The latest news, views, and strategies

for living Hfe at your best

S E C T I O N
e
bod
A hidden hormone

ca n't problem could

be to blame—
but there are easy
ose ways to get help.
by Melanie Haiken

weight? -r->-'' T liAl'fLN^s MORI, uilcii ihan

you might think: I'm standing
in hne a( the Hupt'imarkci, ad-
iiiii ing 111)' plate at a barbecue,
or cashing my paycheck at the
bank, when suddenly I realize with
absolute ceiLainly that the woman
in from of me has polycystic ovary
syndrome (PCOS). And I know, with
the sympathy that comes only liom
shared experience, that she's suffer-

m ing in shame-filled silence, unaware

that there's a name—and a wealth of

j f l ^ ^ K A L E ' S TALE:
j!li^H||^xcess weight,
especially around
your middle, is
a sign of polycystic
ovary syn

PHOTOGRAPHY BY SHELLY STRAZIS health

O
body TREATMENTS

polenlial treatments—for the con-
dition that's causing her so much
misery. It happened last summer,
when I met my daughters" peppy
young swimming instructor, Nikki,
for the first time. One look at her
hefty girth, downy checLs, and chin
reddened by acne and plucking, and
1 knew. But did I say anything? Weil,
no. It never seemed like the right
time, we didn't really know each oth-
er—my list of excuses was endless.
But to this diiy I wonder if Nikki ever
got the help she needed, and I wish
I'd offered a gentle word of advice
and support.
Most women with PCOS are like
Nikki: They don't know they have it.
So they ob\'iously don'l know thai
experts are thinking about the dis-
ease in a new way—and that this sliift
is paving the way for better remedies,
ones that can dramatically improve
symptoms and curb the disorder's
threat to long-term health.
Where experts used to classify
PCOS as a reproductive ailment,
they now see it as a problem with
the endocrine system, an imbalance
of the control center that regulates
GOT
QUESTIONS?
Find more info about
hormones. "PCOS is polycystic ovary syndrome
in places where most
not an inferlility disor- at www.inciid.org/faq/ women don't have it.
der or a gynecological pco5.html.Need support? Combine that with the
Log on to www.soul
condition; it is a meta- acne and the pounds that
cysters.com.
bolic disorder with wide- stubbornly refuse to come
spread systemic effects," says off, and you get the picture.
John Nestler, M.D., professor and It's tiot a pretty one. "The seif-esteem
chair of the Division of Endocri- issues are still so huge," says Lesa
nology and Metabolism at Virginia Childers, who runs PCOStrategies
C-ommonwealth University School (828-508-8811, www.pcostrategies
of Medicine. .oig), a noupiolit counseling sei^-
Excess weight is one of the more ice for women with the condition.
common effects; about 75 percent "Women tell me they just can't bear
of women who have PCOS ai e ovei- to tell anyone about it. They feel ter-
weight or obese, and they typically ribly isolated."
cartT the excess weight around their But ihey're noi nearly as alone as
abdomens. The syndrouie is also they might ihiuk. Expert.s used to
one of the leading causes of infertil- project that up to 4 percent of wom-
it). Small cysts that develop on the en in their chiklbearing years suf-
surface of the ovaries often lead to fered from PCOS. But new lesearch
irregular and infrequent periods, and broader guidelines for diagno-
keeping many women with the con- sis and treatment released in Janu-
dition from ovulaiing. ary have bumped ihe estimate up to
Another sign of PCOS—hyper- 6 to 10 percent worldwide.
androgenism—can make the disor- The guidelines, revised by the
der pat ticiilarly devastating, even American Society for Reproductive
shameful. A fancy term for overly high Medicine and the European Society
levels of male hormones, including for Human Reproduction and Em-
testosteione, liyperandn)gemsm aius- bryology, prominently acknowledge
es hail' to sprout on the face and body the role of insulin resistance (the

could it be PCOS?
p T'S NOT UNCOMMON for women with polycystic ovary syndrome
'i (PCOS) to see as many as four doctors before being diagnosed and
treated. Don't let this happen to you. If you've got just a couple of
the follovi/ing symptoms, ask your doctor to refer you to a reproductive
endocrinologist who specializes in diagnosing PCOS. Or check the
American Association of Clinical Endocrlnologists'online Physician Finder
(wwvy.aace.com/memsearch.php).

THE SYMPTOMS: difficulty losing vi/eight even

irregular or infrequent periods
* acne
® hair on your face, neck, chest,
or abdomen
thinning hairon your head,espe-
cially male-pattern-type bald spots
• excess weight or obesity
• darkpatchesof skin on your
neck, armpits, or inner thighs
v^fhen you diet
blood sugar fluctuations,
often marked by feeling shaky
a few hours after a meal
diabetes
high blood pressure, elevated
cholesterol, or high triglycerides
unexplained infertility or
repeated miscarriage

health
body

same problem that afflicis people

with type 2 diabeles) in the develop-
ment of PCOS. Insulin, a hormone,
regulates blood sugar. The link be-
tween it and PCOS makes uealing
insulin resistance all the more cru-
cial: Not only does (his condition
actually cause excess male-hormone
production, but if left untreated il
increases a woman's risks of type 2
diabetes, high blood pressure, ele-
vated cholesterol, and cardiovascu-
lar disease.
My situation offers a perfect exam-
ple of why the new view of PCOS is
so important. I was first told I had it
in my late teens, when I failed to have
regiilaj" periods. My doctor said I was
almost certainly infertile. I still re-
member spending that night locked
in my room, in tears. Over the yeais,
TAKE A GOOD
liowever, my FC^OS proved lo be fair- Acne and facial hair
ly mild. To regulate my periods, I are common among
stayed on birth control pills, which women with PCOS. Don't
helped control my acne and excess ignore these signs—
they're easy to treat.
liair. Although ii took me 2 years to
some women wilh P(X)S who lost
New medications—and lifestyle changes— just 5 percent of their body weight
went on to ovnlate sptjntaneously.
are helping many women with PCOS llie ke)' to this minor miracle seems
to be curbing insulin resistance.
wavegood-hye to their symptoms. Once the weight starts to come off
and overall fitness improves, "you
conceive myfiist child, I did .so with- miscarriage, induce weight loss, and can quickly reverse insulin excess
out fertility drugs—and my second reduce caiclio\'ascLiIai' lisk factors. R^r in a day or two, believe it or not,"
pregnancy was almost an accident. I many PCOS sufferers, it's the first says Ronald Feinberg, M.D., Ph.D.,
had practically stopped worrying thing that's worked after a lifetime a reproduclive endocr inologist in
about it until 3 years ago, when my of yo-yo dieting and self-blame. Of Newark. Delaware, and the author
doctor announced that my choles- course, some women find that they of Hpaling Syndrome O: A Strategic
terol iind triglyceride levels were dan- don't want to stay on such a strong Guide to Fertility, Polycy.stir Ovarie.s,
gerously out of whack. Suddenly, this drug indefinitely. Fortunately, thai arid Inxulin Imbalance {Avery Publisti-
disorder I thought I had beaten was may be unnecessary. ing Group, 2004).
once again a threat. When women wilh the disorder' Losirrg weight, of coLrrse, is n<j easy
The real treatment breakthrough make dramatic lifestyle changes llial task for women who have PCOS, in
is the use of medications known as help them lose weight, exper ts say, part because insulin resistance actu-
insulin sensitizers, usually prescribed the effect on their insulin r'esistance ally makes it harder. Wildly fluctuat-
to treat diabetes. Among the most can be startlhrg. Orre recent study ing blood sugar levels lead to food
popular is metformin (Glucophage showed metformin was consider ably cravings. And liigh insulin levels, a
is the brand name). Recent research more effective when combined with by-product of resistance to the hor-
shows ihat it helps re-establish ovu- a healthy diet and exercise. And last mone, actually cause the body to
lation, facilitate pregnanc)', prevent year, a landmark study showed that bur n fat less efficiently. At the same

health

lime, Nestier says, "The heavier you
are, the more insulin-resistant you
are." So it's a vicious cycle.
Still, experts say eating a diabetes-
friendly diet (see www.diabetes.org
for recipes and tips) and exercising
regularly may help many women with
PCOS shed pounds once and for all
and keep other symptoms under (•on-
irol. Although my weight has never
been a huge problem, 1 do eat much
more carefully now since learning
about the insulin connection. I've
ctit out all sugar and most refined
carbohydrates, and Tm big on pro-
tein: eggs, fish, and meat, especially
chicken. Those changes have proved
effective in curbing my insulin resist-
ance and keeping my blood sugar
levels from spiking. I take a supple-
ment aimed at leducing my choles-
terol, and that's helped, too. I also
exercise much more frequently—at
least four titnes a week tor 45 min-
utes, often more.
Childers, the PCOS counselor,
thinks these kinds of lifestyle adjust-
ments are critical. "I spent years try-
ing all sorts of diets, and notliing ever
worked," she says. But once she dis-
covered the insulin connection, quit
the low-fat and low-cal diets, and in-
stead focused on avoiding foods like-
ly to raise her blood sugai—anything
loaded with sugar, white flour, and
refined carboliydrates—she was able
to cut calories without counting and
lost 50 pounds. She also conceived
her third child naturally. And while
Childers leaned on exercise, which
also improves insulin sensitivity, to
liclp her lose weight, you don't have
to go all out: She says 30 minutes of
moderate activity four times a week
will bring immediate results.
Now if I could just find Nikki and
lell her. O
Melanie Haiken, the former health «rf?-
/oro/Parenting, livens in northern Cal-
ifornia ivith her two daughters.
body
o
( brief)
Focus on fruit—your eyes will thank you
Move over, carrots: New research
suggests that fruit may be the
real snack for sharp eyes. Eating at
least three daily servings may
cut your risk of a type of age-related
macular degeneration (AMD).
This condition can damage straight-
ahead vision, which is critical for
reading and driving. Substances in
fruit, such as fiber and fiavonoids,
could help sharpen sight and guard against deterioration of the
retina,thepartoftheeyethat responds to light, researchers say.
PMS: a sign of things to come?
If your premenstrual syndrome is so bad that you're actually
looking forward to menopause, we've got some not-so-
good news for you. University of Pennsylvania researchers recently
discovered that PMS sufferers are up to twice as likely to ex-
perience troublesome hot flashes, depression, and poor sleep
during the big change; sensitivity to hormone fluctuations
seems to be responsible. Silver lining: If antidepressants or other
treatments relieve your PMS symptoms, they may work well
when you're older, too.
Have a glass of bubbly (water, that is)
Could better cholesterol numbers be as easy as drinking carbon-
ated mineral water? In a small Spanish study, women who
drank 1 literperday ofa waterrich in sodium bicarbonate and
sodium chloride lowered their total cholesterol by 7 percent
and their LDL (bad) cholesterol by 15 percent over 2 months.Their
HDL increased by 8 percent. Researchers think the minerals
and carbonation may help your body metabolize cholesterol.
Nasal sprays: Sniff, don't snort
Studies suggest zinc nasal sprays can cut the length of a cold in
half if used early enough. But don't get too carried
away.The U.S.Food and Drug Administration is
investigating reports from dozens of people
who say they lost their sense of smell (a con-
dition known as anosmia) after using these
products. Some experts think that snort-
ing the sprays—instead of gently sniff-
ing them, as the labels advise—may
expose smell receptors high up in the
nose to the drug.The manufacturers main-
tain no patients in their clinical studies devel-
oped anosmia.
health