PCOS symptoms

[ajd76]

I'm 32 years old and a year and a half ago I was diagnosed with PCOS with insulin resistance by my primary care doctor.  I was having irregular periods, hair loss, had weight gain inconsistant with my caloric intake and activity level and could not lose weight...in fact I was gaining despite lifting weights and a daily walking regimen of 2 miles or more and cardio on an eliptical.  I was also starting to grow hair in a small patch on my chin and neck and on my abdomen.  I also was trying to get pregnant with my 3rd child (first took a year and a half at age 23, second 6 months after going on very low carb diet and losing 30 pounds..I had not been diagnosed with PCOS yet) and had not gotten pregnant after a year and a half.  I think I've had this since starting my period at almost 14 as my weight gain and trouble losing weight started then along with horrid acne I had to have a prescription for and my cycles were never regular.  However doctors kept telling me nothing was wrong, it was just puberty and when I got older I was just told I ate too much (I didn't) and that some people just have irregular cycles.  My doctor put me on Metformin 500 mg twice a day then upped it to 850 mg twice a day.  Within 6 months I was pregnant and had a healthy baby boy this last November.  After 6 weeks postpartum, I was put back on the metformin same dosage and Yaz birth control pills.  I've just started a low carb diet to try to lose the pregnancy weight.  However, even when I was on the metformin before getting pregnant and now that I'm back on it, I have not noticed any reduction in the hair growth on my neck and chin and abdomen, in fact, I think the hair growth on my abdomen is getting worse!  It used to just go up to my navel, now it's growing in a line above it almost to my chest.  I also have noticed a few long dark hairs on my breasts.  Is there anything else I can do other than shaving/waxing?  Should the metformin and BC pills stop this?  

[Elaine Brown, MD]

Hi!
Its unfortunate that your doctors didn't figure things out sooner, but the medical community has learned a lot about PCOS within the last 10 years or so.

Metformin  and oral contraceptives are a good combination for excess hair growth--but it will only stop NEW hairs from growing--the old ones will continue to be a problem.  The best way to get rid of the ones that are already there is with a hair removal laser.

You might also want to ask your doctor about Spironolactone--this medicine is usually used for blood pressure, but it blocks testosterone receptors and might really help the hair growth and acne both.  Two important things to know about spironolactone are that it is a diuretic (water pill) and so you will urinate a lot,  AND it can cause birth defects if taken during pregnancy--so you definitely want to continue with your pills too,

By the way, PCOS sure seems to be hereditary--so keep an eye on your kids--and congratulations on having such a nice healthy family!

Good luck!
Dr B

[ajd76]

Thanks so much for the advice.  I will definitely talk to my doctor about the spironolactone.  I had never heard of this before as a treatment for PCOS.  The only treatments I've read about on the internet and in books is metformin and birth control pills.  

I'm sure that PCOS is hereditary...I have a cousin who has it, an aunt who I'm pretty sure has it (she's morbidly obese, diabetic now and on metformin too and had to have a hysterectomy years ago due to uterine cancer) and my sister is overweight and doesn't have periods unless she's on birth control.  I've tried to get her to see a doctor and get on metformin but she as yet has decided against it though I don't know why with all the other risks PCOS opens one up to.  I have one daughter who is 8 and I will definitely be watching out for signs of it when she hits puberty.  

Thanks again.