PCOS...POS.. it's kind of all the same.

I have a new doctor that I love. I started seeing a Reproductive Endocrinologist and got a really clear explanation of what PCOS is and how it affects the body. I am not a doctor, and nothing I'm about to say is medical advice. I could also have a few things wrong, so talk to your doctor if what I am saying doesn't match up with your understanding of PCOS.

Every woman has something in the brain that tells her body when to release different hormones in order to have a normal monthly cycle. In a woman without PCOS, that message from the brain is like a steady beat on a drum. "1 and 2 and 3 and 4 and 5 and..." The message is sent from the brain at the right time, at the right interval, and the body has time to complete each step in the monthly process before moving on to the next step. 

In a woman with PCOS, that message is still being sent from the brain, but the rhythm is totally different. It's like you gave a toddler the drumset. Since the messages are sent very irradically, the body never gets the time/sequencing it needs to go from step to step in the monthly cycle. The follicles on the ovaries never get long enough to release an egg. They start to lengthen in preparation for releasing an egg, but then the brain sends a message out of rhythm, too early, and the body jumps ahead to the next step without ever completing the first step. An egg isn't released.

As a result, the body starts to have surplus hormones which lead to an imbalance and ultimately give you excess testosterone in your system. 

• My doctor says that birth control can help regulate the hormones and the monthly cycles. In fact, if you are trying to get pregnant and have PCOS, if you take the birth control for a few months and then go off of it, you may be able to get pregnant (more) easily. Some women with PCOS that get pregnant, have the baby and then want to get pregnant again a few months later can experience more difficulty the second time if they don't go back on the pill first. But as I understand it, at the same time you take the pill, you manage your diet, exercise and you may also be taking metformin. Without doing these other things, the pill can mask the PCOS symptoms and those symptoms can be getting worse without you even knowing it.

At the same time as that crazy toddler is banging away in your head, many women with PCOS also have insulin resistance. The way he described the insulin resistance is this: 

• Your body doesn't need all the sugar you eat. So, picture something like this... your body uses insulin to grab the excess sugar you ingested and basically send it down a shoot and out the body (I know, it's not scientific, but it kind of illustrates what happens). When you have insulin resistance, the shoots are really rusty and the insulin can't get the sugar out easily. Things start to back up at the shoot. Your body produces more insulin to try to get the sugar out and it doesn't really help the situation - it's kind of like trying to unclog a plugged up sink drain by running more water from the faucet. Perhaps in theory more water pressure would bust the clog loose, but what really happens is you end up flooding your sink AND your bathroom and your drain is still clogged. That's what's happening in the body.
• So, now your body has too much insulin and too much sugar in it and your blood sugar levels start peaking and crashing. And you start craving more sweets and carbs. He said that the excess insulin can also increase your testosterone levels.
• A drug called metformin is commonly prescribed for diabetes, but it can also help with the insulin resistance. Metformin sort of greases up the shoots so the insulin can get the sugar out without more easily. However, the drug forces your body to stop absorbing the sugars and carbs at a certain threshold, so if you keep eating them, your body will not absorb them and you can experience unpleasant things like diahrrea, etc because you ate too many sugars/carbs. 

Overall, a low carb, high protein diet is what he is recommending for me. I'm already doing it, but am going to go with the hubs to see their dietician because I feel lost with how to handle supplements and also want to be sure I am balancing my meals properly. 

The doctor is having me come back in to do a fasting glucose test to find out more about the severity of my insulin resistance. After that he'll probably prescribe the metformin. 

I've been off the birth control pill for almost a month now. So far my weight has been pretty steady and I haven't been losing weight as easily. My hormones have been a little funky with more frequent mood swings, but I'm pretty aware of them which is helping. The part I am struggling with the most is being super fatigued at the end of the work day. It's getting better, but it sucks and I'm not happy with it. The acne is at bay so far and I'm hoping that some of this may just be my body getting used to the hormone changes because I went off the pill. It would be nice if next month is easier. Or if I were pregnant next month. That would be nice too. :)