BIRTH CONTROL AND PCOS

 
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By Julia

Birth control pills or oral contraceptive pills are often prescribed for women who are suffering from polycystic ovarian syndrome or women who tend to have hyperandrogenism, which is an excess of male hormones. All women typically have male hormones, such as testosterone, naturally, but in deficient concentrations.

Because of this excess of male hormones, a series of symptoms and complications of PCOS can occur. Treating hyperandrogenism with birth control can alleviate some of the most uncomfortable symptoms of Polycystic Ovarian Syndrome (PCOS) or Polycystic Ovarian Diseases (PCOD.)

Combined Hormonal Contraceptives

By supplying combined hormonal contraceptive pills, the problems of hyperandrogenism are reduced because the pills help in a number of ways:

● By introducing estrogen, the production in the liver of sex steroid transport globulin (SHBG) increases, thereby decreasing the amount of free testosterone.
● On the other hand, the hypothalamus reduces the release of gonadotropin-releasing hormone (GnRH), decreasing the levels of LH which in turn causes the ovary to stop producing androgens.

For these reasons, the administration of hormonal contraceptives is one of the first therapeutic options for women with a polycystic ovarian syndrome.

Choosing the Right Pill for PCOS

Choosing the right contraceptive pill for PCOS can be a challenge because the variety of contraceptive pills available may seem overwhelming. Fortunately, they can be classified into just a few categories, which make it easier to evaluate your options. The choice of the most appropriate contraceptive depends mainly on the general health of the woman, her age, and her doctor’s decision.

There are two main types of birth control pills: combined contraceptive pills, which contain estrogen and progesterone, and the mini-pill, which only contains progestin. Combination contraceptive pills are also classified according to whether the hormone dose remains the same or varies:

● Single-phase: In this type of combination contraceptive pill, each active pill contains the same amount of estrogen and progestin.
● Multiphasic: In this type of combination contraceptive pill, the amount of hormones in active pills varies.
Also, combined oral contraceptives can also be classified according to the concentration of estrogen, with ethinylestradiol being the most widely used estrogen today. The combined oral contraceptives are subdivided into two groups: high dose and low dose.
● The high doses are also called macrodoses and are those in which the concentration of ethinylestradiol is higher than 50 ugs in each tablet.
● Those of low dose are subdivided into microdoses if the ethinylestradiol concentration is between 30 and 35 ugs per tablet.

High doses vs. low doses

It is essential to keep in mind that even the lowest dose of estrogen can be effective in preventing pregnancy and is less likely to cause side effects such as bloating, weight gain and mood swings. On the contrary, high doses increase the risk of irregular periods instead of reducing it. On the other hand, low and very low levels of estrogen are associated with a risk of intermenstrual bleeding that can cause some women to stop taking it.

Progestin-Only Options

The progestin-only pill is often called a “minipill.” It may be prescribed for young and adult women experiencing abnormal menstruation, who can’t take estrogen due to an underlying medical condition. Although progestin-only pills can produce side effects, particularly bleeding or spotting between periods, the side effects often improve or disappear after a few months.

The Bottom Line

PCOS can be treated using a variety of options. If you suspect you’re dealing with PCOS or are desperate to figure out how to manage PCOS, you should see a medical doctor as soon as possible. The longer you leave your PCOS untreated, the worse it will become.


You can see all of Julia’s posts here.

Metformin for the treatment of PCOS

 
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DID YOU KNOW? Most people don’t need sugars in their diet to maintain a healthy blood glucose level (unless you are hypoglycemic or diabetic). This is because your liver can create glucose on its own to be released in the blood to keep you healthy. Understanding this concept is essential for understanding the role Metformin plays in your PCOS treatment.

Metformin, also known as Glucophage, is a medication commonly used in the treatment of type II diabetes and blood sugar regulation disorders, such as Polycystic Ovary Syndrome. It inhibits the production of glucose in the liver (glucose = a kind of sugar and the fuel of all your body’s cells) and increases insulin sensitivity (insulin = the hormone that tells your body to open up an accept the fuel; if that fuel can’t be used, this hormone is also responsible for fat storage). Metformin is of great utility in non-diabetic women who have PCOS and has demonstrated long-term improvements in weight loss, ovulation, period regularity, hair loss, and body hair growth. Metformin is also effective at helping ease the intense sugar cravings associated with disorders of insulin resistance, such as PCOS and type II diabetes.

DID YOU KNOW? Contrary to popular belief, Metformin DOES NOT lower the impact foods you eat have on your blood sugar. Instead, Metformin tells your liver to stop making sugar (glucogenesis) in response to your body’s signals related to its insulin resistance. This means that you cannot get away with eating more sugar just because you’re on this pill; taking more of it in response to poor dietary choices will probably only make you feel sicker.

A glucose tolerance test is done before you start metformin. In most patients over 17 years old, the usual starting dose is 500 mg a day, which is increased to twice a day and then increased to 850 mg, twice a day. The first dose is taken in the morning after breakfast and the second at night, after dinner. Doses increase until you reach the maximum dose of 2500 mg per day.

DID YOU KNOW? 2000 mg – 2500 mg a day is considered a prophylactic dosage – meaning it will help prevent PCOS from progressing rather than curing it. This often exceeds the dose given to type II diabetics!

Side effects
Metformin is a modern wonder drug but the side effects can be daunting, particularly when you first start taking it. This is medication women with PCOS stop taking on their own against their doctor’s advice because it is not a pill you can feel working instantly. It is not psychoreactive (there’s no high associated with it) and it prevents the onset of worsened disease rather than curing something. This means that the positive effects are not always obvious to the person taking it, making it often difficult to justify enduring the side effects.

DID YOU KNOW? You need to build up a tolerance to this medication in your liver before the side effects will diminish. If you start and stop only to start again, you will be met head on at every false start with the full impact of these side effects!

The most common side effect that patients experience when they start metformin are stomach upset and diarrhea. These symptoms are most acute when you begin your Metformin regimen and they generally subside when you achieve tolerance to the medication. Tolerance usually sets in about a month after you’ve reached the full prophylactic dosage.

You may experience a relapse of these negative side effects if you eat a meal high in simple sugars or fructose. This is similar to the “dumping syndrome” experienced by bariatric weight loss surgery patients. Believe it or not, this is a signal that your Metformin is doing a good job of sensitizing your liver to the sugars in the food you eat. These foods may also begin to change flavor – and certain hyper sweet foods may even start to taste bad to you!

DID YOU KNOW? Dietary changes are a MUST whenever you start a Metformin regimen to best avoid digestive problems. A low carbohydrate diet low in processed convenience foods, in combination with your Metformin, is generally your best bet for defeating sugar cravings and getting your health back on track.

Other side effects are headache, weakness, intestinal gas and abdominal pain. These symptoms can be relieved by taking the medication with a meal. Talk to your doctor about switching to the time released version of this medication if the symptoms persist after tolerance is reached. The time released version is called Metformin ER and it is often much easier on your digestion than the instant release pill form.

Metformin with other treatments
Metformin can be used successfully in combination with other. Spironolactone (Aldactone) is another medication commonly prescribed in combination with Metformin for the treatment of PCOS. The success of metformin treatment increases when patients follow a healthy diet. Since obesity is a common symptom of polycystic ovarian syndrome, many doctors pair their patients with a nutritionist. Regular exercise helps lose weight and improves overall health because it helps the Metformin do a better job of sensitizing your body to glucose in the blood.

In conclusion, Metformin constitutes a fundamental, almost universally accepted treatment in patients with PCOS in any clinical presentation. Metformin regulates the menstrual cycle and induces spontaneous ovulation, thereby increasing fertility and overall health in the process.

DID YOU KNOW? Metformin presents benefits for improving metabolic syndrome, blood glucose levels, total cholesterol, LDL (bad cholesterol), and blood triglycerides. While you may not see or feel it working for you, you are reducing your heightened risk of cardiovascular diseases and other PCOS complications by taking this pill.

Do you have questions about Metformin or PCOS? We highly recommend talking to your doctor or an Endocrinologist (hormone specialist) to discuss possible diagnosis and treatment options. PCOS is often a diagnosis of exclusion because its symptoms mirror so many other possible conditions – such as Cushing’s Syndrome, hypothyroidism and Hashimoto’s Disease. Working closely with a doctor you trust is an essential part of achieving a correct diagnosis. Your doctor will probably want to rule out these other conditions first before prescribing Metformin or any other treatment to you.

Stay tuned for next week’s installment: Spironolactone

Legal Disclaimer


This article contains general information about medical conditions and treatments.  The information is not medical advice and should not be used to replace the advice of a trained physician. If you have any suspicion that the information in this article may apply to you, be sure to contact your doctor for more details!
References

https://www.healthline.com/health/polycystic-ovary-disease
http://www.acog.org/~/media/For%20Patients/faq121.pdf?dmc=1&ts=20120510T1116545699
http://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001408


You can see all of Jesse’s posts here.

The Hottest (but really coolest) Wigs of Summer: Part Three

 
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Last week, I shared ten of the CysterWigs team’s favorite summer wigs. Now it’s time to reveal the final five picks. You probably know everyone by now, so I’ll spare you the clever intros. Let’s just get to the meat…or meat substitute of this post.

Kathleen had Isla by Tony of Beverly  on her list of summer picks. I can see why. This look is smoooooking hot and not for the shy…or maybe it is if you’re looking to bust out of your shell!

Isla by Tony of Beverly is a chic bob with amazing layering, a ready-to-wear, 100% hand-tied lace front and a unique cap design. Not only is this a sultry, modern look, but it’s also comfortable to wear. Another reason why it’s a must — it features lighter and more stretchable elastic around the entire cap for a more custom fit. That means the cap will mold to the shape of your head. And the best part is that Isla is available in 44 shades. So go ahead and try one in a summery color like Sangria, Malibu, Seashell or Sunset Red.

Nancy had Winner by Raquel Welch on her short list of short styles. This wig happens to be a best seller for the brand. This ready-to-wear style is a textured cut that’s easy to style and comfortable to wear.

This wig is probably a best seller because it’s known to be flattering on almost every face shape. It also comes in a wide variety of colors. Nancy said she comes back to this one year after year. It’s totally understandable because Winner is a light wig that looks beautiful and breathes well. It’s also ready to wear and requires virtually no maintenance or styling whatsoever! It’s the perfect choice for parties, weddings or even just sitting on your patio and relaxing. No matter what summer brings, you’ll always look like a winner in this wig.

So for these last two picks, I’m going to toss my own suggestions into the ring.

My first pick is Sarah by Jon Renau. Why this one? While I haven’t tried it personally, I saw it on our fearless leader, Heather, in a recent color spotlight video. Heather does this mermaid/pinup girl hair flip in the video, and the hair just looked so natural and beachy. The curls sprung back into place effortlessly and the color was beautiful. I figured I’d toss this one out there for those of you who love longer hair even in warmer weather.

Sarah features high-end, 100% hand-tied monofilament cap that is stretchy, comfortable and lightweight and an 100% hand-tied SmartLace front. This wig is also available in Jon Renau’s new California Blonde Collection colors. To me, this is flower crown hair. I can see a flower crown or a pretty jeweled headband on this one. Or if you want to keep things simple, you can switch up the part or even pin it back.

Now my second pick is one that I’ve actually tried out and liked — a lot. It’s Rae by Rene of ParisI’m not trying to act like an expert or anything. I’m still a noob (newbie) to the wild and wonderful world of wigs. But I got my hands on this one in Pastel Blue-R and I had fun wearing it.

Rae  is a saucy girl. If you’re not afraid of pastels or vibrant colors, give this one a whirl. Rae is an A-line cut with a tapered nape and loose wavy layers that frame the face to the chin. She features a 100% hand-tied lace front and monofilament part that makes styling easy. Now to be completely up front, I wore this in the comfort of AC and my sports bra. Just keeping it real! I always run hot year-round, so I was surprised that this one didn’t make me feel itchy or sweaty after two seconds. I loved the color and shine of the hair, too. As for styling, I just shook it out, put it on and scrunched it up with my hands. As I played with it, the style took shape and I could even picture other looks for the wig — pinned back, tied back with a shorter scarf or accented with some small braids around the face. I plan to wear her out soon really to prove to myself that I can be sultry and daring anytime.

There you have it. Five more wigs to consider for the summer. I hope the team’s picks have been helpful or have inspired you to find a new look for the warmer months. And if you’re feeling a little meh about our picks, no biggie. Feel free to share what has worked for you when the temperatures start to rise. Anyway, have a great summer and no matter what you decide to wear, just make sure you wear it proudly.

Hugs and high fives.

Snaps and wig caps,

devon the social media fairy

About PCOS.

 
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Originally Posted on May 10, 2015 by Heather Hershey

I recently received an email from a YouTube subscriber who wanted to know more about PCOS. I thought this might be great info for anyone who wondered why we put the “Cyst” in CysterWigs!

Hi Heather,

I just saw your channel and, specifically, your YT Vid about the giveaway. What I am curious about is what is PCOS?  

PCOS: Polycystic Ovary Syndrome (sometimes also called PolyCystic Ovarian Syndrome or Stein-Leventhal Disease).

PCOS is a chronic (meaning there is no cure and it develops over the course of many years, perhaps as the result of lifestyle variables or environmental factors), systemic (meaning it effects multiple body parts and systems, and sometimes even the whole body), syndrome (meaning that it is a collection of multiple typical symptoms as part of a cluster; no two women experience the same symptoms in the same way).

Please see my commentary here for a detailed explanation of what PCOS isn’t:

PCOS is not caused by cysts on the ovaries. In fact, cysts on the ovaries are not even diagnostic for all women, as a large percent of women with this disorder don’t even have the cysts. In fact, women can still have PCOS after undergoing a full hysterectomy – so the name is a misnomer.

This is a chronic disorder and at this time there is no cure. Once you have it, you will ALWAYS have it, regardless of how much weight you lose or what kind of diet or medication you’re on. A diagnosis of PCOS means that you will have to manage the disease your entire life – even after the onset of menopause. 

This disease used to be called Stein-Leventhal Syndrome and for a long time doctors thought that removing part of the ovary would cause a cessation of symptoms. This treatment, however, only worked some of the time. That is because this isn’t an ovary issue; It’s a hormone issue. This is a bad thing because hormone issues are much more difficult to treat and understand. In fact, many doctors don’t know anything at all about this disease and think that birth control pills and a diet can cure it. I WISH! 🙂

PCOS is a systemic metabolic hormone disorder, with the principle hormone in question actually being insulin. Insulin creates havoc in women with PCOS and causes weight gain. The fat cells are, in and of themselves, hormone producing and the hormones generated by the fat cells interact with the ovaries and create imbalances of testosterone, estrodial, progesterone, thyroid, and many other hormones…and can often lead to even more irregularities with insulin on top of all that! This often leads women with PCOS, especially those who are a little older like me, to feel like they are on a roller coaster where progress seems to come in small doses with severe rebounds and set backs. 

Insulin biology is a hard thing to overcome, even with medications, diet, and will power. Treating it like a gynecological disorder or a fertility problem (PCOS is the #1 cause of female infertility in the Western world) may help deal with some of the symptoms, but doesn’t address the underlying cause. 

This is why I always recommend that women with PCOS seek out the opinion of a qualified endocrinologist in lieu of a gynecologist or general practitioner. This is a very complex disorder that affects many different systems within the body and the only kind of doctor qualified to treat hormone disorders is a hormone specialist – an endocrinologist. 

Just a little food for thought!

In addition this, another important nugget of info about PCOS are the symptoms. Here, is a fairly comprehensive list of the most common ones, with an asterisk (*) next to any that I have, just in case you are curious:

 – Missed periods/abnormal periods*

– Very heavy periods that last a very long time* (both of these symptoms are just different flavors of a common PCOS symptom called amenorrhea)

– Hirsutism (excessive hair growth in funny places, like the face)

– Cystic acne*

– The classic “string of pearls” ovarian cyst presentation apparent during a pelvic ultrasound

– Rapid, mysterious weight gain that does not correlate with a change in eating patterns*

– Rapid, mysterious weight loss that does not correlate with a change in eating patterns

– Obesity*

– Vitamin D deficiency*

– Infertility* (PCOS is the #1 cause of female infertility in the US. In fact, many women don’t even know they have it until they try to conceive (TTC).) 

– Sharp pelvic pain 

– Male pattern baldness* (androgenic alopecia)

– Female pattern baldness* (also called androgenic alopecia, but present as a more diffuse hair loss throughout the scalp)

– Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black, can be fuzzy and soft like felt or kind of rough and scaly

– Skin tags

– Pelvic pain* (generally sharp, stabbing pain – but if you experience this symptom see a gynecologist ASAP because it could be a number of other things!)

– Depression and/or anxiety* (Could, again, be caused by other things such as environmental factors; it’s usually just something made worse by PCOS due to hormone fluctuations.)

– Sleep disturbances without any obvious cause* (insomnia is common in women with PCOS)

– Excess fat deposits in androgenic placement*: upper arms, middle or lower abdomen, upper back; instead of female placement: breasts, hips, butt, thighs. (FTR: I have both; what this really just means is that a big belly is usually abnormal fat placement for women, who tend to store fat in the boobs, butt, and thighs.) 

– Strange, spontaneous reduction in breast size*

– Deepening of the voice

– Faster and more intense fight or flight response and/or decreased impulse control and/or anger management (from hormonal fluctuations)

– Elevated blood glucose levels*

– Type II Diabetes (Diabetes Mellitus); PCOS is often a precursor to T2D and most women with PCOS will become diabetic during their lifetimes

As you can probably tell, PCOS symptoms can be caused by a LOT of other issues, ranging from the psychological to the infectious. Because of this, PCOS is notoriously hard to diagnose. It is a diagnosis of exclusion. If a doctor diagnoses you on sight, or without testing your blood or a pelvic ultrasound, then seek a second opinion. This diagnosis should not be given lightly.

You don’t need to have polycystic ovaries to have PCOS. The symptoms coupled with any of these can be diagnostic all on their own…

 – Excessive testosterone in the blood

– Odd ratio of luteinizing hormone (LH) to follicle stimulating hormone (FSH) in the blood*

– Pre-diabetes and/or insulin resistance*

 

Left untreated, PCOS can eventually lead to:

– Infertility

– Diabetes Mellitus

– Hypertension

– Stroke

– Heart Attack

– Coma

– Death

This is a chronic disease that disables and kills very slowly…as in, over the course of several decades in most cases. Because of that, it is easy to take it for granted until it’s too late.

If you suspect you have PCOS, then it’s a good idea to seek a competent specialist in the disorder. I recommend going to an endocrinologist in your area…and NOT a gynecologist or general practitioner. This is a complicated hormone disorder and requires a lot of very specialized training in hormones to truly understand. Who better than an endocrinologist (AKA: Hormone specialist)?

PCOS should NEVER be self-diagnosed because so many other disorders could case the same symptoms…and some of those disorders can be immediately life-threatening, including untreated hypothyroidism.

Word to the wise: finding a doctor who is well read on this disorder and knows what they are talking about can be VERY difficult. Be prepared to visit several doctors until you find one who takes your symptoms seriously and is up to date on the latest PCOS research. A LOT of new information has come out about this disorder in the last decade alone!

I have been diagnosed with Hypothyroid and also have, what I thought was, male patterned baldness, but I have other symptoms as well that have not been diagnosed and am trying to find answers.  I was investigating going on hormones, when I came across your channel.

If you are being treated for a clinical (as opposed to a “subclinical” – IE: tests come back normal yet symptoms, such as lethargy, are still present) case of hypothyroid, then you are probably already on hormones! Lots of women with PCOS also have insensitivity to TSH and T3. It is common for these conditions to be comorbid (as in, they occur together). A competent endocrinologist should be able to help you with both of these chronic conditions. 🙂

For the record: alopecia can also be caused by hypothyroid.

If you are seeing an endocrinologist for hypothyroid, then ask them about PCOS during your next appointment. If you are NOT seeing an endocrinologist for hypothyroid…then this might be something to consider. Thyroid issues are hormone issues, and again, my advice is to seek a hormone specialist for it. 🙂

If you are diagnosing yourself – then I urge you to stop.

These are very complicated disorders that can impact various body symptoms. Heck, most trained doctors don’t even know much about these diseases, as the jury is still out about the causes. They are still debating the name and classification of PCOS, for crying out loud!

However, I urge you to see a doctor. Seriously. Either of these conditions can be very serious if not handled properly. Like I hinted at earlier, untreated hypothyroid can cause problems with your heart (the same can also be said for hyperthyroid) and should be considered potentially life-endangering. Take it seriously and see a doctor if this is a self-diagnosis!

But, again, what I want to know is, what is PCOS? And what are the things you pointed to on the under side of your jaw at the chin.

That was cystic acne. Cystic acne is very much unlike the regular, run-of-the-mill breakouts most people get during puberty. Cystic acne occurs much deeper under the skin and is caused by hormones, so no level of exfoliation or cleanliness can stop it. (Though I spend a small fortune on topical stuff and good concealer anyway to try to minimize it’s appearance.) This type of acne presents in large round bumps that are often warm to the touch, very inflamed, and quite painful. Mine also itch when they come in. Spironolactone (Aldactone) is usually prescribed to women with PCOS who have this issue. In my case, I’ve found that it really helps a lot! Even still, I still get the cysts. The only difference now is that I get one or two at a time in stead of a “Beard of Acne” (that’s really what it’s called!) that is typical of women with PCOS.

Now you know!

– Heather

Hormones are freaking weird.

 
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Originally Posted on November 20, 2013 by Heather Hershey

And, might I add, hormones are also a huge pain in the you-know-what!

I was out of my prescriptions for spironolactone – a.k.a. aldactone – and metformin and lazy about refilling them for about a week.

Both of these pills are commonly prescribed to ladies with PCOS. The metformin controls two things: the amount of glucose created in the liver that is pumped into the blood stream and the sensitivity of body tissues to that glucose. Aldactone is a water pill that helps with bloat, but is also a testosterone antagonist, meaning that it minimizes the impact of androgens in women with PCOS related acne and hair loss.

So, if you can imagine, this was a generally bad lapse in judgement on my part.

I had epic cravings and epic bloat for that entire week. I returned right back to my original powerful lust for refined sugar. (It certainly doesn’t help that everything pumpkin is in season right now. I never met a pumpkin spice cake I didn’t like. Cream cheese frosting? UMDUHYESPLEASE.)

I could feel myself getting puffier.

I gained nine pounds in one week. This sounds really impressive, but I wasn’t eating any more than usual calorically. I WAS, however, eating a sh’load more carbs than I normally do.

This was clearly a big problem (no pun intended).

I filled my script and began taking my meds again STAT.

I lose five pounds in two days! This is an even more impressive finding. My tummy is flatter and the cravings are completely gone.

The moral of this story is: Remember to fill your PCOS prescriptions early and, if they are working for you, keep taking them.