PCOS Questions

[ticklish]

Hi Cricket,

The irregular periods, acne and hirsuitism are all symptoms of PCOS. I was diagnosed with PCOS 13 years ago and have all of these but I am not a particularly bad case of it. So I would say, there is a chance that she may have PCOS.

I am not overweight but I find that my periods are most regular when I my BMI is 21, which I am finding impossible to get down to post-baby!!

Testing for PCOS involves blood tests for hormone levels and ultrasound to check the appearance of the ovaries. Your SIL should ask for a referral to an endocrinologist who specialises in the condition, generally I find that the Drs who specialise in reproductive endocrinology and gynaecology to be more knowledgable about PCOS, than a general endocrinologist.

Not all women diagnosed with PCOS have insulin resistance, I am one of them. The last time I checked about 75% do (I am in the minority). This has lead some drs to believe that insulin resistance is the main factor involved (but it does not explain all of us!!!!!). Therefore your SIL may not necessarily have the insulin resistance. She may not necessarily have elevated testosterone either (I don't!!), she just be more sensitive to it leading to the hirsuitism and acne. So, it can be confusing to get an accurate diagnosis!! Some women have PCO as shown on ultrasound but do not have PCOS due to the absence of other symptoms.

I still find that the low GI diet is beneficial to maintaining weight even though I am NOT insulin resistant. For me, just being at the upper end of normal weight range causes my symptoms to be worse than if I am leaner.

It does run in families, but the familial connection has not been proven in my case. My mother DOES NOT have it and there is no evidence of it on her side. Could be on my father's side but no strong evidence there except for male premature boldness. So yes, given that her mother has it there is a good chance that she may have it.

With PCOS, the right kind of pill is important as the pill prescribed for "normal" women without PCOS can actually make things worse. The pills prescribed for PCOS women have different hormones in it to counteract the androgens. In Aus, we have Diane-35ED and Brenda - there may be others. My acne and hirsuitism were helped by the pill.

I don't think PCOS is particulary difficult to diagnose from the blood tests and ultrasound, it is just there is such a wide degree of symptoms and the degree to which each person is affected varies enormously and so does the emphasis that drs place on the importance of the results v. the symptoms. Your SIL would need to come off the pill for a while in order to be tested.

Temp charting can be a useful guide, but may not be all that accurate in determining ovulation. It doesn't really work for me. I find the CM a much more useful guide, especially when TTC, but your SIL is probably not at that stage yet. A better guide may simply be how often she is getting periods. Generally, if you are within the normal range of about 28 - 36 days, give or take a few days, there is a good chance that she is having ovulatory periods. Anovulatory tend to be outside this normal range, but even this is not always the case. (My DS was concieved naturally in a 60 day cycle, and a cycle this length would usually be considered by some drs to be anovulatory!!). Ovulation can also be tested via blood and ultrasound but in my experience Drs don't worry about this until your are TTC. Before then it is about managing the symptoms.

There are some books written by Colette Harris, an english woman with PCOS about the lifestyle issues involved with PCOS and they give some ideas on how to manage the condition. Basically, I find too that it is a lifestyle thing. I have to maintain a healthy diet and lifestyle, reduce stress otherwise my body just rebels.

There is also a good Australian book about the low GI diet for PCOS - "The New Glucose Revolution - Managing PCOS, The Glycemic Index solution for Optimum Health" by Prof Brand-Miller, Prof Farid and Kate Marsh. Basically a healthy diet focusing on the right type of carbohydrates and fats.

I think that the irregular periods, acne and hirsuitism should be enough for your SIL to be referred for blood tests and ultrasound. She should question her DR about coming off the pill for a while in order to do the tests and ask why the acne gets worse in the week off.

Good luck and I hope she finds the answers she is looking for. I would just keep in mind, that even if she does have PCOS, it affects all of us very differently.

If she has any more questions, there are more of us here who have the condition and may be able to help.

TICKLISH.