I got an email today that absolutely floored me. One of my friends emailed me and opened up to me about some very personal things. I feel blessed that she was able to tell me about these things. I asked her if I could repost her email here and she agreed. I wanted to post it here because it helped me refocus. I have never been in this situation and I hope I never am. God bless her and her little girls. They say that it is better to have loved and lost then never to have loved at all.....I'm not so sure that's always true:
I am posting this in remembrance to two very precious lives and those they touched:
Okay. Good. I know that I was talking about pregnancy with you and I didn't know if that upset you. The reason I only have one child is because in 2000 I was pregnant with girls and I was so excited. I went into premature labor when I was 7 months and there due date was July 11th. I gave birth to them and they only lived a short time. One lived for 3 days and the other for a little over a week. One had a heart condition, the other developed an infection. It was the hardest thing I ever had to go through. The anniversary of their would be birthday is coming up and it is very difficult for me around this time. My boyfriend ( who would have been the girls father) is taking me away that weekend because he knows it is a hard time for me. It is also hard when the date of their "birth" comes around but that has already passed. My girls are buried in the same cemetery as my father and my brother so I like to think that they take care of each other. My daughters names are Mia Christina and Lillie Ana and I really miss them. They were a week away from being 8 months when they were born. I know that is why my boyfriend is afraid for me to get pregnant again because he is afraid of the same thing happening. I go to visit them when i visit my dad and my brother. I also visit them on the day they were "born". My family says it is unhealthy but I don't know what else to do, I just don't want to forget them. For a brief time they were here, a part of the world, a part of life, and they will always be a part of me. Every year for earth day my son and I plant 2 trees in honor of them. Well, I'm rambling on, I'll talk to you soon.
XOXOXOXO
6.26.2008
My Twisted Mind
DISCLAIMER: This entry was not written to make anyone feel bad or for people to tiptoe around me or avoid certain topics after reading this. I love all my friends and am so happy for each of them and their little ones. I am trying to write this blog as honestly as I possibly can and this is a part of my life.......the large majority of the time I am fine but there are times when it all catches up to me.
I am currently cleaning houses for a living until I can finish my medical transcriptioning courses. The other week I went to a new client's home. She greeted me at the door. She was a sharp looking woman, dressed nicely and I would have never noticed that she had just had a baby. She was very nice and showed me around, telling me what she wanted done. We went upstairs and we walked right into the baby's room and there he was sleeping in the bouncy seat on the floor. She started gushing about her lil baby and how much she loves him and how cute he is and all I could get out was, "Awwww....how old is he?" Turns out he is 8 weeks old. She is a first time mom and is entitled to gush....every mom is entitled to gush. I'm sure I did it and I'm sure I will do it again too. My problem was I wasn't mentally prepared for it and it slammed me in the face and took me to a not so good place. Later she brought the baby downstairs and walked right up to me and said, "Here he is up from his nap." Again I was forced to croon over the baby as my heart sunk deeper and deeper. I cried the whole time I cleaned the baby's room. I couldn't help it. It just got the best of me. I went downstairs when I was finished and her and her husband were sitting in the kitchen talking to the baby. She said to the baby, "What are you trying to tell us? Are you trying to tell us that you are just the cutest baby in the world?" I needed to get out of there as soon as possible. I just needed to get away. Several of my friends have just had babies and I am so happy for them. In no way am I vengeful or upset about the blessings in their lives. They have done nothing to upset me or frustrate me at all and really neither did this couple. I love hearing about the babies and the newest "stage" they are going through but sometimes I just can't handle it as well as others and that is on me.....it has nothing to do with anyone else. It is just something I need to deal with and process with in my life and like I said before I'm sure I will do the same thing when I'm a mommy again. Heck, I probably still do it with Owen because I am intoxicated with that kid and I am so proud of him.
Anyway.....I can't remember the last time I got my period back to back in a month. I think I was a teenager....well no actually it was when I got pregnant with Owen. For six months my body kicked into motion and did all the right things. It hasn't at all since then. As long as I am not on birth control I don't get regular periods. I had 4 in the last year. So last Friday I woke up and had my period. What the heck???? I was still like two weeks late but it was there. I had to laugh at the irony for a second. The one time I want my period to hold off so I can have it induced and do the testing I need done it comes. I called the fertility clinic and of course my insurance hadn't responded yet so I will just have to let this one ride and wait until next month to induce and have the testing done. GRRRRRRR...... It seems like this is the way my life has been going lately. Yesterday we got the letter in the mail saying that the insurance will cover the prescreening for Glenn and I but will not cover IUI or IVF. I have to check into that a little more and see why because I thought Maryland was one of like 5 states where they covered things like that. It may just be that they won't cover it at this point because we haven't jumped through 90,000 hoops yet. I'm not even worried about that at this point. I am just glad that it covers what it does for starters and we will think positively and go with the doctors inclination that we won't even need to go that far. We shall see.....I have to call the clinic again and see what we do from here. I know I need to get a pap done (oh...i can't wait......NOT) but I'm not sure after that. Okay...I'm done being long winded for today......
I am currently cleaning houses for a living until I can finish my medical transcriptioning courses. The other week I went to a new client's home. She greeted me at the door. She was a sharp looking woman, dressed nicely and I would have never noticed that she had just had a baby. She was very nice and showed me around, telling me what she wanted done. We went upstairs and we walked right into the baby's room and there he was sleeping in the bouncy seat on the floor. She started gushing about her lil baby and how much she loves him and how cute he is and all I could get out was, "Awwww....how old is he?" Turns out he is 8 weeks old. She is a first time mom and is entitled to gush....every mom is entitled to gush. I'm sure I did it and I'm sure I will do it again too. My problem was I wasn't mentally prepared for it and it slammed me in the face and took me to a not so good place. Later she brought the baby downstairs and walked right up to me and said, "Here he is up from his nap." Again I was forced to croon over the baby as my heart sunk deeper and deeper. I cried the whole time I cleaned the baby's room. I couldn't help it. It just got the best of me. I went downstairs when I was finished and her and her husband were sitting in the kitchen talking to the baby. She said to the baby, "What are you trying to tell us? Are you trying to tell us that you are just the cutest baby in the world?" I needed to get out of there as soon as possible. I just needed to get away. Several of my friends have just had babies and I am so happy for them. In no way am I vengeful or upset about the blessings in their lives. They have done nothing to upset me or frustrate me at all and really neither did this couple. I love hearing about the babies and the newest "stage" they are going through but sometimes I just can't handle it as well as others and that is on me.....it has nothing to do with anyone else. It is just something I need to deal with and process with in my life and like I said before I'm sure I will do the same thing when I'm a mommy again. Heck, I probably still do it with Owen because I am intoxicated with that kid and I am so proud of him.
Anyway.....I can't remember the last time I got my period back to back in a month. I think I was a teenager....well no actually it was when I got pregnant with Owen. For six months my body kicked into motion and did all the right things. It hasn't at all since then. As long as I am not on birth control I don't get regular periods. I had 4 in the last year. So last Friday I woke up and had my period. What the heck???? I was still like two weeks late but it was there. I had to laugh at the irony for a second. The one time I want my period to hold off so I can have it induced and do the testing I need done it comes. I called the fertility clinic and of course my insurance hadn't responded yet so I will just have to let this one ride and wait until next month to induce and have the testing done. GRRRRRRR...... It seems like this is the way my life has been going lately. Yesterday we got the letter in the mail saying that the insurance will cover the prescreening for Glenn and I but will not cover IUI or IVF. I have to check into that a little more and see why because I thought Maryland was one of like 5 states where they covered things like that. It may just be that they won't cover it at this point because we haven't jumped through 90,000 hoops yet. I'm not even worried about that at this point. I am just glad that it covers what it does for starters and we will think positively and go with the doctors inclination that we won't even need to go that far. We shall see.....I have to call the clinic again and see what we do from here. I know I need to get a pap done (oh...i can't wait......NOT) but I'm not sure after that. Okay...I'm done being long winded for today......
6.18.2008
About PCOS
This information comes by way of womanshealth.gov
What is polycystic ovary syndrome (PCOS)?
Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance. With PCOS, women typically have:
high levels of androgens (AN-druh-junz). These are sometimes called male hormones, although females also make them.
missed or irregular periods
many small cysts (sists) in their ovaries. Cysts are fluid-filled sacs.
How many women have polycystic ovary syndrome (PCOS)?
About one in ten women of childbearing age has PCOS. It can occur in girls as young as 11 years old. PCOS is the most common cause of female infertility (not being able to get pregnant).
What causes polycystic ovary syndrome (PCOS)?
The cause of PCOS is unknown. Most researchers think that more than one factor could play a role in developing PCOS. Genes are thought to be one factor. Women with PCOS tend to have a mother or sister with PCOS. Researchers also think insulin could be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. For many women with PCOS, their bodies have problems using insulin so that too much insulin is in the body. Excess insulin appears to increase production of androgen. This hormone is made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation.
Does polycystic ovary syndrome (PCOS) run in families?
Most researchers think that PCOS runs in families. Women with PCOS tend to have a mother or sister with PCOS. Still, there is no proof that PCOS is inherited.
What are the symptoms of polycystic ovary syndrome (PCOS)?
Not all women with PCOS share the same symptoms. These are some of the symptoms of PCOS:
infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
infertility (not able to get pregnant) because of not ovulating
increased hair growth on the face, chest, stomach, back, thumbs, or toes—a condition called hirsutism (HER-suh-tiz-um)
ovarian cysts
acne, oily skin, or dandruff
weight gain or obesity, usually carrying extra weight around the waist
insulin resistance or type 2 diabetes
high cholesterol
high blood pressure
male-pattern baldness or thinning hair
patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
skin tags, or tiny excess flaps of skin in the armpits or neck area
pelvic pain
anxiety or depression due to appearance and/or infertility
sleep apnea—excessive snoring and times when breathing stops while asleep
Why do women with polycystic ovary syndrome (PCOS) have trouble with their menstrual cycle?
The ovaries are two small organs, one on each side of a woman's uterus. A woman's ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These sacs also are called cysts. Each month about 20 eggs start to mature, but usually only one matures fully. As this one egg grows, the follicle accumulates fluid in it. When that egg matures, the follicle breaks open to release it. The egg then travels through the fallopian tube for fertilization. When the single egg leaves the follicle, ovulation takes place.
In women with PCOS, the ovary doesn't make all of the hormones it needs for any of the eggs to fully mature. Follicles may start to grow and build up fluid. But no one follicle becomes large enough. Instead, some follicles may remain as cysts. Since no follicle becomes large enough and no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the cysts make male hormones, which also prevent ovulation.
Does polycystic ovary syndrome (PCOS) change at menopause?
Yes and no. Because PCOS affects many systems in the body, many symptoms persist even though ovarian function and hormone levels change as a woman nears menopause. For instance, excessive hair growth continues, and male pattern baldness or thinning hair gets worse after menopause. Also, the risks of complications from PCOS, such as heart attack, stroke and diabetes, increase as a woman gets older.
What tests are used to diagnose polycystic ovary syndrome (PCOS)?
There is no single test to diagnose PCOS. Your doctor will take a medical history, perform a physical exam, and possibly take some tests to rule out other causes of your symptoms. During the physical exam the doctor will want to measure your blood pressure, body mass index (BMI), and waist size. He or she also will check out the areas of increased hair growth, so try to allow the natural hair growth for a few days before the visit. Your doctor might want to do a pelvic exam to see if your ovaries are enlarged or swollen by the increased number of small cysts. A vaginal ultrasound also might be used to examine the ovaries for cysts and check out the endometrium, the lining of the uterus. The uterine lining may become thicker if your periods are not regular. You also might have blood taken to check your hormone levels and to measure glucose (sugar) levels.
How is polycystic ovary syndrome (PCOS) treated?
Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, whether or not you want to become pregnant, and lowering your chances of getting heart disease and diabetes. Many women will need a combination of treatments to meet these goals. Some treatments for PCOS include:
Birth control pills. For women who don't want to become pregnant, birth control pills can control menstrual cycles, reduce male hormone levels, and help to clear acne. However, the menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone, like Provera®, to control the menstrual cycle and reduce the risk of endometrial cancer. (See Does polycystic ovary syndrome (PCOS) put women at risk for other health problems?) But progesterone alone does not help reduce acne and hair growth.
Diabetes medications. The medicine metformin (Glucophage®) is used to treat type 2 diabetes. It also has been found to help with PCOS symptoms, although it is not FDA-approved for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production. Abnormal hair growth will slow down, and ovulation may return after a few months of use. Recent research has shown metformin to have other positive effects, such as decreased body mass and improved cholesterol levels. Metformin will not cause a person to become diabetic.
Fertility medications. Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used. Also, there is an increased risk for multiple births (twins, triplets) with fertility medications. For most patients, clomiphene citrate (Clomid®, Serophene®) is the first choice therapy to stimulate ovulation. If this fails, metformin taken with clomiphene is usually tried. When metformin is taken along with fertility medications, it may help women with PCOS ovulate on lower doses of medication. Gonadotropins (goe-NAD-oh-troe-pins) also can be used to stimulate ovulation. These are given as shots. But gonadotropins are more expensive and there are greater chances of multiple births compared to clomiphene. Another option is in vitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any one cycle and gives doctors better control over the chance of multiple births. But, IVF is very costly.
Medicine for increased hair growth or extra male hormones. Medicines called anti-androgens may reduce hair growth and clear acne. Spironolactone (speer-on-oh-lak-tone) (Aldactone®), first used to treat high blood pressure, has been shown to reduce the impact of male hormones on hair growth in women. Finasteride (Propecia®), a medicine taken by men for hair loss, has the same effect. Anti-androgens often are combined with oral contraceptives.
Before taking Aldactone®, tell your doctor if you are pregnant or plan to become pregnant. Do not breastfeed while taking this medicine. Women who may become pregnant should not handle Propecia®.
Vaniqa® cream also reduces facial hair in some women. Other treatments such as laser hair removal or electrolysis work well at getting rid of hair in some women. A woman with PCOS can also take hormonal treatment to keep new hair from growing.
Surgery. "Ovarian drilling" is a surgery that brings on ovulation. It is sometimes used when a woman does not respond to fertility medicines. The doctor makes a very small cut above or below the navel and inserts a small tool that acts like a telescope into the abdomen. This is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these effects may only last a few months. This treatment doesn't help with loss of scalp hair and increased hair growth on other parts of the body.
Lifestyle modification. Keeping a healthy weight by eating healthy foods and exercising is another way women can help manage PCOS. Many women with PCOS are overweight or obese. Eat fewer processed foods and foods with added sugars and more whole-grain products, fruits, vegetables, and lean meats to help lower blood sugar (glucose) levels, improve the body's use of insulin, and normalize hormone levels in your body. Even a 10 percent loss in body weight can restore a normal period and make a woman's cycle more regular.
How does polycystic ovary syndrome (PCOS) affect a woman while pregnant?
There appears to be higher rates of miscarriage, gestational diabetes, pregnancy-induced high blood pressure (pre-eclampsia), and premature delivery in women with PCOS. Researchers are studying how the diabetes medicine metformin can prevent or reduce the chances of having these problems while pregnant. Metformin also lowers male hormone levels and limits weight gain in women who are obese when they get pregnant.
Metformin is a FDA pregnancy category B drug. It does not appear to cause major birth defects or other problems in pregnant women. But, there have been no studies of metformin on pregnant women to confirm its safety. Talk to your doctor about taking metformin during pregnancy or if you are trying to become pregnant. Also, metformin is passed through milk in breastfeeding mothers. Talk with your doctor about metformin use if you are a nursing mother.
Does polycystic ovary syndrome (PCOS) put women at risk for other health problems?
Women with PCOS have greater chances of developing several serious, life-threatening diseases, including type 2 diabetes, cardiovascular disease (CVD), and cancer. Recent studies found that:
More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40.
Women with PCOS have a four to seven times higher risk of heart attack than women of the same age without PCOS.
Women with PCOS are at greater risk of having high blood pressure.
Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol.
The chance of getting endometrial cancer is another concern for women with PCOS. Irregular menstrual periods and the absence of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Progesterone causes the endometrium to shed its lining each month as a menstrual period. Without progesterone, the endometrium becomes thick, which can cause heavy bleeding or irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the lining grows too much, and cancer.
I have PCOS. What can I do to prevent complications?
Getting your symptoms under control at an earlier age can help to reduce your chances of having complications like diabetes and heart disease. Talk to your doctor about treating all your symptoms, rather than focusing on just one aspect of your PCOS, such as problems getting pregnant. Also, talk to our doctor about getting tested for diabetes regularly. Eating right, exercising, and not smoking also will help to reduce your chances of having other health problems.
How can I cope with the emotional affects of PCOS?
Having PCOS can be difficult. Many women are embarrassed by their appearance. Others may worry about being able to get pregnant. Some women with PCOS might get depressed. Getting treatment for PCOS can help with these concerns and help boost a woman's self-esteem. Support groups located across the United States and on-line also can help women with PCOS deal with the emotional affects.
For More Information...
You can find out more about PCOS by contacting the National Women's Health Information Center (NWHIC) at 1-800-994-9662 or the following organizations:
National Institute of Child Health and Human Development (NICHD), NIH, HHSPhone: (800) 370-2943Internet Address: http://www.nichd.nih.gov/womenshealth
American Association of Clinical Endocrinologists (AACE)Phone: (904) 353-7878Internet Address: http://www.aace.com
American Society for Reproductive Medicine (ASRM)Phone: (205) 978-5000Internet Address: http://www.asrm.org
Center for Applied Reproductive Science (CARS)Phone: (423) 461-8880Internet Address: http://www.ivf-et.com
InterNational Council on Infertility Information Dissemination, Inc. (INCIID)Phone: (703) 379-9178Internet Address: http://www.inciid.org
Polycystic Ovarian Syndrome Association, Inc. (PCOSA)Internet Address: http://www.pcosupport.org
The Hormone FoundationPhone: (800) 467-6663Internet Address: http://www.hormone.org
What is polycystic ovary syndrome (PCOS)?
Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance. With PCOS, women typically have:
high levels of androgens (AN-druh-junz). These are sometimes called male hormones, although females also make them.
missed or irregular periods
many small cysts (sists) in their ovaries. Cysts are fluid-filled sacs.
How many women have polycystic ovary syndrome (PCOS)?
About one in ten women of childbearing age has PCOS. It can occur in girls as young as 11 years old. PCOS is the most common cause of female infertility (not being able to get pregnant).
What causes polycystic ovary syndrome (PCOS)?
The cause of PCOS is unknown. Most researchers think that more than one factor could play a role in developing PCOS. Genes are thought to be one factor. Women with PCOS tend to have a mother or sister with PCOS. Researchers also think insulin could be linked to PCOS. Insulin is a hormone that controls the change of sugar, starches, and other food into energy for the body to use or store. For many women with PCOS, their bodies have problems using insulin so that too much insulin is in the body. Excess insulin appears to increase production of androgen. This hormone is made in fat cells, the ovaries, and the adrenal gland. Levels of androgen that are higher than normal can lead to acne, excessive hair growth, weight gain, and problems with ovulation.
Does polycystic ovary syndrome (PCOS) run in families?
Most researchers think that PCOS runs in families. Women with PCOS tend to have a mother or sister with PCOS. Still, there is no proof that PCOS is inherited.
What are the symptoms of polycystic ovary syndrome (PCOS)?
Not all women with PCOS share the same symptoms. These are some of the symptoms of PCOS:
infrequent menstrual periods, no menstrual periods, and/or irregular bleeding
infertility (not able to get pregnant) because of not ovulating
increased hair growth on the face, chest, stomach, back, thumbs, or toes—a condition called hirsutism (HER-suh-tiz-um)
ovarian cysts
acne, oily skin, or dandruff
weight gain or obesity, usually carrying extra weight around the waist
insulin resistance or type 2 diabetes
high cholesterol
high blood pressure
male-pattern baldness or thinning hair
patches of thickened and dark brown or black skin on the neck, arms, breasts, or thighs
skin tags, or tiny excess flaps of skin in the armpits or neck area
pelvic pain
anxiety or depression due to appearance and/or infertility
sleep apnea—excessive snoring and times when breathing stops while asleep
Why do women with polycystic ovary syndrome (PCOS) have trouble with their menstrual cycle?
The ovaries are two small organs, one on each side of a woman's uterus. A woman's ovaries have follicles, which are tiny sacs filled with liquid that hold the eggs. These sacs also are called cysts. Each month about 20 eggs start to mature, but usually only one matures fully. As this one egg grows, the follicle accumulates fluid in it. When that egg matures, the follicle breaks open to release it. The egg then travels through the fallopian tube for fertilization. When the single egg leaves the follicle, ovulation takes place.
In women with PCOS, the ovary doesn't make all of the hormones it needs for any of the eggs to fully mature. Follicles may start to grow and build up fluid. But no one follicle becomes large enough. Instead, some follicles may remain as cysts. Since no follicle becomes large enough and no egg matures or is released, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the cysts make male hormones, which also prevent ovulation.
Does polycystic ovary syndrome (PCOS) change at menopause?
Yes and no. Because PCOS affects many systems in the body, many symptoms persist even though ovarian function and hormone levels change as a woman nears menopause. For instance, excessive hair growth continues, and male pattern baldness or thinning hair gets worse after menopause. Also, the risks of complications from PCOS, such as heart attack, stroke and diabetes, increase as a woman gets older.
What tests are used to diagnose polycystic ovary syndrome (PCOS)?
There is no single test to diagnose PCOS. Your doctor will take a medical history, perform a physical exam, and possibly take some tests to rule out other causes of your symptoms. During the physical exam the doctor will want to measure your blood pressure, body mass index (BMI), and waist size. He or she also will check out the areas of increased hair growth, so try to allow the natural hair growth for a few days before the visit. Your doctor might want to do a pelvic exam to see if your ovaries are enlarged or swollen by the increased number of small cysts. A vaginal ultrasound also might be used to examine the ovaries for cysts and check out the endometrium, the lining of the uterus. The uterine lining may become thicker if your periods are not regular. You also might have blood taken to check your hormone levels and to measure glucose (sugar) levels.
How is polycystic ovary syndrome (PCOS) treated?
Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatment goals are based on your symptoms, whether or not you want to become pregnant, and lowering your chances of getting heart disease and diabetes. Many women will need a combination of treatments to meet these goals. Some treatments for PCOS include:
Birth control pills. For women who don't want to become pregnant, birth control pills can control menstrual cycles, reduce male hormone levels, and help to clear acne. However, the menstrual cycle will become abnormal again if the pill is stopped. Women may also think about taking a pill that only has progesterone, like Provera®, to control the menstrual cycle and reduce the risk of endometrial cancer. (See Does polycystic ovary syndrome (PCOS) put women at risk for other health problems?) But progesterone alone does not help reduce acne and hair growth.
Diabetes medications. The medicine metformin (Glucophage®) is used to treat type 2 diabetes. It also has been found to help with PCOS symptoms, although it is not FDA-approved for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone production. Abnormal hair growth will slow down, and ovulation may return after a few months of use. Recent research has shown metformin to have other positive effects, such as decreased body mass and improved cholesterol levels. Metformin will not cause a person to become diabetic.
Fertility medications. Lack of ovulation is usually the reason for fertility problems in women with PCOS. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used. Also, there is an increased risk for multiple births (twins, triplets) with fertility medications. For most patients, clomiphene citrate (Clomid®, Serophene®) is the first choice therapy to stimulate ovulation. If this fails, metformin taken with clomiphene is usually tried. When metformin is taken along with fertility medications, it may help women with PCOS ovulate on lower doses of medication. Gonadotropins (goe-NAD-oh-troe-pins) also can be used to stimulate ovulation. These are given as shots. But gonadotropins are more expensive and there are greater chances of multiple births compared to clomiphene. Another option is in vitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any one cycle and gives doctors better control over the chance of multiple births. But, IVF is very costly.
Medicine for increased hair growth or extra male hormones. Medicines called anti-androgens may reduce hair growth and clear acne. Spironolactone (speer-on-oh-lak-tone) (Aldactone®), first used to treat high blood pressure, has been shown to reduce the impact of male hormones on hair growth in women. Finasteride (Propecia®), a medicine taken by men for hair loss, has the same effect. Anti-androgens often are combined with oral contraceptives.
Before taking Aldactone®, tell your doctor if you are pregnant or plan to become pregnant. Do not breastfeed while taking this medicine. Women who may become pregnant should not handle Propecia®.
Vaniqa® cream also reduces facial hair in some women. Other treatments such as laser hair removal or electrolysis work well at getting rid of hair in some women. A woman with PCOS can also take hormonal treatment to keep new hair from growing.
Surgery. "Ovarian drilling" is a surgery that brings on ovulation. It is sometimes used when a woman does not respond to fertility medicines. The doctor makes a very small cut above or below the navel and inserts a small tool that acts like a telescope into the abdomen. This is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric current to destroy a small portion of the ovary. This procedure carries a risk of developing scar tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these effects may only last a few months. This treatment doesn't help with loss of scalp hair and increased hair growth on other parts of the body.
Lifestyle modification. Keeping a healthy weight by eating healthy foods and exercising is another way women can help manage PCOS. Many women with PCOS are overweight or obese. Eat fewer processed foods and foods with added sugars and more whole-grain products, fruits, vegetables, and lean meats to help lower blood sugar (glucose) levels, improve the body's use of insulin, and normalize hormone levels in your body. Even a 10 percent loss in body weight can restore a normal period and make a woman's cycle more regular.
How does polycystic ovary syndrome (PCOS) affect a woman while pregnant?
There appears to be higher rates of miscarriage, gestational diabetes, pregnancy-induced high blood pressure (pre-eclampsia), and premature delivery in women with PCOS. Researchers are studying how the diabetes medicine metformin can prevent or reduce the chances of having these problems while pregnant. Metformin also lowers male hormone levels and limits weight gain in women who are obese when they get pregnant.
Metformin is a FDA pregnancy category B drug. It does not appear to cause major birth defects or other problems in pregnant women. But, there have been no studies of metformin on pregnant women to confirm its safety. Talk to your doctor about taking metformin during pregnancy or if you are trying to become pregnant. Also, metformin is passed through milk in breastfeeding mothers. Talk with your doctor about metformin use if you are a nursing mother.
Does polycystic ovary syndrome (PCOS) put women at risk for other health problems?
Women with PCOS have greater chances of developing several serious, life-threatening diseases, including type 2 diabetes, cardiovascular disease (CVD), and cancer. Recent studies found that:
More than 50 percent of women with PCOS will have diabetes or pre-diabetes (impaired glucose tolerance) before the age of 40.
Women with PCOS have a four to seven times higher risk of heart attack than women of the same age without PCOS.
Women with PCOS are at greater risk of having high blood pressure.
Women with PCOS have high levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol.
The chance of getting endometrial cancer is another concern for women with PCOS. Irregular menstrual periods and the absence of ovulation cause women to produce the hormone estrogen, but not the hormone progesterone. Progesterone causes the endometrium to shed its lining each month as a menstrual period. Without progesterone, the endometrium becomes thick, which can cause heavy bleeding or irregular bleeding. Over time, this can lead to endometrial hyperplasia, when the lining grows too much, and cancer.
I have PCOS. What can I do to prevent complications?
Getting your symptoms under control at an earlier age can help to reduce your chances of having complications like diabetes and heart disease. Talk to your doctor about treating all your symptoms, rather than focusing on just one aspect of your PCOS, such as problems getting pregnant. Also, talk to our doctor about getting tested for diabetes regularly. Eating right, exercising, and not smoking also will help to reduce your chances of having other health problems.
How can I cope with the emotional affects of PCOS?
Having PCOS can be difficult. Many women are embarrassed by their appearance. Others may worry about being able to get pregnant. Some women with PCOS might get depressed. Getting treatment for PCOS can help with these concerns and help boost a woman's self-esteem. Support groups located across the United States and on-line also can help women with PCOS deal with the emotional affects.
For More Information...
You can find out more about PCOS by contacting the National Women's Health Information Center (NWHIC) at 1-800-994-9662 or the following organizations:
National Institute of Child Health and Human Development (NICHD), NIH, HHSPhone: (800) 370-2943Internet Address: http://www.nichd.nih.gov/womenshealth
American Association of Clinical Endocrinologists (AACE)Phone: (904) 353-7878Internet Address: http://www.aace.com
American Society for Reproductive Medicine (ASRM)Phone: (205) 978-5000Internet Address: http://www.asrm.org
Center for Applied Reproductive Science (CARS)Phone: (423) 461-8880Internet Address: http://www.ivf-et.com
InterNational Council on Infertility Information Dissemination, Inc. (INCIID)Phone: (703) 379-9178Internet Address: http://www.inciid.org
Polycystic Ovarian Syndrome Association, Inc. (PCOSA)Internet Address: http://www.pcosupport.org
The Hormone FoundationPhone: (800) 467-6663Internet Address: http://www.hormone.org
Visit #1
We are choosing to work with Shady Grove Fertility Center. They have a very good reputation and have centers all over Maryland. It just so happens that one of them is about 5 minutes from our house. Our Dr. is Dr McKeedy and our Nurse's name is Dana.
We both were a little anxious going to this appointment because neither of us were quite sure what to expect. I was very impressed with both Dr. McKeedy and Dana. They were very professional and very down to earth. We met with the Dr first and he listened as we told our histories. He then said something I have been waiting to hear for years. I had always expected it and self diagnosed myself but no doctor previously had ever "labeled" me. He told me it sounds as though I have PCOS (poly cystic ovary syndrome). He went on to explain tons of things to us. I wish I could have taped him because he told us so much and it was such good information but I can't remember it all. He explained to us what happens in PCOS and why it causes infertility. He explained what our course of action would be after this and also said he doesn't think at this point that it will be something severe that we would make it as far as considering IVF (invitrofertilization). Of course he can't know that for sure at this point. They deal with many cases like this and he referred to me as young several times through out conversation. I joked with him that my son reminds me how OLD I am and he laughed and said compared to the age group of the patients he sees, I am young.
We talked about the past treatments I had received as far as medication regimen. Previously I had been put on Clomid (stimulate ovulation) and Metformin (which is an anti-diabetic and since insulin resistance plays a part in PCOS it helps fertility). Dr. McKeedy said that in the past the two were given together but recently they found that success rate is better just with starting clomid alone first. Before we would even proceed with medications he wants to do a panel of blood tests/hormone levels on me as well as a procedure he described as painful to ensure that my Fallopian tubes are not blocked. Apparently they will shoot some kind of dye into my uterus in order to do that. Then with Glenn they will want to do blood work and semen analysis. None of this can start though until we are preapproved by the insurance. We should hear something from them in 8-10 days. Then I can go in and they will induce my period and on the third day I can have all the above tests. So here is the first of what I'm sure will be many more "waiting games." As soon as I will know....you will know.....
At one point Glenn and I were sitting in the office alone and he looked over at me with tears in his eyes. I asked him why he was crying. He said he was really excited. I am too but I am so cautious and tend to be pessimistic about this whole ordeal. I don't know what the future brings but I remember all to well what it is like to look at negative pregnancy tests over and over and over....hopefully this time will be different......
We both were a little anxious going to this appointment because neither of us were quite sure what to expect. I was very impressed with both Dr. McKeedy and Dana. They were very professional and very down to earth. We met with the Dr first and he listened as we told our histories. He then said something I have been waiting to hear for years. I had always expected it and self diagnosed myself but no doctor previously had ever "labeled" me. He told me it sounds as though I have PCOS (poly cystic ovary syndrome). He went on to explain tons of things to us. I wish I could have taped him because he told us so much and it was such good information but I can't remember it all. He explained to us what happens in PCOS and why it causes infertility. He explained what our course of action would be after this and also said he doesn't think at this point that it will be something severe that we would make it as far as considering IVF (invitrofertilization). Of course he can't know that for sure at this point. They deal with many cases like this and he referred to me as young several times through out conversation. I joked with him that my son reminds me how OLD I am and he laughed and said compared to the age group of the patients he sees, I am young.
We talked about the past treatments I had received as far as medication regimen. Previously I had been put on Clomid (stimulate ovulation) and Metformin (which is an anti-diabetic and since insulin resistance plays a part in PCOS it helps fertility). Dr. McKeedy said that in the past the two were given together but recently they found that success rate is better just with starting clomid alone first. Before we would even proceed with medications he wants to do a panel of blood tests/hormone levels on me as well as a procedure he described as painful to ensure that my Fallopian tubes are not blocked. Apparently they will shoot some kind of dye into my uterus in order to do that. Then with Glenn they will want to do blood work and semen analysis. None of this can start though until we are preapproved by the insurance. We should hear something from them in 8-10 days. Then I can go in and they will induce my period and on the third day I can have all the above tests. So here is the first of what I'm sure will be many more "waiting games." As soon as I will know....you will know.....
At one point Glenn and I were sitting in the office alone and he looked over at me with tears in his eyes. I asked him why he was crying. He said he was really excited. I am too but I am so cautious and tend to be pessimistic about this whole ordeal. I don't know what the future brings but I remember all to well what it is like to look at negative pregnancy tests over and over and over....hopefully this time will be different......
6.17.2008
Curiouser and Curiouser.....the tale of our pasts
Glenn and I were recently married, May 17th of this year to be exact. It is a month to the day that I begin this blog. We have had some hard and crazy things happen to us individually as well as together and I will not bore you with all the details.....just what pertains to the purpose of this blog.
My issues with the whole idea of "infertility" began when I was 18. My periods had been irregular for a couple of years at that point and I had some hormonal work up done and the dr told me that I had too much testosterone in my body. He told me and I will never forget these words, "It will be very difficult for you to get pregnant if you ever can at all." I remember going back to my college dorm room devestated and crying because I had always wanted to get married and be a mommy. My irregular periods continued and I went on and off birth control to keep them regular and provera (which made me really sick) to induce them. At one point in my previous marriage I had lost about 50 pounds and my periods started coming regularly for the first time in years. I still never thought about the prospect of having a baby because after taking what seemed like 5,000 pregnancy tests only to have them read negative you start to not even entertain the idea at all. It turns out that I got prenant and carried to term with little issue a healthy baby boy who is now almost 6 years old. After that my husband at the time and I tried again, over and over and nothing worked. I went through medictation regimines and ultrasounds and basal temp taking and nothing came of it. We didn't go as far as we could have with it because I chose another route. I was quite heavy after my first pregnancy so I decided that since losing weight the first time helped that maybe it would the second time as well. My OB was in agreement and so I started the process to have gastric bypass. I was aproved, had the surgery and lost 140 pounds. In the midst of all of that my marriage went bad and I found myself divorced and now remarried. Apparently weight is not the key this time because Glenn and I have not been using protection for over a year and I haven't gotten pregnant. I have only had my period 4 times in the last year.
Glenn had went with his ex wife to some very preliminary testing done on his sperm. It was found that he had lazy sperm. They were together for 4 years or a little more and she never was able to get pregnant .....well not by Glenn anyway. She chose her own route for having children and is now married to the baby's daddy. (I could write a blog on her alone.....grrrrr)
So here we are together now....each of us with our issues and wanting to have children of our own. Glenn has had 3 step sons now and while he is a great daddy to my son, I know he would like to have one of his own and I also would love to be able to give that gift to him.
We have our first appointment at Shady Grove Fertillity Center today. As I understand it, it will be an "intake" of sorts and then we will go from there. I am excited and nervous. They are supposed to be a really great fertility center.
I have gone through many cycles of frustration and hurt at other's being able to have baby's so quickly and easily, teenage mom's who can't support or raise a child or those who I deem "unfit" . I do know this for sure. Ten years from now it will not matter all the tears I cried in the past. What will matter is that no matter how hard we had to fight we did whatever we needed to do to realize our dreams.
My issues with the whole idea of "infertility" began when I was 18. My periods had been irregular for a couple of years at that point and I had some hormonal work up done and the dr told me that I had too much testosterone in my body. He told me and I will never forget these words, "It will be very difficult for you to get pregnant if you ever can at all." I remember going back to my college dorm room devestated and crying because I had always wanted to get married and be a mommy. My irregular periods continued and I went on and off birth control to keep them regular and provera (which made me really sick) to induce them. At one point in my previous marriage I had lost about 50 pounds and my periods started coming regularly for the first time in years. I still never thought about the prospect of having a baby because after taking what seemed like 5,000 pregnancy tests only to have them read negative you start to not even entertain the idea at all. It turns out that I got prenant and carried to term with little issue a healthy baby boy who is now almost 6 years old. After that my husband at the time and I tried again, over and over and nothing worked. I went through medictation regimines and ultrasounds and basal temp taking and nothing came of it. We didn't go as far as we could have with it because I chose another route. I was quite heavy after my first pregnancy so I decided that since losing weight the first time helped that maybe it would the second time as well. My OB was in agreement and so I started the process to have gastric bypass. I was aproved, had the surgery and lost 140 pounds. In the midst of all of that my marriage went bad and I found myself divorced and now remarried. Apparently weight is not the key this time because Glenn and I have not been using protection for over a year and I haven't gotten pregnant. I have only had my period 4 times in the last year.
Glenn had went with his ex wife to some very preliminary testing done on his sperm. It was found that he had lazy sperm. They were together for 4 years or a little more and she never was able to get pregnant .....well not by Glenn anyway. She chose her own route for having children and is now married to the baby's daddy. (I could write a blog on her alone.....grrrrr)
So here we are together now....each of us with our issues and wanting to have children of our own. Glenn has had 3 step sons now and while he is a great daddy to my son, I know he would like to have one of his own and I also would love to be able to give that gift to him.
We have our first appointment at Shady Grove Fertillity Center today. As I understand it, it will be an "intake" of sorts and then we will go from there. I am excited and nervous. They are supposed to be a really great fertility center.
I have gone through many cycles of frustration and hurt at other's being able to have baby's so quickly and easily, teenage mom's who can't support or raise a child or those who I deem "unfit" . I do know this for sure. Ten years from now it will not matter all the tears I cried in the past. What will matter is that no matter how hard we had to fight we did whatever we needed to do to realize our dreams.
Subscribe to:
Posts (Atom)
