My Doctor Said I Have Polycystic Ovary Syndrome

Each week, I wonder what I should write about on the SeasonsWC blog. Then, I listen to my patients, and they tell me what they want to know. (Funny thing listening to your patients). This week, at least three women had questions about their diagnosis of polycystic ovary syndrome. Some time ago an ultrasound revealed that they had multiple ovarian cysts, and they were given birth control pills to control their symptoms. That was all they knew.

“So I learned I have cysts on my ovaries,” they said. “But what does that mean?”

Doctors call it polycistic ovary syndrome. To make things even more confusing, we’ll often just call it PCOS or PCO. (It’s fewer syllables.)

PCO is a hormonal syndrome. A syndrome is a group of symptoms that collectively indicate a disease or other abnormal condition–and PCO is an abnormal condition, not a disease. Of course, abnormal conditions can lead to disease. But an abnormal condition can also be restored to a healthy condition, whereas disease cannot.

PCO is the most common hormone problem in women today, effecting 5% of reproductive aged women. It causes androgen excess, another fancy medical term that means a woman’s body is producing too many male hormones. This means women may have facial hair, hair loss, low voice, acne… Androgen excess in women has been recognized by doctors since Hippocrates. You may have heard of the Hippocratic Oath. Hippocrates discovered a lot of things, including facial hair in women.

To be more specific, PCO is characterized by

• High androgen levels (think testosterone)
• High insulin levels and insulin resistance
• Irregular cycles (due to anovulation)
• Multiple ovarian cysts

It doesn’t really sound so bad–just facial hair, acne, deep raspy voice, and irregular cycles. Obviously, those symptoms are a very big deal for many women. In fact, they are the primary complaints of women with PCO. But they aren’t the biggest problems. PCO is associated with some pretty serious diseases and health problems:

• Obesity (50% of women with PCO)
• Type II diabetes (10% of women with PCO)
• Infertility
• Cardiovascular disease (hypertension, abnormal cholesterol, atherosclerosis)
• Psychopathology (anxiety, depression, bipolar, eating disorders)
• Cancer (breast, uterine…)
• Metabolic syndrome

Worst of all, polycystic ovary syndrome, if untreated, leads to poor health and early death. But don’t worry! We know how to treat PCO, and I’ll talk about that in my next post.

Bioidentical Hormones: What Does The Scientific And Medical Evidence Say?

A young lady came into my office the other day to discuss hormones. She was a breast cancer survivor. Her concern, and rightly so, was her risk of getting breast cancer again. Since she lived in the south (our main office is in Ruston, Louisiana), she had experienced the women’s ritely passage of menopause: “the hysterectomy ceremony.”

Her question to me was: can she take hormones? Years ago, her cancer doctor had placed her on premarin, telling her that it was safe. She also was told that because she had a hysterectomy, progesterone was not necessary. Her gynecologist, in contrast, told her she couldn’t take premarin. Different doctors, different opinions.

I’m not trying to offer a third opinion here. I just want to stay focused on the evidence. That is what evidence-based medicine is all about. Unfortunately, market forces are clouding evidence-based medicine today.

In earlier posts, I’ve talked about progesterone, synthetic progestins and their polar opposite effects on a woman’s breasts. Progesterone lowers risks. Progestin increases risks. I want to get a little more specific today with some information from an outstanding review of the evidence. In Dr. Kent Holtorf January 2009 article, the Bioidentical Hormone Debate, he exhaustively reviewed 196 research articles. (If you aren’t up to reading the full article, you can read an abstract of the review.)

Here is my summary of the risks associated with synthetic progestins:

• increased breast cell growth
• increased conversion of weaker estrogens into more potent estrogens
• promoted the formation of toxic estrogen metabolites (16-hydroxyestrone)
• stimulated the conversion of inactive estrogen to active estrogen (estrone sulfate to estrone)
• had anti-apoptotic effects. (Apoptosis is programmed cell death: which is a way to control cancer growth. Anti-apoptosis means your body lacks this method of controlling cancer growth.).

Contrast this with the benefits of the natural bioidentical hormone progesterone.

• reduced breast cell growth by 400%
• downregulated estrogen receptors in the breast
• induced cancer cell apoptosis (programmed cell death that helps control cancer growth)
• reduced breast cell division and growth
• and in some studies, progesterone actually arrested human breast cancer cells.

After looking at nearly 200 independent studies, Dr. Kent Holtorf concluded that “Both physiological and clinical data have indicated that progesterone is associated with a diminished risk for breast cancer, compared with the increased risk associated with synthetic progestins.” Studies have shown that synthetic progestins increase the risk of breast cancer:

1. by approximately by 25% for each 5 years of use
2. by triple the risk (67%) of breast cancer when added to estrogen therapy
3. double the risk to 4% per year when compared to estrogen therapy alone.

This is in stark contrast to bio-identical progesterone, which reduces the risk of breast cancer by 10%.

“As far as the east is from the west”—that is how different the effects of progesterone and synthetic progestins are on the breast. Holtorf concludes his article in Postgraduate Medicine with statements like this: “With respect to the risk for breast cancer, heart disease, heart attack, and stroke, substantial scientific and medical evidence demonstrates that bioidentical hormones are safer.”

In my next post, I’ll look at synthetic premarin versus bioidentical hormone estrogen.

Related articles by Zemanta

• The Bioidentical Hormone Debate (www.postgradmed.com)
• Abstract: Are Bioidentical Hormones (Estradiol, Estriol, and Progesterone) Safer or More Efficacious than Commonly Used Synthetic Versions in Hormone Replacement Therapy? (holtorfmed.com)
• Study: Hormone therapy caused breast cancer for thousands (cnn.com)

Bioidentical Progesterone Helps Your Heart

President Eisenhower said, “Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing ever happened”

In my last post, we looked at some new discoveries in science about the truth of bioidentical hormone therapy. Specifically, we looked at the different ways bioidentical progesterone and synthetic progestins affect the breasts. This week I want to look at the different ways they affect the cardiovascular system.

I can hear what you’re probably thinking. “You mean some hormones might have beneficial effects on the heart? That is not what my doctor told me.”

I don’t know your doctor or your specific situation, but I do know about the latest scientific research.

Synthetic hormones increase cardiovascular risks.

One study, the Women’s Health Initiative saw a large increase in the risk of heart attacks and stroke in women who used Provera. This is not at all surprising since synthetic progestins have previously been shown (in the PEPI study) to negate the positive cardiovascular benefits of estrogen.

These results stand in stark contrast to studies using bioidentical progesterone, which has been shown to provide additional cardiovascular benefits.

Here’s some more down and dirty science. First, you need to understand that blood vessel constriction and plaque formation both increase your risk of stroke and heart attack. Bioidentical progesterone reduced blood vessel constriction and plaque formation by 50%, but synthetic progestins actually increased blood vessel constriction and plaque formation.

Wow. I wish President Eisenhower’s words weren’t so appropriate. The truth is easy when everyone believes it; but the truth is hard to follow when so many people seem blind to it.

Here’s the truth: Bioidentical progesterone provides cardiovascular benefits to women.

Fuller Lips, Fewer Wrinkles

Have you ever wished for fuller lips? Have your lips seemed to “disappear” the older you’ve gotten? How would you like your lipstick to last longer? If any of these questions spark your interest, then Juvéderm® may be the answer you’re looking for.

As we age, our skin changes. Over time the natural volume of youthful skin begins to diminish as wrinkles and folds form. But you don’t have to just sit back and let it happen!

This product is a smooth consistency gel made of hyaluronic acid—a naturally occurring substance in your skin that helps to add volume and hydration. Your healthcare professional eases hyaluronic gel under the skin to instantly restore your skin’s volume and smooth away facial wrinkles and folds—like your “smile lines” or “parentheses.” Technically, these are nasolabial folds—the creases that run from the bottom of your nose to the corners of your mouth and lips.

First, we give you a dental block using Lidocaine to numb the nerves associated with the lip, then the gel is injected slowly and evenly. After the injection, the product is gently massaged to insure an even result. The procedure is virtually painless, and the results are absolutely fabulous! Your lips will have a smooth, natural look and feel—so everyone will notice (but no one will know).

The process takes about 30 minutes and results are immediate. Plus, there’s minimal recovery or downtime. So you can step into your doctor’s office for treatment and step right back into your life!

Call or come by for a complimentary consultation and let us help you achieve the younger, fuller, more supple lips you desire. Call Seasons Medical Aesthetics at 255-3223 or It’s Permanent at 340-1778 to schedule your consultation.

Confession #1: The Worst-Case Scenario

My body is in a state of decay. Yes. I said it. You heard it here. This was this big year for me…a birthday with a zero at the end. Okay. I’ll go ahead and tell you. I turned 40.

As I approached this birthday, I had great plans.

1. I would lose the weight I’ve gained in the last 10 years through 2 pregnancies, the death of my father, and a cross-country move.
2. I would regain my health which has really deteriorated because all my energy seems to go to my family with myself being the last priority.
3. I would work on my “look.” It’s been many years since I really put a huge amount of effort into the way I look. And I really just wanted to enter my 40s feeling good about what I saw in the mirror.

So in September of 2007, a good eight months prior to the big birthday, I scheduled the fabulous and always-looked-forward-to ANNUAL VISIT.

You know the one. The pap smear. Ah, yes. You gotta love the stirrups. It’s the most fabulous moment in a girl’s life, isn’t it? So I made an appointment with a new doctor in our new town (refer to the above-mentioned cross-country move) as a first step on my quest for a better life in my 40s.

The annual visit was pretty uneventful until Dr. Goodyear said, “So what are your goals for yourself this year?”

He knew I was turning 40. I started with my list. “Lose weight and get healthy. And I think something might be wrong with my hormones… Something just isn’t right, but I can’t quite put my finger on it. I’ve been tested previously and told that my thyroid was just fine. But I don’t think it is.”

Dr. Goodyear has probably heard this as many times as he has seen patients. But for me, this felt like a scary confession. I’ve felt so alone with my struggles: weight, energy level, and turning 40.

So the good doctor said that we needed to start with my hormones. The testing was different than anything I had done before. In addition to drawing my blood, they made me spit in a cup.

I know. It sounds archaic.

Actually, I had to spit into 4 different vials at different points during the day on the 20th day following the first day of my last period. Did you follow that? It’s much easier than it sounds. But I recommend drinking a lot of water when you do saliva testing. It is hard to get that much spit!

So what happened next, you ask? Test results came back a few weeks later, and I was right. My hormones were all wrong. In fact, after I realized how out-of-whack I really was, I looked Dr. Goodyear straight in the eyes and said, “Am I the worst case you’ve ever had?”

He looked at me and said in the nicest possible way, “Yes.”

So here I am, the worst-case scenario. I am truly the hormonal woman. And I am on a personal mission to make sure that other women like me know that they aren’t alone and that there is help. Every week, I will update my blog and continue to share with you the journey I have been on since September of 2007. I have been using bioidentical hormones for 13 months now, and I am a completely different person than I was when I first stepped into Dr. Goodyear’s office. This journey continues. I’m not there yet. But every day I make another step towards the good health that I want so much.

Please join me on my journey, even if you aren’t a hormonal woman. You probably know someone who is!

–Elizabeth