Ask MetaFilter questions tagged with pcos

PCOS and Insulin Resistance: Some Questions.

mygothlaundry — Wed, 25 Mar 2009 08:39:39 -0800

My 26 year old daughter has just been diagnosed with PCOS and insulin resistance. Where does she go from here? My daughter, who has been having wildly irregular periods - one a year if that - and has been gaining weight steadily without being able to lose it for some years now, finally got health insurance and went to the doctor. The gynecologist ran a bunch of blood tests and gave her this diagnosis, as well as a prescription for birth control pills to start her period up again, a prescription for Metformin and the stern admonition to lose weight. Considering that one of the reasons she went in for testing was that she has been unable to lose weight even on a very strict diet with about 12 hours of gym time a week, that's easier said than done. She didn't give her much if any more information. We've been googling like crazy but so much of the information is contradictory or strange and I don't want to get entangled by mistake in any of the weirder theories or treatment plans out there - and wow, they do seem to exist.

Yes, we should be asking her doctor and that's the first question - should we go to another doctor? What kind of doctor treats this? Her OB/Gyn (who is my doctor too) is nice but a bit harried and busy and getting an appointment to talk to her literally takes months. So I have some other questions:

There is absolutely no history of diabetes or any kind of insulin problem in either side of her family. There's no history of obesity in women, either, although some of the men do tend to bulk up as they get older. So where did this come from?

She's afraid to start taking the Metformin due to possible side effects and because of the strictures it has: i.e., you must take this at exactly the same time each day with a full meal. She has a crazy work schedule and simply is not able to eat at the same time every day: she works with autistic patients and at any given moment could be anywhere in the area, depending on where she's needed, thus, she spends a lot of time in her car. How bad are the side effects? Earlier AskMes seem to say they are worst in the first 2 weeks after starting the medication. True? How important/necessary is it that she take the Metformin with food? At the same time? And what about alcohol? Can she really never have a drink again? Also, is she on this medication for life? Is this thing curable or not? She doesn't want to change her entire lifestyle and while I keep telling her she may have to, I sympathize completely.

Should she see a nutritionist? Where do you find those? Some of the suggested online diets are insanely restrictive. Is she really going to have to be on a completely carb free diet forever? Is that even a good idea?

If I ate and exercised the way she does - honestly, she's very diligent - I'd get very thin in about four weeks. Yet she just keeps on gaining weight. Is the Metformin really going to help with that? What else can be done?

I'm sure there are lots more questions that I can't think of right now. Basically, if you have this condition or know anyone who does, any information would be really helpful. We're both a little freaked out by the whole thing.

Open-Minded OB In Chattanooga?

Gianna — Tue, 18 Nov 2008 20:57:09 -0800

Looking for an OB/Gyn in or near the Chattanooga, TN area that is knowledgeable (or willing to learn) about PCOS and open-minded about nonstandard births. Alternately, looking for any feedback from folks who have used the midwifery services of Ina Mae Gaskin or the other midwives at "The Farm". I have a very bad case of Polycystic Ovarian Syndrome, and have had a great deal of trouble finding a local doctor who will work with me on treatment.

I was initially diagnosed by a doctor in another city, an endocrinologist who specialized in reproductive health. Everything he prescribed did wonders for me.

He is now far away, and trying to replace him has been pretty awful. I've tried a handful of local gynecologists, every single one of which has clung steadfastly to their years-out-of-date knowledge on the topic of PCOS, refused to prescribe me the medications my prior doctor did, insisted on prescribing medications that I already knew didn't work and made me ill, and became condescending, defensive, and accusatory when I tried to change their minds.

I'm now pregnant, and need to get an OB... but I'm extremely leery after the bad experiences I've had. I really do not want to spend my entire pregnancy at odds with my doctor.

To complicate matters even more, I'd really prefer to have a non-traditional birth... ideally, at home. I know most doctors aren't jiggy with that sort of thing.

I've been considering skipping the traditional medical track altogether and using the midwives at the Farm. I've read Ina Mae Gaskin's books and found them extremely interesting and encouraging. Summertown is about a three-hour drive away, but it would be worth it to me to have prenatal care I felt good about.

Does anyone have a recommendation for a good OB or midwife in Chattanooga, or has anyone used the midwives at the Farm and could tell me a little about their experience?

Ugh.

Anonymous — Mon, 27 Oct 2008 17:15:33 -0800

Is it possible to gain 12 pounds of actual weight/fat in three days? For the past 3 years of so I have been following a very strict low carb diet. I was obese ever since puberty, and not until a few years ago did a doctor not assume that I was eating Twinkies for dinner, do actual tests and diagnose me with PCOS. My doctor informed me that a low carb lifestyle worked well for people with PCOS and following such a diet has been no problem. Until this weekend I'd lost a total of 149 pounds.

I turned 30 a few days ago and my partner and I (who is also following a low carb diet) decided to suspend our diets for the three days that we would be out of town celebrating. And boy, did I celebrate:

Day 1:

3 egg omelet with feta, sun-dried tomatoes, olives w/homefries and toast

5-6 sushi rolls )avocado, tempura, various fish, etc) and a few pieces of sashimi

half bottle of champagne

a handful of almonds

6 pieces of chocolate from a box of chocolates

Day 2:

bagel with cream cheese/orange juice

indian buffet (a plate and a half of food and appetizers)

2 spoonfulls of macaroni and cheese, two baked chicken tenders (unbreaded), 2 pieces of ice cream cake

Day 3:

3 pancakes with syrup & a side of homefries

few slices of rotisserie chicken, bowl of salad (no dressing), mixed vegetables, small spoonful of rice and beans

handful of almonds

half a loaf of homemade challah bread (4-5 slices?) with butter

After this three day binge I got on the scale and weighed 12 pounds more than on the morning of the first day. Before this I'd restricted more than usual (knowing that I was planning to overindulge) and lost about that much in a little over a month.

Generally, I'd pass it off as water weight, etc, but since I was eating so little for the month beforehand, I'm wondering if I could have actually gained that much in fat. Add the facts that I have PCOS, started birth control a week or so before the trip, and ate a crapload of carbs in a such a short amount of time, I'm worried that it will take me a long time to lose the weight again (I'll be going back to my regular low carb diet, not the super restrictive diet of the month before the trip). Before these last three days, I was 15 pounds from my ideal weight, and I basically just feel crappy, though not exactly regretful.

So is it possible that I gained 12 real pounds? I'm not looking for diet or exercise advice, just the answer to that question. Thanks!

Can frequent periods of low blood sugar be a precursor to diabetes?

Anonymous — Thu, 19 Jun 2008 10:12:20 -0800

Can frequent periods of low blood sugar be a precursor to diabetes? I know that diabetes is actually high blood sugar. I am obese with polycystic ovarian syndrome (which people say predisposes one to diabetes) and a family history of diabetes. If I don't eat for a certain amount of time (sometimes as little as 4 hours if I don't have a big meal), my blood sugar will drop... I get irritable, shaky, and nauseated. Eating solves the problem but since it takes about 20 minutes for the sugar in the food to hit my bloodstream, for those 20 minutes I feel like eating everything in sight. (This doesn't happen that often - I'm not a binge eater.)

It doesn't make sense to me that I am prone to diabetes but I experience the opposite so easily. My fasting blood sugar is always in the normal range, and when I had it tested last year, my cholesterol was actually slightly low. I've never had a glucose tolerance test and I currently don't have health insurance, so I'm nervous about being diagnosed with something that will prevent me from getting insurance later on.

I did read this thread but it doesn't indicate if hypoglycemia could be a precursor to diabetes.

Also, after reading in a previous thread about Emetrol, I'd like to try it for the nausea I experience when I have a migraine. Given that the ingredients are Dextrose and Fructose (Levulose) and the warning says "This product contains sugar and should not be taken by diabetics except under the advice and supervision of a physician," would it be harmful for me to take it since I am only predisposed to diabetes? Would it be okay to take it when I am feeling a low blood sugar attack along with eating food as soon as possible?

I know YANMD.

BrainFilter: What is my major malfunction?

DecemberRaine — Mon, 21 May 2007 10:23:16 -0800

I am a 24 year old female at a pivotal point, and I need to address some serious personality and behavioural issues before I can figure out what I want to do with my life. Where are things going wrong here? So, a bit about me. I'm 24 y/o in relatively good health. I'm overweight, but have never had a problem with blood pressure, cholestorol, strength, flexibility, etc. I have lost about 60 pounds in the past year and most of the time feel quite well. I don't get a lot of planned exercise, but I do walk 20 minutes to work and back each day. I have had a history of hormone imbalance - never tested out of whack enough to treat, but I was started on birth control at age 14 to control my cycles, and took it off and on for almost 10 years. I am now off and my cycles are regular. I was once diagnosed with Poly-Cystic Ovarian Syndrome though and do still notice some of the other symptoms associated with this.

From the age of 9 to 22 I struggled furiously with anxiety attacks, most often brought on in social situations. They were never treated, didn't know what they were until they started to go away. School was always easy for me, and I eventually learned how to do the least amount of work possible to get what I needed to get. I always did projects, essays and reports at the very last minute, and rarely did homework. I studied for exams the week before finals, sometimes the day of the exam. I graduated high school with an 85% average.

This system failed miserably in university, however, because I had no idea what I wanted, let alone needed, to achieve. Thus, I did no work. Actually, I passed a couple courses that were distance ed where I didn't listen to any of the lectures or read the textbook. I studied the course notes the night before and slept in the student lounge. Wrote a 60% on the exam. I drank and smoked a lot of pot in university to deal with the anxiety and ended up in a lot of debt with only half of a degree. I got involved with a married man and things ended horribly, as they tend to do.

(enter the upswing)

I move back to my home town, get a convenient job, meet some wonderful people. Job changes, move in with some friends, have a pretty good situation going on. I am happy, healthy, and involved in some wonderful, honest friendships and other relationships. Now I'm looking for the next step.

I am making enough money right now to pay my bills. I have the ability to also work from home in my spare time, but for some reason, not the motivation. I feel like I'm not sure where I'm going. Mentally, I'm struggling. I feel out of focus. I spend all my spare time repeating conversations in my head, daydreaming about conversations I want to happen (and more importantly, practicing what I will say). I have a hard time sleeping with this constant dialogue running through my head, and when I do manage to sleep deeply, I have a very difficult time waking up, mostly because I always just want to rest "a little bit longer". I write in my blog and spend a ton of time chatting to people online (mostly people that I'm sleeping with - I also seem to have a peaked libido). I do manage to get out of the house (when I'm not going to work) at least once a week, more during the summer as the weekends are always busy. Oh, and I work the midnight shift, so I sleep in the afternoons.

This isn't a self-confidence issue. I am totally comfortable with myself and who I am. I know that I am smart and if I can focus myself on something and really want it, I can do it. But I feel as if my mind gets stuck in a feedback loop. I used to spend a lot of time counting things (ceiling tiles, etc.) or counting out notes on my fingers when listening to music, being picky about making sure that my stride is the same length as the sidewalk blocks (not because of superstition, just as something to focus my attention on I think). I am "habitually ambiguous" in almost all of my day-to-day communications with people. I don't do well taking orders, mostly because I don't feel like the people giving them are worthy of my service - but someone who has a naturally dominant personality and is smart enough to understand my needs could, with the right amount of encouragement, at least motivate me to get *something* done.

I keep tossing back and forth "what I want to do". I know that I want to go back to university, but for what? Philosophy, psychology, women's studies, nursing - all things I've considered, and with my university background, all doable in 1 year part-time and 1.5 years full time. That will require me to pay off my debt (about $8,000), so that I can qualify for student loans. I currently make $12/hour working at a call center which is dull but tolerable. I know that working a couple hours a day of SOLID work from home, I could probably double my income. I was self-employed for almost 2 years, and always made *just enough* to get by, because I was only working *just enough*.

I should add that I am a fairly regular pot smoker. As with most other things in my life, I tend to binge. I will smoke a lot at once, but I also go several weeks or more without any (a couple years ago it would have been several months without any), and the behaviour is not improved. This started years before I had ever smoked a joint.

So, finally, my question. What on earth can I do to focus myself? Do I need therapy? Prescriptions? A good hard slap in the face? I am willing to entertain all suggestions here - behavioural therapy, drugs, herbs, books, meditation, getting a Chia pet, whatever just throw it out there.

Introducing the bearded lady...

Anonymous — Thu, 22 Feb 2007 12:02:45 -0800

I'm a hairy woman. What is the criteria for being "hirsute" on a woman? How can I tell if I have PCOS? I'm a hairy woman.

This is troubling enough. I want to have an idea of whether or not I'm medically "hirsute" before I approach my doctor about this. I'm really embarrassed. I've already seen him for my horrible razor burn on my legs; I have a referral to a dermotologist (though most have been unhelpful about my razor burn). Should I ask the derm about my hairiness?

For the record: I have hairy thighs and dark hair below the knee. I have dark hairs on my breasts, a few on my chin, a mild 'stach, and a dark happy trail. My arms are hairy enough to warrant comment and my back and butt are fuzzy. I even had a rogue hair on my neck this morning, which broke the straw on the camel's back and urged me to post here.

My mom is a bit hairy, but only on her arms. My dad's not outrageously hairy. I asked my mom whether I had a hairy aunt or something, but none's to be found. I have heavy, painful periods and high-normal blood glucose. I'm about ten pounds overweight.

Does this sound like PCOS? Does it sound like a freak mutant gene and I should just deal with it? Is this hairiness benign or is something more sinister going on behind the scenes?

Summer's coming, and I have to wear shorts eventually...

I don't have periods. Anyone else?

Anonymous — Sun, 04 Dec 2005 08:43:37 -0800

I don't really have periods. I have one maybe twice a year and when it comes it's very normal (slight PMS symptoms, minor cramps, lasts about 5 days). I started my period when I was 11 and I've never had regular periods, it's always been this exact pattern. I saw a doctor about this when I was 16, he didn't seem too concerned/interested, he said it could take a while for periods to settle down (five years seems excessive) and put me on the combined pill. I took the pill for a couple of years, but when I came off it, it was the same deal again.

I’m 25 now and still having periods once or twice a year. A little relevant background in no particular order: I weigh quite a bit more than I should right now, but this is a fairly recent development and two years ago I was 135lbs. I don’t find it especially hard to lose weight. Throughout my teens I was a little bit chubby, but not really, and the pattern has been the same whatever my weight. I’m pretty stressed out right now, but again, the periods have been the same whatever. I don’t have anything I would think of as PCOS symptoms, I’m unusually un-hairy, and I have somewhat dry skin. I’ve been more or less depressed since I was a teenager, and I was much less depressed on the pill. I also have some pretty extreme moods but they aren't the same as what I feel just before I get a period.

I’ve been ignoring this for too long, I actually forget that most young women have periods; then I remember and feel weird. I want to start thinking about having kids, and I’m starting the process of getting this all investigated. I am getting hormone tests done when I can, I had a thyroid test a few months ago that came back ok.

The reason I’m asking this here is that I feel like this situation can’t be THAT unusual, but looking around on the internet I only ever find stuff about periods that are irregular in ways that mine aren’t –length, pain, etc, and most of the stuff I find seems to point to PCOS, which I guess I might have, but it doesn’t seem at all like me. I just go for a year at a time without a period. Does anyone else have any experience of this?

I feel irrationally embarrased about this, but I will almost certainly comment to respond to any questions.