I feel like I am in a different boat than many of the people I see on this site and on the forums. I am 40, I was diagnosed about 6 years ago with PCOS and I am not trying to conceive. My symptoms started after I had my daughter 15 years ago and I had two miscarriages when she was two. My Dr. at the time refused to look into it and told me to keep trying…I gave up because I was too devastated and then a divorce followed so it wasn’t a good thing for me. At 40, I don’t want to have more kids, I don’t care so much about my fertility, though I do understand that it is part of my normal body functions. I was taking YAZ and Spironolactone. the YAZ was helping with my symptoms, but my periods never returned. (I always had very painful heavy ones, so I was happy they were gone). Recently my MD took me off the YAZ due to high blood pressure and started me on metformin (previous MD never offered this). Now my cycles have started back where they left off. I am back to two weeks of cramps and PMS and then a full week of heavy bleeding.

I just started the Insulite PCOS system yesterday, so it is too early to tell what will happen here, but do you think it will help with the painful and frustrating periods?

What do you recommend for me at this point where fertility is not something I want? I have read elsewhere that hysterectomy will not remove PCOS symptoms?

I have scheduled an appointment with a natural medicine/chinese medicine/acupunture Dr. in the Seattle area (also a graduate of Bastyr)who is also a friend/former co-worker of mine.

I am severely frustrated and angered by my PCOS as it really affects my quality of life and I know my weight is also an issue, but hoping with the Inuslite system and more energy that I can work on this too.

Any feedback about the issues faced by being over 40 and at the later stages of my fertility would be appropriated.

Dear Laura,

Thank you for writing into the PCOS Support Blog. These are great questions.

First, we understand that not all women with PCOS are trying to conceive. Many women are not interested in having more or any children.

Although it affects fertility in many cases, PCOS is an endocrine disorder. It is our goal to address the underlying cause, insulin resistance, that will further affect other hormones that will affect ovulation, and cycles and other symptoms related to PCOS.

So in fact, even though we do want more balance of hormones associated with reproduction (estrogen, progesterone, testosterone) and elevated insulin and/or glucose, we also know that imbalances affect symptoms of PCOS, excess facial and body hair, acne, increase risk for obesity, cardiovascular disease and diabetes. We can then see imbalances in other areas as well such as adrenal hormone production and thyroid function. So in fact, we are trying to be comprehensive in the approach to PCOS, but we hear from many women whose goal is to conceive.

The metformin will decrease glucose and insulin levels but often if other lifestyle changes are not being made, then you are continuing the same pattern. You did mention this. Exercise is going to help even if it is a 5 minute walk after lunch or dinner.

Also, you can start with the nutrition changes as these will be necessary for long term control of symptoms. You are right, it is frustrating however, I feel that you are taking some really positive steps in seeking help from someone you can work with in your area as well as committing to the Insulite PCOS System.

I am glad to hear that you have chosen to use the PCOS System and recommend that you take it with you to your appointment. This way, if at some time there are modifications that need to be made, your doctor will have the information needed.

Now, for your other questions and possibly the most important. You are correct. Initially we don’t know how the pain and cramping will be impacted by the System but I have had many women report that cramping and pain have decreased. With that, the amount of cysts that are present and if there are any other reasons for this, may need to be addressed.

This will be an area that your doctor can help address if it does not decrease. There are many herbs and treatments that can help as you work through all of this.

Hysterectomies only remove certain symptoms but many times other symptoms continue and the other risks are not changed with a partial or complete hysterectomy. Hormones are produced in several places in the body: the ovaries, the adrenal glands, and even in fat cells! Simply removing the uterus, cervix, or ovaries may have some effect on the hormone imbalance, but not necessarily. Removal of these organs would not affect the insulin resistance.

So, my advice is to continue working to address the insulin resistance, find ways to get some exercise in your life, continue making nutrition changes that support reducing insulin levels and work with appropriate practitioners who will also support the goals and the treatment of PCOS. You are already doing some of these and getting ready to start the others. You are on the right track, Laura so keep it up. We understand the frustration women experience but we hope that we can encourage you to continue through it all in order to change how your body responds.

I hope that this helps and wish you the very best. Please keep us posted and feel free to write in at any time.

–
Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Consulting & Advisory teams

DISCLAIMER: The information contained in this email
and the Insulite Labs website is for the sole purpose
of being informative. This information is not and
should not be used or relied upon as medical advice.
Always seek the advice of your physician, nurse or
other qualified health care provider before you
undergo any treatment, take any medication,
supplements or other nutritional support, or for
answers to any questions you may have regarding a
medical condition.

Dear Angelina,

Thank you for writing into the PCOS Support blog.

It sounds like you were diagnosed with insulin resistance, in that you are producing insulin, maybe too much and that your body is not as sensitive to it. This can lead to weight gain. It can also lead to hormone imbalances.

Insulin resistance vastly reduces the insulin sensitivity of cells, which impairs the processing of glucose through the cell wall for conversion to energy. As a result, glucose remains in the blood stream, causing elevated levels of blood sugar, some of which is sent to the liver. Once there, the sugar may be converted into fat and stored via the blood stream throughout the body. This process can lead to weight gain and obesity, key factors in creating PCOS.

Sometimes insulin resistance results in high blood sugar, sometimes in low blood sugar, and sometimes there is no change whatsoever in blood sugar levels. I think this probably depends on how long the person has been insulin resistant, among other things. Like many things, developing insulin resistance was probably a combination of environmental and genetic factors.

Here are the tests that are commonly used to diagnose PCOS along with symptoms (irregular/absent periods, weight gain, acne, excess facial and body hair, etc.):

- testosterone- elevated in PCOS

- DHEA-S- elevated in PCOS

- fasting insulin- elevated in PCOS. Some doctors may hesitate to order this test because the normal range (0-20) is so wide. However, we find that results greater than 9 indicate Insulin Resistance. insulin resistance is usually the underlying cause of PCOS, as you may have read about on our site.

- fasting glucose or glucose tolerance test- elevated in PCOS. Using this information in combination with the fasting insulin helps to diagnose insulin resistance. Also, women with PCOS have a higher risk of diabetes so it is important to screen for this early and often.

- LH:FSH- Some doctors may also look at the ratio between these two hormones. In PCOS, we would expect LH to be elevated in comparison to FSH.

- You could get an ultrasound to check for the presence of ovarian cysts.

Metformin is used to reduce glucose levels and insulin levels. Some women notice benefits and some do not. What remains crucial is that you also make lifestyle changes. Reducing carbohydrate intake, especially refined and processed foods (pasta, rice, breads, sweets, etc.). Your diet should include a variety of foods but focus on vegetables, lean proteins, healthy fats, and some fruits and whole grains.

You can also consider using the Insulite PCOS System. This is a comprehensive approach to addressing PCOS, cause and symptoms with researched supported supplements and lifestyle changes as well as support while you are on the program. You can read more about this at: http://pcos.insulitelabs.com/

Angelina, regarding the levothyroxine, I cannot make any recommendations on whether or not you should continue, it would be unsafe and unethical, since I am not your doctor and have never seen you as a patient. You should discuss how you are supposed to take it with the doctor who prescribed it for you. It may be that you still need the thyroid support but that the dose may need to be changed so that your TSH (thyroid stimulating hormone) is at a more optimal level. This is what is often measured when looking at thyroid function.

Also, it is not uncommon to see other endocrine problems with PCOS. What I mean is that many women with PCOS can also have other endocrine issues and we see this first when insulin (a hormone) increases and affects other hormones such as reproductive (estrogen, progesterone, leuteinizing hormone, follicle stimulating hormone, testosterone, etc) and thyroid hormone.

Research has shown that for overweight women with PCOS, losing at least 5-10% of their weight increased the likelihood of restoration of regular menstruation. Regular menses means that the woman is probably ovulating, therefore losing weight can increase the chances of becoming pregnant for these women with PCOS.

Focusing on weight loss will help to restore your periods and some other symptoms by helping to control some of the hormone imbalances seen in PCOS, which can positively impact your ability to conceive, when the time comes.

I hope that this provides you with some insight. Please feel free to write in at anytime.

–
Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Consulting & Advisory teams

DISCLAIMER: The information contained in this email
and the Insulite Labs website is for the sole purpose
of being informative. This information is not and
should not be used or relied upon as medical advice.
Always seek the advice of your physician, nurse or
other qualified health care provider before you
undergo any treatment, take any medication,
supplements or other nutritional support, or for
answers to any questions you may have regarding a
medical condition.

Sincerely,
Peggy

Dear Peggy,

Thank you for writing into the PCOS Support blog. I am sorry to hear that you are having a difficult time conceiving.

There are women who do not have insulin resistance but some women with PCOS hyper secrete insulin but do not yet manifest insulin resistance. Furthermore, in many women with PCOS, their ovaries are highly sensitive to insulin, so that even if their serum insulin levels are normal, the ovaries are highly reactive to that insulin.

How did your doctors determine that you are not insulin resistant? The reason I ask is that this is often seen in PCOS, not everyone as you know but often seen in those who are overweight. This is done by looking at fasting insulin levels. However, we have found that a fasting insulin level of about 9 or higher is starting to indicate problems with insulin resistance. For the random insulin, results over 25 or 30 may indicate insulin resistance. Other factors that would make me suspicious of insulin resistance include high blood pressure, difficulty losing weight, skin tags, acanthosis nigricans (dark brown patches on the skin), and a family history of diabetes or metabolic syndrome.

You may know these levels and you may not have an elevated insulin level but I just wanted to check to see if this was measured. Glucose levels are often the only test done to determine the presence or absence of insulin resistance.

The fact that you just stopped birth control you may have some changes as your body readjusts to not having hormones. Some women will continue a regular cycle, some will not. However, if you are still overweight, we can continue to see irregular or absent cycles.

Have you considered a non-pharmaceutical approach to addressing PCOS? In your case, this is what I would recommend in addition to helping you lose weight with lifestyle changes, the nutrients in the Insulite PCOS System can help to normalize the hormone imbalance. This can be a great option for you right now.

If you are interested, please visit our website at http://pcos.insulitelabs.com/. Since you have done very well with losing weight, you know some of the changes that are crucial to helping to manage this condition and I would continue with this as well.

Peggy, the topics of PCOS without insulin resistance are still not entirely understood in the medical community. But often it is addressed similarly and then adjustments can be made along the way. Let me know if this helps or if you have any other questions or concerns. I hope you consider the PCOS System as I think that it can help.

–
Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Consulting & Advisory teams

DISCLAIMER: The information contained in this email
and the Insulite Labs website is for the sole purpose
of being informative. This information is not and
should not be used or relied upon as medical advice.
Always seek the advice of your physician, nurse or
other qualified health care provider before you
undergo any treatment, take any medication,
supplements or other nutritional support, or for
answers to any questions you may have regarding a
medical condition.

Dear Tanya,

Thank you for writing into the PCOS Support blog. I am glad that you found us.

It is interesting that your doctor did not diagnose if there is reason to do so. What I mean is it seems you are having some of the symptoms of PCOS. Has your doctor done any additional tests that may indicate that PCOS is the reason for the symptoms you are experiencing?

The tests would include:

- free testosterone- elevated in PCOS

- DHEA-S- often elevated in PCOS

- Sex Hormone Binding Globulin (SHBG)- usually low in PCOS

- Fasting insulin- elevated in PCOS. Some doctors may hesitate to order this test because the normal range (0-20) is so wide. However, we find that results greater than 9 indicate insulin resistance. Insulin resistance is usually the underlying cause of PCOS, as you may have read about on our site. Some doctors may also order a 2-hour post-prandial insulin test, along with a 2-hour post-prandial glucose test. For the post-prandial insulin, results over 25 or 30 may indicate insulin resistance.

- Fasting glucose or 2-hour post-prandial glucose test- elevated in PCOS. Using this information in combination with the insulin levels helps to diagnose insulin resistance. Also, women with PCOS have a higher risk of diabetes so it is important to screen for this early and often.

- LH: FSH- Some doctors may also look at the ratio between these two hormones. In PCOS, we would expect LH to be elevated in comparison to FSH.

- You could get an ultrasound to check for the presence of ovarian cysts. Even if the ovaries do appear normal, the absence of ovarian cysts does not mean that you don’t have PCOS. Not everyone with PCOS has ovarian cysts.

- I would also check your cholesterol levels and liver function tests, as these can also be abnormal in PCOS (as well as in many other conditions).

Lab testing is not mandatory for diagnosing PCOS, especially if you are experiencing so many of the symptoms. However, the above tests do give us numbers which, along with the improvement of your clinical symptoms, help us monitor your progress.

PCOS is notoriously difficult to diagnose. It is a diagnosis of exclusion. In other words, it is important to rule out other diseases that can cause symptoms similar to PCOS (such as Congenital Adrenal Hyperplasia). To diagnose PCOS, we use a combination of clinical symptoms (what you experience as the patient, such as excess hair growth, irregular menses, acne, skin tags, weight gain, infertility, etc.) and lab tests.

I do want to let you know that there is another condition called Cushing’s disease that has many symptoms of PCOS and is sometimes mistaken for PCOS. Cushing’s is not very common, but I still wanted to mention it to you. This would be something to discuss with your doctor to ensure it has been ruled out.

Have you made changes to your nutrition and exercise program over the last 9 months to help with the symptoms? These will be crucial in helping to manage your symptoms and addressing the underlying insulin resistance that often is attributed to causing PCOS. Based on the information you posted, I am not sure that you are controlling your symptoms or if more is needed. Regardless, I would recommend that if you are waiting for a diagnosis when it seems you are on the path that can increase the likelihood of PCOS, that you make the appropriate changes as soon as possible.

It is important to be proactive about your health. You might want to consider using the Insulite PCOS System to help you control the symptoms and prevent progression of the problem. If you are interested, please visit the website: http://pcos.insulitelabs.com/.

I hope that this has given you some information that you can use and helps you determine what steps might be needed. Please feel free to write in at any time.

–
Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Consulting & Advisory teams

DISCLAIMER: The information contained in this email
and the Insulite Labs website is for the sole purpose
of being informative. This information is not and
should not be used or relied upon as medical advice.
Always seek the advice of your physician, nurse or
other qualified health care provider before you
undergo any treatment, take any medication,
supplements or other nutritional support, or for
answers to any questions you may have regarding a
medical condition.

Dear Katrina,

I am delighted that you found our blog! We hear from many women who struggle just as you do to find the best way to manage PCOS that works with their life and their goals. We understand how frustrating and distressing this can be, but there is hope and things can get better!

Thanks for writing in!

Our view on the pharmaceutical treatment of PCOS is that there is no one drug on the market that will change your condition. The only way to reverse the disorder is to reduce elevations in insulin which directly affect testosterone and other hormonal changes that are responsible for causing PCOS.

We do not recommend oral contraceptives as a treatment for PCOS because they are synthetic hormones that mask some of the symptoms of PCOS rather than fixing the problems. Treating absent menses or other symptoms with oral contraceptives does not treat the underlying disorder of PCOS and when the contraceptives are discontinued, the PCOS symptoms will persist.

As you may have read on our website, the underlying cause of PCOS in most cases seems to be insulin resistance. With insulin resistance, the body becomes insensitive to the insulin it produces, which leads to elevated circulating levels of insulin. This in turn leads to hormonal imbalances such as increased testosterone and other androgens (male hormones).

The increased testosterone is responsible for many of the symptoms of PCOS such as hair growth and abnormal menstrual cycles. Elevated insulin also contributes to the formation of cysts in the ovaries in part due to the hormonal imbalances and also because the ovaries are highly sensitive to the influence of insulin. In women with PCOS, the ovaries are over-sensitized to insulin’s effects.

The weight gain associated with PCOS is intricately related to insulin resistance. Losing weight helps to improve insulin sensitivity, and vice versa: becoming more sensitive to your insulin helps you to lose weight.

Unfortunately, people who have insulin resistance have a very difficult time losing weight, as you have experienced.

That said, it is not normal under any circumstances to have your menstrual flow every day for an entire year. It is true that women can experience significantly heavier periods after a pregnancy, but these typically regulate within a few months. Also, we want to be careful that you are not bleeding so much as to become anemic. You might see your doctor about a blood test to check for anemia. And also to check your hormone levels because you may need to also supplement with progesterone.

I hope this information is helpful for you! There is amazing customer support at Insulite Labs; we are here to help you through this healing journey. Please don’t hesitate to contact us again if you have any other questions or concerns.

Best Wishes,

Dr. Andrea Lee, ND
Insulite Laboratories Consulting and Advisory Team

DISCLAIMER: The information contained in this email and the Insulite Labs website is for the sole purpose of being informative. This information is not and should not be used or relied upon as medical advice. Always seek the advice of your physician, nurse or other qualified health care provider before you undergo any treatment, take any medication, supplements or other nutritional support, or for answers to any questions you may have regarding a medical condition.

Dear Dee,

Thank you for writing into the PCOS Support blog.

As you may be finding out, many women do see their cycles regulate with the use of birth control and with weight loss. You mentioned that with weight loss you did see your cycles return, however not as regularly as you would have liked.

Weight loss is important both for your general health and also to help increase your chances of conceiving, when you are ready to start trying. For an overweight woman with PCOS, losing 5-10% of her weight can help her to achieve regular menstruation, which increases the chances of ovulation and conception. The Insulite PCOS System addresses this component not only with the supplements but also with diet and exercise guidelines. We advocate gradual weight loss which is healthier and more permanent.

As you know weight loss is not always as easy as predicted. Exercise and nutrition are of course crucial for anyone wanting to lose weight, but can be more difficult to get results with a condition such as PCOS.

However, with PCOS, it is important not to only address the symptoms of the condition, such as weight gain, irregular or absent cycles, acne, excess facial and body hair, etc. but to also address why this is happening and how these symptoms develop as a result.

The underlying cause of PCOS in most cases seems to be insulin resistance. With insulin resistance, the body becomes insensitive to the insulin it produces, which leads to elevated circulating levels of insulin. This in turn leads to hormonal imbalances such as increased testosterone and other androgens (male hormones).

The increased testosterone is responsible for many of the symptoms such as hair growth and abnormal menstrual cycles.

Elevated insulin also contributes to the formation of cysts in the ovaries in part due to the hormonal imbalances and also because the ovaries are highly sensitive to the influence of insulin. In women with PCOS, the ovaries are over-sensitized to insulin’s effects.

Finally, the weight gain that is often associated with PCOS is intricately related to Insulin Resistance. Losing weight helps to improve insulin sensitivity, and vice versa: becoming more sensitive to your insulin helps you to lose weight.

Women with PCOS may also find it more difficult to achieve pregnancy because of the hormonal changes (elevated testosterone and DHEA-S) and ovarian cysts that are characteristic of PCOS.

You can ask your doctor to do a vaginal ultrasound to detect the presence of ovarian cysts. If you are not having monthly periods or they are being controlled with birth control, you may or may not see cysts. Not all women with PCOS have cysts.

There are many types of birth control and it would be best to discuss other options with your doctor. Yasmin has a lower androgen index, which means that it does not increase testosterone levels. However, some of the side effects can include acne and increased weight.

Since you have already been diagnosed with PCOS, your doctor may not feel the ultrasound is necessary or she/he may want to wait until you are ready to try to conceive.

If you are trying to conceive and cysts are present, they may recommend a procedure called ovarian drilling. Ovarian drilling may make it easier to become pregnant, however ovarian drilling does NOT cure PCOS. The cysts can return once drilling is complete because ovarian drilling does not address the underlying cause of PCOS, it merely removes one of the symptoms of PCOS (the ovarian cysts) temporarily.

What steps are taken will depend on the doctor.

What the goal would be is to work towards having regular periods so that the you are ovulating and this is one way to prevent the cysts from forming. The goal should also be to reduce they symptoms you are dealing with in addition to the irregular periods and the risks associated with PCOS, such as diabetes and cardiovascular disease.

Dee, I recommend that you consider the Insulite PCOS System. What we have designed is a non-pharmaceutical approach to addressing the cause of PCOS and to reduce the symptoms and long tern risks of PCOS. The PCOS System helps to reverse insulin resistance, reduce symptoms of PCOS to help you reach your goals and manage this condition.

You can read more about it at: http://pcos.insulitelabs.com/.

I hope that this helps Dee. Please keep coming back to the blog, our forum ( http://pcos.insulitelabs.com/forums/index.php ) and other support sites for women with PCOS.

–
Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Consulting & Advisory teams

DISCLAIMER: The information contained in this email
and the Insulite Labs website is for the sole purpose
of being informative. This information is not and
should not be used or relied upon as medical advice.
Always seek the advice of your physician, nurse or
other qualified health care provider before you
undergo any treatment, take any medication,
supplements or other nutritional support, or for
answers to any questions you may have regarding a
medical condition.