had painful periods so my doctor put me on the pill."
Estimates are 20% of women have PCOS. The cause is
unproven; symptoms vary widely but could include infertility (sometimes
the first indication that anything is wrong), hirsuitism (male pattern
hair, even baldness), overweight, lack of cycles, acne, dark skin
spots, and menstrual irregularity. You
may have no periods, or bleed all the time. Both are bad.
Untreated, it can cause various cancers and vascular disorders.
The standard care for adolescents with PCOS, painful periods or
irregularity is to put them on OC's
(oral contraceptives). It makes you bleed "on time." It is
for the doctor, and he can just keep you on OC's during your fertile
years, and hormone replacement after. Guaranteeing a
customer for 30+ years is pretty good. The problem for the patient: the
Pill doesn't treat the underlying PCOS; it trades one set of problems
for another (as explained in this
excerpt below). It may not even offer any relief. It doesn't repair
your fertility. And there are the usual problems with risk and side
(more about that on the rest of our website). But
there is hope.
There are lots of PCOS websites, but Dr. John Lee has
written an excellent article that explains what
causes PCOS, why the common treatments tend to be ineffective, and how
you can overcome it, mainly treating yourself. Check
it out here.
To sum up his points:
- An interesting theory: predisposition to PCOS starts when
conceived. Xenoestrogens (synthetic hormones) are almost
everywhere in our environment
- It is triggered by the usual diet of the teenager: refined
and carbs, animal fat, and generally low nutrition, along with excess
- Chemical castration through artificial hormones is a common
treatment, but attacks the symptoms only
- Natural progesterone administered during the luteal phase,
with nutrition and lifestyle changes, treats the hormone
First of all, you
should learn NFP and chart your fertility symptoms so you know what is
going on. If you take a class, be sure to talk to the teachers so they
know you have (or suspect) this problem. Your charts won't
like the "perfect" ones in the textbook. Don't give up, but keep
charting! It will give you quick feedback on the effectiveness of
treatment. This is valuable data for your doctor, too.
Your mucus symptoms may not be so helpful; in fact, they could be wild
and unpredictable, with mucus all the time and no dryup, or long
patches. Mucus doesn't show ovulation; the BBT
does that. Even in the Billings/OM/Creighton methods of NFP,
allowed when necessary to confirm ovulation even if not used to
determine Phase 3 (post-ovulation infertility). Being STM
recommend a full sympto-thermal charting. Your mucus will return to a
normal pattern when your hormones straighten out after proper
treatment. Meanwhile, your temperature will tell you a lot.
PCOS is a hormonal problem, and your chart indicates the two most
important: estrogen (mucus) and progesterone (temperature).
you get a number of cycles charted, analyze them or have your teachers
analyze them (CCL members can send them in to Central for
interpretation, if necessary). If you have a scanner, set it to
grayscale at 200 dots per inch and e-mail it. It will be
if you aren't ovulating. This happens to everyone
once in a while due to stress or whatever, but shouldn't happen every
Other problems such as luteal phase inadequacy, unruptured follicles,
low progesterone or low
thyroid will also be apparent. (We're looking for a PCOS representative
chart for this page, so if you can, send it to Jim at work,
james.vandamme (at) rl.af.mil, where he's got a high speed connection.)
Effective self-treatment for PCOS consists of some combination of diet
modification, exercise, and natural progesterone. Since everybody's
PCOS is different, you will have to experiment to see what gives you
relief. It won't hurt to try everything to see how well it works. Then
you could slack off on one thing at a time to see if the PCOS comes
Improving your health through diet and exercise is the primary part of
your treatment. The latest edition of the book we go to in cases of
menstrual problems, Marilyn Shannon's Fertility,
, has 2 appendices on the
subject of PCOS. The recommendations of other authorities
look very similar to her PMS diet, which after all is
designed to restore hormonal balance. Shannon's recommendations for
supplements include chromium picolinate and vanadium for insulin
resistance, and flax oil. A small Japanese study (2)
suggests that 750 mg
vitamin C increases
progesterone. Try it and see.
The proper amount of body fat is
also necessary to store the right amount of estrogen. Too much or too
little can cause menstrual and fertility problems, although PCOS is
usually less severe the skinnier you are. The Atkins diet is good for
eliminating carbs and losing weight if needed, but watch the meat fat
and do eat some whole grains and fiber. The Sugarbusters diet is
another good one because it doesn't eliminate any food groups but
reduces sugar intake and restricts a small group of foods. Of course
weight should be adjusted slowly; but exercising and getting rid of
junk food will start to help you right away.
If your chart shows that you are low on progesterone, you can
supplement with natural progesterone cream applied at the right time
in your cycle. Artificial progestin drugs are not as safe or effective.
have to experiment with the amount of progesterone, but the maximum
dose won't be harmful. It simply supplements the hormone you should be
making with the same hormone at the correct time. When using the cream,
wait a couple days
past ovulation as indicated by a temp rise or mucus dryup.
Applied too early, it can prevent
ovulation, so allow your body to try to function normally. Continue it
until day 28, or your usual cycle end, or if you are ovulating, stop 14
days after the first day of temp rise. If you suspect you are pregnant,
it isn't harmful since you are supposed to be making your own
progesterone; but taper it off gradually since stopping abruptly might
cause a miscarriage. Remember, 3 weeks of elevated temperatures after
ovulation is indicative of pregnancy.
Make sure you chart the use of progesterone. Charts are blank on the
back; make good use of that space with notes.
Central has more corporate knowledge on PCOS treatments, but first
learn NFP well, chart, and try the easy stuff.
varies widely in severity, so treatment is an art. It will
become apparent within a few cycles how well a treatment is working.
Getting your hormones to work right is of course the best way to treat
PCOS, but don't expect your doctor to be your dietician or personal
It's worth it to find a NFP only doctor, who can use your chart as a
valuable tool for diagnosis and treatment. If you have your hormone
levels tested, it has to be at the proper time in your cycle to be
accurate, and of course they change over your cycle. Your temp chart
indicates relative levels of progesterone, but you may need a blood
test to find out if your progesterone is adequate in your luteal phase.
If you do use OC (birth control pills) as a last resort to try to get
some relief, the effect on your
cycles will vary widely depending on the type of pill. Some pills do
not suppress ovulation, and the temp chart will show this; they are
also abortifacient if you do conceive during one of these
ovulations. Perhaps the standard phase 1 rules for avoiding
conception will prevent this, but no one is sure.
Your doctor might put you on Glucophage (metformin) to see if that
your hormones by fixing your insulin sensitivity. In theory, the
hormonal imbalances that cause the PCOS also, in turn, cause
insulin resistance. Insulin
blockers prevent ovulation which causes the pituitary
gland to continuously try for another ovulation, unsuccessfully,
resulting in cystic follicles. Metformin works to inhibit the insulin
blockers. This may restore ovulation. Treating the insulin resistance
also addresses a dangerous symptom, although you can have PCOS and not
have insulin resistance.
At the Pope Paul VI
Omaha, headquarters of the Creighton Method of NFP, they do ovarian
wedge resection for severe cases, and natural progesterone therapy for
others. You may be able to find a local Creighton/NaProTech doctor to
help you. Resection cuts the ovary down to a manageable size while
leaving fertility intact. This alleviates the pain and removes the risk
of rupture and emergency surgery. Zapping the ovary through a small
incision with diathermy or lasers is also an option, but usually less
effective. Removal of the ovaries is not
necessary and would immediately put you into menopause.
Other good links
Kat Carney (Health reporter
for CNN) is a
pretty good place for camaraderie
Fellow sufferers, who tend to be very well-informed
has a PCOS
FAQ of 116 questions, including tables of what your blood work levels
should be, but they're still stuck on using OC's
Your comments are solicited: use the "contact" button above or write us
at vandamme (at) juno dot com.