Meal Planning

You will stay fuller longer, have an easier time keeping your weight healthy, and have better control of your insulin levels if you include protein, a high-fiber source of carbohydrate, and some fat at each meal and snack.

The table below lists some suggestions for foods that are a source of the nutrients protein, carbohydrates, and/or fat. Remember to pick carbohydrates that are high in fiber (like whole wheat bread or vegetables) or those that are found in nutritious foods (like fruit, yogurt, and milk). Try to choose mostly unsaturated fats.

Plan sample meals and snacks using the foods from this table. Remember to include something from each column of nutrients at all of your meals and snacks! After you've done your planning, make a grocery list of the foods you will need to help you eat your balanced diet.

Protein	Carbohydrates (High fiber when possible!)	Fat
Beans* Beef Cheese* Chicken Egg substitute Eggs* Energy Bars* (>10 grams of protein per bar) Fish Hummus* Milk (lowfat)* Nuts* Peanut Butter or other nut butters* Pork Shellfish Tofu* Veggie Burgers* Yogurt*	Beans* Bread (whole wheat) Brown rice Cereal (>5 grams fiber per serving) Crackers (>2 grams fiber) English muffin (whole wheat) Energy Bars* (<25 grams of carbs per bar) Fruits Hummus* Milk (lowfat)* Pasta (whole wheat) Non-starchy vegetables Yogurt*	Avocado/Guacamole Butter/margarine Canola or olive oil Cheese* Cream cheese Eggs* Energy Bars* Fish* Hummus* Peanut Butter or other nut butters* Salad dressing

*These foods have more than one of the 3 nutrients (protein, carbohydrates, or fat).

Birth of a Butterfly

PCOS can be very dark and lonely. I don't know the author of this poem, but it was shared with me by a fellow cyster.
"Birth of a Butterfly"

Locked in the dark
I struggle to see
To break the chains
And set myself free

Such a long battle
With no end in sight
I fight to break loose
I fight to see light

I scream from my prison
But nobody hears
The silence around me
Intensifies my fears

Struggling alone
In my little cocoon
I finally break free
And crawl out on my own

My heart once was locked
By my dark memory
I found a bright light
And I turned the key

I learned to love
And came to realize
How beautiful I am
In my very own eyes

What I saw outside
Was not the real me
Just a shell that held
The woman I could be

I saw my potential
My personality
I focused on ME
And I set myself free

I stretch my wings
And begin to fly
Finally I am
A beautiful Butterfly!

Diet, exercise and stress...

To truly come to grips with PCOS, you need to do three basic things: improve your diet, get more exercise, and reduce stress. Here are ten essential tips for making these changes.

Tip #1: Improve your carbs.

Avoid refined carbohydrates such as white bread, white rice, pastries, candy, breakfast foods, bagels, and other refined grain products. These are "bad carbs" that create insulin resistance. Insulin resistance is thought to be a primary cause of polycystic ovary syndrome.

Refined, manufactured foods in general tend to cause you to gain weight, especially around your middle.

Better carb choices are fresh vegetables, fresh fruit, and some whole legumes.

Tip #2: Increase protein.

Many PCOS women consume too much refined carbohydrate and not enough protein. High-quality protein helps you to keep your hormones normalized. The best protein sources are fish, poultry, eggs, wild game and extremely lean meat.

Tip #3: Change your fats.

Some fats and oils make your PCOS symptoms worse while others improve them. In excess, supermarket vegetables oils such as corn oil or man-made fats such as "trans-fats" can cause cells to not function properly. Saturated fats found in fatty meats and some dairy products are also undesirable.

Better choices include virgin olive oil, flax oil, cod liver oil, and fish oil.

Tip #4: Eat more veggies.

One of the most important things you can do is to eat more whole vegetables. Try to have at least five vegetable servings a day. Eating a significant quantity and variety of fresh, whole vegetables is a cornerstone of self-help therapy for the many health problems associated with polycystic ovary syndrome.

Tip #5: Control your meal portions.

Americans consume excessively large meal portions. The more you are served, the more you will eat. Trim the size of your meal servings. Eat slowly and enjoy a meal. Wait for 20 minutes. If you are still hungry, then you can go back for another portion.

Tip #6: Have salad or soup at the beginning of some meals.

Medical studies have proven that eating a big salad at the beginning of the meal will result in fewer total calories eaten at the meal. Soup is another excellent food to help you feel full without consuming too many calories. Having soup or salad with a meal will cause you to eat fewer calories and improve your ability to lose weight.

And don't forget, fewer calories will help you lose weight and improve your fertility.

Tip #7: Exercise daily.

We often feel that we're too busy or rushed to exercise. However, not exercising is a luxury you cannot afford. PCOS women in particular must exercise more than the average person. Regular exercise has been shown to improve polycystic ovary syndrome and improve fertility.

As a minimum, try to walk or do other exercise for at least 30 minutes a day. More is better. Try a variety of exercise. For example, you might alternate aerobic exercise with weight lifting.

Tip #8: Control stress.

Chronic stress from any source -- your job, your spouse, your family, your finances -- disturbs your hormone balance, and causes you to gain weight around your midsection. Do what you can to improve any situation that is continually stressful for you. You can also work on changing your attitude towards a situation you perceive as stressful. In addition, be sure to take time for relaxation and restful sleep.

Tip #9: Join or form a PCOS support group.

Isolation is not helpful. Find other women who are going through the same thing you are and communicate frequently to give each other support and encouragement.

Tip #10: Consult with a knowledgeable health professional.

PCOS is a complex disease that is difficult to treat. Find at least one doctor who fully understands what PCOS is and has some innovative ways of treating it.

In conclusion, remember that eating the wrong foods -- and living a sedentary and stress-filled life -- will delay or prevent your return to good health. If you follow these Ten Tips, you'll be amazed at how much control you have over PCOS and infertility.

Why does this concern me?

In November of 2006, my 16 year old daughter, Becca, began complaining of lower abdominal pain. She very rarely had a period, and never had cramps, and this occurred during a period, so we assumed that she was having cramps for the first time with her period. After a week of the pain not letting up, we went to our Pediatrician, who did a pelvic x-ray, which came back fine. He then scheduled us for a sonogram of her ovaries. The earliest appointment was weeks away, and the pain was continuing, so we went to the ER about the abdominal pain.

They did a sonogram, and while her ovaries were enlarged, their real concern was that they had found a tumor in her bladder, that ended up being cancer. That's a whole other story that I won't get into here, but the tumor was removed and had not spread, and she is now doing well in that area.

However, after recovering from that surgery, she still had this lower abdominal pain, and had not had another period. We went from one doctor to another, trying to figure out the cause, till we finally saw a Urologist/Gynecologist at Magee Hospital in Pittsburgh.

When we described all of Becca's symptoms, she immediately told us that she believed Becca had PCOS. She had a vaginal ultrasound immediately and they ran lots of blood tests. She then referred us to an Endocrinologist, also at Magee, and wanted us to see him right away. We got in two days later, and after reviewing her blood work and the ultrasound, he diagnosed her with PCOS.

So this blog will be a bit of information about Becca and her experiences with PCOS, and an information site to help get the word about about this syndrome. There isn't enough information out there, and I want more doctors and women to understand this condition.

Treatments and Options

It isn't known why some women develop PCOS and others don't. But if a close family member has it, you are more likely to have it too. The immediate cause of all the various symptoms is known to be hormonal, and medical treatments are generally designed to change hormone levels.

Treatment tends to be different for each symptom and a treatment for one may not help another, so it is important to decide which symptom is troubling you most.

What treatments are available?

Treating absent or irregular periods
Since the follicles don't ripen with PCOS, the corpus luteum doesn't form and progesterone isn't produced. As a result the endometrium (the lining of the uterus) doesn't thicken. It's the thickened endometrium which is lost with a normal menstrual period. Many women feel better for having a period each month. If a woman doesn't want to get pregnant, the usual way to manage PCOS is either a low dose combined contraceptive pill, or a progestogen only pill.

Treating infertility
Although not ovulating is likely to be the cause of infertility, it is important to check for other possible causes in yourself or your partner before starting any treatment.

Treatment with the pill for other symptoms will stop you from getting pregnant. If you want to induce ovulation, you will probably be offered fertility drugs such as clomiphene. 80% of women with PCOS ovulate on clomiphene but only 30 to 50% will conceive. If you're not pregnant after three clomiphene treatments, you may be given hormones directly by injection or a small wearable pump. If hormone treatment doesn't work you may be offered other options that your doctor will explain to you.

Treatments for unwanted body hair
Unwanted hair growth (hirsutism) is caused by excess male hormones (androgens). Polycystic ovaries produce excess amounts of an androgen (testosterone). Although all women have some testosterone, people think of it as a male hormone because it influences male characteristics such as body hair and balding.

For women who don't want to conceive, excess hair is usually treated with the combined contraceptive pill and an anti-androgen. If you decide to use these treatments they may take several months to take effect. In the meantime, or as an alternative, you may wish to control hair growth with treatments such as waxing, electrolysis or lasers, or use bleaching and foundation creams to disguise growth.

Treatment for acne
Like hair growth, acne is caused by high levels of androgens and may be helped by similar treatments. The combined contraceptive pill can help with acne as well as regulating your cycle. The progestogen-only pill can make acne worse. Over the counter or prescribed spot treatments might be worth trying, but they dry the skin. Antibiotics, while useful in treating some forms of acne, are not going to solve the problem when it is hormonal.

Weight gain
The metabolism of a woman with PCOS is thought to differ from that of a woman without it. Women with PCOS use energy from food more efficiently, so relatively more is stored as fat. Advice to eat healthily and get plenty of exercise can be very frustrating for women with PCOS because it is more difficult to lose weight if you have PCOS. Try five smaller meals each day to help regulate blood sugar levels and reduce cravings for sweet or high fat foods. Loss of between 5 and 10% of body weight leads to a significant loss of symptoms.

Treating pelvic discomfort
This may be helped by regulating periods. But if you have had investigations to make sure it is nothing more serious then you may feel it is worth trying alternative therapies such as acupuncture, aromatherapy or relaxation. Some women find that regular exercise such as walking eases aches and pains throughout the body.

What is PCOS?

What is it?
PCOS, Polycystic Ovarian Disease affects an estimated 6-10% of all women and the majority of them don't even know they have it. It is a treatable condition, but it is not curable. It can be treated with medications, changes in diet and exercise. It is one of the leading causes of infertility in women, however it affects far more than just reproduction. It is not just a cosmetic problem, it is a true health problem.

What are the symptoms?
The most common symptom is irregular or absent periods (menses). Some of the other symptoms include numerous cysts on the ovaries, high blood pressure, acne, elevated insulin levels, Insulin Resistance, Diabetes, infertility, excess hair on the face and body, thinning of hair on the scalp (Alopecia), pelvic discomfort, and weight problems or obesity that is centered around your middle.

What do the cysts look like?
The many cysts in a polycystic ovary are follicles that have matured but, due to abnormal hormone levels, were never released. In a normal ovary, a single egg develops and is released each month. With PCOS, some of the follicles are immature but contain an egg, and others are empty. A polycystic ovary contains at least ten cysts just below the surface, and although each cyst only measures between two and eight millimeters, together they make the ovary enlarged. The covering of the ovary (the capsule) thickens, which makes release of the egg difficult.
Do I have PCOS?
One of the most important issues is determining whether or not you actually have PCOS. There are other endocrine disorders that are similar to PCOS, and it is important that you work with your doctor to determine if you have PCOS, or something else. If you have any of the symptoms above, contact your Gynecologist and let him know. He will most likely take a blood sample to check your hormone levels and may want you to have an ultrasound scan. Modern ultrasound is very sensitive and can detect even small cysts.