Our Internal Clocks May Sometimes Need Rewinding: PCOS
August 29, 2003
by Dr. Andrea N. Price M.D.
The female body is an amazing timepiece. Acting as part calendar and part almanac, our internal clocks help us gauge how well we are internally, within our bodies. Nearly every month from menarche until menopause we ovulate, and for most women, our menstrual cycles, like the seasons, arrive more or less on time. Sometimes arriving a bit early, other times a few days late, but just as Spring invariably arrives, so will your period. But what if “that time of the month” never arrives this month (or the prior month) and your cycle has always been like clockwork? Further, you are confident that you are definitely not pregnant.
If your menstrual cycle has been out of sync lately, don’t panic. Your biological clock is not broken! You are possibly experiencing something called "secondary ammenorrhea". No, it's not an embarrassing digestive problem or something you caught from a public restroom! This means that you have had normal periods in the past, but you are currently not having periods. There are many causes of this condition and most of the time it has to do with some form of hormonal imbalance. It may be caused by large weight gain, excessive weight loss such as in anorexia, as a result from intense exercise in female athletes, or even while on the birth control pill. If you use the depo provera shot for contraception, it is normal to stop having periods. At other times amenorrhea may be a sign of an overactive or underactive thyroid gland. You may have heard of Polycystic Ovarian Syndrome (PCOS). This is the most common cause of secondary ammenorrhea.
In general women with PCOS have a hormonal imbalance in which their bodies may be producing excess androgens (male hormone). These male hormones will not cause you to suddenly dominate the TV remote control nor resist the urge to stop and ask for directions or the urge to scratch in public! Instead, the more common complaints of women who suffer from PCOS may include excess facial and body hair, acne, irregular periods, difficulty becoming pregnant and obesity (especially around the midsection). Is these symptoms aren’t a woman’s worst nightmare, I don’t know what is! Women with this condition ovulate infrequently, if at all, and these symptoms account for the irregular periods and difficulty becoming pregnant. The ovaries may be enlarged with multiple cysts because eggs continue to mature in the ovaries that never get released. Women with PCOS tend to be insulin resistant. This means that their bodies don’t respond to the hormone insulin in the usual way, so their bodies may not use sugar for fuel in the same way that others do. Here is the catch, weight loss is very helpful in improving PCOS, but because of insulin resistance, it is often very difficult to lose weight even with proper diet and exercise.
Don’t despair, there are treatments to “rewind our biological clocks”. Birth control pills such as Yasmin are very helpful in controlling acne and facial hair growth while regulating your menstrual cycle and giving you regular periods. Recently it has been found that oral hypoglycemic pills (used to treat diabetes) are very effective in promoting ovulation if you wish to become pregnant. This class of drugs can also be used to enhance weight loss in PCOS. PCOS is diagnosed by taking your medical history, physical exam, and a few simple lab tests to measure hormone levels.
A patient who recently wrote to me suspecting she has PCOS is a classic example. She mentioned that her doctor felt something on her right ovary and she was experiencing right sided pain but that her physician was unresponsive.
In her particular case, I suggested an ultrasound of the pelvis to rule out any abnormalities. It may be that her physician was feeling an enlarged ovary or an ovarian cyst, which are quite common in PCOS. Occasionally a cyst may leak fluid or rupture. This can cause significant pain, which usually goes away on its own in a few days. In a case like this, her first course of action should have been to call her doctor for another pregnancy test. If this is negative, ask for a pill called Provera to bring on her period. This pill is a hormone, which should be taken daily for either 5 or 10 days (depending on the dosage). After finishing the medication she, like most women, should get their period within a week. Once her cycle begins she may then start taking a birth control pill that will give her a period every month.
No woman should ever go for more than three months in a row without a period, otherwise the lining of the uterus might become too thick. If you decide not to take the birth control pill and you miss your period for three months in a row again, (and you are not pregnant) it is time to call your doctor once again to get Provera to induce your menses.
If you have experienced symptoms like this reader, PLEASE make an appointment and speak to your OB/GYN about your concerns ASAP. If your physician seems unresponsive to your concerns or if you are uncomfortable with your current doctor, it never hurts to seek another opinion.
Remember to monitor or check your internal clock regularly. As always, Love Thyself.
Dr. Andrea N. Price F.A.C.O.G.
andi@womenofcolorobgyn.com
source:
http://www.WomenOfColorOBGYN.com
Our Internal Clocks May Sometimes Need Rewinding: PCOS 
