What Polycystic Ovaries Means

If you go to a search engine and type in PCOS or polycystic ovarian syndrome, you will find a wealth of information about this syndrome.  Using the information I've gleaned from various sources, I'll try to explain what it means as I understand it in my life.  First, I want to say that there is no cure and treatment is based on reducing symptoms.

Basically, every menstrual cycle, a follicle containing an egg develops on the surface of the ovary.  Triggered by a hormone, that follicle bursts and an egg is released into the Fallopian tube which travels to the uterus.  In my case, the follicles develop but due to imbalanced hormone levels, they don't burst and release an egg.  Instead those follicles become cysts.  According to the ultrasound, I have more than 20 of these cysts on my ovaries with my right ovary having slightly more than my left.  This makes me ovaries twice their normal size and I sometimes get lower abdominal pain on my right side.  

What usually causes this to happen is an endocrine disorder through the entire body.  The endocrine system is your body's hormone system, including the sex hormones (estrogen, testosterone & progesterone), insulin, thyroid hormones, etc.  The hormones in your body work together to produce a delicate balance of your body systems. In PCOS, the hormones are out of whack. Most of the time, women with this disorder are insulin resistant (aka Type 2 diabetes) which is what causes the follicle not to burst.  High insulin levels with or without insulin resistance or high adrenal hormones (think adrenaline and cortisol) can also cause this to happen.  For me, I am not insulin resistance (yet) and since my doctor denied my request to test my other hormone levels, I'm not really sure what is going on with my hormones.

With insulin resistance, some women have difficulty maintaining or losing weight, skin tags, and darkened skin around the base of their neck, armpits and groin.  Lucky for me, I only have the difficulty maintaining or losing weight (which I will talk about more later) as well as skin tags in my arm pits.  For me, instead of my blood sugar being too high, it is actually too low under certain circumstances.  If I were to drink a pure sugar drink and nothing else, in about 2 hours, I would feel really bad because I would have low blood sugar.  This is called reactive hypoglycemia.  I drank the sugar drink as a test in the lab at the hospital and felt terrible afterward.  The reason for this could be because I have high insulin levels and it could be a precursor to insulin resistance.  Again, I'm not entirely sure because I don't have the tests to back it up.

In addition, another hormonal imbalance that happens is from the follicular cysts themselves.  Those cysts release male hormones (androgens, like testosterone) and estrogen.  As you can imagine, if you have many cysts, you will have a hormone imbalance.  In terms of female hormones, you can have too much estrogen and not enough progesterone.  So if I was to get pregnant, if I didn't have enough progesterone, I may not be able to sustain the pregnancy due to the fact that progesterone stabilizes the lining of the uterus for pregnancy.

As for the male hormones, too many androgens causes symptoms that many women with PCOS despise.  Some women get allopecia or hair loss which is somewhat like male pattern baldness.  Thankfully, I don't have this.  On the other hand, some women get hair growth in areas where men typically grow hair such as the face, chest, etc.  For me, I noticed thick black hair on the backs of my elbows several years ago.  Also, I had more hair growth on my toes, the tops of my feet and my upper thighs.  Luckily, I don't have to wax my face, although my husband always notices and wants to pull out those few hairs on my chin that grow extra long.  Thanks hun!

In addition to the hair issue, women will gain weight around the middle due to the increase in male hormones.  Obesity is very common in women with PCOS because it is so difficult for them to maintain their weight.  This has definitely happened to me over the past few years.  Also, acne is a huge problem for some women, but again, thankfully not for me.  Lastly if you've ever heard of  women "being hormonal", you can imagine that with hormones that are out of whack, it could produce some moodiness.  Depression is also in the list of symptoms for PCOS.

I left the biggy symptoms for last because they are obvious and troublesome for me.  First, you can probably see how conceiving a child in this condition can be tricky. This really concerns me.  Alongside this is irregular periods.  This is something that I've had ever since I could remember.  In the last year, it got worse and I only menstruated 6 times that year.  When I do, it is so heavy and long that it knocks me out.  I have to take iron supplements or else I get iron deficiency anemia.  This feels like exhaustion and tiredness that you would get only if you were drugged.  It feels like I'm living life through a haze.  If you can't tell, I hate this.  I'm normally a very active person so feeling this way is not fun for me.

So what causes all these wonderful things to happen?  Well, "they" aren't quite sure.  The prevailing theory is that there is some genetic connection.  Women with PCOS are more likely to have a sister, daughter or mother with it as well.  I'm ok with not knowing exactly why I have this going on.

Polycystic ovaries in my body means a few things for me.  First, I am worried about my ability to get and stay pregnant.  Until I am finished with school, I'm trying not to worry about this.  My biggest concern at the moment is the difficulty losing weight.  For the past several weeks, I've been on a 1340 calorie diet with extra calories when I exercise.  I exercise for 30-90 minutes every day so I usually average about 1750 calories per day.  However, after several weeks, it seems that I've stayed about the same weight.  This week, I've decreased my calories to 1270 per day to see if this will work.  I hope that I'll lose at least a half a pound per week this way.

Another concern of mine is the irregular periods.  Last month, I had my first set of periods back-to-back (one 4 weeks after the other).   I can't remember the last time this happened.  It has been more than a year.  Hopefully, this trend will continue.

So now that you know about this syndrome, I hope you might look at that obese woman with thinning hair, acne and skin tags differently.  She might be really struggling due to her hormones going crazy which is not something that she asked for or wanted.  Some people like myself have to go to extreme measures to not be overweight or obese.  I'll talk about that more in another blog post.  

Thanks for reading this long post and I hope you know more about what is going on with me and other women with PCOS.  Although PCOS sucks, I want to put it out there that it isn't the end of the world and I'm very thankful for the health that I do have.  Despite having polycystic ovaries, I think it is possible and imperative for me to remain positive.  It helps that optimism and the desire to fight to stay healthy is part of my personality.