PCOS and Me

As soon as i started using progesterone cream i started feeling better. The first thing to go was my insomnia (i think i forgot to list that under symptoms of low progesterone in my last entry and im sorry, it is a major, major issue!) For the first time in a long time i was able to sleep and stay asleep. Or, if i woke up, i was able to get back to sleep. The next thing that left me was my depression; i was able to feel calm and happy. After a few weeks i was able to get off the Welbutron and am happy that i no longer have to take antidepressants. After that it was the brain fog that cleared up. I had not noticed how fuzzy my thinking had become until it was more clear. Like putting on glasses for the first time and going, "hey look! i can see!"

Just getting rid of those few symptoms made a world of difference in my life i felt much more functional, i was working at 75% instead of 25%. The problem was that i wanted to be at 100% but i was still having issues. For one i was still gaining weight, and two i was still coming up against anxiety as a hurtle.

I have to admit that i had been hoping and praying and looking, for a long time, for a little pill that would magically, over night, make me all better and drop 20lbs instantly. I thought that if i finally found out what my body needed and finally gave it, i would be rewarded with rapid weight loss with no effort. I was counting on by body to spring back like it did after i winged Emily, but it didn’t.

Some women are lucky and using progesterone will go very far very fast, and that is fantastic, but sometimes it can’t work alone. Sometimes there are women like me whose case is a bit more severe and takes a bit longer to recover from. Most everything i have studied says that your hormones need about 12 weeks to recover and good six to seven months for underlying issues to heal. It can be very frustrating to suffer for a long time, finally get your answer and then be told that it is going to take another six the seven months to work. In the long run, i guess it is not long to wait, but when you just don’t have much more to give, it looks like forever.

But i was undeterred, now that i knew that low progesterone was the cause of my problems, i knew that if i were to truly heal from it i needed to find what was causing it in the first place. So i did what i do best, research!

I started by seeing if there was a connection between low progesterone and any of the other conditions my endocrinologist had discovered. There was no real connection between the low vitamin D, but a big one with the insulin resistance.

Insulin Resistance (a.k.a. pre diabetes or syndrome X) is what happens when your body has trouble processing the insulin you produce to help break down complex carbohydrates (like sugar and starch) that you eat. Insulin floating around in your veins with nowhere to go is very dangerous and if it can’t help carbohydrates be used for energy (which is its job) your body will store them as fat. This is a very serious syndrome that most women with low progesterone (and who are usually overweight) have. I will talk more about this later.

Apparently, 98% of women who have insulin resistance also have PCOS. Polycystic ovary syndrome (which happens to be one of the most common female endocrine disorders) is when cysts develop on your ovaries. When this happens it can cause a laundry list of problems. Because it inhibits your ovaries from producing progesterone, these are some things that can happen: weight gain (predominatly around the stomach), depression, anxiety, facial hair growth, menstrual problems, acne, infertility, mood swings, thinning hair and even skin tags. Do a lot of these sound familiar? They should, most of them of symptoms of estrogen dominance.

There are six kinds of Ovarian Cysts, the first two are pretty normal:

1. Follicular cyst. The pituitary gland in your brain sends a message, by increasing luteinizing hormone (LH), to the follicle holding the ripening egg. This is called a “LH surge”. Normally, the egg is released from the follicle and starts down the fallopian tube where it may then become fertilized by a sperm cell. If the LH surge does not occur, the follicle doesn’t rupture or release its egg. Instead, it grows until it becomes a cyst. These cysts seldom cause pain, are usually harmless, and may disappear within two or three menstrual cycles.

2. Corpus luteum cyst. When there is a successful LH surge and the egg is released, the follicle responds by becoming a new, temporarily little secretory gland called the corpus luteum. The corpus luteum produces large amounts of progesterone and a little bit of estrogen, to prepare the uterus for conception.

Occasionally, after the egg is released, the escape hatch seals off prematurely and tissue accumulates inside, causing the corpus luteum to enlarge. This type of cyst will usually disappear after a few weeks. Rarely, a corpus luteum cyst can grow to 3"-4" in diameter and potentially bleed into itself, or twist your ovary, thus causing pelvic or abdominal pain.

These are the cysts you have to watch out for:

3) Dermoid cyst. A dermoid cyst is mainly fat but can also contain a mix of different tissues. They are often small and usually don’t cause symptoms. Very rarely, they become large and rupture, causing bleeding into the abdomen, which is a medical emergency.

4) Endometrioma or "chocolate cyst". These are cysts that form when endometrial tissue (the type that lines the inside of the uterus) invades an ovary. It is responsive to monthly hormonal changes, which causes the cyst to fill with blood. It’s called a “chocolate cyst” because the blood is a dark, reddish-brown color. Multiple endometriomas are found in the condition called "endometriosis". Although often asymptomatic, chocolate cysts can be painful, especially during your period or during intercourse.

5) Cystadenoma. Cystadenomas are cysts that develop from cells on the surface of your ovary. They are usually benign. Occasionally, they can become quite large and thus interfere with abdominal organs and cause pain.

6) Multiple cysts – the polycystic ovary. Women who don’t ovulate on a regular basis can develop multiple cysts. The ovaries are often enlarged and contain many small cysts clustered under a thickened, outer capsule. There are many factors causing a woman to not ovulate and develop polycystic ovaries. Polycystic ovarian syndrome is a complex condition that involves multiple hormonal and organ system dysfunction. Multiple ovarian cysts are just one facet of this disorder.

The only way to be sure that you have PCOS is to get a pevlic ultrasound and have a doctor look at the little buggers.....so i did. Sure enough, my ultrasound showed that i had "quite a few" cysts clustered around my ovary.

Here's the thing, it is likely that every women will experience some form of PCOS in her life, occupational hazard of being a women. Most of the time, it will happen and resolve itself without you even knowing it. It is not uncommon for your body to miss an ovulation (even though your period is regular) every once in a while, it is also very normal to have several follicles developing at once. Your body is forever eager to reproduce. Sometimes things like stress or birth control interfere with your body's natural rhythm and things just get in a traffic jam. Some cysts develop but a lot of the time they dissolve by themselves and life goes back to normal. What is not normal is if the cysts stay around, grow bigger and symptoms start to interfere with daily life.

How a women develops PCOS seems to be a topic of debate among the professionals, no one seems to know for sure. Mostly it is a "chicken or the egg" scenario, do you get fat from having PCOS or do you get PCOS from being fat? Personally, i think it could be both and i will explain how.

Usually, PCOS works in this vicious cycle: cysts slow the production of progesterone, androgens (the “male” hormones in your body) start to get overloaded (that is a lot of the reason for hair growth), low progesterone causes other hormones not to be as affective (insulin, adrenals, thyroid) and causes weight gain, fat cells that store estrogen (estrogen goes into making fat cells, so the more and bigger they are, the more estrogen is floating around in your body) add to estrogen dominance, lowering progesterone and causing more weight gain.....

So the way i see it, if you allow yourself (through a sedentary life style and poor food choices) to accumulate lots of fat on your body to the point where you can no longer process insulin (because your body has literally had so much glucose that it's receptors no longer take note of it) and there is an excess of estrogen being stored in your fat cells, you can very likely cause your body not to produce enough progesterone to ovulate. When that happens, things get backed up and a cyst will develop. From there things compound and go down the crapper pretty fast.

OR...

You can be a healthy person, a fit person, and just miss an ovulation or have something like birth control interferes with your body's normal mojo. Things get backed up, a cyst develops, blocks progesterone production causing estrogen dominance. Estrogen dominance causes other hormones not to work, you start gaining weight, which causes more estrogen dominance and craziness and from there things compound and go down the crapper pretty fast.

In my particular case, i think i got PCOS first. Thinking back on it, i can honestly say (though i had not yet reached my goal) that i was in the best shape of my life. If being fat is all it takes to develop PCOS, why didn’t i do it when i was a size 20 instead of a size 12? I think that it had more to do with the IUD i was using for birth control at the time. I believe that from either the hormones or the devise itself, i missed an ovulation. Because of that i developed cysts on my ovaries and once that happened things compounded and my life went down the crapper pretty fast and nobody could tell my why because no one knew that i had PCOS.

I don’t know what my doctors think; i still don’t know why the endrocynologist didn’t know that if i had insulin resistance (that she diagnosed me with) that meant that i most likely had PCOS (the most common of all female endocrine disorders) which is a byproduct of LOW PROGETERONE!

Doctors do not have a cure for PCOS, they do not have a little pill that will magically heal you over night and make you drop 20lb. They do have surgery options and a pill (Metformen) that helps blood sugar in diabetes patients (and therefore it helps those with insulin resistance and therefore women with PCOS) that has a lot of unsavory side effects, but not a cure. Nature however, dose.

Using natural progesterone can completely heal PCOS and help with all of the hormone problems in between. That being said, i guess i should do a disclaimer now. Everyone is different, and i am not a doctor. Going the surgical route may be the best option for your particular case, and all though there are a lot of people who have major problems taking Metformen, there are some who do well on it. All i can tell you about is my experiences and the things i have learned. For me, this has been the safest and most logical way to heal. If you have been searching for an answer, this could be the right choice for you too.