Читать книгу The Ultimate PCOS Handbook - Theresa Cheung - Страница 38

CHAPTER 4 WHAT AM I DEALING WITH?

Below you’ll find a list of the key short- and long-term symptoms that women with PCOS are likely to have. We stress likely, as your symptoms will be unique to you and different from those of another woman with the syndrome. There’s a wide menu of PCOS symptoms out there, and you can get any combination to any degree of severity, which is why it’s important to find the solutions that work for you.

The most important thing to note is that PCOS is a combination of day-to-day symptoms and longer-term health effects. Even if your day-to-day symptoms aren’t bothering you so much, don’t ignore the self-help plans that come later in the book – the long-term health risks of PCOS mean you need to take action now.

‘The thing that got me started on a self-help plan was worrying about diabetes, but actually I lost some weight and got less spotty just from eating better and getting fitter, and I feel great!’

Amy-Jay, 29

EARLY SIGNS

Many symptoms of polycystic ovary syndrome (PCOS) start gradually, and you may think they’re related to some other medical problem.

IRREGULAR PERIODS

Nine or fewer menstrual cycles per year, or no menstrual cycles at all, may be one of the most common signs of PCOS. When periods do occur, they may be heavier, longer and more painful than normal. These conditions are caused by a hormone imbalance. Almost 50 per cent of women with PCOS don’t ovulate every month.

EXCESS HAIR

Sometimes called ‘hirsutism’, this can be a difficult symptom if you have it. For most women with PCOS, hair in the moustache and beard areas becomes heavier and darker. Masculine hair on the arms and legs, and excess hair in the pubic region, abdomen, chest or back, or on your thumbs or toes, is also possible. This symptom is caused by high levels of male hormones (androgens), as are thinning hair and acne. Up to 70 per cent of women with PCOS complain of excess hair growth.

‘One of the things that bugs me most is the hairs around my nipples.’

Harriet, 42

SKIN PROBLEMS

Skin problems such as acne, oily skin or dandruff can also crop up, due to excess testosterone. The acne is usually found around the face (especially along the jaw line), chest and back. Also, dark skin patches (acanthosis nigricans) on the neck, groin, underarms, or in skin folds, or skin tags (acrochordons) in the armpits or neck area can also bother women with PCOS. These are related to insulin resistance and diabetes.

‘I can’t believe I still have spots at the age of 30!’

Karen

GRADUALLY DEVELOPING SYMPTOMS

MOOD SWINGS

These may be caused by the emotional problems or body image insecurities related to, and triggered by the physical symptoms of PCOS, but they can also be a result of hormonal imbalance – if you’ve ever experienced PMS you’ll know how hormones can affect your feelings.

WEIGHT GAIN

‘Apple-shape’ weight gain, or upper-body obesity (more abdominal fat than hip fat) is also known as android obesity and is associated with increased testosterone levels. Many women with PCOS gain weight around their middle, and this type of weight gain can increase your risk of insulin resistance and diabetes.

Yes, it’s official. If you’ve got PCOS you’re not only more likely to be overweight but more likely to find it hard to lose weight. Research¹ shows that obesity is four times more likely in women with PCOS and irregular periods than those without. And the tendency² is to put on weight around the waist rather than the hips. Researchers think they’ve discovered the reason for this. Studies³ show that women with PCOS actually store fat more efficiently and burn calories more slowly than women without PCOS, even when they are on a diet.

In Part 2 we’ll explain in more detail what research has uncovered and, more importantly what you can do to kick-start weight loss, but for now if you’re struggling with your weight just bear in mind that you’re not alone and there are things you can do about it. If you’re struggling, we have an action plan in Chapter 11.

FERTILITY PROBLEMS

If you don’t have regular menstrual cycles, you may have problems getting pregnant. This isn’t the same as infertility, though – with help, most women with PCOS can get pregnant.

INSULIN RESISTANCE

For women with PCOS, insulin resistance increases the risk of developing diabetes. You may also develop diabetes at a younger age because of PCOS. About 30 per cent of women with PCOS have impaired glucose functioning, and 7 to 10 per cent have Type 2 diabetes. Some symptoms associated with insulin resistance include skin changes, such as skin tags or dark skin patches and upper-body weight gain.

MALE PATTERN BALDNESS

Just as heavier hair growth on your face and body is possible, thinning hair (alopecia) is also a symptom of PCOS. This is caused by higher levels of androgens.

SLEEP APNOEA

This has been reported to occur in up to 30 per cent of women with PCOS who are overweight. It’s a disorder characterized by excessive snoring at night with brief spells where breathing stops completely. Patients with this problem experience fatigue and daytime sleepiness. It can be diagnosed by a sleep study, and there are a variety of treatments available.

THE LONG-TERM HEALTH RISKS

Some conditions related to PCOS may not be obvious but are potentially dangerous. The long-term health risks⁴ include:

 Diabetes – about 30 per cent of women with PCOS have a problem processing blood sugar (glucose intolerance). This is a major risk factor for adult-onset diabetes.

 High blood pressure – if you’ve got PCOS, research⁵ shows that your risk of hypertension is higher than normal. This is because weight gain, high cholesterol levels and insulin resistance are known risk factors for high blood pressure.

 Heart and blood vessel disease – people with high insulin levels, as in PCOS, often have low levels of so-called good cholesterol (HDL cholesterol) and high levels of other fats, including triglycerides. These factors are known to increase the risk of heart attack or stroke later in life.

 Uterine cancer – if you don’t have regular periods, the lining of the uterus may not shed as often as it should, and instead build up and grow thicker, increasing the risk of cancer of the uterus. If PCOS goes untreated, this may increase the risk of cancer of the uterus.

There are some other conditions that women and/or PCOS experts suspect may be linked to PCOS, though research has yet to confirm this:

 Breast cancer – some studies have suggested that women with PCOS have an increased risk due to the obesity link and the hormonal fluctuations that can lead to an excess of oestrogen in the body and irregular periods. Other studies,⁶ however, haven’t found this link.

 Eating disorders – a recent study suggested that PCOS doesn’t cause eating disorders, but as weight-management problems are a common symptom of PCOS it’s hardly surprising that research⁷ suggests that as many as 60 per cent of women with PCOS may have eating disorders, such as bulimia.

 Osteoporosis (brittle bones) – women with PCOS and unhealthy eating patterns such as bulimia just aren’t giving their bones the nutrients they need to stay healthy and strong.

 Thyroid imbalance – since the hormonal systems in your body are all interconnected, it’s logical to assume that the hormonal havoc PCOS causes could trigger an imbalance in thyroid hormone production.

 Chronic Pelvic Pain – some women with PCOS suffer from chronic pelvic pain. Although no research has been done it’s not difficult to see why women with PCOS think there may be a link with their PCOS.

 Digestive complaints – many women with PCOS complain of digestive problems, in particular constipation and Irritable Bowel Syndrome. So far research has not discovered why this is the case, but it may have something to do with the slightly lowered metabolic rate associated with PCOS, which would make your digestive system a bit slower.

 Lowered immunity – many women with PCOS say they get ill more than women without PCOS. There could be an explanation for this. Research⁸ has suggested a link between lowered immunity and menstrual irregularity. It seems the high levels of testosterone associated with PCOS cause a fault in the way the body processes the stress hormone cortisol, so the body’s ability to deal with stress is weakened. And people under stress are more likely to get ill.

 Fatigue – although fatigue and lack of energy aren’t officially recognized as symptoms of PCOS, the hormonal fluctuations and blood sugar issues suggest energy levels could be an issue.

 Endometriosis – it’s not uncommon to see both PCOS and endometriosis in the same woman. Some experts believe the two conditions are not only similar but may be linked in some way.

 Ovarian cancer – a 1996 study reported an increased risk of ovarian cancer among women with PCOS, but more recent research suggests that the link is by no means established.

 Depression – some experts believe that depression, in particular bipolar disorder, is more common in women with PCOS, but is there a direct biological cause or is it because dealing with PCOS can just really get you down?

 Asthma – could the excess oestrogen associated with PCOS worsen asthma? Research⁹ indicates that women with irregular periods have higher rates of asthma and allergy than women with regular periods. Metabolic problems, such as insulin resistance, have been suggested as an underlying cause for both.

 Fibroids – there is no doubt that fibroids are related to oestrogen levels. Could they also be related to PCOS?