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Connecting the dots to obesity, infertility
By CHARLOTTE MOORE
Atlanta Journal-Constitution Staff Writer
BITA HONARVAR / AJC
CNN health reporter Kat Carney struggled with polycystic ovarian syndrome and obesity.
Related:
• Facts about PCOS
• Web sites
It took a 240 to prompt Kat Carney to do a 180. At age 27, Carney went to see her doctor about excruciating back pain. During the pre-exam weigh-in, she tipped the scales at a shocking 240 pounds.
"I couldn't believe it," said Carney, now 33 and a health reporter for CNN Headline News. "That's, like, what heavyweight boxers weigh. I thought to myself, 'I have lost my mind.' "
But her health problems didn't end with her weight. The second blow came moments later when she saw an ultrasound of her ovaries. They were filled with dozens of little cysts. Carney was suffering from polycystic ovarian syndrome, a hormonal and ovulation disorder characterized by infertility, irregular menstrual cycles, excessive body hair, acne and obesity.
"I remember thinking, 'I weigh 240 pounds, and now you're telling me I have something that sounds really scary,' " Carney said.
According to the National Institutes of Health, 5 percent to 10 percent of American women suffer from PCOS, the leading cause of infertility in women with irregular periods. This finding was confirmed by Atlanta infertility surgeon Eric Scott Sills in a recent study published in the British journal BMC Women's Health.
"We think that's a conservative estimate," said Sills of Georgia Reproductive Specialists. Sills suspects there are many undiagnosed women who know little or nothing about the syndrome. "I believe we should focus on the underlying hormonal imbalance problem, promote a healthier lifestyle, lower the insulin levels -- all this may naturally help them to lose weight."
Turning her life around
The ovaries of women who suffer from PCOS produce more testosterone -- the male hormone that induces and maintains secondary sex characteristics -- than needed. And, the ovaries are typically filled with numerous benign cysts that interfere with ovulation, making it difficult to conceive. The association between PCOS and obesity is well-known, said Sills.
"Since insulin levels are relatively elevated in many women with PCOS and since insulin is a potent growth factor causing multiple cell systems -- including fat cells -- to accelerate their growth, women who have an elevated insulin level would certainly be more predisposed to have weight gain. This is why patients who have the problem, unregulated and untreated, usually have problems with weight," he said.
Carney met PCOS head-on and turned her life around. "I revamped everything."
She had always been an overweight kid. By adulthood, she was cozy with her corpulence. In fact, the former Atlanta Alliance Theatre Company student found that her weight was key to her success.
"I worked all the time in New York [and Los Angeles] and nobody complained about my weight. I had friends who were starving themselves but I was eating pasta carbonara every night."
Over time, things changed.
She was sent home from a job as a model because she couldn't fit into the clothes. And there was the Weight Watchers gig she wasn't called back for.
Still, she did manage to become a magazine cover girl.
"I was called to do a print job for the cover of Newsweek and we were all to pretend we were looking at this cake," she said. "Weeks later, I was watching 'The Montel Williams Show' and Montel said, 'The topic today is obesity,' then he holds up this magazine with me on the cover and the headline 'The Girth of a Nation: Obesity Out of Control.' I was sitting there watching this while eating a large bag of potato chips."
Customized treatment
After years of self-destruc¬tion, Carney picked up a copy of "Make the Connection: Ten Steps to a Better Body and a Better Life" by Bob Greene, Oprah Winfrey's personal trainer. She began a customized workout regimen, gradually working her way up to exercising for three hours each day -- yoga, cardio, stretching and strength training.
She cut out foods laden with sugars and flours and added lean proteins, free range chicken, fish and vegetables. She researched PCOS and began taking the best medication for her. In an attempt to educate others, she launched two Web sites, one of which -- www.soulcysters.com -- has grown into a community of more than 8,000 members.
Carney, 90 pounds lighter, was featured on "The Oprah Winfrey Show" that aired July 18. Looking svelte in red pants and a long black jacket, Carney beamed as Winfrey said, "You look good, girl."
"I felt like Dorothy in 'The Wizard of Oz,' " Carney said. "Like -- wow -- I had the power the whole time."
Meanwhile, Greenville, S.C., resident Shannon Seckinger, 32, was feeling powerless. Unlike Carney, she was of average weight for her height, but she was suffering from other health problems. She was taking Accutane for adult-onset acne. She'd lived with endometriosis -- a painful condition in which cells and tissue that should be growing inside the uterus grow outside -- since high school. And when she and her husband decided to begin a family, they weren't surprised when they failed to conceive.
"I didn't question the doctors when they said the endometriosis was affecting my fertility."
To facilitate a pregnancy, in 1998 and 1999, she underwent two laparoscopic procedures in which doctors examined her reproductive organs using a small tube inserted into her abdomen. They confirmed the endometriosis but stopped there, citing it as the primary cause for her infertility. In 2000, the Seckingers went to Las Vegas to participate in an in vitro fertilization drug study. The procedure yielded no babies. But a physician in Las Vegas asked Seckinger if she'd heard of PCOS.
"I hadn't. At the time, I was so convinced my problem was the endometriosis, I didn't pay much attention. My problems had always been attributed to the endometriosis."
After IVF failed, Seckinger began to wonder if PCOS, not endometriosis, was her problem. She logged onto the Internet and began researching the disorder. Her search led her to Atlanta's Georgia Reproductive Specialists.
"Dr. Sills called me in person. He told me, 'I've looked at your case and I'm not sure you need to do IVF again.' "
Sills was certain that Seckinger's problem was PCOS. But to confirm his assumption, Seckinger came to Atlanta where she met with Sills. Because PCOS sufferers are typically overweight, a first glance at someone like Seckinger might steer doctors away from diagnosing the disorder.
"I weighed about 131 pounds, and I'm 5 feet 7 inches tall," Seckinger said. "I had facial hair growth and [adult-] onset acne, but I just thought these were things I was fighting. I never thought they were at all related to my fertility."
Lack of awareness
Women's failure to connect all their health problems, some doctors' propensity to diagnose problems too quickly, and a general lack of awareness about PCOS can contribute to late diagnoses and years of avoidable poor health.
"It's sad -- some women will bring charts from dermatologists, psychologists, family practice physicians, OB-GYNs -- all radiating away from the central problem of hormonal imbalance," Sills said. "When that one piece of the puzzle is solved, there's this ripple effect and improvements in overall health."
Taking all of her health problems into consideration, Sills suggested that Seckinger treat her condition with an oral medication primarily used to treat diabetes but has been shown to be effective for combating PCOS by balancing endocrine and hormonal levels. He also suggested she begin an exercise regimen. Three months later, the Seckingers were pregnant.
Nearly three years passed from the time they decided to begin their family to the moment they conceived.
"They were totally chasing the wrong demon," she said.
Today, the Seckingers are enjoying their 15-month-old daughter, Emma, and they're expecting to deliver another bundle any day.
"I'm so grateful for Dr. Sills. If it weren't for him, we would not have had a child because I don't think I would have gotten anyone else to take me seriously," Seckinger said.
FACTS ABOUT PCOS
What it is: Polycystic ovarian syndrome is a hormonal problem that raises a woman's insulin level, which can lead to the overproduction of testosterone and other male sex hormones. Up to 10 percent of American women suffer from PCOS, the leading cause of infertility in women with irregular periods.
Symptoms: Irregular or no periods, acne, obesity, excess hair growth, infertility.
Treatment: Drugs can be prescribed to control the symptoms of PCOS and treat infertility. Lifestyle changes -- involving diet and exercise -- are often suggested. Talk to your physician if you suspect you may suffer from PCOS.
FYI: Call the Polycystic Ovarian Syndrome Association at 1-877-775-7267 or visit www.pcosupport.org.
Other Web sites
www.soulcysters.com
www.pcos.net
www.obgyn.net/pcos/pcos.asp |
