Читать книгу Healing PCOS - Amy Medling - Страница 9
ОглавлениеAs early as age fourteen, I wrestled with many common PCOS symptoms such as acne, hypoglycemia, irregular periods, fatigue, scalp hair loss, and unwanted hair, especially on my face. I wasn’t alone. My mother and both grandmothers had similar struggles. It seemed to be the genetic fate of women in my family. Unfortunately, no one was diagnosed with PCOS, so we didn’t know there was a root cause for all of these symptoms.
My mother took me to a general practitioner, a dermatologist, a gynecologist, and even a psychologist, and I was subjected to countless tests including a scalp biopsy, yet I had no diagnosis. Not one doctor thought to check my androgens, insulin, or blood sugar. Still, I took the doctors’ advice, filled prescriptions, and followed orders. I felt like a victim of my genetics, destined to struggle to get pregnant and some days just to get off the couch. That is, until I chose to take control of my health.
Looking back, I am grateful for my journey. It has shaped the woman that I am and enabled me to help tens of thousands of other women to thrive with PCOS as well. But it was a long journey.
I remember clearly one day in college, when I found myself sitting in a cold medical exam room scared and confused, feeling lousy, not having had a period in months and months, and not understanding why. The doctor looked me in the eye and told me they would have to “jump through hoops” to get me pregnant one day. She renewed my prescription for the pill and sent me on my way. It was a dark moment. I felt helpless and hopeless. I still had no diagnosis. There was no end in sight for my out-of-control symptoms, and now I was facing infertility. Through my twenties, my symptoms worsened. I struck out on my own after college, and that meant eating a lot of inexpensive prepared foods like pasta and macaroni and cheese. I began to struggle with depression. I wondered what was wrong with me. I was a strong, successful, and intelligent woman. Why could I not stop myself from eating Tootsie Rolls? Why was my hair falling out? I was running every day without fail and still gaining weight. I visited an endocrinologist, who gave me spironolactone for my hirsutism (male-pattern hair growth), which did not help because it was only an attempt to treat a symptom. I still didn’t receive a diagnosis.
Eventually, I married the love of my life. We wanted to start a family, so I stopped taking the pill. My health struggles and symptoms continued, but four years later, with the help of clomiphene (Clomid), I became pregnant with my first son. He felt like a miracle. After his birth, we decided to try the Creighton Model for family planning, because I didn’t want to go back on the pill. I met monthly with a Creighton Model teacher who reviewed my charting, and she soon realized that I was not ovulating. She was the first to notice my patterns and mention PCOS. When we were ready to try for a second child, she referred me to a specialist who put me on Actos, guaifenesin, and Clomid. As with all prescriptions up to this point, I took them without question. No dice. I didn’t become pregnant, and I felt awful.
Then I searched out a reproductive endocrinologist. She knew the right labs to request and immediately ordered an ultrasound. Finally! At age thirty, I had my official diagnosis—PCOS. I was put on metformin (which made me horribly sick) and monitored cycles of Clomid. With this help, I conceived my second miracle.
After the birth of my second son, I felt worse than ever. I swore I would never go back on metformin or the pill because both made me feel so awful. I had two beautiful children and a wonderful husband, but I was exhausted all the time and could barely function. My fatigue, hirsutism, brain fog, and hypoglycemia were out of control. I certainly wasn’t the wife or mother I knew I could be. After years of following mainstream advice from countless doctors, I realized that nothing was helping. The drugs they offered made me sicker and more miserable. The drugs that helped get me pregnant couldn’t heal my PCOS. I was way too young to feel so old, and sick and tired of feeling sick and tired—I couldn’t go on living this way.
I knew that if I wanted to feel better, I had to adopt a different approach. I found a naturopath to help me get to the root of my symptoms instead of trying to put a Band-Aid on each one. At thirty-two years old, I found the right person. She guided me in selecting supplements that could naturally balance my hormones. Maybe most important, she taught me to how to use a glucometer. Thanks to this tool, I made the connection between what I was eating and how I was feeling. I had empirical evidence to help make sense of my symptoms. Glucometer in hand, I began to experiment with my diet. As I mastered this piece of my life, my energy returned, my hair slowly began to grow back, I lost weight, and my menstrual cycles began to regulate.
In working with my naturopath and doing my own research and experimentation, I realized that I had the power to take control of my health. No one else could do it for me. I couldn’t take advice at face value and continue to think and act like a victim.
I scoured the internet for information and read books about PCOS and holistic medicine by pioneers like Samuel Thatcher, Walter Futterweit, and Nancy Dunne. I went back to school to learn from experts about nutrition and healing. After hundreds of hours and tons of trial and error, I developed a protocol that allowed me to thrive. I changed my diet and lifestyle and, most important, my mindset. I started taking care of myself. My husband noticed the shift and declared me a “diva.” At first, I was offended, until I realized that in order to be my best and give my best to my family, I did have to be a PCOS Diva.
When my reproductive endocrinologist started seeing my success and sending women with PCOS who also couldn’t tolerate metformin or the pill to me for help, I knew I was onto something. I received my health-coaching certificate and began to formally coach women one-on-one with great success. Soon I realized that the small, manageable steps of what is now my Healing PCOS 21-Day Plan could help the millions of other women struggling to alleviate their symptoms with medicine and advice that didn’t help. Now sharing what I know about PCOS is my passion and career. And, despite what doctors warned all those years ago, I conceived my third child, an amazing girl, naturally. She’s the direct product of the PCOS Diva lifestyle I forged.
I want you to know that you are not a victim. Struggling with PCOS is not your fate. There is no magic pill, but you can thrive with PCOS when you embrace the power of knowledge, diet, and lifestyle.
What Is Polycystic Ovary Syndrome (PCOS)?
You are not alone. Polycystic ovary syndrome (PCOS) is one of the most common endocrine system disorders found in women and the most common cause of infertility in women. As calculated employing the widely used Rotterdam Criteria, PCOS affects approximately 15 to 20 percent of women worldwide, of whom less than 50 percent are diagnosed. It is present throughout a woman’s life from puberty through postmenopause and affects women of all races and ethnic groups.
As an endocrine disorder, PCOS disrupts hormone balance, negatively impacting many bodily functions including insulin levels, cell and tissue growth and development, metabolism, fertility, and cognition. A diagnosis is often difficult to obtain because PCOS is a syndrome, a collection of symptoms. It affects many different hormones, resulting in an array of symptoms that may seem unrelated and vary from woman to woman. Some symptoms include obesity, irregular menstrual cycles, insulin resistance, infertility, depression, male-pattern hair growth, acne, and hair loss.
In addition, women with PCOS have a four to seven times higher risk of heart attack, and 50 percent will develop prediabetes or diabetes before age forty. They are also more likely to develop endometrial cancer. The increased risk of these serious health issues makes managing symptoms even more imperative—and stressful.
What Are the Symptoms of PCOS?
You may have one or two of these symptoms or a dozen. Although some symptoms are more common than others, there is no single model for PCOS.
Oligoovulation (irregular ovulation) or anovulation (absent ovulation)
Polycystic ovaries (20–39 percent)
High levels of insulin, insulin resistance (30–50 percent)
Easy weight gain and/or obesity (55–80 percent)
Acne (40–60 percent)
Cardiovascular issues
Type 2 diabetes
Depression (28–64 percent)
Anxiety (34–57 percent)
Poor body image, eating disorders (21 percent)
Sexual dysfunction
Thyroid disorders
High levels of androgens (60–80 percent)
Irregular menstruation (75–80 percent)
Male-pattern hair growth (70 percent)
Skin tags
Sleep apnea (8 percent)
Gray-white breast discharge (8–10 percent)
Scalp hair loss (40–70 percent)
Darkening skin areas (acanthosis nigricans), particularly on the nape of the neck (10 percent)
Pelvic pain
Hidradenitis suppurativa (painful boil-like abscesses in the groin)
Some of the Most Common Symptoms
The most common symptoms of PCOS are insulin resistance and hyperinsulinemia, hormone imbalances, and chronic inflammation.
INSULIN RESISTANCE AND HYPERINSULINEMIA
Insulin resistance, when cells fail to respond normally to the hormone insulin, and hyperinsulinemia, chronically high levels of insulin in the blood, are both symptoms with which I struggled all my life. Unfortunately, as is probably the case with many of you, they went undiagnosed for many years.
I remember fainting multiple times in sixth grade. The nurse didn’t know what was wrong. My mom took me to doctors, who also found nothing and finally referred me for psychiatric evaluation. Imagine being twelve years old, feeling horrible, and being told it is all in your head. Many years later, still undiagnosed, I remember feeling baffled when every Sunday morning, after my fiancé and I had our traditional waffle breakfast complete with syrup and orange juice, I would get woozy in church. Little did I know, it was the waffle breakfast throwing my blood sugar out of whack and giving me hypoglycemia! Since then, I have learned to interpret my body’s signals. Now when I feel that way, I know exactly what to do.
Insulin resistance and hyperinsulinemia are conditions in which the body becomes less and less efficient at processing and managing levels of sugar (glucose) in the bloodstream. This has serious overall health consequences. In the short term, insulin resistance is at the heart of most PCOS symptoms, including infertility, obesity, hirsutism, hyperandrogenism (elevated androgen levels), chronic fatigue syndrome, immune system defects, eating disorders, hypoglycemia, gastrointestinal disorders, depression, and anxiety. In the long term, when insulin levels rise too high, type 2 diabetes may result. Hardening of the arteries (atherosclerosis) is a common result of insulin dysfunction and may lead to an increased risk of high blood pressure and stroke.
Symptoms of Insulin Resistance
Weight gain
Sugar cravings
Skin tags
Hypoglycemia
Rough or red bumps on upper arms
Dark skin patches on neck, knees, elbows, knuckles, chest, or groin
In a healthy system, insulin plays an important role in metabolism. This powerful hormone is produced by the pancreas and enters the bloodstream after a meal. Its main function is to transport glucose to cells throughout the body to be used for energy. When there is excess glucose, insulin delivers the glucose to muscles, fat, and the liver, which helps to lower the blood glucose levels by storing it and signaling the body to slow production of insulin. But in an unhealthy system, insulin resistance and hyperinsulinemia may result.
Between 50 and 70 percent of women with PCOS have some degree of insulin resistance. Insulin resistance may be caused by poor diet, ethnicity, certain diseases, hormones, steroid use, some medications, older age, sleep problems, and cigarette smoking. Although insulin resistance is often associated with obesity, research indicates that lean PCOS patients are also prone to insulin resistance. Research also indicates that the birth control pill may cause insulin resistance in all women, particularly those with PCOS.
Insulin resistance occurs when a person’s body does not react properly to the amount of insulin in the bloodstream. In a healthy system, after a meal, the pancreas creates insulin to balance the glucose in the blood. Ideally, the body detects if the level of glucose in the blood is still too high and signals the pancreas to create more insulin. The hope is that since there is more insulin, more glucose will be picked up.
Insulin in large quantities can be toxic to cells, so when there is too much insulin in the body over time, cells become insulin resistant in order to protect themselves. Alternatively, the hypothalamus may become insulin resistant and continue to send signals to the pancreas to create more insulin unnecessarily. When insulin resistance occurs, the insulin does not pick up or cannot deliver the glucose to the cells that need it. Glucose levels in the blood remain high, and diabetes and other serious health disorders may result.
Hyperinsulinemia results when more insulin is present in the bloodstream than is considered normal, usually as a result of insulin resistance. Although it is associated with diabetes, someone with hyperinsulinemia does not necessarily have diabetes.
Insulin resistance and hyperinsulinemia create a self-perpetuating and destructive cycle called the insulin resistance cycle. Insulin resistance creates chronically high levels of insulin, and those chronically high levels bombard cells, forcing them to protect themselves, thus perpetuating insulin resistance. Eventually, your pancreas can no longer keep up with the insulin demand. This means there is less insulin in the body to store and regulate glucose levels, and the result is diabetes.
In addition, high levels of insulin and insulin resistance sometimes pave the way for hyperandrogenism, excessive levels of male hormones. This may be the cause of missed periods and infertility in some women with PCOS. The relationship between hyperandrogenism and hyperinsulinemia in women with PCOS is unclear. Researchers disagree about whether hyperinsulinemia causes hyperandrogenism, hyperandrogenism causes hyperinsulinemia, or a third cause is responsible for both. One way or the other, we have a destructive cycle: insulin resistance leads to hyperandrogenism, which increases insulin levels.
A top priority of the Healing PCOS 21-Day Plan is to get your insulin under control.
HORMONE IMBALANCES
When my hair started falling out during high school, my mom took me to a dermatologist who did a scalp biopsy. When it came back negative, the hair loss as well as other symptoms such as fatigue, acne, and sporadic periods were written off as a result of stress. Things got worse as I grew older. I began gaining weight, growing facial hair, experiencing anxiety and depression, and still fighting the symptoms I had since puberty. The birth control pill that was supposed to be my “quick fix” manipulated my hormones, leaving me feeling moody and dull. I wish that I had had a better understanding then of how my hormones work and how hormone imbalances caused by diet and lifestyle choices could be the source of my symptoms.
Hormones are responsible for keeping your major bodily functions running smoothly, so when hormone levels become imbalanced, you’ll feel the effects in many ways. Hirsutism, acne, hair loss, higher stress levels, mood disorders, depression, anxiety, and infertility can all result.
The most common hormones that become imbalanced and the ones that you will learn to manage with the Healing PCOS 21-Day Plan are androgens, cortisol, progesterone, estrogen, and thyroid hormones.
Androgens: Androgens are male hormones, such as testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), and DHEA sulfate (DHEA-S). In males, these steroid hormones are responsible for sexual development and muscle mass. In women, they play a much subtler, though no less important role. Among other things, they help us maintain muscle mass, regulate our weight, and keep our libidos humming. They are produced in the ovaries, adrenal glands, and fat cells. The problem isn’t that women with PCOS have androgens; it is that we typically have an excess. This androgen excess, or hyperandrogenism, affects about 25 percent of women with PCOS and is often the root cause of common symptoms such as hirsutism, acne, hair loss, and infertility.
Androgen excess may be caused by:
Ovarian dysfunction, which causes the ovaries to produce excess testosterone.
Insulin resistance, which signals the ovaries to produce excess testosterone.
Stress, which taxes the adrenal glands and stimulates the production of androgen hormones. For this reason, women with PCOS should practice stress relief from an early age.
Early adrenal activation, which initiates early puberty and correlates with increased lifelong androgen formation. Girls who experience early puberty may have an increased risk of developing PCOS.
Obesity.
Genetics.
Taking artificial hormones in birth control.
Individual hypersensitivity to a normal amount of androgen.
A defect in the hypothalamus, a part of the brain responsible for regulating the production of many hormones, including androgens.
Cortisol: Women with PCOS often make too much cortisol, the “stress hormone” produced in the adrenal glands. In fact, research indicates that many women with PCOS may naturally have higher cortisol levels. Being overweight also increases cortisol production.
Raised levels of cortisol change the way your body manages other critical hormones, putting you at risk for insulin resistance, anxiety, depression, and thyroid dysfunction. In addition, the overproduction of cortisol can overwork the adrenals to the point of adrenal fatigue. For this reason, stress—emotional or physical—takes more of a toll on women with PCOS than on those without it.
Progesterone: Progesterone is a hormone, produced mainly in the ovaries, that plays an important role in the menstrual cycle and maintaining and nourishing the body during pregnancy. After ovulation each month, progesterone helps thicken the uterine lining in preparation for a fertilized egg. This is called the luteal phase of the menstrual cycle. Women with PCOS almost always have low progesterone and thus a luteal-phase defect. This makes it nearly impossible to maintain a pregnancy even if ovulation and implantation do occur and is often the cause of miscarriage and unsuccessful assisted reproduction. Some doctors recommend supplemental progesterone for women with PCOS in order to support early pregnancy if they have suffered multiple miscarriages.
Anxiety
Waking at night
Fibrocystic breasts
PMS
Bone loss
Low libido
Infertility or irregular periods
If you have a progesterone deficiency and your doctor suggests hormone replacement, you may be prescribed a bioidentical progesterone. Bioidentical, or natural, progesterone is a combination of elements derived from natural plant sources that identically matches the progesterone we naturally make in our bodies. Prometrium is a micronized (reduced to tiny particles and mixed with peanut oil) natural progesterone in the form of a pill. It is approved by the Food and Drug Administration (FDA) as a natural hormone-replacement therapy medication. Because natural progesterone is molecularly identical to the hormone produced by the body, it causes few side effects.
Alternatively, your doctor may suggest a synthetic progestin such as Provera, since it was the standard before good natural alternatives were developed. Provera is also a constructed compound, but its chemical structure is not identical to natural progesterone. As a result, it can cause changes in vaginal bleeding, blood sugar issues, blood clots, and depression. Unfortunately, many women are told that synthetic progestin is the same as natural progesterone. Be a PCOS Diva at the doctor’s office and discuss the differences between these two hormone-replacement options to find one that is best for you.
Estrogen: Estrogen, the primary female sex hormone, is produced in the ovaries, adrenal glands, and fat tissues. Many women with PCOS experience estrogen dominance, that is, too much estrogen and not enough progesterone to balance its effects. Symptoms such as heavy or painful periods, infertility/miscarriage, and hypothyroidism (an underactive thyroid gland) may result.
Signs of Estrogen Dominance
PMS
Headaches and/or migraines
Fluid retention
Heavy or painful periods
Endometriosis
Moodiness, anxiety, or depression
Hypothyroidism
Infertility or miscarriage
Breast pain or tenderness
Thyroid hormones: Many women with PCOS have a dysfunctional thyroid. It may be overactive (hyperthyroidism) or, more commonly, underactive (hypothyroidism). Hashimoto’s disease, an autoimmune disease and the most common cause of hypothyroidism, is prevalent in women with PCOS.
If the thyroid is not functioning properly, the balance of thyroid hormones and every other hormone in the body will be disrupted, causing abnormal sexual development, menstrual irregularities, and possibly infertility. I encourage all women with PCOS symptoms to have a complete set of thyroid labs to rule out thyroid dysfunction.
“Think of PCOS as being in an extended state of puberty, where androgens, luteinizing hormone (LH), and insulin resistance dominate and follicle-stimulating hormone (FSH), estrogen, and progesterone haven’t established their rhythm.”
—DR. FIONA MCCULLOCH
Signs of Hypothyroidism (Underactive Thyroid)
Unexplained weight gain or trouble losing weight
Fatigue
Depression
Hair loss and dry hair
Muscle cramps
Dry skin
Swelling of the thyroid gland
Brittle nails
Slow heart rate
Irregular period
Sensitivity to cold
Constipation
Signs of Hyperthyroidism (Overactive Thyroid)
Unexplained weight loss
Palpitations
Feeling wired or anxious
Shakiness
Sweating spells
Feeling hot frequently
Tremors
Shortness of breath
Itchy red skin
More frequent bowel movements than usual
Fine hair and hair loss
CHRONIC INFLAMMATION
I should be a dentist’s dream patient. My brushing and flossing habits are impeccable. I have my teeth cleaned every six months. I don’t poke around in my mouth with pointy objects. Then why did my gums bleed every time I went to the dentist? For years, no matter what I tried, from my dentist I would get that face and “the talk.” You know the one I mean, about brushing and flossing regularly? As it turns out, it wasn’t my oral hygiene that was the problem. It was my systemic inflammation.
Inflammation isn’t necessarily bad. Our bodies use inflammation to fight off microbial, autoimmune, metabolic, or physical attacks. For example, it’s what causes our knees to puff up and bleed when we fall and scrape them. It’s a sign the body is deploying white blood cells, which help heal injuries, fend off disease, and replace aging cells. The problem is chronic inflammation, inflammation lasting from a few months to several years. That type of inflammation takes a tremendous toll on every system of the body.
Symptoms of Inflammation
Weight gain
Allergies
Brain fog
Joint pain
Irritable bowel syndrome
GI issues (bloating, gas, diarrhea)
Acne
Asthma
Gum disease
Chronic sinusitis
High blood sugar
Depression
Belly fat
Fatigue
Eczema
Psoriasis
According to integrative physician Felice Gersh, chronic inflammation is the root cause of many of the conditions women with PCOS experience, such as obesity and weight-loss resistance, infertility, hirsutism, mood swings, and acne. And recent research suggests that women with PCOS have higher levels of circulating C-reactive protein (CRP), an indicator of general inflammation independent even of obesity.
Inflammation is widely recognized as the root of many of the major diseases that plague the Western world. Cardiovascular disease, metabolic syndrome, hypertension, some cancers, diabetes, and PCOS all share the common root of inflammation.
Chronic inflammation may be caused by obesity, food sensitivities and allergies, and stress. It may also result from environmental and lifestyle factors such as pollution, poor diet, smoking, lack of exercise, and poor dental health. Getting to the root of these problems through a proper inflammation-reducing diet and lifestyle is critical for women with PCOS.
Why Do I Have PCOS?
Although the exact cause of PCOS is unknown, it is generally agreed that genetics, hyperinsulinemia (high levels of insulin) and insulin resistance, and/or a defect in a hormone-producing organ play a role. I have already discussed the chicken-and-egg debate about insulin and PCOS, whether chronically high levels of insulin cause excess androgens or vice versa. With regard to genetics, studies show that a woman with PCOS has a 40 percent likelihood of having a sister with the syndrome and a 35 percent chance of having a mother with the disorder. It is possible that a mother’s obesity, insulin resistance, or exposure to food high in advanced glycation end products (AGEs) or industrial toxins such as bisphenol A (BPA) may be the root cause. If PCOS is genetic, the genes involved in its expression may be triggered by environmental stimuli such as poor diet or rapid weight gain.
Some women with PCOS first experience symptoms when they stop taking the birth control pill. Typically, there was a predisposition before taking the pill, but only when they stopped taking it did symptoms emerge as a result of the disruption in communication between the pituitary gland and ovaries. In this case, symptoms should clear as soon as communication is reestablished.
How Can I Get Diagnosed?
Getting a firm diagnosis can be a long journey. There are several things to remember when seeking a diagnosis:
Be honest with your doctors. Tell them all of your symptoms. Try not to be embarrassed, and don’t write symptoms off to genetics, saying something like, “My aunts all have thinning hair; it must be genetic.” Your aunts may all have PCOS!
PCOS has a name problem. Approximately 20 percent of women who do not have PCOS have cysts on their ovaries. Similarly, about 30 percent of women who do have PCOS have no cysts.
Doctors are not always well-educated about PCOS and may try to treat each symptom separately instead of looking for the root cause. Press to get to the heart of your symptoms.
Be assertive when asking for lab tests. The more information you and your doctor can collect, the quicker you will get to the root of your symptoms and develop an effective plan. For a complete list of suggested labs, visit PCOSDiva.com/labs.
There is no definitive test to determine whether you have PCOS, but the most widely accepted diagnostic criteria are the Rotterdam Criteria. These were developed by the European Society for Human Reproduction and the American Society for Reproductive Medicine and include the original National Institutes of Health and EAE-PCOS Society diagnostic criteria. To be diagnosed with PCOS, a woman must present two of these three criteria:
1 Oligoovulation (irregular ovulation) or anovulation (absent ovulation)
2 Hyperandrogenism (elevated levels of androgenic hormones such as testosterone, clinical and/or biochemical)
3 Polycystic ovaries (enlarged ovaries containing at least twelve follicles each, shown on an ultrasound)
Even with these criteria in place, diagnosis can be tricky. Medications like birth control pills alter androgen levels and make testing inaccurate. Keep in mind that women may have irregular or even regular cycles and not ovulate or only ovulate occasionally. Having a period does not mean that you are ovulating. In addition, the presentation of symptoms may vary. There is no one-size-fits-all characterization of PCOS. You may be overweight and have irregular periods and acne, and the next woman may be lean with polycystic ovaries, absent periods, and hirsutism.
It is possible that you do not meet the Rotterdam Criteria at all, but still suffer from the symptoms. PCOS is often used as an umbrella term to include women with similar symptoms stemming from hyperandrogenism. You may also have a thyroid condition, and, again, I encourage all women with PCOS symptoms to have a complete set of thyroid labs to rule out thyroid dysfunction. You may have post-pill PCOS, a temporary condition with many of the same symptoms as PCOS caused by coming off of the birth control pill. If this is the case, once you rebalance your hormones, your symptoms should clear up for good.
As you can see, no single treatment will work for all women. The Healing PCOS 21-Day Plan is designed so that you can examine your symptoms, find the root cause, and discover what works for you.
Why Medications May Not Help: The “Band-Aid Effect”
I hear from women every day whose PCOS journeys had a very similar beginning. In their teens, they had irregular periods, acne, and/or painful PMS. Their doctor “fixed” these symptoms by prescribing the pill. Now the journeys divide. Some women tolerated the pill, but when they got off it, their symptoms returned with a vengeance and they struggled to conceive. Others could not tolerate the pill (nausea, headaches, weight gain, loss of libido) and have struggled with their symptoms and a series of drugs meant to help ever since.
There is a reason that these drugs cannot provide real, sustainable healing. At best, they are nothing more than Band-Aids, covering symptoms but not treating the root cause. At worst, they complicate your health picture with destructive side effects.
The Birth Control Pill
The pill is hands-down the go-to prescription from doctors. It has been touted as a miracle drug for everything from regulating periods to clearing up acne. In many cases, it seems to work for a while, but eventually you stop taking it and your symptoms return. Unfortunately, the pill has some serious downsides that most women are never told about.
Blood clots. Research indicates that women on the birth control pill increase their risk of blood clots by a factor of 1.6. For those taking pills with higher levels of estrogen, that risk is twice as high. This risk throws fuel on the fire for women with PCOS who are already at higher risk for heart attacks and stroke.
Increased insulin resistance. Studies show that with certain types of birth control pills, women suffered “unfavorable changes of insulin sensitivity.” This was certainly my experience. Researchers believe that this may have to do with the ratio of estrogen and progestin used in the various pills. Due to this concern about estrogen and insulin resistance, many doctors do not prescribe the pill for women at risk for or who already have diabetes. Whatever the reason, women with PCOS should not be taking any medications that worsen insulin resistance.
Lower libido. The pill, by definition, alters your hormones. Unfortunately, for some women, it dampens libido (you see the irony). This happens for a couple of reasons. First, the steady stream of synthetic hormones from the pill evens out the body’s natural cycle of high (around ovulation) and low libido. Second, it suppresses testosterone levels. That’s great for taking care of androgen-induced symptoms (acne, facial hair), but is lousy for your sex drive.
Nutrient deficiency. The pill depletes levels of valuable nutrients such as B vitamins, folic acid, vitamins C and E, magnesium, and zinc. You need sufficient levels of zinc to maintain a healthy hormone balance. Weight gain, fluid retention, mood changes, depression, and even heart disease can all arise from nutrient imbalance.
Candida. Estrogen promotes the growth of yeast in the gut, sometimes causing a condition called Candida overgrowth. Candida is a fungus (a form of yeast) that occurs naturally in small amounts and aids in digestion. If an overgrowth occurs, symptoms like brain fog, fatigue, digestive and skin issues, mood swings, and fungal infections occur. In addition, it breaks through the intestinal wall and allows byproducts into the surrounding area, triggering systemic inflammation. Since the major ingredient in the pill is estrogen, the risk of Candida overgrowth increases; it also causes sugar and carb cravings.
Metformin
After the birth control pill, metformin is the most commonly prescribed drug to “treat” PCOS. The purpose of metformin is to decrease the amount of glucose (sugar) and insulin produced by the liver and pancreas, and increase sensitivity to insulin in muscle cells. Getting insulin resistance under control is critical to thriving with PCOS, so it makes sense to take a pill and get quick results, right? Unfortunately, according to a National Institutes of Health 2012 study: “Metformin decreases androgen levels but has demonstrated only modest effect on fertility and has little effect on insulin action.” Here are a few of the problems with metformin:
GI issues. Metformin doesn’t only work in the liver; it takes action in the gut. It effectively adds to the protective mucus layer and stimulates pathways for fat burning and cellular rejuvenation, which should lead to more effective glucose regulation. In the process, many women (like me) find that it causes more GI distress (nausea, cramping, diarrhea) than it is worth.
Nutrient depletion. Metformin is widely acknowledged to deplete vitamin B12. A shortage of B12 is associated with nerve pain (neuropathy), cognitive dysfunction, and anemias.
Band-Aid effect. Like so many medications, metformin does not fix the underlying problem. Poor diet and lifestyle choices are usually the root of insulin resistance. Failure to change those will limit the effectiveness of this drug, and if it is ever stopped, the symptoms will return.
Spironolactone
Spironolactone (Aldactone) is a diuretic often prescribed to treat symptoms associated with high levels of androgens such as acne, hirsutism, and thinning scalp hair. It is not meant to treat insulin resistance, the cause of high levels of androgens in women with PCOS. Reducing the level of androgens in the body with a pill instead of addressing the root cause is a Band-Aid at best. The moment a woman stops taking the drug, symptoms will return.
Flutamide
Like spironolactone, flutamide works as an anti-androgen. In fact, its intended purpose is to reduce testosterone in the treatment of prostate cancer. In women, it has been found to be an effective drug for treating hirsutism and mild to moderate acne. Some studies indicate it works better than spironolactone. Like all of these drugs, flutamide is a Band-Aid treatment and does not attempt to resolve the root cause of the condition. In addition, there is risk of serious liver problems and birth defects if taken when pregnant. In fact, many doctors will not prescribe flutamide to women at all.
Although you cannot cure PCOS, you can manage your symptoms through diet, exercise, and other lifestyle approaches.
What Can I Do?
So now that you know why you feel lousy, what can you do?
You can heal and thrive! Although you cannot cure PCOS, you can manage your symptoms through diet, exercise, and other lifestyle approaches. Doctors and researchers agree that lifestyle therapy should be the first line of treatment for women with PCOS. Managing diet, lifestyle, and emotional health will lead to better health, restore hormonal balance, and help get your insulin levels back on track. Before you know it, your symptoms will begin to ease and your risk of diabetes, heart disease, hypertension, sleep apnea, anxiety, depression, and infertility will decrease. Therefore, a holistic approach is required to tame the symptoms of PCOS and improve your quality of life. Above all, we need to be thoughtful about the foods we use to fuel our bodies, the exercise we choose, the toxins we are exposed to, and, just as important, the emotional and mental care we take of ourselves.
But I Really Just Want to Take a Magic Pill
Good news. There is a magic pill. It’s you. The moment you decide that you deserve to be healthy and happy, you will begin to make the changes necessary to heal. You will wake up every day and make choices that nurture yourself, and you will feel better. As you feel better, you will make even more upgrades, and the cycle will continue. You are the magic pill that makes it all possible.
