KatCarney

Coping With Polycystic Ovary Syndrome

It might be hard to talk about if you're a teen girl. Who wants to talk about their ovaries and missed periods, anyway? Or maybe you don't even know what's wrong - all you know is that you keep gaining weight even though you exercise and eat right and you're totally embarrassed about the dark hair on your upper lip.

Don't be embarrassed - polycystic (pronounced: pah-lee-sist-ick) ovary syndrome (PCOS) is more common than you might think, and with the proper treatment, its symptoms can be a part of your past and not your future.

What Is Polycystic Ovary Syndrome?
You can't see them, hear them, or feel them, but the hormones that regulate your reproductive system make themselves known in many ways. Both girls and guys produce hormones called androgens (pronounced: ann-droh-jens), which play a role in sexual function. Although androgens are sometimes referred to as male hormones, every female produces them, too.

In teen girls with PCOS, the ovaries produce higher than normal amounts of androgens, which can interfere with egg production. The eggs that the ovaries normally produce develop into cysts (pronounced: sists), which are little sacs filled with liquid. Instead of being released during ovulation as an egg would be during a normal menstrual cycle, the cysts build up in the ovaries and may become enlarged. Because of the way the cyst production interferes with the menstrual cycle, it's common for girls and women with PCOS to have irregular or missed periods.

Even though PCOS was first recognized in 1935, doctors can't say for sure what causes it. Research has suggested that PCOS may be related to increased insulin production. Women with PCOS may produce too much insulin, which signals their bodies to release extra male hormones. PCOS seems to run in families, too, so if someone on your mom or dad's side of the family has it, you might be more likely to develop it. Karen Klein, MD, a doctor who specializes in hormonal problems in teens and kids in San Diego, California, says, "It is also now thought that girls who develop pubic and underarm hair before 8 years may be at greater risk for PCOS later on." Between 6% to 10% of teen girls and women have PCOS, also called Stein-Leventhal syndrome.

Unfortunately, if PCOS is not treated properly, it can put a girl at risk for lots of problems, such as infertility, excessive hair growth, acne, diabetes, heart disease, bleeding in the uterus, and cancer. The good news is that even though PCOS never goes away, if a girl is treated for PCOS, she doesn't have to experience those problems.

What Are the Signs and Symptoms?
Because you can't see how hormones are affecting your ovaries, how can you tell if you have PCOS? The increased hormone levels usually cause changes in your entire body, not just your ovaries. One sign a girl might have PCOS is irregular or missed periods because she is not ovulating. "If there is any chance a girl could be pregnant, she should be seen after missing one period for a pregnancy test. 'Any chance' means if she has ever had sexual intercourse, no matter when it was or whether she used protection," Dr. Klein says. Because it can take up to 2 years for menstruation to become regular, doctors look for other symptoms that might indicate PCOS.

PCOS can cause abdominal discomfort or severe premenstrual symptoms such as cramping, bloating, and irritability. Some doctors think the abdominal discomfort is caused by the enlarged ovaries filled with cysts. In addition, girls with PCOS may gain weight easily or be overweight or obese and may tend to carry the extra weight around their abdominal areas. Only about half of the women with PCOS are overweight, though, so you can be at a healthy weight and still have PCOS. High blood pressure is another common symptom.

Frequently, girls with PCOS grow extra hair on their faces, chests, abdomens, nipple area, or backs - a condition called hirsutism (pronounced: her-suit-iz-um). They may have increased acne and clogged pores as well as darkened skin around the neck or armpits or under the breasts. Hair loss is also common in girls with PCOS. All of these symptoms are the result of the increased androgen levels, which affects not only the reproductive system, but the hair and skin, too.

What Do Doctors Do?
If you've taken your concerns about your body to your doctor, you're on the right track. Your doctor may refer you to a gynecologist, a doctor who specializes in the reproductive system, or an endocrinologist, a doctor who specializes in hormonal problems, for a diagnosis. The gynecologist or endocrinologist will perform a thorough physical examination and obtain a detailed history, which will involve asking you lots of questions about your family history and your period and its regularity, checking your weight, and checking for physical symptoms such as acne, hair growth, and darkened skin.

Blood tests to measure insulin and other hormone levels will also probably be used to diagnose PCOS or to rule out other conditions, such as thyroid or other ovarian problems. Another test, called an ultrasound, may be used to look at your ovaries and to determine if you have cysts, although Dr. Klein points out that cysts are not always visible, so some doctors may not do this test routinely.

If your doctor diagnoses you with PCOS, there are several ways you may be treated. Your doctor may recommend that you lose weight if you are overweight or obese. "Weight loss helps and is important, but is difficult to do," Dr. Klein says. "Weight loss may affect the high insulin state, which leads to the darkened skin," she explains.

There are medications that are effective in treating PCOS. Your doctor might first prescribe birth control pills to help to regulate the androgen levels in your body and regulate your menstrual cycle. Birth control pills may help the symptoms of acne and excessive hair growth, but not in every case. Other medications used to treat PCOS include antiandrogens, such as spironolactone and flutamide. These types of drugs help clear up the skin and hair problems associated with PCOS. Metformin is a medication that "lowers insulin levels and helps with weight management in girls with significantly high insulin levels," Dr. Klein says. Some girls and women who have used metformin have experienced weight loss, lowered blood pressure, and the regulation of their menstrual cycles.

Early diagnosis and treatment for PCOS is important because the condition can put girls at risk for long-term problems, such as heart disease, diabetes, and breast and uterine cancer. Getting treated for PCOS is also a good idea if you want to have a baby someday - PCOS often causes infertility if it's not treated, but when it's treated properly, many women with PCOS are able to have healthy babies.

Dealing With PCOS
Dealing with the symptoms of PCOS can be discouraging if you're a teen girl trying to look and feel your best.

Losing weight can be difficult if you have PCOS, so the best thing to do is to consult with your doctor or a registered dietitian. He or she can look at your medication, your food intake, and your exercise program to tailor a weight-loss program for you. Some people with PCOS find that a diet lower in carbohydrates helps to regulate their insulin levels and helps with weight loss.

Exercise is a great way to combat the weight gain that often accompanies PCOS as well as a way to reduce bloating, another symptom girls with PCOS often experience. Be sure to drink tons of water so you stay hydrated and retain less water.

There are lots of beauty products that may help you battle hair loss, facial hair, and acne. Try a thickening shampoo and conditioner such as Kiehl's Thickening Lotion, or talk to your doctor about safe hair regrowth treatment, such as nioxin. Depilatory creams can gently remove facial hair on your upper lip or chin; be sure to follow the instructions carefully so you don't develop a rash or allergic reaction. Waxing, tweezing, and electrolysis are other effective methods of hair removal.

Your acne may get better if part of your treatment includes birth control pills or antiandrogens, but if not, your doctor may refer you to a dermatologist, a doctor who specializes in skin problems, for further acne treatment. In addition, a dermatologist may be able to recommend a medication to reduce discoloration on your neck, armpits, and breasts.

You should feel comfortable talking to your doctor about your physical and emotional concerns. In addition, talking with other teens and women with PCOS is a great way to share information about treatment and get support. Your doctor may be able to recommend a local support group or give you the names of other teens in your area who also have PCOS. If you can't find a local support group, the Polycystic Ovarian Syndrome Association offers a "Big Cyster" program for teen girls - if you join, you'll be hooked up with other women or teen girls with PCOS to whom you can turn for advice, support, or just a listening ear.

Having PCOS can be hard on your self-esteem because the symptoms are so noticeable. Focus on what you can change about the unpleasant PCOS symptoms and put the rest of your energy into the parts of your life that PCOS can't touch - your friends, family, school, and the things you enjoy doing.

Reviewed by: Karen Klein, MD
Date reviewed: March 2001


Source:
http://kidshealth.org/teen/sexual_he...irls/pcos.html

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