After a long series of emails back and forth between myself and my doctor and a refreshing five days in the tropics, I did some soul searching and have made some decisions.
First, though, a little background.
I am grateful for the fact that even though I may not love my OB/GYN, I can at least email her and she will respond quickly and deal with my crap. You may remember that I was arming myself with a series of questions to ask my doctor. I now have answers to everything I need to know for the time being. Specifically, in my doctor's words...
Regarding being thin with PCOS and taking Clomid:
You are correct that a large number of women with PCOS are overweight. It is good that you are not overweight, but the treatment would be the same even if you were. However, though I don't have any hard numbers for you, the Clomid will probably be more effective for you since you are not overweight.
Regarding insulin resistance:
We did not check to see if you are insulin resistant because it is no longer recommended to do so routinely. This is because the insulin resistance tests are not reliable. And even if they were reliable, the treatment would not change based upon the results. Sometimes we screen for diabetes in overweight patients with PCOS. You had a normal diabetes screening test less than 18 months ago. Since you are not overweight and do not have a family history of diabetes (please let me know if this has changed recently), you do not need to repeat the test at this time. I can check it if you want, but it is not necessary now.
Regarding Metformin vs. Clomid:
Metformin has fallen out of favor as routine treatment for PCOS. We used to use it as a first line treatment for PCOS in women not desiring pregnancy, but it was not very good at regulating periods. We used to use it in conjunction with Clomid to improve ovulation, though this never panned out. So, currently it is not recommended to use Metformin routinely in women with PCOS. The exception is in women with abnormal fasting glucose, which you do not have. So, the Metformin would not be helpful for you for fertility treatment.
Regarding lifestyle/diet changes:
Since you are not overweight, there are no lifestyle changes that you would need to make prior to taking fertility medication.
Now, maybe my doctor doesn't have all the answers. In fact, I am convinced she doesn't, but I'm also now convinced that no one has all the answers to the situation I'm dealing with. She's not a fertility specialist, and I shouldn't expect her to be one. For now she seems knowledgeable enough, and nothing in our recent correspondence has been out of sync with the copious amounts of information I've been reading lately from other sources, so this is a good sign.
Now, for the decisions:
I've decided that I am willing to try Clomid. I'll give it a shot in June when I am not working, and provided it doesn't work on the first try (unlikely, the pessimist in me says) and depending on how it makes me feel, I'll either stick it out through the three rounds back-to-back in the summer or choose the take the Clomid in between attempts to get my body to ovulate on its own or even quit the Clomid if I have too many intense side effects. Even though my doctor will only prescribe me three rounds of Clomid, that doesn't mean I have to take the drug for three continuous months.
This does mean that I have to go in for some expensive appointments and additional tests before I can start the Clomid. Goodbye, $15 co-pays and free lab work. Hello, ridiculously expensive visits and tests because anything with the "infertility" label stamped on it means big business and minimal, if any, insurance coverage. (I would like to point out the irony here: that I have cost our nation's medical establishment and insurance companies virtually nothing in my entire life thanks to my perfect health and general fear of doctors, and yet the ONE TIME in my almost 30 years of existence that I ACTUALLY NEED intervention is the ONE TIME I can't get coverage. This is the salt in the wound of infertility.)
The next step:
So today I officially made my first infertility appointment, an infertility consult. This is a 20-minute in-person appointment where my doctor gets to tell me answers to the questions I've already asked over email for free, expect now I get to pay $75 for the in-person greeting and several hundred dollars for another blood test she'll schedule after my appointment for whenever day 3 of my next cycle should be (your guess is as good as mine!!! -- right now I'm at CD 38 with no signs of ovulation close by). If you're surprised about this required visit, so am I. I figured that because I already have a diagnosis -- that is remarkably accurate given my symptoms -- that I wouldn't need to go in for a consult. Turns out this is the first of no doubt many hoops I'll need to jump through before I can get what I want.
Here's the info, straight from my doctor:
Though your diagnosis is accurate, the infertility consult is necessary to get the ball rolling so to speak. I can't order your lab work or HSG without it. The infertility consult is the beginning of the process, during which we discuss the parts of you and your husband's medical history that may relate to fertility. There will be an additional co-pay of about $75 for the visit. Husband's often attend this visit, though it is not required. All I need to know from him is if he ever got anyone pregnant in the past, if he has ever had the mumps, if he has ever had pelvic or genital surgery, if he has any medical problems or takes any medication for any reason and what he does for a living. If you can answer those questions for him, then he does not need to come. Though, he is welcome if he wants to come.
Of course, my doctor already has my complete (and extremely limited) medical history, and I've asked every question in the book, and my husband has no prior medical problems or other concerns listed above that would be interfering with our ability to conceive. All this she already knows, but I have to tell her in person so she can check a box. Now I'm starting to understand why people get annoyed with the medical establishment.
But I will suck it up. I am a fighter, but I am not in the mood to bring down the system. I will quietly show up at my March 8 appointment, pay my $75, and hope that all this will be worth it in the end. Because right now I have to believe it will be.
Thursday, February 24, 2011
Sunday, February 13, 2011
Self esteem
The thing I have the most of in my life is self esteem. I really like myself. I think I'm smart, and funny, and talented in many areas. I'm a good friend and wife. I also love my body. I love my figure and my hair and my eyes. According to one book I just read, with a BMI of 21 I have a "perfect" height-to-weight ratio which is also considered ideal for baby making.
Loving my body in particular puts me in the extreme minority of women. A 2003 survey by the Women's Channel of AOL found that only 4 percent of 45,000 women polled were happy with their looks.
In the last two weeks, though, since being diagnosed with PCOS, and in the months leading up to my diagnosis when I suspected a problem, I've started to dislike my body from an internal perspective. On the outside, I still look the same. I'm happy with everything I see in the mirror, including the little bit of jiggle I see on my thighs and butt (where I tend to carry my weight). On the inside, I feel like my body isn't doing what it's supposed to do.
These recent feelings seem very un-PC and very 1950s housewife of me. All my life I've been an exceptionally strong woman. I've scoffed at people who've told me I need to learn to cook for my husband. I've been (and continue to be) staunchly pro-choice, believing that no one should be able to tell me or any other women what to do with our bodies. Yet at this moment when what I am completely ready for in life is a baby, I feel like my body is failing me.
After reading my ever-going-pile of books, I know I am not alone in these feelings. Still, it is a blow to my ego, which up until this point has been stronger than probably any other woman's in history, besides maybe Cleopatra. Even when my parents virtually disowned me and refused to attend my wedding, I knew it didn't matter and I brushed it off and moved on. This latest problem, though, is not so easy to brush off.
One of my good friends just told me that when she thinks of me, she thinks of a strong woman who just attacks whatever problem is in front of her. She even envisioned me giving myself hormone injections, shouting at the top of my lungs, fists clenched, "BRING IT ON!" Yes, to some extent, that is true of me, but at this moment I'm not quite there.
At this moment, though, I am in the process of formulating my plan of attack, which is getting further solidified each day and which I will share with you shortly. For the time being, though, I am trying to remember these words contained in chapter 7 of the book PCOS and Your Fertility titled "Riding the PCOS Emotional Roller Coaster...":
This quotation describes me to a T. Just because I now have the PCOS label for my condition does not mean I need to suddenly change my personality. This is something I need to remember each day as I move forward.
Loving my body in particular puts me in the extreme minority of women. A 2003 survey by the Women's Channel of AOL found that only 4 percent of 45,000 women polled were happy with their looks.
In the last two weeks, though, since being diagnosed with PCOS, and in the months leading up to my diagnosis when I suspected a problem, I've started to dislike my body from an internal perspective. On the outside, I still look the same. I'm happy with everything I see in the mirror, including the little bit of jiggle I see on my thighs and butt (where I tend to carry my weight). On the inside, I feel like my body isn't doing what it's supposed to do.
These recent feelings seem very un-PC and very 1950s housewife of me. All my life I've been an exceptionally strong woman. I've scoffed at people who've told me I need to learn to cook for my husband. I've been (and continue to be) staunchly pro-choice, believing that no one should be able to tell me or any other women what to do with our bodies. Yet at this moment when what I am completely ready for in life is a baby, I feel like my body is failing me.
After reading my ever-going-pile of books, I know I am not alone in these feelings. Still, it is a blow to my ego, which up until this point has been stronger than probably any other woman's in history, besides maybe Cleopatra. Even when my parents virtually disowned me and refused to attend my wedding, I knew it didn't matter and I brushed it off and moved on. This latest problem, though, is not so easy to brush off.
One of my good friends just told me that when she thinks of me, she thinks of a strong woman who just attacks whatever problem is in front of her. She even envisioned me giving myself hormone injections, shouting at the top of my lungs, fists clenched, "BRING IT ON!" Yes, to some extent, that is true of me, but at this moment I'm not quite there.
At this moment, though, I am in the process of formulating my plan of attack, which is getting further solidified each day and which I will share with you shortly. For the time being, though, I am trying to remember these words contained in chapter 7 of the book PCOS and Your Fertility titled "Riding the PCOS Emotional Roller Coaster...":
An assertive woman knows what she wants, respects her own wishes, believes she can make things happen -- and does, isn't afraid to say no or take a chance, accepts responsibility for her actions, expresses her true feeling, and respects and values the feelings of others. Above all, she values herself.
This quotation describes me to a T. Just because I now have the PCOS label for my condition does not mean I need to suddenly change my personality. This is something I need to remember each day as I move forward.
Thursday, February 10, 2011
Finding a friend
If up to one out of 10 women has PCOS, then I have to know some women who have it, right? Obviously I do, but how to find out? Well, I have officially found that friend because I recalled her trouble conceiving and that her symptoms were similar to mine. Turns out, I was right.
Although this is a time where I realize this isn't exactly something to celebrate as I wouldn't wish PCOS on anyone -- except maybe an enemy? Am I going to hell for that? -- it is comforting to know someone else who has been through this. Even if it's just one person.
As a seasoned veteran of the PCOS world, my friend has already shared a little bit of positive information with me. I already knew that she managed to get pregnant, but what I didn't really know is how. She also has a couple friends with PCOS, and each of them has two children. Each of these three women with PCOS got pregnant in different ways: Metformin, Fermara (a breast cancer drug that can actually help women with PCOS ovulate), herb supplements and acupuncture, and IVF. Not one of the three ever got pregnant on Clomid. This is of particular interest seeing as this is the solution my doctor immediately offered.
My friend said her friends recommended she read The Fertility Diet. She said she never got around to it because she just happened to get pregnant, somewhat miraculously and unexpectedly. Oddly enough, by the time my friend told me about The Fertility Diet recommendation I was already partway through the book. It's one of the two books I picked up this weekend at the library.
I am hoping to learn a lot more details from my friend in the near future. In the meantime, I've finished reading A Patient's Guide to PCOS: Understanding and Reversing Polycystic Ovary Syndrome, I am blazing through The Fertility Diet and I am awaiting the arrival of my other book PCOS and Your Fertility. Once I'm done with this reading, I'll post some book reviews, and I hope I'll be one step closer to figuring out what I should do. Right now I don't feel much of a sense of urgency because I'm on CD 23 with no sign of ovulation in sight, and I know that if I decide to go on a medication I can't start it until I get my next period, which probably won't happen until early April.
At least while I wait I know one person who's been down this road and who I can seek out for support.
Although this is a time where I realize this isn't exactly something to celebrate as I wouldn't wish PCOS on anyone -- except maybe an enemy? Am I going to hell for that? -- it is comforting to know someone else who has been through this. Even if it's just one person.
As a seasoned veteran of the PCOS world, my friend has already shared a little bit of positive information with me. I already knew that she managed to get pregnant, but what I didn't really know is how. She also has a couple friends with PCOS, and each of them has two children. Each of these three women with PCOS got pregnant in different ways: Metformin, Fermara (a breast cancer drug that can actually help women with PCOS ovulate), herb supplements and acupuncture, and IVF. Not one of the three ever got pregnant on Clomid. This is of particular interest seeing as this is the solution my doctor immediately offered.
My friend said her friends recommended she read The Fertility Diet. She said she never got around to it because she just happened to get pregnant, somewhat miraculously and unexpectedly. Oddly enough, by the time my friend told me about The Fertility Diet recommendation I was already partway through the book. It's one of the two books I picked up this weekend at the library.
I am hoping to learn a lot more details from my friend in the near future. In the meantime, I've finished reading A Patient's Guide to PCOS: Understanding and Reversing Polycystic Ovary Syndrome, I am blazing through The Fertility Diet and I am awaiting the arrival of my other book PCOS and Your Fertility. Once I'm done with this reading, I'll post some book reviews, and I hope I'll be one step closer to figuring out what I should do. Right now I don't feel much of a sense of urgency because I'm on CD 23 with no sign of ovulation in sight, and I know that if I decide to go on a medication I can't start it until I get my next period, which probably won't happen until early April.
At least while I wait I know one person who's been down this road and who I can seek out for support.
Tuesday, February 8, 2011
Moment of irony
A couple days ago I needed to order a new baby gate to keep our dogs contained inside our house while we're away. This is, of course, ironic that I need to make this purchase the same week I find out I've been diagnosed with a disorder that will make it much more difficult (if not impossible) to get pregnant.
This simple fact would be sadly hilarious enough on its own. It's even more ridiculous, though, that I went ahead and added to the Amazon order the PCOS fertility book I've been unsuccessful at finding in local bookstores and at our local library. (You know, take advantage of free shipping.)
So, my finished order looked like this:
Good thing I still have my sense of humor.
This simple fact would be sadly hilarious enough on its own. It's even more ridiculous, though, that I went ahead and added to the Amazon order the PCOS fertility book I've been unsuccessful at finding in local bookstores and at our local library. (You know, take advantage of free shipping.)
So, my finished order looked like this:
Good thing I still have my sense of humor.
Sunday, February 6, 2011
Thin cyster
OK, now I know where I fall on the PCOS spectrum: I'm a thin cyster.
I can appreciate the pun here (for community support purposes). I can also appreciate that I found a virtual community of women with PCOS who are also thin here at the PCOS Support site.
Even though the following message below cut-and-pasted from the site may look bad, it gives me some questions to ask my doctor (also, this woman below just sounds a lot like me).
This is kind of negative, but this is what my RE said to me today:
Saw my RE today and this is what he said:
"About 33% of women have thin PCOS. Since you are thin, there is no environmental factor to it. You can't just lose 50 lbs and increase your chances of pregnancy like the other 66% of women with PCOS that have that environmental factors (weight, diet, etc.). So with thin PCOS, your infertility is all genetic. Therefore, it is a strong genetic factor against you vs. environment. Environment you can change, Genetics you can't. Most women with thin PCOS require more than fertility drugs."
I thought it was advantage being thin. I thought that automatically gave us that increased chance of getting pregnant that the overweight PCOSers get when they lose weight and that it was one less thing to worry about and one more thing on our side. Guess I was wrong!
So, even though I haven't reached any decisions yet about the next course of action to take, here is my list of questions I'm formulating to ask my doctor:
I can appreciate the pun here (for community support purposes). I can also appreciate that I found a virtual community of women with PCOS who are also thin here at the PCOS Support site.
Even though the following message below cut-and-pasted from the site may look bad, it gives me some questions to ask my doctor (also, this woman below just sounds a lot like me).
This is kind of negative, but this is what my RE said to me today:
Saw my RE today and this is what he said:
"About 33% of women have thin PCOS. Since you are thin, there is no environmental factor to it. You can't just lose 50 lbs and increase your chances of pregnancy like the other 66% of women with PCOS that have that environmental factors (weight, diet, etc.). So with thin PCOS, your infertility is all genetic. Therefore, it is a strong genetic factor against you vs. environment. Environment you can change, Genetics you can't. Most women with thin PCOS require more than fertility drugs."
I thought it was advantage being thin. I thought that automatically gave us that increased chance of getting pregnant that the overweight PCOSers get when they lose weight and that it was one less thing to worry about and one more thing on our side. Guess I was wrong!
So, even though I haven't reached any decisions yet about the next course of action to take, here is my list of questions I'm formulating to ask my doctor:
- What is my insulin level? Am I insulin resistant? If we don't know, if there a way to know based on blood work?
- Is my glucose high?
- If I am insulin resistant and/or have high glucose, can I control either of these factors by changing my diet, such as pursuing a gluten-free diet? Or is it better for me to go on a drug like Metformin? Or will changing my diet not really affect my chances of getting pregnant because I don't need to lose weight?
- What are the differences between Clomid and Letrozele/Femara (another ovulation-stimulating drug) for thin women? Is there any evidence that Femara is better at inducing ovulation in thin women than Clomid is?
- Is extended Clomid (an 8-10 day dose as opposed to 5-day) a possibility for someone like me, or is it necessary to start with a regular Clomid dose?
Saturday, February 5, 2011
Where do I fall in the PCOS spectrum?
Seeing as it's 6 a.m. on a Saturday and I've been awake since 3:45, I obviously am preoccupied with this week's PCOS diagnosis. I am now in the hard-core researching stage, and I'm loving the fact that today I can go to my local library to pick up A Patient's Guide to PCOS: Understanding -- and Reversing -- PCOS. Because all the branches of my extensive local library system only carry three books about PCOS -- this one and then two other books that look rather out-dated -- I'm also considering purchasing PCOS and Your Fertility from Amazon. This book may be a nice complement to the book I'll check out at the library because this one combines anecdotes from patients and the author's personal experience to supplement the story.
I have been enjoying the fact that I can preview so much of each book I've been finding on Amazon -- I absolutely love this site feature. While scanning through about 20 books so far online, I've started to formulate a few observations, but there is one that stands out most particularly in my mind: I do not sound like the typical woman suffering from PCOS.
But before I go there, here are the things that make me typical:
1) I have the most tell-tale sign, irregular cycles.
2) I have high levels of testosterone (I still hate saying that).
3) I have been battling acne ever since I went off the pill.
And then there are the differences:
1) The first most obvious difference between me and the majority of PCOS sufferers is that they are overweight. Approximately 50 percent of women with PCOS are even labeled obese. My entire life I have been fortunate to have normal weight/I've watched myself to help maintain a healthy weight. (I give these two distinctions because while I may be genetically predisposed to be on the thin side, I am not just "lucky" in this regard -- I've also worked for it with careful eating habits and exercise through most of my life [until when I thought exercise could hinder my ability to conceive and I took a 5-month hiatus].)
2) Women with PCOS also write about how their diagnosis helped them finally understand their lack of energy. In previews I've read from PCOS and Your Fertility, the author asks you to check your energy level by asking if you are tired after a brisk 10-minute walk or if you're out of breath after walking up a flight of stairs. If we're using this as the measurement tool, then I can say I have plenty of energy. Even if the measurement was more rigorous, I guess I've always felt like I have more energy than the average woman I know.
3) A lot of women with PCOS report being incredibly moody and having severe mood swings. Maybe I'm giving myself too much credit, but I think I'm about as un-moody as they come. Yes, I have my moments like we all do, but I don't face extreme emotional ups and downs (except for, you know, the week I find out I have a serious medical condition).
So far I can relate to all PCOS sufferers when it comes to irregular periods. Even then, at this point, I'm glad to know that I am not like some women who go from 6 to 12 months or more without getting a period. I cannot relate to the weight control issues, lack of energy or moodiness. A lot of what I'm reading in book excerpts has to do with regaining normal menstruation by changing your diet. The main issue here is that I already abide by the general PCOS diet directions. There are, though, some people with PCOS who go so far as to follow a completely gluten-free diet. I definitely am not gluten-free, so that's something else I'll continue to investigate. Before I can really consider a gluten-free diet, though, I really want to know if I have insulin resistance. Some but not all women with PCOS are insulin resistant, so if I'm normal in this regard then going gluten-free probably won't help me restore regular ovulation. Looks like I have my first post-diagnosis question for my doctor.
I have been enjoying the fact that I can preview so much of each book I've been finding on Amazon -- I absolutely love this site feature. While scanning through about 20 books so far online, I've started to formulate a few observations, but there is one that stands out most particularly in my mind: I do not sound like the typical woman suffering from PCOS.
But before I go there, here are the things that make me typical:
1) I have the most tell-tale sign, irregular cycles.
2) I have high levels of testosterone (I still hate saying that).
3) I have been battling acne ever since I went off the pill.
And then there are the differences:
1) The first most obvious difference between me and the majority of PCOS sufferers is that they are overweight. Approximately 50 percent of women with PCOS are even labeled obese. My entire life I have been fortunate to have normal weight/I've watched myself to help maintain a healthy weight. (I give these two distinctions because while I may be genetically predisposed to be on the thin side, I am not just "lucky" in this regard -- I've also worked for it with careful eating habits and exercise through most of my life [until when I thought exercise could hinder my ability to conceive and I took a 5-month hiatus].)
2) Women with PCOS also write about how their diagnosis helped them finally understand their lack of energy. In previews I've read from PCOS and Your Fertility, the author asks you to check your energy level by asking if you are tired after a brisk 10-minute walk or if you're out of breath after walking up a flight of stairs. If we're using this as the measurement tool, then I can say I have plenty of energy. Even if the measurement was more rigorous, I guess I've always felt like I have more energy than the average woman I know.
3) A lot of women with PCOS report being incredibly moody and having severe mood swings. Maybe I'm giving myself too much credit, but I think I'm about as un-moody as they come. Yes, I have my moments like we all do, but I don't face extreme emotional ups and downs (except for, you know, the week I find out I have a serious medical condition).
So far I can relate to all PCOS sufferers when it comes to irregular periods. Even then, at this point, I'm glad to know that I am not like some women who go from 6 to 12 months or more without getting a period. I cannot relate to the weight control issues, lack of energy or moodiness. A lot of what I'm reading in book excerpts has to do with regaining normal menstruation by changing your diet. The main issue here is that I already abide by the general PCOS diet directions. There are, though, some people with PCOS who go so far as to follow a completely gluten-free diet. I definitely am not gluten-free, so that's something else I'll continue to investigate. Before I can really consider a gluten-free diet, though, I really want to know if I have insulin resistance. Some but not all women with PCOS are insulin resistant, so if I'm normal in this regard then going gluten-free probably won't help me restore regular ovulation. Looks like I have my first post-diagnosis question for my doctor.
Thursday, February 3, 2011
The silver lining
After having myself a fantastic pity party last night following my official PCOS diagnosis, I woke up this morning a little more optimistic. (This appears to be a trend -- pessimism at night, optimism in the morning.)
Here's the good news:
I guess in some small sense I am fortunate when I consider the fact that so many other women spend two to three times as much time as me stuck in a TTC rut before they can reach any sort of diagnosis. Knowledge really is power, and I hope to use the coming days and weeks to figure out what's best for me now that I'm armed with new knowledge.
Here's the good news:
- I now officially know what my condition is.
- My doctor took me seriously. A lot of women under the age of 35 can't even get their doctors to hear them or see them until they've been officially trying to conceive for a year. My doctor diagnosed my problem after 6 months of TTC.
- My doctor is ready and willing to put me on Clomid provided I am ready for that.
I guess in some small sense I am fortunate when I consider the fact that so many other women spend two to three times as much time as me stuck in a TTC rut before they can reach any sort of diagnosis. Knowledge really is power, and I hope to use the coming days and weeks to figure out what's best for me now that I'm armed with new knowledge.
Wednesday, February 2, 2011
Diagnosis
Today my doctor told me what I was about 90 percent sure I'd hear: I have PCOS (polycystic ovarian syndrome).
For a while now I've feared this is what I have and what's keeping me from getting pregnant. With anywhere from 5-10 percent of women of child-bearing age being diagnosed with this condition, it is the leading cause of female infertility. If you read message boards on sites like The Bump or Baby Center you quickly discover all these women talking about their PCOS diagnosis and how many rounds of Clomid their doctor has prescribed.
The thing that tipped me off to the fact that I probably have PCOS is the fact that I have such horribly irregular periods. Even though my periods were fairly regular before going on birth control, there is no known link between PCOS and the pill or any other type of birth control. PCOS can develop at any time for inexplicable reasons, and there's nothing you can do to prevent it. Irregular periods are a tell-tale sign of PCOS. Another sign of PCOS is elevated testosterone levels. Well, guess what: I have really high testosterone levels. This is not the kind of thing you want to find out about yourself at 5 a.m. It makes you feel, well, ugly and unfeminine. So, add high testosterone to infertility and you feel rather man-ish. (Also, women with high testosterone and PCOS tend to have trouble with adult acne -- which is true for me -- and tend to be confident, Type A characters -- which is painfully true for me.)
As I was going through almost all the stages of grief during my 15-minute phone conversation with my doctor and I was in my denial/bargaining stage, I asked her if my elevated testosterone levels could still be a sign of the birth control hormones exiting my body. She said that I am officially past the point of being affected by my birth control pills (which also contradicts the point about birth control maybe taking one year to exit my body). So, as much as I would now like to say that my body is still adjusting to being off birth control, it really does seem that I have PCOS.
There is no way to cure or even really treatment for PCOS. My doctor told me that her goal for me is to get a period once every three months, and if I don't get that, then I could face even more serious health issues. I have two main choices at this moment: I can do nothing and continue on with my irregular but not medically concerning long cycles, or I can start taking a medication called Clomid.
Clomid is a drug that increases ovulation. You take it five days in a row at a certain time in your cycle to stimulate ovulation. My doctor told me that I could try it for three cycles, and if the medicine didn't help me get pregnant in three cycles, then she would have me visit a reproductive endocrinologist. After that she mentioned scary acronyms like IUI and IVF which just made me break down and cry while talking to her. But, my doctor added that the chances of conceiving on Clomid are quite good -- and I've read reports that say anywhere from 50 to 75 percent of women with PCOS achieve pregnancy on Clomid -- but maybe she just wanted me to stop crying.
As with any other drug, though, Clomid does not come without costs. Besides the monetary costs, which wouldn't be that substantial (yet), there is a 5 percent increased chance of having multiples conceived while on Clomid. Additionally, because women on Clomid often do what my doctor referred to as "super ovulate" it can actually increase your risk of developing uterine cancer. It also sounds like -- through some anecdotal accounts I've read on message boards -- that many women who are on Clomid also face extreme mood swings and hot flashes, though obviously everyone reacts differently.
At this moment, I am just trying to process this information. I don't know if I want to take Clomid quite yet. My doctor told me that I can still get pregnant without Clomid, but with PCOS the chances of conceiving on your own are really, really low. For people with normal fertility, the chances of conceiving on any given cycle are only 20 percent, so when you ovulate as irregularly as I do, that just means I get about as third as many chances to conceive as the average woman. I also want to research insulin resistance, because that is a side effect of PCOS and some doctors prescribe drugs to decrease insulin resistance which can also assist in restoring ovulation.
Obviously, I need to sleep on this information (for probably more than just a night) and figure out what's right for me. My husband is totally supportive of whatever I decide; he's truly a great man, and I'm so fortunate to have him.
For a while now I've feared this is what I have and what's keeping me from getting pregnant. With anywhere from 5-10 percent of women of child-bearing age being diagnosed with this condition, it is the leading cause of female infertility. If you read message boards on sites like The Bump or Baby Center you quickly discover all these women talking about their PCOS diagnosis and how many rounds of Clomid their doctor has prescribed.
The thing that tipped me off to the fact that I probably have PCOS is the fact that I have such horribly irregular periods. Even though my periods were fairly regular before going on birth control, there is no known link between PCOS and the pill or any other type of birth control. PCOS can develop at any time for inexplicable reasons, and there's nothing you can do to prevent it. Irregular periods are a tell-tale sign of PCOS. Another sign of PCOS is elevated testosterone levels. Well, guess what: I have really high testosterone levels. This is not the kind of thing you want to find out about yourself at 5 a.m. It makes you feel, well, ugly and unfeminine. So, add high testosterone to infertility and you feel rather man-ish. (Also, women with high testosterone and PCOS tend to have trouble with adult acne -- which is true for me -- and tend to be confident, Type A characters -- which is painfully true for me.)
As I was going through almost all the stages of grief during my 15-minute phone conversation with my doctor and I was in my denial/bargaining stage, I asked her if my elevated testosterone levels could still be a sign of the birth control hormones exiting my body. She said that I am officially past the point of being affected by my birth control pills (which also contradicts the point about birth control maybe taking one year to exit my body). So, as much as I would now like to say that my body is still adjusting to being off birth control, it really does seem that I have PCOS.
There is no way to cure or even really treatment for PCOS. My doctor told me that her goal for me is to get a period once every three months, and if I don't get that, then I could face even more serious health issues. I have two main choices at this moment: I can do nothing and continue on with my irregular but not medically concerning long cycles, or I can start taking a medication called Clomid.
Clomid is a drug that increases ovulation. You take it five days in a row at a certain time in your cycle to stimulate ovulation. My doctor told me that I could try it for three cycles, and if the medicine didn't help me get pregnant in three cycles, then she would have me visit a reproductive endocrinologist. After that she mentioned scary acronyms like IUI and IVF which just made me break down and cry while talking to her. But, my doctor added that the chances of conceiving on Clomid are quite good -- and I've read reports that say anywhere from 50 to 75 percent of women with PCOS achieve pregnancy on Clomid -- but maybe she just wanted me to stop crying.
As with any other drug, though, Clomid does not come without costs. Besides the monetary costs, which wouldn't be that substantial (yet), there is a 5 percent increased chance of having multiples conceived while on Clomid. Additionally, because women on Clomid often do what my doctor referred to as "super ovulate" it can actually increase your risk of developing uterine cancer. It also sounds like -- through some anecdotal accounts I've read on message boards -- that many women who are on Clomid also face extreme mood swings and hot flashes, though obviously everyone reacts differently.
At this moment, I am just trying to process this information. I don't know if I want to take Clomid quite yet. My doctor told me that I can still get pregnant without Clomid, but with PCOS the chances of conceiving on your own are really, really low. For people with normal fertility, the chances of conceiving on any given cycle are only 20 percent, so when you ovulate as irregularly as I do, that just means I get about as third as many chances to conceive as the average woman. I also want to research insulin resistance, because that is a side effect of PCOS and some doctors prescribe drugs to decrease insulin resistance which can also assist in restoring ovulation.
Obviously, I need to sleep on this information (for probably more than just a night) and figure out what's right for me. My husband is totally supportive of whatever I decide; he's truly a great man, and I'm so fortunate to have him.
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