What is PCOS?

Polycystic ovary syndrome (PCOS) is a disorder that affects up to 1 in 10 women of reproductive age (the years between the first menstrual period and menopause.

PCOS changes a woman’s hormones balance, which can interfere with monthly ovulation. That can lead to infertility, weight gain and skin changes. When a woman trouble in conceiving because she’s not ovulating regularly, PCOS is the most common reason.

           What are signs and symptoms of PCOS?

Not all women with PCOS have the same signs and symptoms. This is why some women can have PCOS for years and not know it.

• Extra hair growth on the face, chest, and and abdomen caused by the increased male hormone.

• Thinning of the hair on the crown of the head.

• Tendency to gain weight around the waist, resulting in an “apple shape” instead of the typical female “pear shape.” For women, a waist measurement of more than 35 inches may be a sign of PCOS.

• Acne or swollen sweat glands in thearmpits and groin.

• “Dirty looking” raised velvety areas on the skin, often on the back of the neck, the armpits, the groin area, and beneath the breasts.

This is one symptom of insulin resistance.

• Other skin symptoms caused by insulin resistance can include skin tags, rough elbows, and rough, reddened hair follicles on the upper arms.

Women with PCOS may also have:

• Menstrual periods that are irregular or absent. When periods do happen, they may be heavy.

• Difficulties in conceiving.

• Problems with blood sugar (glucose). This may include high blood glucose, or episodes of low blood sugar, which can make you feel tired and weak.

• Strong cravings for carbohydrates.

• High blood pressure.

• High LDL (“bad”) cholesterol, low HDL (“good”) cholesterol, and/or high triglycerides(blood tests)

How is PCOS diagnosed?

Women with PCOS do not all have the same signs and symptoms.

There are specific signs your health care provider can check to help diagnose PCOS. These include:

• Checking to see if you have hyperandrogenism (too much androgen, a male hormone). This is diagnosed with blood tests and by physical signs.

• Asking you about your menstrual periods. With PCOS, you might have irregular periods (oligo-ovulation) or no periods at all (anovulation). A woman with PCOS usually has fewer than 8 periods a year.

Another sign of PCOS is having tiny cysts on your ovaries (polycystic ovaries). About 3 out of 4 women with PCOS have these cysts. An ultrasound can be done to check for them. You do not need to have these cysts on your ovaries to be diagnosed with PCOS. At the same time we will measure lining of your womb to make sure it is healthy.

What are the complications of PCOS?

Women with PCOS:

• Are at higher risk of developing gestational diabetes, a type of diabetes that sometimes occurs during pregnancy. This can harm the health of both mother and baby.

• May be more likely to have a miscarriage than women without PCOS.

• Tend to have higher LDL (“bad”) cholesterol, lower HDL (“good”) cholesterol and higher triglycerides (blood fats) than women without PCOS. Each of these is a risk factor for heart disease.

• Have a higher risk of developing heart disease and type 2 diabetes:

– About 30% to 40% of women with PCOS have pre-diabetes,

• Have a higher risk of some cancers:

– Women who miss a lot of periods do not shed the endometrium (lining of the uterus) each month. This increases the risk of endometrial cancer.

        –High blood sugar caused by insulin resistance may cause cancer cells to grow.

Overweight or obese women who have PCOS have a greater risk of heart disease than normal weight women who have PCOS.

What can I expect at my health care visit?

Your provider will do a full health exam. You may have blood tests for:

• Levels of lutenizing hormone (LH) and follicle stimulating hormone (FSH), the hormones that your pituitary gland produces and that control the menstrual cycle

• Levels of estrogen, which your ovaries secrete (release into your body)

• Levels of male hormones, including testosterone, which your ovaries secrete, and  DHEA-sulfate, secreted by your adrenal glands

• Levels of blood sugar (glucose) and insulin, including:

– Fasting levels of blood glucose

– Fasting levels of insulin in your blood

– Oral glucose tolerance test, which measures your blood glucose levels at certain times after you drink a sweet beverage

– Hemoglobin A1C, a blood test that shows average blood glucose over the last 3 months

• Levels of cholesterol and fats (triglycerides) in your blood To help rule out other health conditions, your provider may also do blood tests to check:

• Levels of thyroid-stimulating hormone and prolactin (another

hormone secreted by your pituitary gland)

• Levels of vitamin D

• Your liver function

What are the treatment options for PCOS?

If you are diagnosed with PCOS, your health care team will work with you to develop a treatment plan to manage your symptoms.

The plan will also treat underlying hormonal imbalances that are

causing the symptoms and increasing your risk of diabetes and heart disease. Your plan will likely include both healthy lifestyle changes and medicine. If you are concerned about fertility we will devise a plan to give you the best chance of conceiving...

Your 30s are a time to find a balance. They say 30 is the new 20. And while we have to admit that 30-year-olds are raring to go, it's not all rosy. With the fancy corporate jobs and the expert balancing act, women barely manage to find time for themselves. Add to that, there are certain changes that occur in a woman's body post 30. As a result, believe it or not, women are more prone to certain disease and illness. Your 30s are a time to find a balance. Even as you juggle all of your responsibilities, find a way to make your health a priority

The healthiest you, in your 30s and beyond

Time passes, and our bodies change. Our day-to-day health is kind of like the weather. Like sunny days or passing storms, colds come and go. So do sniffles, aches and pains, and pimples and blisters. Our overall health, though, is more like the climate. It's an accumulation of lots of different factors - genetics, chance, and the lifestyle choices we make - and has more impact on our lives in the long run.

Some of the factors that affect our health are out of our control, like our family's medical legacy. If your mother or sister have had breast cancer, you might be more likely to have breast cancer, too. Accidents, injuries, and genetically unforeseen conditions can sideswipe us and set our health off-balance, too.

But we can control the lifestyle choices we make, and these choices certainly do accumulate and either enrich or endanger the quality of health we enjoy through the years of our lives. Decisions you make, like whether to smoke or not, what sort of foods you eat, and how much physical activity you fit into your life, may make or break your health.

You also need to keep up with a few routine preventive health screenings and integrate beneficial, age-defying habits into your life. Time passes, so make the most of the time you have, no matter what your age.

Your 30s: body basics

Your 30s can feel sort of bittersweet. Just as you're coming more into your own and feeling stronger in your identity, your body begins to show some of the first subtle signs of aging. And just as you're achieving more stability in your career or personal life, you may discover the stressesthat sprout from that stability. Of course, for some women these things will have less impact than for others. But there are some common concerns among thirty-somethings.

One of the more common stresses among women in their 30s is finding time to stay fit. It seems like all of that stress - from keeping up with work, relationships, or your children - would keep you active enough! Maintaining a fit, strong, lean body will make you less prone to weight gain and loss of muscle mass and tone. Not to mention that regular physical activity can decrease your risks of heart disease, diabetes, and the symptoms of stress and depression. The peak fertility years may be the 20s, but many women have healthy pregnancies and give birth to healthy babies well into their 30s. Past the age of 35, there is an increased risk of birth defects, pregnancy difficulties, and miscarriage. It can also become a bit more difficult to become pregnant, and the reasons are natural.

As you move through your 30s, your body continues its path along the reproductive continuum. Adolescents have several hundred thousand egg cells, but only about 400 mature into eggs, and by the time you've reached your 30s, you've shed roughly half of those. This ebbing egg trend can affect a woman's health in a lot of different ways, difficulty conceivingbeing one of the most common and emotionally challenging.

The shift in hormones could also cause some changes to your menstrual cycle. Heavy bleeding may also be due to fibroids, uterine tumours that are not cancerous. If you've had children, you may also experience some degree of urinary incontinence.

All these changes sound like a real party, huh? But don't despair, thirty-something female, keep reading for lots of ways you can make your 30s much less bitter and much sweeter.

Your 30s: maintaining wellness with healthy habits

Fitness and nutrition. Once you hit your 30s, you may notice some shifts in your weight - how much weight you gain and where you gain it.  Depending on your body mass index (BMI), a woman of 30 who is not very active needs 1,600 to 1,800 calories per day. For each year past the age of 30, subtract 7 calories from your total. If you are more active, you will need more calories per day. Explore ways you can balance the amount of energy you take in (through calories from eating and drinking) with the amount of energy you burn up (through activity).

Move it. The stress avalanche of modern life may leave little time or enthusiasm for exercise. You could try the countless forms of dance, yoga, or martial arts. Leave your desk for 15 minutes in the afternoon and go for a walk. Play with your kids: jump rope, shoot hoops, or hop on the latest fitness video game console. Swim, hike, or join a soccer or softball team. Explore the many variations on aerobic exercise classes at gyms these days - hula hoop, pole-dancing and strip tease, spin, or step, to name just 5 of the 5 zillion kinds out there.

Find order in the food chaos. By the time you reach your 30s, you've heard a lot of news about food: Eggs are bad, eggs are good, superfood-this, omega-that. Whether you're feeding the whole family, eating for two or eating just for you, keep in mind a few basic ideas. Freshen up your fridge with colourful, seasonal fruits and veggies. Cook in healthy oils, choosing canola or olive over options with more saturated fat. Focus on foods rich in vitamins and minerals, paying special attention to your intake of folate, calcium, and iron if you plan on getting pregnant. Do what you can to maintain a healthy weight and cholesterol level, and avoid the foods that cause you stomach upset or heartburn.

Sit pretty on strong bones. In your 30s, you lose more bone than you produce. Losing too much bone mass now heightens your risk of slumping into osteoporosis. Balance bone loss by doing weight-bearing exercises and eating a diet rich in calcium, vitamin D, magnesium, and folic acid.

Be good with your breast self exams . Notice the changes in your breasts. You should be familiar with the look and feel of your breasts by now - continue to get to know them so you can scan for any lumps. Some lumps you may find could just be benign cysts. Fibrocystic breast disease is thought to occur due to hormonal changes. Breast -feeding-is as good for you as it is for your baby: studies suggest breast-feeding may actually lower your risk - and your child's future risk - of breast cancer. Wear a supportive, well-fitted bra, and don't be too shy to go in for a professional fitting. Eat an antioxidant-rich diet to fight back breast cancer risks.

Your 30s: check-up checklist

Use this check-up checklist to stay on top of the tests and examinations you need all through your 30s.

• Blood pressure and cholesterol: You're not at too much risk of elevated levels now, especially if you're following healthy heart habits like exercising regularly, eating a nutritious diet, and not smoking. Anytime you go in for any health care visit, your blood pressure will be gauged, and you should get a cholesterol work-up every few years. If you fall into certain risk groups, your doctor may screen your levels more frequently. You may be at risk if you have diabetes or a large waist circumference, or if you smoke.
   
• Pap test and pelvic exam: By the time you've hit 20, you should be having routine pelvic exams and Pap tests. Pap tests screen for cervical cancer, while the pelvic exam allows your health care provider to examine your cervix and vagina and to get a sense of the health of your uterus. Your health care provider might also look for signs of infections. 
   
• Breast exam: Breast cancer is a very common cancer among women. Your health care provider may do an exam when you go in for your Pap test and pelvic exam. If not, ask your doctor whether you should have a breast exam, and if so, how often. You should also become familiar with the look and feel of your breasts so you know what's normal for you. 
   
• Skin check: Anyone at any age can develop skin cancer. In addition to minimizing your risk with healthy sun habits, your health care provider should do a thorough skin check to screen for new or changed moles or marks. You can also do a skin check yourself (or with a helpful partner). Remember the letters ABCDE when looking at skin growths:
  • Asymmetry (not round)
  • Border (irregular)
  • Colour (uneven, changing, different from other moles)
  • Diameter (larger than a pencil eraser)
  • Evolving (changing in size, shape, or colour)

If anything seems out of the ordinary or alarming, contact your doctor. 
 

• Dental check-ups: Visit your dentist for preventive check-ups and routine cleanings. The frequency of visits will really depend on individual needs, though most authorities on the subject recommend at least once or twice a year. 
   
• Eye exams: Even if your vision is 20/20, you should have your eyes examined every one to two years. After all, optometrists check for other things besides how good your vision is - like signs of glaucoma. If you have a condition like diabetes, high blood pressure, or a family history of vision problems, your optometrist will let you know if you need more frequent eye exams and check-ups. 
   
• Immunizations: You think shots are just for kids? Certain vaccinations you received as a child may need to be updated, while other immunizations are available that can protect you from needless health issues. Ask your doctor if you're due for any of these: 
   
  • Get shots to protect you from measles, mumps, and rubella (MMR)if you've never had the vaccination before. Should you find yourself in certain risk situations, you'd also need the MMR vaccination. Those risky situations include working in health care, attending college, and travelling to certain countries. 
     
  • The tetanus, diphtheria, and pertussis (DPT) vaccine is recommended for anyone whose last  shots were more than 10 years ago. Others who should get the vaccine include those who work in close contact with infants, those who plan on becoming pregnant, and those who have received a "dirty" wound (e.g., from a rusted nail). 
     
  • Each year, get the influenza vaccine. The flu shot is especially important if you have medical conditions that put you at risk of complications from the flu.
     
  • Considering world travel? Consider being vaccinated against meningitis and hepatitis A and B, and consult with a travel clinician or your doctor in regards to other risks of particular destinations. 
     
  • If you never had chickenpox as a youngster, you should get vaccinated against it now. And if you're unsure whether you did, go ahead and get the vaccination, just in case. It's a good idea to get it, too, if you're hoping to get pregnant sometime in the future. Hold off, though, if you're already pregnant (or hope to be within several weeks of vaccination).