, and now i would get a period aproxiamately 3 times a year.
I have had this for about 7 years, and mostly because of the hirsutism, i have tried every thing under the sun when it comes to natural healing. i've tried chinese medicine, kniesiology, naturopath, herbal remedies, and after coming to the realisation that none of these helped, i went back to my doctor who originally prescribed me the pill. i did not want to take the pill everyday of my life until i get married, but having a bone densitometry show that my bones were thinning because of lack of eostrogen, i had no choice. now, i'm taking the pill everyday - and i was wondering if anyone found anything else that i could do or take, that would regulate my periods and rid my hirsutism?
i have tried doing laser, five times this year. it definately helped a little, making the hairs finer, but i don't feel it helps so much. i'm so sick of this problem - and i want to know what's the best thing to do or take, and what are the reprecussions. especially at my stage, unmarried as of now, i want to know what's the best thing to be doing before i get married.
thanks
msy
 
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chanieF
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4/28/05 12:53 AM
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att msy:

I'm not sure what kind of dr you are seeing or where you live..but you should be seeing an endocrinologist or reproductive endocrinologist (who is well versed in this area!!!) for managing it.
if you are not having periods more often this can chas bi'shalom be dangerous, as rates of certian cancers go up if the lining of the uterus is not shed often enough.
also, 1) make sure you have pcos and not CAH (which also runs in ashkenazim, and is often misdiagnosed as pcos)
2) metformin is the way to go for pcos...it will help ovulation, hormone levels etc. may take longer to work in those with non-IR pcos, but is still getting at the root of the problem.

re general info on unwanted hairs:
Bleaching is a safe way to deal with dark hairs.
Cutting hairs will not make the root grow back thicker so is a safe method between electrolysis treatments.
To remove hairs long term, electrolysis is a very good option. (Though regulated hormone levels help guarantee minimal new growth.)
There are 3 kinds of electrolysis:
1. short-wave. The most commonly practiced. Hurts the most. 1 needle.
2. galvanic. Older method. Much less regrowth. multi-needle. (Newer galvanic machines have 16 needles.) A lot of hairs can be removed during one session. Practically painless when used with a good OTC number electrologists can purchase.
3.the blend. A combination of the other 2 kinds of electrolysis. Practiced by very few.

GALVANIC electrolysis is the one with excellent success rates and the least painful. Even within each of these kinds there are both older and newer machines and some work better than others. The level of the current is also important re regrowth.

hope this helps some.
gutten moed
 
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msy
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4/28/05 3:10 AM
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I am seeing someone well-versed in this area. he is my family dr for years, and a gaenecologist. I have also had tests which resulted the same, by an edocrinologist. What is CAH?
I have been taking the pill for almost a year now, as my dr told me it was dangerous not to get my period. that is why i am taking the pill - and also to get the eostrogen levels i need. what would be the benefit of taking metformin over the pill? is there any difference? i know that the pill gives me a 'fake' period every month, and gives me the eostrogen i'm lacking. what does metformin do? does it make me ovulate too? because i know the pill doesn't do that. are there any side effects to taking metformin? i'm wondering why my dr felt the pill was the best option...
 
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BH613
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5/3/05 2:55 PM
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Because I had a hysterectiomy (lots of issues with the PCOS) and had both ovaries out (due to massive cysts) I am not on medication for periods. I had the hysterectomy at 30 (I was not able to have more children due to my prior c-sections so this was not a bad thing) and, at this point, am dealing with hirsutism and weight loss issues. I get tested regularly for diabetes and B"H am in the normal range!!! I tried electrolysis and found that my hair came back and I would need to start from scratch! It was expensive and painful, so I stopped. At this point I just (gasp)shave and it seems to work fairly well. I notice that there are times that the hair comes back faster than others, but I don't like the bleeching or other hair removal ideas, so that is it!!
Miriam
 
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chanieF
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5/3/05 9:52 PM
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att BH
although you may have already done this...you should have a GTT to check for IR, b/c even if someone with a h/o pcos does not have Dm, if they do have IR, they should be on metformin b/c now we know that so many systemic issues are secondary to the pcos issues. (Blood sugar levels are NOT enough to diagnose IR!!!)
also, re electrolysis-depends which type you have done. the single needle one is VERY painful (i had it done once) and does not last.
 
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chanieF
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5/3/05 10:39 PM
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Quote

Originally posted by: msy
I am seeing someone well-versed in this area. he is my family dr for years, and a gaenecologist. I have also had tests which resulted the same, by an edocrinologist. What is CAH?
I have been taking the pill for almost a year now, as my dr told me it was dangerous not to get my period. that is why i am taking the pill - and also to get the eostrogen levels i need. what would be the benefit of taking metformin over the pill? is there any difference? i know that the pill gives me a 'fake' period every month, and gives me the eostrogen i'm lacking. what does metformin do? does it make me ovulate too? because i know the pill doesn't do that. are there any side effects to taking metformin? i'm wondering why my dr felt the pill was the best option...



there is a huge difference in both diagnosis and treatment and management of pcos by drs (such as pcp or gyn vs. an RE). there was an article not long ago on this topic. though conducted in australia, and concerned gyns vs endocrinologists (not REs, some of whom are far more educated on pcos than endocrinologists) the results are reflective of treatment and diagnosis of pcos in many other countries too.
i will post the summary at the end of this post...the take home message of it is that gyn's objective is for a patient's specific symptoms to be treated, whereas endocrinologists look to treat the underlying issues so as to get at the root of the problem (for ex, note 3:1 metformin use by endo vs. gyns for irregular cycles.) this is especially important b/c we now know of the long term systemic problems (lipid,cholesterol, cardio etc) associated with pcos.

note that there is nothing wrong with going on the pill for now if you do not have IR, but 1) yasmin is the best pill for pcos, and the only pill with a synthetic progesterone that has no androgenic potency at all (and should therefore help alot with hair growth!!!)2) if your levels do not stabilize, you should consider metformin, b/c it CAN cause you to ovulate b/c it gets at the underlying issues. as a matter of a fact, nowadays most women who are on metformin for pcos stay on it through pregnancy and nursing b/c it helps so much with hormone levels that it also helps prevent miscarriages and can help with nursing.

oh..and about the Congenital Adrenal Hyperplasia thing..my point is that most who are not REs do not test for conditions that mimick PCOS. for ex, 17OH progesterone and DHEA levels should be checked before a diagnosis of pcos is given. congenital adrenal hyperplasis presents with ALL OF THE SAME SYMPTOMS as pcos, the only difference being blood levels of certian hormones that differ. and if someone does have it, it must be treated totally differently!!!!

hope this helps some....
here's the summary:


Polycystic Ovarian Syndrome: Marked Differences Between Endocrinologists and Gynaecologists in Diagnosis and Management


Andrea J. Cussons; Bronwyn G. A. Stuckey; John P. Walsh; Valerie Burke; Robert J. Norman

Clin Endocrinol. 2005; 62 (3): 289-295.


Summary
Background: Women with polycystic ovarian syndrome (PCOS) commonly consult endocrinologists or gynaecologists and it is not known whether these specialty groups differ in their approach to management.
Objective: To compare the investigation, diagnosis and treatment practices of endocrinologists and gynaecologists who treat PCOS.
Design and Setting: A mailed questionnaire containing a hypothetical patient's case history with varying presentations oligomenorrhoea, hirsutism, infertility and obesity was sent to Australian clinical endocrinologists and gynaecologists in teaching hospitals and private practice.
Results: Evaluable responses were obtained from 138 endocrinologists and 172 gynaecologists. The two specialty groups differed in their choice of essential diagnostic criteria and investigations. Endocrinologists regarded androgenization (81%) and menstrual irregularity (70%) as essential diagnostic criteria, whereas gynaecologists required polycystic ovaries (61%), androgenization (59%), menstrual irregularity (47%) and an elevated LH/FSH ratio (47%) (all P-values < 0·001). In investigation, gynaecologists were more likely to request ovarian ultrasound (91% vs. 44%, P < 0·001) and endocrinologists more likely to measure adrenal androgens (80% vs . 58%, P < 0·001) and lipids (67% vs. 34%, P < 0·001). Gynaecologists were less likely to assess glucose homeostasis but more likely to use a glucose tolerance test to do so. Diet and exercise were chosen by most respondents as first-line treatment for all presentations. However, endocrinologists were more likely to use insulin sensitizers, particularly metformin, for these indications. In particular, for infertility, endocrinologists favoured metformin treatment whereas gynaecologists recommended clomiphene.
Conclusions:There is a lack of consensus between endocrinologists and gynaecologists in the definition, diagnosis and treatment of PCOS. As a consequence, women may receive a different diagnosis or treatment depending on the type of specialist consulted.


Edited: 5/3/05 at 10:44 PM by chanieF
 
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BH613
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5/5/05 4:17 PM
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thanks for the article. What is ir?
Miriam
 
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chanieF
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5/8/05 5:43 PM
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Originally posted by: BH613
thanks for the article. What is ir?
Miriam


insulin resistance.

since they have recently discovered that many women with pcos go on to develop type 2 diabetes (and other cardio problems), they now test for insulin resistance- the precurser to diabetes- to prevent the diabetes from coming on altogether.
a glucose tolerance test is the best way to test for this (as fasting blood sugar levels are not necassarily indicative of IR.)
 
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msy
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6/5/05 10:54 AM
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I am taking the pill for pcos, which is making sure i get a period every month, but sometimes there is a bit of staining. i'm concerned about this since i am getting married soon - i was wondering if i should stop taking the pill altogether, or if i should continue taking it until i get married. does it matter if i'm not taking something for pcos over a couple of months until i get married? i hear that anyway the body changes after getting married - can this be true in regard to pcos too? could it get rid of pcos?
 
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chanieF
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6/6/05 10:04 PM
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att msy:
pcos does not go away. however, in milder cases (and excercise and a good diet can help ensure that it stay mild), not everyone has a problem ttc just b/c they have pcos.
in addition to other health concerns from irregular cycles (such as endometrial and uteine cancer, G-d forbid), staying on the pill will help regulate your cycles and hormones so that IYH when you get off of it they are still 'normal' so that you may ovulate on your own when you get off it of.
which pill are you on??? the best one for pcos is yasmin; in addition to being a low-dose pill, it is the only pill that has no androgenic potency at all, and is therefore optimal for pcos. it also has few-if any- side effects.
 
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msy
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6/9/05 2:26 PM
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I never heard of yasmin. where can i get a hold of it? do doctors prescribe it?
I am on the contraceptive pill right now - as my doctor prescribed me about a year ago. i don't think it will help me to ovulate though. please can you tell me more about yasmin and where i can find it. is it something that is used all over the country? do doctors know about this pill?
 
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chanieF
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1/8/06 2:01 AM
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my apologies; sorry i never saw your last post!
if you are in the US , yasmin has been around for a few yrs already and most drs know about it. one does not ovulate when she is on the pill. but many women with pcos will ovulate on their own as soon as they get off the pill if they've been on it long enough to get their body into a pattern of normal cycling.
a low carb-high protein diet, as well as exercise, is ideal for controlling pcos and can throw your body into ovulation as well.
if you are already married and have related Qs, you can check out the atime site and get alot of good info from many people. you can even just read through posts if you do't feel comfortable posting anything.
 
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msy
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1/17/06 1:05 PM
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You write that yasmin has no androgenic potency. What is androgenic potency?
I am taking a bcp called 'brenda' - it's prescribed from Australia, where my doctor is.
i've been taking it for a few years, and recently i have becoming extremely emotional at times.
i'm wondering if it has anything to do with the pill i'm taking?
my dr prescribed it as it helps with the hormone levels, hirsutism, eostrogen and insulin levels.
is yasmin something that would do the same for me? does it need to be prescribed?
and is it available in australia??
i'm not insured in the states, so i'm not sure how to go about this
any suggestions?
thanks
 
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chanieF
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1/17/06 4:22 PM
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yasmin is the name of the bcp-so it does need to be prescribed. all bcp have hormones in them that simulate the bodies hormones. so they're usually a combination of estrogen and progersterone. there were 3 synthetic progesterones available until a couple yrs ago. they all had different amounts of strength in terms of their progesterone effects and androgenic effects- androgenic meaning male hormone effects. however, yasmin is made of a new kind of synthetic progesterone which had no androgenic effects. and since the problems with pcos is too much male hormones, this works very nicely.
fyi, since we now know that the underlying problem in most women with pcos is in relation to blood sugar (even when the blood sugar levels are fine), women with pcos are also often very successfully treated with diabetic medications. most commonly glucophage, but also some other ones.
 
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chanieF
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1/17/06 4:43 PM
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here's an excellent site to give you an idea of the differnt pills (though you may have to check into what they're called in australia vs. the us)

http://www.wdxcyber.com/ncontr13.htm
 
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