I have taken yasmin for 4 years. 4 months ago when I went off it for 2 months i got some acne, 11 lbs and weight gain. Before I ever started the yasmin, the only symptoms of pcos I had was a little more than normal hair growth and abnormal periods, no acne or weight gain (I am a thin pcos'er). The doc put me on 1500mg of met recently to see if it would get my periods straight. I don't feel as tired anymore and my concentration is better, and I am not craving a lot of food, but that could be from the stomach upset side effect,however I am still having anxiety attacks and depression. I have not gone off my yasmin yet because I am scared of the acne and weight gain. It seems I have been researching and researching overload since I was diagnosed 6 months ago, but I still don't have many answers. Maybe you can help me with something. Here are my lab results from when I was off the bc and met:
Insulin Fasting: 6 reference range: 4-27 * this seems low!
Insulin after 120 mins: 23 reference range: 22-79 *this seems very low!
** This definately does not show that I have insulin resistance because the numbers are so low, am I right? So maybe I have PCOS without IR? Is this possible? So why then do all the articles say that met may help these women with their PCOS symtoms if they do not test IR? If it helps with the symptoms, then does that mean that I am IR? I am so confused! Also, couldn't the symptoms that I got after I went off the pill (acne, small wt. gain) just be my hormones adjusting? The only symptom that I had before I ever started the pill 4 years ago was a little excess hair, no acne, weight gain etc. So my ultimate question is: Could I have the type of PCOS that includes high androgens and no IR? If so, how can it be treated? If I do not always want to take yasmin, what can I take instead? Another: How long should I wait after I stop my yasmin to supposedly get my hormones back to the way they were before I ever started bc w/out the ance etc? Sorry this is so complicated.
Other lab results:
DHEA: 7.1 reference range: 1.9-7.6 *higher
don't have testosterone #'s with me but were on the higher end
FSH: 5.1
LH: 13
On the yasmin, DHEA, testosterone and FSH/LH ratio are all normal.
I am so confused and scared that I might be insulin resistant and may get diabetes in the future. Please help!
My symptoms got worse the older I got, I am now 31 and have full blown symptoms, when I was on the pill I had NO symptoms, everytime I would go off, my symptoms would get worse and worse. Birth control pills really are the best treatment for women with PCOS that AREN'T TTC (trying to concieve). If your not TTC then I would just stay on the pill for now. When I went off I gained A LOT of weight, and started experiencing hair loss and all the lovely things that go along with PCOS. I am insulin resistant though...are you seeing and Endocrinologist??? If not you really should make an appt...
Good Luck!!
Stormy~
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I am seeing and endocrinologist. He was the one who perscribed me the met eventhough my numbers didn't show any insulin resistance. How did you find out you were insulin resistant? Did you have the glucose tolerance test? That was the one that I had. What were your numbers like? I do agree that the birth control works well, but what about if I want to TTC down the road, then what does one take?
Birth control pills really are the best treatment for women with PCOS that AREN'T TTC (trying to concieve). If your not TTC then I would just stay on the pill for now. When I went off I gained A LOT of weight, and started experiencing hair loss and all the lovely things that go along with PCOS.
Bcps aren't the best choice for all of us, though, because they 'mask' our symptoms rather than curing them. For me, they made a lot of PCOS symptoms worse. What's worked, instead, has been a healthy diet and Met. Good luck to you!
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I wanted to say that I am in (almost) exactly thre same boat as you!!!! It's kinda freaky.
All my hormones are within normal ranges except for my testosterone which was at the higher end of the scale. Even though I haven't had my insulin levels done yet, I suspect I am not insulin resistant. And yes we can still have PCOS. I am currently not on the pill cos my doc wanted to see what my hormones were doing while I was off it. My last tests were only 4 weeks after I stopped taking the BCP so she is seeing me again in August to have them all redone (fun fun).
Can I ask a couple of questions?
First, did you testosterone levels test free testosterone? That's the one they should do cos it's the one that causes the problems (mostly).
Also, have you had an ultraound? Do you have cysts on your ovaries? I know all women with PCOS don't always have cysts but worth getting checked out.
I also think you should probably have gone off the pill to have your tests done. As one-hit wonder so nicely put it, the BCP can mask our symptoms and if you're on it your blood results may also be affected. As for whether you are IR or not, I'd say by your result you aren't, but you could try a low GI diet anyway to keep your blood sugar levels under control. The way I see it when we go on a carb binge our body never really appreciates it anyway and eating the low GI is GOOD FOR ALL OF US!!!
In saying all this though, I'm no expert and I am certain an Endo knows more than me!
What I finally decided after 4 years of being pushed around from pillar to post is to get EVERYTHING done. That way I knew for sure. It's a peace of mind thing really.
Good luck - feel better soon. I feel like garbage some days too. It's a perfectly normal feeling.
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Thanks Artic! I did have both my free and total testosterone levels done. I also had all the tests done 2 months after being off bcp (sorry I forgot to mention that earlier). I had an ultrasound done when I was 16. There was one small cyst on my left ovary. It could be different now though. I'm thinking about going off the met and getting another glucose tolerance test and fasting insulin while carb loading 72 hours before the test just to see if I am really insulin resistant. I hope I'm not, but I think I may be. I feel totally better on the met. I am not as tired, I don't crave carbs like crazy, my thinking is more clear etc... But then again, this may all be due to the side effects, who knows. Anyway, I will let you know how it goes. Thanks for everything everyone!
Oh my God, you guys have just made my whole year! Until I read the initial post up there, I thought I was the only one with all the depression and panic attacks, and I'm taking Paxil for that. It just doesn't seem to work as well as it should, though. I was tried on Gluc too, and that just made my symptoms worse. (Yup, I'm insulin resistant.) I'm not seeing an enocryinologist (sp?) though. I can't afford it.
I have all the trouble with my weight and blood sugar, but we can't seem to find a way to fix everything. I've been terrified, because I don't really know what's going on with the PCOS, or how to make myself feel normal again. But hopefully, talking to some of you girls on here will help! *hugs*
Yup, good old Glucophage. It messed up my sugar levels though, and made my panic attacks about 10 times worse. So I had to go off of it. So now I'm not really taking anything to counter the PCOS.
Aaaw don't be confused depressed, we are right with you!
I think what you are experiencing is what a lot of women on this board experience when they first notice that something didn't seem right when they couldn't get pregnant anymore, when they notice excessive hair, lack of periods for some time, and etc. We can go on, can't we? If you need to understand the science of PCOS, Kat had put a video on board about a doctor name Dr. Katherin Sherif (ironically she's my doctor too!) explaining the whole thing in medical jargon to NIH (National Institute of Health. If you don't understand some of that stuff PM me, and we can talk about it. Besides I've been using that language so far in medical school. There is just too many acronyms, I tell you! It might bore you, but if can understand the gist of it especially when she shows the chart of how insulin plays a role in PCOS, you will understand it a lot better. I also should warn you it's an hour long, but it's great stuff and I highly suggest a lot of women with PCOS who don't seem to understand but want to understand the details of it to see this. In this video Dr. Sherif talks about lean women with PCOS, Acanthosis nigrans, acne, insulin levels (whether your insulin resistant or not), metformin versus clomiphene and, metformin side effects (I often call it metarrhea for it's wonderful carthatic purge lol) and benefits, cardiovascular diseases associated with PCOS, genetic risks, et cetera, et cetera all on PCOS. But, it's something you sit and listen to get schooled on PCOS. I hope you enjoy it and appreciate her talk. The video is found under Research Articles on the front page of the message boards. It is titled VIDEO CAST: Managing PCOS. But here is the link: http://videocast.nih.gov/ram/orwh102805.ram Dr. Sherif directed me to this site to meet all you wonderful people!! It's truly made my life easier . . . I will say!
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Multi-Vitamin & Mineral with iron (Natrol) - the best one I've found!
Done with Lupron...The cycle is on! Metformin 1500mg
peppagrl:
Thanks you so very much. The lecture was definately very helpful and interesting! I do still have a couple of questions though if you know the answers. How come metformin can help with the andrengic effects of pcos (acne, hirsturism etc) in thin women who have tested negative for insulin resistance? I doesn't seem like that would be possible. Don't be afraid to go into the patho if that's how you have to answer it, I can understand it pretty well. Also, do you recomment that I get an insulin/glucose ratio charted from at glucose tolerance test to better dianose if I have insulin resistance? Should I go off the metformin and/or yasmin for this? If so, how long should I be off them? Thanks for all your help! Have a great day and be happy. Thanks again!
Wow scared2! You are no joke! What a great question!! There is a relationship between insulin levels and hormone levels in PCOS. Whenever we eat something with carbohydrates specifically glucose, our insulin levels will spike. So there is a correlation. The more carbs (glucose) you eat, the higher will your insulin levels will be. It is up to your body to manage it! The better you manage it, the lower your insulin levels are.
Now, here comes the complicated part . . . In our brains (particularly the anterior pituitary) we release a hormone called Leutinized Hormone (LH) to stimulate these particular cells on our ovaries called ovarian theca cells. These ovarian theca cells make androstenedione and testosterone (which are both later on converted into estrogen). Well, insulin comes in and continues this stimulation of not only more estrogen and testosterone but also more LH (it becomes a bad cycle). We have more LH than FSH, so the ratio of LH to FSH is like 2-3:1.
Our ovaries don't respond the right way to this stimulation by saying "okay! I had enough!" and tell our brain (anterior pituitary) which releases the LH to shut it down. Instead, these theca lutein cells become luteinized cysts resembling that famous "strings of pearls sign" on ultrasound. They release more androgens that goes in our blood and cause the increase build up of our endometrium (estrogen) and the acne, hirsuitism, etc (testosterone).
So, insulin is the culprit in constantly being the go between our brain and our ovaries. Metformin will help lower our insulin levels by decreasing the glucose levels in our blood. There is a whole biochemical process to it, it's called glycogenolysis (breakdown of glycogen (a stored form of glucose)) and gluconeogenesis (the making of glucose). Therefore, metformin works on our liver to interrupt glycogenolysis and gluconeogenesis. All in all, we want to lower glucose and we want to lower insulin level and we want lower estrogen and particularly testosterone levels. And, that is why the low carb diet is optimal for us!
Well thin or non-thin cysters may not have insulin resistance. But it has been proven in studies of people with insulin resistant (Type II diabetes) that when they lost weight their insulin resistance had decreased. Exercise makes your cells no longer insulin resistant, but insulin sensitive to respond to it and says "I don't want anymore, I already done my job!". Therefore, you will decrease insulin levels .
There is also some talk that we also have a lower binding protein (called sex hormone binding globulin or SHBG) that allows free testosterone to do its nasty male effects. BCPs may also increase the levels of SHBG (maybe that is why your doc put you on it). Hirsuitism or acne may or may not be in found in a thin or non-thin cyster, so it's not necessarily a MAIN criteria for PCOS, because some may have higher SHBG than others.
Also, Yasmin (I didn't know this until I watched the video) has a higher progesterone than other bcps and so helps women with PCOS regulate their cycles. It brings on a pseudo-menstruation, so you can break down that endometrium that you've been building up for some time and send a signal to your brain to start regulating your body. You can also do this with progesterone (Provera, NPC, etc). Normally, when a woman ovulates (releases the egg from the ovary) the egg produces progesterone that sends a signal back to the brain to decrease estrogen and she gets a period. So, we want to send the right signals to our brain and have it regulating things the right way.
In answer to your questions (after that book I wrote lol), I don't think the insulin glucose tolearance test (what they call a GTT) would hurt. But, did they prescribe you metformin before they tested your insulin levels? They should of done the GTT first, then prescribed you met to give you a baseline for the future which they will look at in blood work. And, you don't have to stop yasmin nor metformin for these results.
But, I'm glad I can help you and I hope that helped some! It's perfectly understandable to feel scared and upset at this diagnosis, I felt that way too. I later on thought to myself, "Hey, at least I can control this one thing in my life!" Take care and God Bless!
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To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. Daily Regimen
Multi-Vitamin & Mineral with iron (Natrol) - the best one I've found!
Done with Lupron...The cycle is on! Metformin 1500mg
confused, depressed 
