Do You Have PCOS?

Polycystic Ovarian Syndrome (PCOS) affects millions of women in the United States and causes a variety of fertility, hormone, skin, and ovarian problems.  In January 2013, a panel based on the Evidence Based Methodology Workshop at the National Institutes of Health suggested renaming and redefining the diagnostic criteria as they reported that PCOS should be determine by having 2 out of 3 criteria: excess androgens, ovulatory issues and multiple cysts in the ovaries.  This eliminates the requirement for ovarian cysts in absolute diagnosis as many people currently believe.

Typical symptoms of PCOS include: acne, excessive hair growth in places women typically do not want it, missed periods or irregular periods, not ovulating, weight gain especially around the middle, blood sugar and insulin problems, fertility problems, and ovarian cysts.  Androgens are a group of hormones such as DHEA, testosterone, androstenedione, and dihydrotestosterone that cause the skin and hair complaints.  Testing for PCOS can be difficult and as it is very multi-factorial .  First, evaluating for symptoms is important. Next, testing for androgens and looking for elevated levels.  Evaluating the menstrual cycle history looking to see if it is regular (roughly every 26 to 32 days) and if she ovulations. Testing for fasting blood sugar and insulin levels may indicate further consequences.  An ultrasound will visualize cysts on the ovary and discussing fertility challenges are important.

One of the issues the panel discussed was the difficulty in diagnosis as women will see different doctors or specialists for different issues.  A woman having trouble conceiving may see a fertility specialist while the woman with no menstrual cycle visits her gynecologist.  Acne and hair growth around the upper lip, chin, neck, nipples and abdomen may be evaluated by a dermatologist or aesthetician. If all symptoms are not accounted for, PCOS may be missed.  Also, women and their doctors may rule PCOS out if the ultrasound does not show multiple cysts on the ovaries yet she still has all the other symptoms.

Treatment for PCOS is important as long term sequelae can include diabetes mellitus, high blood pressure, high cholesterol, obesity, and a higher risk for cancer.  Seeking a healthcare provider who can evaluate all the symptoms, blood work and imaging then come up with a short and long term plan addressing all aspects is critical for health.  If the symptoms of PCOS sounds like you, do not hesitate to seek help as your health is important.

References:

1.       PCOS Diagnostic Criteria Clarified; Name Must Change.  Web.  27 January, 2013.
http://www.medscape.com/viewarticle/778066
2.       Increased Risk of Type 2 Diabetes with Polycystic Ovary Syndrome.  Web.  27 January, 2013.
http://www.medscape.com/viewarticle/767811

Sleep to Improve Your Metabolism

Who does not love a good night’s sleep?  Sleep is critical for brain function, energy, the restoration of our cells, and helps rejuvenate our mood.  It seems like everything is improved after a night of rest.  Unfortunately, many are not getting the appropriate amount of shut-eye that they need and as a result, they are chronically sleep deprived which can lead to unhealthy symptoms such as worsened insulin sensitivity.  If you are trying to lose weight or improve your diabetes numbers, then sleep will be very important.

In the October 2012 Annals of Internal Medicine, the researchers looked at a small sample of people and found that those who only slept 4.5 hours per night had 30% less insulin sensitivity in their fat cells.  Insulin sensitivity is critical for moving glucose into the cells which helps with, among other things, weight loss.  The more sensitive a cell is, the easier it is for insulin to do its job, maintain balance and not gain weight.  Unfortunately, as a cell loses its sensitivity it becomes known as insulin resistant which can lead to pre-diabetes, diabetes, elevated insulin levels and fat gain. 

Another study examined the relationship to sleep, insulin and adolescents finding that those who averaged 6.4 hours of actual sleep per night had higher levels of insulin resistance compared to those who slept longer.  This information is important as the nation’s obesity epidemic is affecting children and teenagers just as much as it is affecting adults.  Quality sleep habits need to start young in order to help with expanding waistlines. 

Many people find that they cannot fall asleep, stay asleep or both.  Plagued by nightly issues, this leads to other problems such as daytime drowsiness/fatigue, memory issues, attention problems, and changing moods.  There are several sleep habit tips that are important to recognize when it comes to good sleep.  While many of these suggestions seem simple, how many of you are actually doing them?

First, go to bed early.  Try to re-set your clock to be in bed at a decent hour.  Second, focus on winding down so that your mind is not spinning with everything about your day, or that you need to get done, or what is worrying you.  Third, get off your phone, ipad and computer and do not sleep with those things next to your head with sounds going off through the night.  Fourth, do not eat sugar or drink alcohol before bed as this often causes blood sugar issues through the night causing frequent wake-ups.  Fifth, consider bed time rituals such as tea that helps with sleep, 5 minutes of quiet meditation, deep breathing, journaling, snuggle with your animal, partner or child, and focus on all the positive things that happened in your day so that you end on a happy note.

 

References:

1)      Impaired Insulin Signaling in Human Adipocytes After Experimental Sleep Restriction: A Randomized, Crossover Study.  Web.  27 October, 2012. 

http://annals.org/article.aspx?articleid=1379773

2)      Insulin sensitivity: modulation by nutrients and inflammation.  Web. 27 October, 2012.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2522344/

3)      Insulin sensitivity: modulation by nutrients and inflammation.  Web.  27 October, 2012.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2522344/