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#1 Jayne

 

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Posted 04 March 2005 - 12:30 AM

I saw the article in the newspaper (at the end of this) and wrote to the doctor. This is a simple example of the things you can do to promote awareness when ever you get the chance. Like letter writing and emailing doctors!
:huh:
MY EMAIL:Dr Lewis,

I enjoyed reading your article "Ovarian syndrome treatable" because it is informative and well written for a general audience. I am surviving Cushing's Disease and am now an advocate for Cushing's Awareness. I want to remind you about Cushing's Syndrome as it is misdiagnosed as PCOS and if left untreated--fatal. In my experiences our medical community dismisses a diagnosis of Cushing's because "it is rare". I don't think this is the case. About 20% of adults have a pituitary tumors (functioning and non-functioning). You did state "The work up of women with suspected PCOS includes lab tests to rule out tumors, adrenal gland and pituitary problems" in the article. I hope that in future references you will use the name of this life threatening malady--Cushing's. If more people recognize it by name more lives may be saved. Please support a Cushing's Awareness Day on April 8, 2005 (Dr Harvey Cushing's birthday), by acknowledging this disease to your colleagues.


HER RESPONSE: Dear Ms. Kerns: Thank you for your letter and for reading my column. You are correct in stating that Cushings syndrome can mimic PCOS and is so rare as to be overlooked at times. Cushings syndrome is on the list of possible causes for women with PCOS, and when warranted I do tests to rule this out. I haven't uncovered a case yet, but I continue to suspect it when faced with these patients. It's encouraging to hear from people dedicated to increasing awareness of devastating medical conditions, especially the relatively rare ones that can get lost in the shuffle. Thank you again for your letter, and I will continue to consider Cushings as a possibility in these patients as well as encourage my colleagues to do so as well. Arlene D. Lewis, M.D.
Gynecology & Gynecologic Surgery


THE ARTICLE:
PCOS Source: http://www.frederick...2202005/1670562
Polycystic ovarian syndrome is a treatable condition

Date published: 2/20/2005

DO YOU sometimes go months at a time without having a period only to fear that you're bleeding to death once it finally starts? Are you doing all the right things to lose weight, but the weight just won't come off--in fact, you're gaining weight?

Have you noticed hair growth in places where women just aren't supposed to have hair? Have you had trouble getting pregnant?

If you answered yes to any of these questions, you may have polycystic ovarian syndrome.

PCOS is a common condition affecting approximately 5 percent of all pre-menopausal women. Although the exact cause of PCOS is not fully understood, insulin resistance and over-secretion of androgens (male hormones) are important factors.

When we eat carbohydrates, our pancreas secretes a substance called insulin, which allows our cells to use the glucose in our food. Some people's cells are resistant to insulin, so the glucose isn't absorbed as well. The pancreas responds by secreting more insulin, and blood levels of this important hormone rise.

Among other things, this overabundance of insulin affects the ovaries, causing them to secrete excessive amounts of androgens--which leads to abnormal hair growth and anovulation (the failure of the ovaries to release an egg on a regular schedule). That then leads to irregular periods and infertility.

PCOS can be diagnosed by symptoms alone, but sometimes laboratory studies are necessary to make or confirm the diagnosis, and to rule out conditions that can have similar symptoms.

For an overweight woman with infrequent periods and hair on her chest, there's a good chance that PCOS is the problem. However, the diagnosis is a bit trickier in a woman of normal weight with no abnormal hair growth.

The work-up of women with suspected PCOS includes lab tests to rule out tumors, adrenal gland and pituitary problems. It's also important to commence routine screening for associated conditions such as high blood pressure, diabetes and elevated cholesterol. A pelvic ultrasound also may be helpful.

Once the diagnosis is made, one of the best and longest-lasting treatments in those who are overweight is weight loss. This can be difficult because insulin promotes weight gain, but it's not impossible.

Lower-carbohydrate diets are often more effective than lower-fat diets. Also, simple sugars should be avoided; instead, opt for complex carbohydrates such as whole grains.

Among the medications that are helpful in alleviating the symptoms and physical signs of PCOS are: the birth control pill/patch/ring; drugs commonly used for diabetes such as metformin; and a host of medications aimed at reducing abnormal hair growth.

For those women trying to get pregnant, medications to induce ovulation are available.

Women with PCOS are at higher risk for endometrial cancer (cancer of the lining of the uterus) so it's important for them to have periods, which can be induced using birth control.

The higher cancer risk stems from anovulation, which leads to a secretion of estrogen without a counteracting secretion of progesterone. This is called unopposed estrogen.

It stimulates the endometrium, which is the lining of the uterus, and the part that partially sloughs off during a period. If there is no progesterone around to counteract the estrogen, then the endometrium is under continual stimulation, and this can lead to endometrial cancer.

The missed periods, infertility, hair growth and weight gain of PCOS can be very unnerving. If you happen to recognize yourself in this description, don't fret--you're not turning into a hairy, overweight man. It's infinitely more likely that you have PCOS, and effective treatments are available.

DR. ARLENE LEWIS welcomes reader comments and questions. She can be reached by writing at Free Lance-Star, 616 Amelia St., Fredericksburg, Va., 22401 or by e-mail at newsroom@freelancestar.com.

Date published: 2/20/2005




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