The reason that I'm intrigued by this syndrom is that visually I don't have a great deal of PCOS characteristics. My Primary Care and Gynecologist, both dismissed PCOS despite my hormone levels. The only hormone that is out of whack is my testosterone. So, I've been intrigued to see what characteristics do pertain to me.
My initial research led me to The International Council on Infertility Information Dissemination, Inc. (I have a link to the site on the left.) On this site, it has PCOS frequently asked questions. Per this site, many women with PCOS suffer from the following (I've highlighted the items that effect me.):
- Amenorrhea (no menstrual period), infrequent menses, and/or oligomenorrhea (irregular bleeding) — Cycles are often greater than six weeks in length, with eight or fewer periods in a year. Irregular bleeding may include lengthy bleeding episodes, scant or heavy periods, or frequent spotting.
- Oligo or anovulation (infrequent or absent ovulation) — While women with PCOS produce follicles — which are fluid-filled sacs on the ovary that contain an egg — the follicles often do not mature and release as needed for ovulation. It is these immature follicles that create the cysts.
- Hyperandrogenism — Increased serum levels of male hormones. Specifically, testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS).
- Infertility — Infertility is the inability to get pregnant within six to 12 months of unprotected intercourse, depending on age. With PCOS, infertility is usually due to ovulatory dysfunction.
- Cystic ovaries — Classic PCOS ovaries have a "string of pearls" or "pearl necklace" appearance with many cysts (fluid-filled sacs). It is difficult to diagnose PCOS without the presence of some cysts or ovarian enlargement, but sometimes more subtle alterations may not have been recorded, or are not recognized as abnormal, by the ultrasonographer.
- Enlarged ovaries — Polycystic ovaries are usually 1.5 to 3 times larger than normal.
- Chronic pelvic pain — The exact cause of this pain isn't known, but it may be due to enlarged ovaries leading to pelvic crowding. It is considered chronic when it has been noted for greater than six months.
- Obesity or weight gain — Commonly a woman with PCOS will have what is called an apple figure where excess weight is concentrated heavily in the abdomen, similar to the way men often gain weight, with comparatively narrower arms and legs. The hip:waist ratio is smaller than on a pear-shaped woman — meaning there is less difference between hip and waist measurements. It should be noted that most, but not all, women with PCOS are overweight.
- Insulin resistance, hyperinsulinemia, and diabetes — Insulin resistance is a condition where the body's use of insulin is inefficient. It is usually accompanied by compensatory hyperinsulinemia — an over-production of insulin. Both conditions often occur with normal glucose levels, and may be a precursor to diabetes, in which glucose intolerance is further decreased and blood glucose levels may also be elevated.
- Dyslipidemia (lipid abnormalities) — Some women with PCOS have elevated LDL and reduced HDL cholesterol levels, as well as high triglycerides.
- Hypertension (high blood pressure) — Blood pressure readings over 140/90.
- Hirsutism (excess hair) — Excess hair growth such as on the face, chest, abdomen, thumbs, or toes.
- Alopecia (male-pattern baldness or thinning hair) — The balding is more common on the top of the head than at the temples.
- Acne/Oily Skin/Seborrhea — Oil production is stimulated by overproduction of androgens.
- Seborrhea is dandruff — flaking skin on the scalp caused by excess oil.
- Acanthosis nigricans (dark patches of skin, tan to dark brown/black) — Most commonly on the back of the neck, but also but also in skin creases under arms, breasts, and between thighs, occasionally on the hands, elbows and knees. The darkened skin is usually velvety or rough to the touch.
- Acrochordons (skin tags) — Tiny flaps (tags) of skin that usually cause no symptoms unless irritated by rubbing.
I may actually suffer cysts or large ovaries, but my insurance doesn't cover ultrasound for infertility testing, therefore my RE has never gone that far. Also, from what I've read you only need to have three of the symptoms to be considered with PCOS. So despite the fact that I don't have hirsutism or obesity (The ten pounds that I would like to go away, don't put me in this category. Also, please note I am not complaining, actually kind of grateful.), I do have PCOS.
After my initial research, I purchased a book titled PCOS and Your Fertility by Colette Harris and Theresa Cheung. An interesting tid bit:
People with PCOS should take extra vitamins and minerals. Because they produce too many stress hormones: cortisol and adrenaline. And when you are under too much stress, "they start to wear you down and overproduce not just cortisol and adrenaline, but testosterone, too. Excess cortisol, adrenaline, and testosterone will not only make PCOS worse, but will also drive your body toward irregular periods and subfertility. The adrenals rely on vitamins C, B5, B6, zinc and magnesium, and these are rapidly depleted when you're under stress, so a good multivatimin and mineral every day makes sense."
Why is this interesting? Well, because I ALWAYS have some type of cold. In the last three weeks, since reading the above paragraph, I've been taking an additional vitamin C to my pre-natal vitamin. Guess what? No colds.
Granted, I found a few more interesting tid bits, but the above paragraph was the most poignant.
Ultimately, to my Primary Care and Gynecologist, please consider more than what you see on the outside, because you may be overlooking something.