My doctor recently diagnosed me with Insulin Resistant PCOS — Polycystic Ovarian Syndrome. PCOS is a complex hormonal disorder that affects 1 in 10 women and is the most common cause of infertility. The cause of the disease is an imbalance of reproductive hormones that prevent ovulation. Insulin Resistance is when your body doesn’t respond to insulin and is unable to use glucose to supply your body energy. Unfortunately, PCOS does not have a cure, but there are multiple treatment options (natural and medical) you can try.
If you’re unfortunate like me, your doctor told you: you’re unable to ovulate, you have too much testosterone, you’re probably infertile, and slapped you with a prescription. Then for days to come, you’re haunted by the woman you could not become. I am here to tell you, what the doctor says is not the end all be all of your womanhood.
There isn’t a one-solution-fits-all guide to tackle PCOS, but the first step is identifying why your hormones are out of whack. For me, my body is insulin resistant, as a result, I’m constantly fatigued, I don’t sleep at night, and I have weird sugar cravings. One time I ate half a dozen giant Prarie Girl cupcakes on my own, wild, right? Due to this insensitivity, I’ve had to restructure my lifestyle, including changing my diet, incorporating exercises, and ensuring I have a self-care routine to help reduce stress.
Yes, PCOS doesn’t have a cure, but there is treatment to help you start ovulating again and get your body back on track. You can have children! You can keep planning for a family! You can take control of your life! It just takes a little bit of work, and I promise you can get there. However, it starts with understanding what the heck is happening in your body! & I hope I can convey all that information to you and provide you with the tools you need to get started.
I’ve listed all the resources used to curate data in this article at the end. I implore you to continue reading and researching about your PCOS. The treatment is in your knowledge.
The Science Behind PCOS
We know the effect of too much testosterone is no ovulation, but what does that mean? I can assure you it doesn’t mean you’re becoming a man. That’s not it. So let’s start at the beginning, your menstrual cycle.
Your menstrual cycle consists of 4 phases: menstruation, the follicular phase, ovulation, and the luteal phase.
Menstruation is the phase we know all too well, and it’s the ugliest part of the month when your body sheds its uterus lining. It sucks, but it’s oddly comforting when that process occurs on time.
The follicular phase is when the pituitary gland (a tiny pea-sized gland in your brain), signals it’s time to release two hormones: FSH — Follicular Stimulating Hormone and LH — Luteinising Hormone. These hormones help your ovaries produce follicles which houses immature eggs.
Eventually, eggs mature, and we move onto the ovulation phase, where the egg is funneled to the fallopian tube and awaits our good ol’ friend, Mr. Sperm. Ovulation is the phase that many of us with PCOS cannot get to.
Finally, the luteal phase, if Mr. Sperm does not fertilize our egg, then pregnancy won’t occur, and progesterone levels drop and causes menstruation (yay we’ve come back full circle).
For ovulation to occur, our bodies need to produce follicles which trigger a rise in estrogen. Our brain internalizes the rise and prompts more chemical release, which then prompts our pituitary gland to release LH and FSH. The impairment of the maturation of your follicles to ovulation is known as follicular arrest.
Follicular arrest happens for two reasons: Follicle Excess and Inhibited FSH. Stick with me. You’ve got this! Inhibited FSH is what it sounds like; our bodies are unable to release FSH during the follicular phase. This inability feeds follicle excess. Many of us with PCOS undergo a vaginal ultrasound, the results reveal what doctors call “cysts on our ovaries,” but they’re not exactly cysts. Those bubbles on your ultrasound are enlarged follicles or follicle excess. Make sense so far?
Okay. So why is FSH inhibited, and why are our follicles growing abnormally large? Remember what your pesky doctor said about you having too much “testosterone”? That’s not entirely true! The reason you have acne on your skin, facial hair, hair loss, and most importantly, the absence of menstruation is because of a condition called hyperandrogenism. Your body has high levels of androgens. There are different types of androgens, and the primary androgen in males is testosterone. However, both males and females produce androgen but at different levels. Women with PCOS produce more androgens than whats considered normal. Insulin levels and cortisol levels offset hyperandrogenism.
If you didn’t know, there are many types of PCOS because there are many reasons for the processes offset. For example, you can have PCOS that is offset by coming off the pill, or you can have PCOS because of a low-grade chronic inflammation in your body. Regardless of the type or the reason, your body is undergoing some form of stress. The physical (internally or externally) or psychological stress causes your insulin and cortisol levels to be out of whack.
You made it to the end! You understand the process! Congratulations! Step one is complete!
When my doctor diagnosed me with PCOS, I was a wreck. I was angry at myself, mad at my doctor, and mad at the world. I was sad, distraught, and ultimately in shambles. I felt like I had nothing left for myself, and I felt incredibly alone. One of my greatest fears is not being able to have a family when I’m ready. I’m an only child, and I’ve always wanted a family bigger than my own, so building one means a lot to me.
Going to the doctor and getting my diagnosis was like a crushing weight on my womanhood. It felt like I watched my womanhood shatter right before my eyes, and I had no way of repairing it. The doctor prescribed me Metformin for my insulin resistance and birth control, then walked away like it was nothing. It’s okay to feel upset, angry, and confused. All of those feelings are valid. It’s a scary feeling, not knowing how to take control of your body and your life, especially when health care providers don’t take the time to explain things to you. However, they’re many amazing women who have been on this journey before and can offer fantastic advice, encouraging words and resources to help you take control.
There are large communities on YouTube, Facebook, and all over the internet to guide you through this time. I assure you, you are not alone, and you are not broken.