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SweetSunshine72: You're right on the money with this information. It is exactly what my doctor told me when he diagnosed me with PCOS over two years ago. (After not having a period for eight months.) I have been on Metformin (2,000 mg) every since that time with regular periods every 21 days. I know that Metformin is working for me, because at the end of last year I had to lower my Metformin to 1,000 mg per day and my periods started to come every six to seven weeks. The second my Metformin was increased back to the regular 21 day cycle.
Edited by: PAGABBY at: 2/15/2010 (16:32)
"Never trust a computer you can't throw out a window."
"Running is the greatest metaphor for life, because you get out of it what you put into it."
If you aren't certain that the ENDO gave your case adequate consideration, then I suggest that you request a copy of your medical file from that office.
Is it possible that the ENDO is evaluating you based on testing from another doctor? My GYN ordered the tests based on ENDO recommendations.
I'm not saying that the ENDO is right, but you need to know on what basis the diagnosis was ruled out. Either way, if the ENDO doesn't communicate with you well, s/he isn't the doctor for you.
"I love to quote Albert Einstein because no one dares contradict me-" Studs Terkel
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If your endo didn't even do any bloodwork, I would get rid of him AS FAST AS POSSIBLE!!!! Go find a new one!!! There are all kinds of disorders that can cause weight gain, which can then affect your menstruation. You can't rule ANY of them out without at least bloodwork!!! He's being irresponsible, and not following his diagnostic protocols.
As for BCP's, yes, they can over-ride your body enough to enforce a monthly bleed, but it's not really a "period" as you are not ovulating. The reason that PCOS women don't have a regular period is because they are not ovulating regularly as a result of improper or incomplete maturation of the egg (which then forms the mini-cysts). These mini-cysts will reabsorb back into your body, usually over about 3 months or so. Being on BCP's may or may not help them shrink, but will prevent new ones from forming while they take care of themselves.
This is really treating things a little backwards. Kindof like treating a large cut that's bleeding heavily just with blood transfusions instead of stitching it up. Eventually, you will run into trouble. Really, you need to treat the cause and allow the body to heal!
One of the big things about long-term use of BCP's that's now being discovered is their connection to worsening metabolic issues, such as Insulin Resistance. IR is also at the heart of PCOS for almost all of us, and is a main cause/trigger of PCOS symptoms. If all you are doing is taking BCP's, then you can end up THINKING that your PCOS is "getting better" because the symptoms are being hidden, but in reality, everything is getting worse behind the scenes. Many women who have been long-term users of BCP's to control their PCOS find that their symptoms suddenly not only re-appear, but balloon out of control once/if they stop taking the BCP's. They think that it's because the BCP's were controlling it so well - what they don't realize is it's simply because the BCP's were controlling the SYMPTOMS!
Also, from my understanding of current PCOS research, the main causes have been narrowed down into 3 main concepts.
1) By far the most common one - Insulin Resistance. Over 80% of PCOS women have some form of IR/pre-diabetes or diabetes. As your body starts to have trouble using insulin properly, it has to make more insulin to compensate and your insulin levels start to rise. You can have IR for about 10 - 15 years before your blood glucose levels start to rise, so it can go undetected by family docs for a long time. Insulin is a growth hormone and not only prevents fat burning and increases fat storage, but it also affects the function of the ovaries and will trigger the ovaries, adrenal and other glands to start producing androgens (ie: testosterone, etc.) and causing other hormone imbalances.
2) Ovarian sensitivity. Some people's ovaries (and other glands) are sensitive to insulin, so even if insulin levels only rise a small amount and are still technically "normal", they will still get the hormone imbalances of PCOS, including disruption of ovulation. This is one possible cause for "thin cysters". IR treatments can still help, as they help the body better control it's insulin levels.
3) Pituitary/thalamus/hypothalamus gland disruption. These three glands control most of your body systems and interact with each other very closely. Even a very small disruption can cause a LOT of issues very quickly! Some of these issues are not PCOS-related, but can cause similar symptoms - like a pituitary tumor for instance. A pituitary tumor can cause PCOS-like symptoms, but there is a specific cause, and once the tumor has either shrunk or been removed, the symptoms fade. This is another possible cause for "thin cysters".
Thrown in there somewhere is also thyroid function (a large number of PCOS women also have under-active thyroid glands), too. Birth Control Pills and other forms of hormone-based treatments have ZERO effect on any of these main causes, except to possibly make them worse.
Sorry for the "book", and I hope I didn't offend anyone who does use BCP's and is happy with them. There is certainly a place for them, and they DO do a good job of controlling symptoms, especially with helping to slow down facial hair growth, which is almost impossible to reverse once it's started. My warning is against using them as the ONLY "treatment" for PCOS, or using them long-term. Their job is symptom control, not really "treatment", but they do that job well.
Certainly, though, metabolic treatments, such as a combination of a low-GI-type diet, exercise, and possibly Metformin do a better job long-term because they tackle the most common underlying issues - Insulin Resistance and elevated insulin levels. They are also the ONLY treatment for PCOS that will actually address the health issues associated with PCOS, such as high triglycerides (cholesterol), high blood pressure, and the risk of later developing Type 2 Diabetes. BCP's will actually increase all of these risks when used long-term.
Whatever treatment you do use, always do your research, and make sure you are going to a doctor that actually does his job and who you feel you can trust! Asking for a referral to a dietician is also an EXCELLENT idea, and one that almost any doctor can do, and should have no problem doing, especially if you have excess weight.
I know this is a LOT of information, but I hope it has helped you understand PCOS better, so you are then better able to take control over your health and find a treatment plan that will WORK for you!
Edited by: SWEETSUNSHINE72 at: 1/31/2010 (08:33)
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BCPs might shrink ones cysts or it might not since every woman's body reacts differently .. also BCPs doesn't treat PCOS it just helps cover it up or so many medical articles to the effect have stated, personally no idea never took BCPs .. i was on Depo Provera for several years plus Lupron - but that is about it when it comes to any form of BC.
Cals Burned for 6 years = 2,359,000
6 years Deficit Total = 1,729,800
Should have lost: 250 to 495 pounds
Actual loss = 139 lbs and 50 inches from core
I don't know if it will shrink your cysts, but, I hadn't had a regular period since... well, ever, and BCPs (I'm on Ortho Tricyclen Lo) have ABSOLUTELY helped. I've been taking them for about 5 months now and I have one period a month. I am still a little abnormal, my period lasts for 10-12 days if you count spotting, but... I can expect to have one, and only one. My dr says it takes 6 months to see full results.
I've had an OBGYN tell me i had it and the endocrinologist tell me no, ENDO didnt do any blood work didnt look into anything just told me to loose weight, The OBGYN did an ultra sound and I do have lots of little cysts that just so happen to cause me some discomfort and pain, and no period. So the OBGYN put me on BCP to start my period and "shrink" the cysts and i'm wondering if thats even logical to do? is that really going to start my periods again and get rid of the cysts? I mean i'm over weight yes but i have a 300 pound friend that still gets her periods and mine have always been regular. I've been maintaining my weight at 185