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Flying With Broken Wings Help, I’m turning into a man!

Post Published: 20 March 2010
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Category: Column, Flying With Broken Wings, Hypothyroidism and PCOS Polycystic Ovarian Syndrome
This post currently has 28 responses. Leave a comment

(Written by Sarah Downing, Editor, Flying With Broken Wings, Dear Thyroid)

It all started at the age of 24 with a mean comment from my ex-boyfriend M, one of the reasons why he is now my ex-boyfriend: he had an arsenal of mean comments, which ultimately destroyed my self-confidence, but that is another story, suffice to say that acceptance of your partner is very important in a relationship. The point is that he was bemoaning the fact that he thought I was “a little too hairy.” I never dreamed that I would actually have one of his cruel slights to thank for anything, but I do because it was ultimately that comment that led me to ask my gynecologist to test my hormone levels, as I felt I was “too hairy.” She felt that it wasn’t really anything to worry about, but complied with my request and, lo and behold, I was diagnosed with hyperandrogenemia or elevated androgens (male hormones).

I was promptly put on an anti-androgen contraceptive pill and from then on none of my future gynecologists seemed particularly bothered about any further treatment. I was always slightly overweight, which they were especially fond of pointing out (and my last gynecologist even made a bitchy remark about it despite me telling her that I have Hashimoto’s to boot), but none of them really did further investigation and, despite subsequent tests that showed that my male hormones were still high, they kept me on the same anti-androgen contraceptives and that was that. Until I met Dr. Heilper, my current gynecologist.

Because there is no one clear definition of what constitutes PCOS (or Polycystic Ovary Syndrome), it had up to now been unclear as to whether or not I suffer from this. In the beginning, the ultrasound had shown one or two incidences of polcystic ovaries, which however soon disappeared – apparently, such cysts can also be a temporary occurrence, but in PCOS such cysts are actually eggs that are unable to be released due to abnormal hormone levels. After months of arguing with my insurance that I have the isolated condition hyperandrogenemia rather than full-blown PCOS, mainly because I don’t have the main accompanying symptoms such as hirsutism, irregular periods or acne (but this is very possibly because I was put on an anti-androgen contraceptive pill early enough!) , my insurance lowered my exorbitant surcharge because apparently hyperandrogenemia and PCOS fall into two different categories, which perfectly illustrates the controversy that surrounds a clear diagnosis of PCOS. Now, because of this, I have to refer to my condition as “hyperandrogenemia” for fear that my insurance will get on my case again.

Perhaps this absence of “obvious” symptoms (other than my fat tummy) is one of the reasons why previous doctors have refused to take my hormonal imbalance seriously, but perhaps it’s also because of ignorance. PCOS is an extremely complicated condition to diagnose and treat and it was discovered comparatively recently – in the 1930s by two doctors Stein and Leventhal, hence its original name Stein-Leventhal Syndrome. These two doctors originally only diagnosed women with the syndrome who were extremely overweight, exhibited lots of facial or body hair and had an absence of periods. I for one do not fit this description, as is the case with many other patients. PCOS can manifest itself in a wide variety of ways and, despite its name, not every woman with PCOS automatically has polycystic ovaries and, in turn, not every woman with polycystic ovaries (PCO) has PCOS. PCOS describes the symptoms that accompany polcystic ovaries, thus making it a syndrome. Despite the fact that PCOS is known to affect up to 25 percent of women of reproductive age, from the time of its discovery 60 years passed in which very little research was done whatsoever.

In fact, the treatment of patients with PCOS rather reminds me of thyroid disease. Too many doctors refuse to treat hypothyroid/hyperthyroid patients unless they exhibit “full-blown” symptoms, but sometimes it is better to proactively intervene and start treatment at an early stage in order to avoid a worsening of the condition. Untreated PCOS can lead to multiple health issues, including cardiovascular disease, miscarriage, preeclampsia, Type 2 and gestational (pregnancy) diabetes (insulin resistance is frequently cited as a trigger to PCOS), fatty liver, Metabolic Syndrome, strokes, Alzheimer’s, endometrial cancer and, surprise, surprise!, our old friend autoimmune thyroid disease. However, from what my doctor tells me, thyroid disease can in fact trigger PCOS, so the question is “what came first: the chicken or the egg?” I don’t wish to alarm you with this list, but merely to raise your awareness of how potentially serious PCOS can be. Some of these symptoms (e.g. Alzheimer’s and endometrial cancer) are more likely to occur in untreated advanced-stage PCOS.

At this stage, you are probably wondering what the connection is between PCOS and hypothyroidism. First and foremost, it’s vital to understand that the entire endocrine system is very closely interlinked. Hence, if one of the hormones is imbalanced, there is a higher likelihood that others are too. For this reason, patients with thyroid disease are more prone to other hormonal imbalances and thus it is even more important to make sure your doctors determine the full picture by doing thorough testing. To be more specific: hypothyroidism can result in a reduction in Sex Hormone Binding Globulin (SHBG) and an increase in free testosterone, which is one of the factors that contributes to PCOS.

To make matters worse, because PCOS is generally treated with an anti-androgen contraceptive, those who are on the pill will need extra thyroid hormone. This is because extra estrogen causes an increase in the amount of circulating thyroid binding globulin (THG), a protein that absorbs freely circulating thyroid hormone, transforming it from “free” thyroid hormone into “bound” thyroid hormone. As a result, your levels of thyroid hormone might be “normal”, but less of this hormone is active. I guess that’s why it’s so important to test for free T3 and free T4. To further complicate matters, women with PCOS are prone to estrogen dominance! And as if that weren’t complicated enough, my doctor recently informed me that excess androgens (e.g. testosterone) in women tends to artificially lower your TSH, whilst excess estrogen in men has the same effect. Hence, your levels may actually look more balanced than they are. Because of the close relationships between all hormones in the endocrine system, it’s vital to ensure that you have a complete balance. Hence, despite the fact that my fiancé’s thyroid disease is much more advanced than mine, I currently require extra thyroid hormone because I also have PCOS to contend with, which in turn impacts the efficacy of my thyroid meds.

As I mentioned above, insulin resistance is cited as the main cause of PCOS. Women with insulin resistance have elevated levels of the hormone insulin in their blood, which stimulates the ovary to produce androgens (male hormones). A normal ovary produces the male hormone testosterone, which it converts to the female hormone estrogen. However, if the ovary is stimulated by either excess insulin or luteinizing hormone (LH), this conversion is impeded and excess androgens flow into the bloodstream (as the blood level of testosterone-binding protein is reduced) and thus more androgens become available to the tissues, resulting in virilization or the development of male characteristics.

It is also important to note here that PCOS can have genetic causes and there may be a family history of Type 2 diabetes. In my case, I strongly suspect that my mother has it and I know for a fact that my sister does. Apparently, there are also genes that predispose us to PCOS, many of which are responsible for the action of insulin and the production or metabolism of sex hormones. Weight gain can also trigger or worsen insulin resistance, which is probably another reason many hypothyroid patients are more prone to PCOS. In turn, losing weight can restore insulin and androgen levels and subsequently ovulation, which is why this strategy often goes hand in hand with medication to normalize these two hormones. To lose weight, PCOS patients are often advised to follow a low-glycemic diet (low GI) diet and many may benefit from visiting a dietician for advice on a diet tailored to their needs.

Metformin (aka Glucophage) seems to be one of the drugs of choice for treatment of PCOS. Originally prescribed for diabetes, in recent years it has also shown some promise in reducing insulin and thus androgen levels, as well as the high triglycerides/cholesterol caused by the Metabolic Syndrome that is often associated with PCOS. A natural alternative that has shown a similar effect is cinnamon (http://bit.ly/9RdNrY; http://bit.ly/c3yEfc). It is important to thoroughly test for insulin resistance, including glucose tolerance testing, as oral glucose tests may uncover insulin issues that are not diagnosed by fasting insulin levels. This is why my doctor is going to perform this test on me next week. My blood sugar appears to be normal, but it’s best to be sure when you have PCOS. Of course, these are not the only medications your reproductive endocrinologist/gynecologist or thyroid doctor can prescribe. I’m currently taking the anti-androgen pill Valette, which is frequently prescribed together with Metformin and now my doctor has me on Androcur to lower my levels further. Be warned: with Metformin, you can expect to suffer from gastrointestinal issues, at least in the first few days. In the US, Metformin XR is also available – an extended release version that you take just once a day and that tends to alleviate the nasty diarrhea and bloating that you may experience with the other one. However, it does get better as your body becomes more accustomed to it.

Now that you know that hypothyroidism puts you at a greater risk of PCOS, it’s important to recognize the symptoms to ensure that you get a correct diagnosis. The classic signs seem to be polcystic ovaries, although (as I mentioned above) not every PCOS patient has these. In addition, you may suffer from acne/oily skin, hirsutism (excess hair growth), male pattern baldness, high blood pressure, lipometabolic disorders such as high cholesterol/triglycerides, weight gain or obesity (particularly around the abdomen), acanthosis nigricans (rough, dark skin in the skin folds that signalizes severe insulin resistance), skin tags, PMS, irregular or absent menstruation, infertility due to lack of ovulation, miscarriages and fatigue. There are other symptoms, but this should provide you with a selection of the main ones.

I decided to talk to some other Thyrellas to find out about their experiences with PCOS. C told me the sad tale of how she struggled to get pregnant and when her doctor prescribed her fertility meds, she even had a miscarriage the first time round. In 2007, after several arguments with her husband, they decided to give up for a while. Her body was stressed by the extra hormones and their relationship was stressed by the effort to successfully carry to term, so they talked about adopting and C went off the fertility drugs. A few weeks later, after eating Taco Bell, C felt nauseous and decided to take a pregnancy test. Based on her irregular periods, it was hard to tell whether she was pregnant, so she took the test and, in shock, her husband and she realized that it was positive. Because of her past experiences, they didn’t want to get excited too early, so they took three more tests to be sure and waited three months before telling their families – at the time, C was seven months pregnant. “AJ was conceived naturally with no fertility meds! Such a miracle … he is my world, my everything!”

B told me that the first time she noticed something was awry was when she was 19 and woke up in the middle of the night feeling as if someone was stabbing her. She ended up in the ER and was diagnosed with a ruptured ovarian cyst. From that point on, she bounced from birth control to birth control. She suffered for years with various symptoms and complications until at age 30 she found an endocrinologist who understood the connection between Hashimoto’s and PCOS: “My doctor tested everything: my thyroid, adrenals, pituitary, sex hormones – the works. He was concerned about the fact I had that cyst rupture nearly a decade ago, the continued weight gain, fatigue and lack of a regular period. He knew my ‘normal’ labs displayed numbers not normal in relationship to each other and diagnosed me with PCOS and insulin resistance.” About three weeks ago, B started on Metformin. She hasn’t seen any weight loss yet, but her energy has actually increased and “the first day I felt hyper, I almost cried. I haven’t felt hyper and motivated in two years. For week four, I plan on starting up at the gym, again.” Her doctor has set three goals for her for the next three months – he wants her to regain her energy, lose some weight and for her period to become more regular. In due course, he will consider putting her on a birth control pill to further regulate her hormones. B is impatient to get rid of her hirsutism and acne, but is confident that this will be dealt with as her meds are adjusted. She is optimistic and relieved to finally receive a definitive diagnosis from a competent doctor. She also hopes to lose the weight she gained thanks to the hormonal imbalances: “At 31, which is almost a month from now, I am hoping I might be able to say I have lost a few pounds and wear my party dress.”

Sources/Further reading

  1. PCOS: A Woman’s Guide to Dealing with Polycystic Ovary Syndrome
  2. Getting Started At SoulCysters
  3. Hypothyroidism and PCOS
  4. Polycystic Ovarian Syndrome (PCOS)
  5. PCOS Symptoms
  6. Polycystic Ovarian Syndrome (Wikipedia)
  7. Can Cinnamon Help You Control Your Diabetes?
  8. Cinnamon: Help for Insulin Resistance and Weight Loss
  9. Popular and Flavorful Spice is New Aid in the Battle Against Buddha Belly/Belly Fat

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28 Responses to “Flying With Broken Wings Help, I’m turning into a man!

  1. Miriam says:

    Sarah, another interesting talking point as always.

    You put put the subjects of your articles so eloquently for everybody to understand and relate to.

    PCOS is such a complicated condition, there are so many symptoms that mimic other conditions including the Thyroid disease, so is it any wonder that so many doctors miss diagnosing the PCOS and in turn do not treat the condition properly.

    I hope you, and other sufferers C and B will benefit from now being properly treated and begin to feel the benefit in the not too distant future.

    Looking forward to reading next weeks column 🙂

  2. Liz says:

    Sarah, thanks for this post. It reminds me of a blog dedicated to fertility and conception via real and traditional foods. The woman had PCOS and slowly found her way to health and mommyhood. Very cool story and site: http://www.naturallyknockedup.com/

  3. Lolly says:

    Sarah,

    Another very informative article by you. I know a few people who have thyroid disease and PCOS and are insulin resistant. a close family member had a TSH of 5.5 had already been dx with PCO and showed insulin resistance I would love to send her some of your links as she is having problems just now.

    thanks for a great Article.

    I had endometriosis and just like PCOS it’s also linked to the Autoimmune system I tried male hormones to start with with no effect.

    Lolly

  4. HD inOregon says:

    Sarah,

    Great educational article. I learned a lot; mainly that if one has to fiddle with the endocrine hormonal system at one end (e.g. thyroid) it may have implications at many other levels. Thanks for sharing your knowledge and research with us.

    HD in Oregon

  5. Miriam, thank you for your kind words. It was quite a challenge to write this topic because my aim was to make it understandable for everyone, but it is such a complex topic and one thing I particularly noticed is the lack of information on the connection to hypothyroidism, something that fascinates me as it is clear that many people who are hypothyroid also suffer from PCOS, many of whom sadly don’t realise it as so little is said about the condition. I think many people are embarrassed to talk about excess male hormones – it may seem like a “yucky” topic, but it is much more common than you’d think.

  6. Liz, thank you very much for your link. I look forward to reading it tomorrow. Eating well and eating the right things (low-glycemic) definitely does help with PCOS, but I should mention that there are also many women who are of a normal weight and I myself am only slightly overweight. In fact, at the time of my diagnosis, I wasn’t overweight at all. Of course, as I mentioned, some people like myself are more predisposed to PCOS because it runs in the family, but once you are hypothyroid you are more prone to other hormone imbalances anyway. Diet is usually used as part of a combination treatment along with meds to balance the hormones, which are tough to balance even with the right meds.

  7. Lolly, glad if you were able to learn something from my article. I’m sorry that you had to suffer with endometriosis and that the male hormones didn’t work – I could have given you some of mine for free if you had asked;-) LOL. Do you have it under control now? Please feel free to send your friend my links if it helps her. Also please feel free to put us in contact and I will happy to anwer any questions she might have.

  8. HD, so glad you learned a lot from my article. PCOS isn’t caused so much by fiddling with the thyroid hormones – in fact, balancing the thyroid hormones should in turn improve PCOS and balancing the sex hormones should in turn improve the thyroid hormone balance. It’s more about being at a higher risk of other endocrine conditions if you already have a preexisting one such as hypothyroidism. That is why it is so important to balance the ENTIRE endocrine system and to check that everything is in balance. Once my PCOS is more balanced, this should also help my thyroid hormones to become more effective and vice-versa.

  9. HD inOregon says:

    Sarha,

    Bad choice of my words, “fiddling”, what I meant was when there is a thyroid imbalance it may trigger other diseases of the endocrine system, and vice versa. – Should one ask ones doctors (endos) to have a look at other endocrine functions and test for imbalances?

    HD

  10. Dear Thyroid says:

    Good question, HD.

    I have endometriosis, but I don’t have PCOS. My OB/GYN is 99% sure that it was a result of my Graves’ disease. I’m pretty sure too, based on when I started exhibiting symptoms. I have had ultrasounds of my down there (love calling it that), and I have never had cysts. I don’t have the symptoms of PCOS, but I think it’s something to be mindful of.

    Great article, Sarah!
    Katie

  11. Jessie says:

    thank you so much for publishing this timely article. I just had my annual ob/gyn on Monday and was sent for an ultrasound due to a pelvic mass on Tuesday. On Wednesday, I found out that both of my ovaries are enlarged, and my right one is elongated. Additionally, for the past 3 months (since I stopped nursing) I have had very crazy cycles (menstual and ovulation) and it has been very painful. I have been trying to conceive since August. Even though I was able to get pregant immediately and safely deliver 3 children, I have not been able to get pregnant this time – and things really just don’t feel right. I am meeting with Repro Endo on 04/06, and in the meantime, I am supposed to “take it easy” (HA! I have 3 young boys!) and repeat ultrasound in 8 weeks. At least now I have some questions to ask RE. Thank you!!

  12. No problem, HD. I’m sure it wouldn’t do any harm for your doctors to check for other hormonal imbalances. Many thyroid patients suffer from insulin resistance/diabetes and many also have problems with adrenal fatigue and too much/not enough cortisol. As I’m sure you already know, if your adrenals are not working as they should, this can also impact the efficacy of your thyroid hormones and result in extra tiredness. In my case, I have elevated cortisol, which can cause problems with weight loss, as can insulin resistance. Sadly, I don’t know as much as I’d like about the impact sex hormones have on men, but I’m sure that it’s very important for them to be balanced too. I’ll have to do more research on that as it’s a very interesting topic. As I mentioned, it seems some men can have excess oestrogen and I think excess androgens can also lead to problems, such as a voracious sex drive, I believe – however, I’d be happy to have any libido whatsoever right now. After my gynaecological operation some weeks ago, my gynaecologist has finally given us the go ahead to get intimate again.

  13. Katie, I am glad that you don’t have PCOS, but I am so sorry about your endometriosis. My doctor says that it is definitely connected to thyroid disease. Fyi, I don’t have ovarian cysts either, but as I mentioned PCOS (as I’m sure most hormonal issues) can come in some many shapes and forms, so some people have the cysts and others don’t. Despite being up to my neck (or thyroid!) in meds right now (although I know it’s only a temporary measure), I consider myself lucky that I don’t have more visible symptoms than I do. My thyroid doctor says his main concern is getting my hormones balanced, my gynaecologist is a little too obsessed about weight when I’m not really that bothered about my weight. I’m about a Size 12/14, so it could be a whole lot worse, but he’s mainly concerned about me losing weight to reduce the androgens and reduce the risk of my PCOS getting worse or me developing diabetes. Somehow, how we look becomes a secondary thing when we are so tired and suffering from other symptoms.

  14. Jessie, I am so glad if my article helped you in any way. Please don’t hesitate to contact me if you have any further questions. Based on the symptoms you shared, it definitely sounds like PCOS could be a possibility, but I’m sure your ob/gyn will figure it out – make sure he or she does a full panel of hormone tests in addition to the ultrasound. As C’s testimony shows, it is possible to get pregnant despite PCOS and I know from my research that there are several treatments they can put you on and I’ve also read about several success stories. In fact, I even read that celebrities Victoria Beckham and Naked Chef Jamie Oliver’s wife Jules both suffer from PCOS and both of them have had kids, so they are very prominent examples. I am very sorry to hear about the complications you are having. Please let me know if I can help in any way and please keep us posted!

  15. Cynthia says:

    Wonderful article! Im printing this out and taking it to my doctor. I hope the bastard reads it!

  16. Hey Cynthia, knowing what you’ve been through with your wanker doctor, I really hope he does read the damn article. Just make sure you don’t print out the comments along with it;-) LOL!

  17. Kathy says:

    Sarah, I could have written this letter word for word. I have walked, no dragged the footsteps of being diagnosed with PCOS when I was 20, to not being diagnosed with Hashimoto’s just about two years ago. Plagued with menstrual irregularities right from the start of my first period when I was 10, I went to the gynecologist to try and get things straightened out when I was a young married 19 year old. Luckily with the aid of fertility drugs I was able to conceive and bear two daughters. My last pregnancy, one that I achieved on my own ended up with a miscarriage at 14 weeks. Four years later at the age of 34, I was diagnosed with endometrial cancer and underwent a total hysterectomy. My ovaries were also involved. Hormone issues much like yours sent me on a roller coaster ride. My own estrogen level was akin to that of a normal woman taking 20 birth control pills a day. The estrogen converted to testosterone, so I am left with the ‘scars’ of hirsutism, excess weight, insulin resistance and high cholesterol. Depression is one of my worst symptoms with the thyroid disease. I have hypometabolism and cannot metabolize many medications. I was being treated for depression and the insulin resistance when I developed serotonin syndrome and lactic acidosis. No one would touch me with a ten foot pole. It was after I Googled my head off with the signs and symptoms, that I BEGGED for someone to check my thyroid. BINGO! Diagnosis..Hashimoto’s..a relief?! I just don’t know. I’m at the end of going through my second menopause..I went through it right after the hysterectomy, never thinking that when I turned 50, it would happen all over again with what residual hormones I did/do have. My advice for anyone..talk about it, talk about it.. learn what you can, and advocate for yourself. Today, at 54, the untreatable depression makes me hide at the bottom of the well until I’m ready to come out. Serious breathing issues are making me OCD, now, but on the whole, I’m taking charge, I’m informed, I’m determined to be well. What a fight! Thanks so much for sharing! Katie told me that we would have a lot in common, and that you would be a good listener. It’s time to come out of the well…again.

  18. Kathy, I am so sorry that you have been through so much crap with struggling to get diagnosed and struggling to deal with symptoms. Thank you for being so brave and sharing your story! When you have Hashimoto’s coupled with PCOS or similar illnesses, it’s hard to be self-confident about who you are and how you look. Few people really understand these diseases, it seems. I didn’t mention it in my article, but not only is depression a symptom of hypothyroidism, it can also be a symptom of PCOS. Then again, there seems to be a lot of crossover with the various symptoms. Because of what society expects of us, we tend to be very hard on ourselves concerning how we look (another reason why I want to write one of my future columns on body confidence) Kudos to you for being informed and for being so determined! I cannot imagine going through as much as you have and yet you still remain admirably brave. Are you currently on meds for the excess androgens? I hope that you are gradually managing to get your Hashimoto’s under control. Hugs, Sarah

  19. Lolly says:

    Sarah,

    I have it under control now I had a full hysterectomy at 35 because it wasn’t under control and I had suffered since puberty with it I did manage to have one child and that was it. I’ve been on HRT ever since, as I had no ovaries.I’ve since had to have laparoscopic surgery to remove adhesion’s around the abdominal wall I think they are back again because of the pain and discomfort they won’t touch around the bowel or bladder for fear of perforating it. So surgery may have worked with endometriosis but also gave me another set of problems I have to deal with on a daily basis.I can go back anytime if I find it too much and it’s getting to that stage, so may ask for a referral back to my gyno

    The only thing with the male hormones was I thought my voice was getting deeper and I swear i was growing balls and a dick but hey enough was enough when the tash and beard came.:-)
    I wonder too if Endometriosis is linked to Graves disease as Katie’s obs/gyn states years ago they didn’t know what caused it just that it was one of the most leading causes of infertility in women. I had pockets of cyst in and around my ovaries and attached to bladder and bowel as they can grow outside of the female reproductive system.

    I hope you can get a handle on yours and balancing everything endocrine will go along way to improving your quality of life and future children.

    #Kathy your story touched me I hope that you and Sarah and link up and she can help you.

    I will let my close family member know that the offer is there and pass on the links and write up to her.

    Lolly

  20. Cindi Straughn says:

    wow – what a great informative article – i learned so much. and it explained to me, much about my younger years (i.e. high testosterone, TSH not rising to reflect severity of hypo, estrogen dominance). in today’s world, being more informed, I probably would have had a PCOS diagnosis. I actually had ovarian cysts show up in the early 90s per transvaginal ultrasound. The doc’s suggestion? surgery of course. I politely declined. as i did other suggestions thru the years from docs wanting to take my lady parts. 🙁
    but really – thx for a great informative article.

  21. Lolly – glad to hear you have it under control now. It sounds like you had a rough ride. At 32, I sometimes feel too young to go through all this hormonal crap, but I also know that it is so very common at more age and more common than most people think. Sorry to hear about the side effects of the male hormones – that must have sucked. My PCOS seems to be mainly a chemical problem, so I am mostly spared a lot of the ghastly symptoms that are very common. Keep us posted on whether you get to see your gyn and how it goes. I’ll keep you posted on my progress. Right now it seems like a steep hill to climb, but I will get there.

  22. Cindi – I am so happy that my research helped you learn some new facts. Are you sex hormones more in balance now? I do hope so. It’s horrific to think they wanted to operate on you when today there are so many other solutions!

  23. Zari says:

    Sarah thanks so much for a very interesting article. It was terribly confusing at first which makes perfect sense as the way our bodily systems interact is so complex.

    As an interesting aside, one of the many symptoms of thyroid problems in men is gynecomastia- breast growth- brought about by similar imbalances in estrogen and testosterone.

    I thought it was also interesting how the initial sign was something so benign-increased hair growth. I was all set to be irritated with what I would thought would just be a culturally biased diatribe against body hair. I’m really glad that’s not what this article was really about.

    Zari

  24. Hey Zari – Thanks for reading my article. I’m glad you found it interesting. I’m not really surprised that it was confusing at first. I tried to explain it as well as possible, but it is a VERY complex topic, which is why I didn’t go into even more detail than I already did. However, I did want to explain how it can be specifically linked to hypothyroidism.

    Thanks for mentioning gynecomastia. As I said in one of my previous comments, I don’t know as much as I’d like about male hormone imbalances, but this was one I’d heard of and it’s interesting to hear that it’s also linked to hypothyroidism.

    I wouldn’t want to write a diatribe about hair growth because I think it would make others feel bad who are suffering from it. After all, it’s a very common problem. The title was supposed to be comical and, above all, to get people’s attention. Despite having PCOS, I don’t feel like I’m turning into a man because I still feel quite womanly. Then again, I am very lucky that I don’t have more visible symptoms. My main problem is the chemical imbalance of hormones. You are so right that hair growth is a cultural thing – we Brits and Americans are very fussy about any excess hair whatsoever, but from my experience some people here in Germany or parts of Europe are less so. There are times when I simply don’t have the energy to epilate (I have to epilate because when I shave I cut my legs and I get an allergic reaction to depilatory creams) and it doesn’t matter because my fiancé loves me for who I am, not for whether or not I have hair on my legs (although sadly that wasn’t the case with my ex whom I mentioned at the beginning – he was obsessed about anything he perceived as excess hair and, in hindsight, I think he went way over the top) and that is the way it should be.

  25. Jackie Kipilo says:

    I was diagnosed with PCOS almost 10 years ago. Although that doc told me I got PCOS BECAUSE I was overweight. Not the other way around.

    Fast forward to last year when I got my medical records and found to my surprise he had diagnosed me with endometrial hyperplasia. He did NOT tell me this, I read it in my records. I also read that due to “body habitus” he could not give me a thorough exam.

    I have excess facial hair, male pattern balding, a deep voice due to the thyroid condition. And now I may have possible uterine cancer because my asshole doctor in the past decided I was too fat to live.

    I found a new gyn and went to him on Friday. he told me that yes, I am overweight, but it did not cause the PCOS. It was the other way around. He said the weight was not my fault. But he said that it is “hard to examine” me because of my weight.

    Can anyone tell me why Ruby (on the TV show of the same name) can have a thorough gyne exam and I can’t? I weigh only 250 pounds.

    I’m glad I don’t have high blood pressure, high cholesterol, or diabetes.

    I go for an ultrasound on Wed. to decide if they are going to do a D&C or just leave it alone. By the way, they said that they “probably won’t remove it” because of my weight. So ok they would rather give me a bypass surgery that I DON’T want, other than a hysterectomy that I NEED?

  26. Hey Jackie,

    I’m so sorry you had to/are having to go through such a rollercoaster ride. My thyroid doctor actually believes that PCOS is triggered by thyroid disease, so if you put on the weight due to your thyroid condition, this could potentially trigger insulin resistance and that in turn could trigger PCOS. Of course, it’s possible it was the other way round – that you developed the PCOS which caused you to put on weight. It’s also difficult for me to know whether my weight gain has been because of the PCOS or my Hashimoto’s. Either way, my docs want me to lose weight because they are worried that insulin resistance may be causing my elevated androgens and, if not taken care of, this could turn into full-blown diabetes. My blood sugar levels have always been normal, but now they want me to do the 2-4 hour glucose tolerance test to see how long it takes for the glucose to be cleared from my body as this is supposed to be a more accurate and subtle measurement of how my body reacts to sugars.

    I’ve been on Metformin for about a month now and my androgens have actually gone up, although it doesn’t seem likely that this can be because of the Metformin because this is the main treatment for PCOS! I guess it could be hormonal fluctuations and I’m sure it also depends on when they take the blood. Either way, now my doctors are really being proactive, so my contraceptive has been switched to Valette and I’m taking Androcur (it’s a very low dosage – 5 mg – and it sounds like it will only be in the short-term to get my levels under control). Furthermore, they may have to increase my dosage of Metformin, so that I’m taking 1000 mg three times a day.

    Their main aim right now is for me to get my hormone levels under control asap. My doctor’s main aim isn’t for me to lose weight, but because of the potential insulin issue, they are giving me the meds that should help lower my androgens/blood sugar, so that in turn the weight should come off. I’m around 172 pounds right now, but apparently any amount of overweight puts you at a higher risk when you have PCOS – it really sucks!

    Concerning the weight issue – I read that there is an increasing number of women of normal weight suffering from PCOS – it affects us all differently, as does thyroid disease. It sounds like your doctors need to give you a break and be less discriminating about your weight! I am so sorry your doc kept you in the dark about your potential cancer. I am sorry you are still suffering symptoms too – have they put you on anything whatsoever to lower the androgens/alleviate the symptoms? The deeper voice could in fact be caused by elevated androgens (I have read about this being a symptom), but I also know that thyroid disease can change your voice and make it more hoarse and raspy.

    If your docs don’t want to operate on you because of your weight, perhaps they can give you some more productive suggestions on how they expect you to lose it when you have all these hormone imbalances. I hate taking pills, but if taking pills in the short-term gets my levels under control and helps me lose the weight, thus reducing the risk of developing other health conditions, that is what I am going to do. However, I should also mention here that far too many people assume overweight people are unhealthy, which is not always the case! Skinny people or those of normal weight can suffer from just as many problems and sometimes more.

    Please keep us posted on your progress. Good luck with your new doctor! I will have to check out the TV series Ruby (I’m in Germany, so we don’t get US television and I only see it when we are back in the US).

  27. Dawn Sibert says:

    THE BEST, MOST INFORMATIVE & COMPREHENSIBLE article on PCOS I’ve read yet!!!! KUDOS SARAH!!!!

  28. Sarah Downing says:

    Thank you so much, Dawn. I’m so glad it helped you! When I finally found a good PCOS doctor and realised that this illness was more complicated than I had previously thought, I realised that this was something I simply HAD to cover on Dear Thyroid. I became more aware that there is a connection between thyroid disease and PCOS and wanted to share that with the rest of thyroid patients out there so that they can recognise any symptoms they may have and get them treated accordingly.

    I think I wrote in the article that my blood sugars were slightly elevated and this was being treated with Metformin. I was on the maximum dose since February and recently I went down to 1 Metformin pill a day (450 mg), which I will probably be on for another 6 – 8 months as a prophylactic effect. I’m due to see my gyno soon for him to check my androgens, but I’m hoping and wishing that they are back down to normal. He certainly seemed happy with the last ultrasound.

    You can get where you need to be, but you need to find a doctor who gives you the right treatment and that’s usually more than just the BC pill. If you do have high blood sugars, as many PCOS patients do, this will probably also impact your energy and this will get better as they are treated.

    Let me know if you have any more questions. It’s a complicated topic, which is why I didn’t even cover all of it, but I learned a lot in researching it too and it took me a whole day to write, but I think it was worth it.

    Love,

    Sarah

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