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What is PCOS?

PCOS, or polycystic ovary syndrome, is a complex condition involving sugar metabolism, progesterone, thyroid, and androgen sensitivity. Women with PCOS produce above average amounts of male hormones.  This imbalance can result in an irregular menstrual cycle and difficulty getting pregnant.  Although it can be characterized by insulin resistance, acne, significant weight gain, unwanted hair growth, spots on the skin, and high testosterone levels, in most cases these symptoms tend to be moderate...and many women do not experience all of them. It’s no wonder that most women dealing with PCOS often don’t even realize they have it!

Symptoms include:

• Irregular menstrual cycle. Missed periods, infrequent or too frequent periods, heavy periods or unpredictable periods.

• Heavier periods. Because the frequency of periods is reduced, the uterine lining can build up causing heavier bleeding when a period occurs.

• Thinning or loss of hair. Male-pattern baldness can affect women with PCOS.

• Acne. An excess of male hormones can cause skin to be oilier, resulting in acne on the face, chest, and upper back.

• Excess hair growth. Up to 3 out of 4 women with PCOs grow heavier and darker hair on their face and body.

• Significant weight gain. Up to 80% of women with PCOS are overweight or have difficulty losing weight.

• Skin blemishes. Darkening of skin along creases such as neck, groin and under the breasts. Skin tags – tiny bits of hanging skin.

• Infertility. PCOS can be one of the most common causes of female infertility.

The effects of PCOS on the body

As a “syndrome,” PCOS is a combination of symptoms that affects the ovaries and ovulation. Three primary features are:

• cysts in the ovaries

• high levels of male hormones

• irregular or skipped periods

Many symptoms of PCOS can be interdependent and aggravate other symptoms.

Infertility
Irregular and less frequent menstrual cycles can make it harder to get pregnant. Simply put, you need to ovulate to get pregnant and women with PCOS can have fewer than 8 periods a year. Being overweight (which can also be attributed to PCOS) can exacerbate irregular menstrual cycles. During pregnancy, PCOS can also cause higher rates of miscarriage, gestational diabetes, preeclampsia, and cesarean section at birth.

Weight gain/difficulty losing weight
Both obesity and PCOS increase your risk for high blood sugar, high blood pressure, low HDL or “good” cholesterol, and high LDL or “bad” cholesterol. Women with PCOS are also more likely to develop impaired glucose tolerance and type 2 diabetes. Being overweight can aggravate the other reproductive and metabolic symptoms of PCOS.

Increased risk of certain types of cancer
Without regular menstruation, the uterine lining can build up, increasing your risk for endometrial cancer. Increased risk of ovarian cancer can also be linked to PCOS.

Sleep apnea (fatigue irritability)
Weight and sleep apnea can be a vicious cycle. Women with PCOS – especially overweight women with PCOS – are at a greater risk for sleep apnea. Decreased sleep quality has been linked to insulin resistance, glucose intolerance, dyslipidemia and hypertension. These conditions can then contribute to weight gain and difficulty losing weight.

Depression (directly from hormones, side affects of other symptoms)
Depression and anxiety are common among women affected by PCOS. This can be directly due to the hormonal changes/imbalance, but other symptoms like obesity, acne, and hair loss or hirsutism can contribute by attacking a woman’s feelings of self-worth.

Treatment

Bio-identical Hormone Replacement Therapy for men is available in many forms. Through an evaluation of your unique symptoms and a thorough review of saliva, urine and blood tests, Dr. Carrozella will make a recommendation that is best for you. Recommended treatment options include:

Pellets - An implant of Bio-identical Hormone is placed underneath the skin in a concealed area. The implants are small and they are inserted under local anesthetic. Pellet therapy can last for up to 6 months between insertions.

Creams – This treatment is usually applied to the skin; however, in some circumstances, the creams can be inserted directly into the vagina for specific treatment reasons.

Tablets– Tablets are a common and effective way to administer BHRT. Tablets are taken every day by mouth. While tablets have gotten a bad reputation in some circles, that reputation was imcorrectly applied to true Bio-identical estrogen. The bad reputation is applied to estrogens obtained from horse urine and chemicalized synthetic progestins that are NOT used by Dr. Carrozzella.

While most women need to start looking at hormone optimization in their mid to late 30’s, PCOS is a condition that can show symptoms as early as late teens and can be treated naturally and successfully with hormone balancing.