Monday, September 15, 2014

PCOS Series Resumes

Image Credit: Jessi from 
September is PCOS Awareness Month.

In honor of the many women of size who suffer with Polycystic Ovarian Syndrome (PCOS), we will be resuming our series of posts about PCOS this month.

In previous posts, we have discussed the definition and symptoms of PCOS, how it presents, its testing and diagnosis, and its possible causes.

Then we began discussing common treatment protocols for PCOS, and the pros and cons of each.   We've already discussed insulin-sensitizing medications like metformin, the TZDs, and inositol. Then we discussed glucose-lowering medications for those who have developed overt diabetes. We also discussed the use of progesterone for menstrual irregularity. Now it's time to continue that discussion about other treatment options for various aspects of PCOS.

Next up is a discussion of Oral Contraceptives for menstrual regularity and control of androgenic symptoms. Then we will continue the series with a discussion of anti-androgen medications, and finish up with a discussion of cosmetic treatment options for some of the most distressing side effects of PCOS, like hirsutism, cystic acne, and alopecia.

One of the difficult things about PCOS is how differently it can present in different women. Very few women suffer all the possible symptoms. I'm fortunate that my case is fairly mild, but that makes it more challenging to write about things I haven't personally experienced. Although I can write about it from an intellectual point of view, it's really important to bring out the personal stories of women and how they've dealt with the challenges of this condition.

Therefore, I am particularly looking for more personal stories to share. Stories have already been submitted, but I would like to have many more. Please spread the word on PCOS forums and social media.

Your submission need not be long; just a quick summary of your experiences with an oral contraceptive, an anti-androgen medication, or how you have dealt with hirsutism, acne, or alopecia. Don't forget to give permission for me to share your story and how you want it attributed (anonymous or first name only). Send your submission to me at kmom AT  plus-size-pregnancy DOT  org. (But remember, we want to avoid weight loss talk.*)

As a springboard to the renewal of the PCOS series, I invite you to leave a comment (feel free to be anonymous) about the most challenging or distressing symptom/aspect of PCOS for you. It's a hard condition to have, and the symptoms can provide many social and emotional challenges. Sharing about those is important for healing and dealing with the condition more proactively. Please share about your particular challenges so other women will know that they are not alone.

More PCOS posts will be forthcoming in the future, but for now, this is the current focus. I welcome appropriate feedback on the posts and hope the information is helpful to you.

*Please note that we are discussing PCOS treatment options from a size-friendly point of view (meaning no promotion of/focus on weight loss; no diet talk/no hate talk allowed in comments). There are plenty of other PCOS resources out there that promote weight loss or dieting approaches as treatment. You are certainly welcome to pursue that if you wish, but if you are only interested in that, this is not the site for you. Please find the site that is right for your needs. 
Remember, though, weight loss is not the only way to treat PCOS! Lifestyle management does not have to include trying to lose weight. The Health At Every Size® and HAES® approach to improve health and manage PCOS symptoms can also be useful. What we want here is a safe place to discuss PCOS treatment that does not center on weight loss, radical diets, or body hate talk; sadly, a safe place like that can be hard to find on many PCOS forums. Considering the tremendous failure and regain rate of diets (and the huge profits this brings the weight-loss industry), a weight-neutral approach to PCOS is long overdue. 


Lara Newell said...

I was just diagnosed with PCOS today. I'm still a little in shock and feeling very overwhelmed with information, questions, what-ifs, and future plans. I just wanted to let you know that I am already finding your blog a place of comfort, where I (a plus-size wife) won't feel stigmatized or judged or where people won't automatically the reason I have PCOS is because I'm overweight. Thank you so much for that.

Anonymous said...

I'm curious if you consider general good nutrition to fall under the umbrella of "extreme diets" and "diet talk" even when they don't explicitly focus on weight loss, ie paleo? Or an overall healthy lifestyle of getting adequate sleep, reducing stress, removing toxin exposure, self care, etc.?

Eating a low fat diet, eating large amounts of soy or animal products that have been treated with hormones, pesticide and plastic exposure in foods, all of those things contribute to serious hormone problems. We're talking about epigenetics here and what goes into your body from conception to adulthood, matters a lot. I'm just confused if you're putting all of that under the "extreme diet" category because you didn't mention if you would include that in discussion of treatments, removing everything in our food and environment that has repeatedly been show to royally mess up our hormones.

I have a renewed interest in this series because my 4yo is currently seeing an endocrinologist with elevated DHEA, cortisol, IGF, and a few others, all of which create the beginnings of PCOS when she hits puberty, which she will likely hit early. It's so scary and infuriates me when doctors are like "Here have some pills!" to cover up symptoms instead of doing any legit research on prevention and cure.

Mich said...

I will contribute a story soon. I see a new doctor this week and will discuss inositols with her.

For the facial hair, I shave.

Well-Rounded Mama said...

Anonymous, look into what Health At Every Size (R) entails. You can absolutely focus on having better nutrition, moderating carb intake, increasing exercise, lessening stress, limiting hormones in your food etc as part of Health At Every long as the focus is not on losing weight, but rather on improving/maintaining health. And I agree, all those things can be very useful in helping with PCOS.

Paleo starts to get a little dicey because so many Paleo resources are about losing weight. But you can have Paleo-like nutrition and use THAT to help reduce symptoms of PCOS and be healthier without having to focus on whether or not it makes you lose weight.

If you look into Health At Every Size (abbreviated HAES), you will see that it IS about health, about healthy lifestyle and habits, about improving or maintaining health....but without having to tie that into losing weight or making your weight or waist size your focus. Sometimes a little weight loss is a side effect of improving habits, but usually not much and as with most weight loss, usually temporary. Sometimes it lasts longer. But that's not the point...the point is your habits, what you are doing to be healthy, not what the scale says. Take the emphasis off the scale and people tend to improve their health habits better and make longer-lasting changes/choices.

Hope that clarifies a little. You can read more here:

and here:

Kasie said...

I have had PCOS since puberty. I too have struggled with the shame of my weight and many people thinking I just have control and commitment issues. I am one of the lucky, however, I have an 8 year old son...I gave birth at age 33, and he is thriving, with no help from any physician save The Great Physician. I am SO thankful for this blog. The blog itself and posts are saying things I've felt, but couldn't share.

As far as the facial hair, I pluck often and use a trimmer (one of those infomercial ones for facial hair, nose, ear, etc...). I also moisturize daily and use an apricot scrub to help soften the skin and hair. Still....annoying and humiliating. Especially when my husband sees me, it makes me feel less womanly. I tried waxes and creams in my 20s, but they burned my skin.