CURRENT article from Washington Times
Washington Times, The (DC)
Uneven hormones wreak havoc
August 30, 2005
Section: LIFE - HEALTH
Page: B04
Shelley Widhalm, THE WASHINGTON TIMES
Caption: Karen Alston of Northeast receives a laser treatment for hair removal from D. Cheryl Burgess at the Center for Dermatology and Dermatologic Surgery. The hair on her chin is a symptom of Polycystic Ovary Syndrome, a hormonal imbalance that affects the entire body and is the most common cause of infertility in women. [Photo by Liz O. Baylen/The Washington Times]
There was a time when Karen Alston of Northeast would not go outside without first shaving and putting foundation and cover-up on her face to hide a physically obvious symptom of Polycystic Ovary Syndrome (PCOS).
"It's tough. You feel like you're a freak of nature," the 37-year-old says about the hair on her chin and neck.
Miss Alston, who was diagnosed with PCOS in 1997, experienced irregular menstrual cycles and weight gain. She took medication for diabetes and hirsutism, or excessive hair growth, but did not take the medication regularly, and she ate poorly.
Eighteen months ago, her doctor, Dr. Richard E. Blake in Northwest, told Miss Alston that she was on a collision course for a stroke, and she took him seriously. She began walking every other day, increased the whole foods in her diet, decreased her intake of carbohydrates and took her medicine.
Now, Miss Alston's cycles are regular and she is losing weight. In addition, she is undergoing laser treatment to remove excess hair, a procedure she started in March.
"The difference is night and day," Miss Alston says. "I'll just go out and face the world."
Miss Alston is among the 5 percent to 10 percent of American women of reproductive age affected by PCOS, says Sara Ducey, certified nutrition specialist and associate professor of nutrition at Montgomery College in Rockville.
PCOS is a hormonal imbalance that causes chronic annovulation, or lack of ovulation, and is the most common cause of infertility in women.
"While the name 'ovary' is in the name of the condition, it's systematic, or body-wide," Ms. Ducey says.
The exact cause of the condition is not known, but some women can be genetically predisposed to it, says Dr. Blake, a board-certified reproductive endocrinologist and associate professor in the obstetrics and gynecology department at Howard University in Northwest.
Women diagnosed with PCOS have at least two of three primary symptoms, which include polycystic ovaries, irregular or missed periods, and clinical or biochemical evidence of elevated androgen levels, Dr. Blake says. Androgen is a male hormone that includes testosterone and, at elevated levels in women, can cause male pattern balding, facial or body hair, and acne, he says.
Women with PCOS can have additional symptoms, including weight gain, insulin resistance, acanthosis nigricans, or discoloring of the skin, and skin tags, pieces of skin projecting from the normal skin layer, Ms. Ducey says. They also can feel exhausted and lack mental alertness, she says.
"Being a syndrome means not everybody is going to have the exact same symptoms," says Amy Shao, board member of the Polycystic Ovarian Syndrome Association, based in Englewood, Colo.
Most women with PCOS have numerous small cysts on their ovaries, or polycystic ovaries. Their bodies do not produce the right amount of estrogen and progesterone to carry out the menstrual cycle.
"There's an imbalance between the level of estrogen and the brain's response to that estrogen," says Dr. David Downing, Ob/Gyn residency program director at Washington Hospital Center in Northwest.
Normally, the hypothalamus, the part of the brain that measures levels of estrogen, sends a signal to the ovaries to ovulate, Dr. Downing says. In PCOS, the hypothalamus is bombarded with high levels of estrogen and responds by reducing the level of follicle-stimulating hormone that needs to be released at a precise time during the menstrual cycle, he says.
Follicles in the ovary, which are tiny sacs called cysts, hold the eggs. Each month, several eggs start to mature, with one usually becoming dominant. In the woman with PCOS, none of the eggs matures properly, and the eggs remain as cysts, causing ovulation not to occur.
"It's the abnormal signals that the ovary is getting that make the ovary produce too much testosterone," Dr. Downing says.
The shift in hormones can alter metabolism rates, causing a woman with PCOS to feel hungrier, Ms. Ducey says. If the woman eats more, the body fat she gains also produces estrogen, increasing the imbalance, she says.
In addition, a diet high in sugars overexposes the body to the insulin hormone.
Insulin is produced to process sugars, but with insulin resistance, the cells do not respond and the insulin cannot enter the cells, resulting in high blood sugar and high blood insulin, Ms. Ducey says. Insulin resistance, over time, can lead to obesity, she says.
"High insulin seems to trigger a predominance of male hormones in women," Ms. Ducey says, adding that PCOS puts women at risk for type 2 diabetes, cardiovascular disease and high blood lipids (cholesterol or triglycerides). "We want to catch this early in young women, and we want to treat it," she says.
Ms. Ducey recommends a diet low in sugars and refined grains and high in whole foods, along with daily exercise to help the insulin receptors in muscle cells become more sensitive to insulin molecules.
Other treatments include using birth control pills to normalize hormones and the menstrual cycle, taking ovulation-inducing medications to help improve fertility, and taking medications that help control blood sugar levels.
"It literally attacks your femininity," says Tulin Reid, who was diagnosed with PCOS in 1997. She is the founder of PCOSLiving.com, a Web site based in Southern California that provides support, research and education on the cure of chronic inflammation-related illnesses.
PCOS, Ms. Reid says, is a hormonal imbalance caused by chronic inflammation, which results from perpetual stimulation of the immune system.
"There are a number of things that can stimulate the immune system," says Ian Stoakes, Dutch author of "A New Dawn," which looks at the relationship between inflammation and fertility. Anything that "is 'non-self' triggers a response. The biggest source is food," he says.
Ms. Reid followed the protocol outlined in Mr. Stoakes' book and eliminated inflammation-triggering foods, which, for her, include wheat and tomatoes, among other foods. She lost more than 22 pounds in six weeks and saw her testosterone levels drop and menstrual cycle normalize, she says.
"For the first time, I feel like my life is under control," Ms. Reid says. "I want women to be able to see that PCOS doesn't have to beat you."
Uneven hormones wreak havoc
August 30, 2005
Section: LIFE - HEALTH
Page: B04
Shelley Widhalm, THE WASHINGTON TIMES
Caption: Karen Alston of Northeast receives a laser treatment for hair removal from D. Cheryl Burgess at the Center for Dermatology and Dermatologic Surgery. The hair on her chin is a symptom of Polycystic Ovary Syndrome, a hormonal imbalance that affects the entire body and is the most common cause of infertility in women. [Photo by Liz O. Baylen/The Washington Times]
There was a time when Karen Alston of Northeast would not go outside without first shaving and putting foundation and cover-up on her face to hide a physically obvious symptom of Polycystic Ovary Syndrome (PCOS).
"It's tough. You feel like you're a freak of nature," the 37-year-old says about the hair on her chin and neck.
Miss Alston, who was diagnosed with PCOS in 1997, experienced irregular menstrual cycles and weight gain. She took medication for diabetes and hirsutism, or excessive hair growth, but did not take the medication regularly, and she ate poorly.
Eighteen months ago, her doctor, Dr. Richard E. Blake in Northwest, told Miss Alston that she was on a collision course for a stroke, and she took him seriously. She began walking every other day, increased the whole foods in her diet, decreased her intake of carbohydrates and took her medicine.
Now, Miss Alston's cycles are regular and she is losing weight. In addition, she is undergoing laser treatment to remove excess hair, a procedure she started in March.
"The difference is night and day," Miss Alston says. "I'll just go out and face the world."
Miss Alston is among the 5 percent to 10 percent of American women of reproductive age affected by PCOS, says Sara Ducey, certified nutrition specialist and associate professor of nutrition at Montgomery College in Rockville.
PCOS is a hormonal imbalance that causes chronic annovulation, or lack of ovulation, and is the most common cause of infertility in women.
"While the name 'ovary' is in the name of the condition, it's systematic, or body-wide," Ms. Ducey says.
The exact cause of the condition is not known, but some women can be genetically predisposed to it, says Dr. Blake, a board-certified reproductive endocrinologist and associate professor in the obstetrics and gynecology department at Howard University in Northwest.
Women diagnosed with PCOS have at least two of three primary symptoms, which include polycystic ovaries, irregular or missed periods, and clinical or biochemical evidence of elevated androgen levels, Dr. Blake says. Androgen is a male hormone that includes testosterone and, at elevated levels in women, can cause male pattern balding, facial or body hair, and acne, he says.
Women with PCOS can have additional symptoms, including weight gain, insulin resistance, acanthosis nigricans, or discoloring of the skin, and skin tags, pieces of skin projecting from the normal skin layer, Ms. Ducey says. They also can feel exhausted and lack mental alertness, she says.
"Being a syndrome means not everybody is going to have the exact same symptoms," says Amy Shao, board member of the Polycystic Ovarian Syndrome Association, based in Englewood, Colo.
Most women with PCOS have numerous small cysts on their ovaries, or polycystic ovaries. Their bodies do not produce the right amount of estrogen and progesterone to carry out the menstrual cycle.
"There's an imbalance between the level of estrogen and the brain's response to that estrogen," says Dr. David Downing, Ob/Gyn residency program director at Washington Hospital Center in Northwest.
Normally, the hypothalamus, the part of the brain that measures levels of estrogen, sends a signal to the ovaries to ovulate, Dr. Downing says. In PCOS, the hypothalamus is bombarded with high levels of estrogen and responds by reducing the level of follicle-stimulating hormone that needs to be released at a precise time during the menstrual cycle, he says.
Follicles in the ovary, which are tiny sacs called cysts, hold the eggs. Each month, several eggs start to mature, with one usually becoming dominant. In the woman with PCOS, none of the eggs matures properly, and the eggs remain as cysts, causing ovulation not to occur.
"It's the abnormal signals that the ovary is getting that make the ovary produce too much testosterone," Dr. Downing says.
The shift in hormones can alter metabolism rates, causing a woman with PCOS to feel hungrier, Ms. Ducey says. If the woman eats more, the body fat she gains also produces estrogen, increasing the imbalance, she says.
In addition, a diet high in sugars overexposes the body to the insulin hormone.
Insulin is produced to process sugars, but with insulin resistance, the cells do not respond and the insulin cannot enter the cells, resulting in high blood sugar and high blood insulin, Ms. Ducey says. Insulin resistance, over time, can lead to obesity, she says.
"High insulin seems to trigger a predominance of male hormones in women," Ms. Ducey says, adding that PCOS puts women at risk for type 2 diabetes, cardiovascular disease and high blood lipids (cholesterol or triglycerides). "We want to catch this early in young women, and we want to treat it," she says.
Ms. Ducey recommends a diet low in sugars and refined grains and high in whole foods, along with daily exercise to help the insulin receptors in muscle cells become more sensitive to insulin molecules.
Other treatments include using birth control pills to normalize hormones and the menstrual cycle, taking ovulation-inducing medications to help improve fertility, and taking medications that help control blood sugar levels.
"It literally attacks your femininity," says Tulin Reid, who was diagnosed with PCOS in 1997. She is the founder of PCOSLiving.com, a Web site based in Southern California that provides support, research and education on the cure of chronic inflammation-related illnesses.
PCOS, Ms. Reid says, is a hormonal imbalance caused by chronic inflammation, which results from perpetual stimulation of the immune system.
"There are a number of things that can stimulate the immune system," says Ian Stoakes, Dutch author of "A New Dawn," which looks at the relationship between inflammation and fertility. Anything that "is 'non-self' triggers a response. The biggest source is food," he says.
Ms. Reid followed the protocol outlined in Mr. Stoakes' book and eliminated inflammation-triggering foods, which, for her, include wheat and tomatoes, among other foods. She lost more than 22 pounds in six weeks and saw her testosterone levels drop and menstrual cycle normalize, she says.
"For the first time, I feel like my life is under control," Ms. Reid says. "I want women to be able to see that PCOS doesn't have to beat you."
