9 of the Most Embarrassing PCOS Questions Answered

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If you suffer from Polycystic Ovary Syndrome or PCOS, there may be a lot of things that don’t make sense to you or questions that you may be too embarrassed to ask about. Here medical experts answer 9 of some of the most embarrassing PCOS questions.

Why Do You Have to Run to the Bathroom Immediately After Eating While Taking Metformin?

You may be aware that a big side effect of metformin is diarrhea. But why does it do that, and especially after a meal? According to Dr. Mark Perloe, a Reproductive Endocrinologist with Georgia Reproductive Specialists in Atlanta, Georgia, it’s related to serotonin. “Serotonin is an important neurotransmitter produced in the small intestine that affects bowel motility. During the first few weeks of metformin therapy, metformin results in excessive release of serotonin which can cause diarrhea and nausea.”

So what can be done to help with the unwanted side effects of metformin? Perloe offers “if you are just beginning with metformin, start with small doses, gradually increasing over time, and taking metformin at mealtime with a full glass of water.” Avoiding high carbohydrate meals or meals that include processed or refined foods can also help to minimize the side effects of metformin.

What Are Those Large and Scary Blood Clots You Pass With Your Period?

If you get heavy periods, you may sometimes come across large and somewhat terrifying blood clots. While many women suffer from heavy bleeding during their periods and pass blood clots, it doesn’t necessarily mean that something bad is going on.

“During menses, the body releases anticoagulants to keep the blood from clotting as the lining sheds from the uterus. When bleeding is heavy (released at a quicker pace), there is not enough time for the anticoagulants to do their job and therefore clots form,” explains Dr. Heidi Strieb, an OBGYN in West Reading, Pennsylvania.

Should you be worried? “If you continue to pass clots larger than a quarter or are saturating a tampon or a pad in an hour,” says Strieb, “you need to be evaluated by a doctor to determine the cause.”

Why Do You Worry All the Time?

Do you feel like your mind is constantly racing at 100 plus miles per hour and you can’t slow down your worried thoughts? It may be related to anxiety. According to Dr. Stephanie Mattei, co-founder of the Center For Acceptance and Change and the co-author of The PCOS Workbook: Your Guide to Complete Physical and Emotional Health, “if you notice yourself worrying more often than those around you, and you find it difficult to control your worry, you might have an anxiety disorder.”

How do you know if it’s serious? “If you feel nervous most of the day, every day, or have difficulty concentrating, or are irritable, or if it interferes with your ability to socialize, sleep or eat, you might want to seek help from a professional who specializes in anxiety disorders.”

Why Did Your Doctor Prescribe Metformin If My Glucose Is Normal?

While metformin is the most common medication prescribed for individuals with type II diabetes, it has been shown beneficial in women with pre-diabetes or PCOS. “Metformin works in the liver and primarily allows for better sugar control with less insulin. As a result, when combined with a low glycemic diet and exercise, metformin will often reduce post-meal insulin response,” explains Perloe. “This drop in insulin leads to a reduction in androgen [testosterone] production in the ovary and restoration of ovulation.” Perloe adds “Metformin is associated with weight loss which can further improve menstrual irregularity and the odds of conceiving.“

Why Can’t You Just Stop Eating?

If you find yourself battling constant carb cravings and can’t stop eating, you’re not alone. Women with PCOS tend to have high insulin levels which stimulate the appetite. “High circulating insulin levels make every cell in a woman's body scream ‘eat those brownies NOW!’ as if life depends on it,” says Julie Duffy Dillon, a registered dietitian and food behavior expert in Greensboro, North Carolina. “It's not a lack of willpower or a personality flaw. Managing insulin levels with nutrition, supplements, and/or medication can help lower insulin levels. Once insulin levels are lower, the craving to binge eat is significantly lower as well.”

What to do about it? Dillon recommends women with PCOS focus on healthy food choices, activity, and self-care and offers these helpful tips: “be sure to eat consistently throughout the day, include all the food groups, and stop thinking about food as good or bad. Being more flexible with food choices will help cravings lose their intensity.”

Why Are There Boils and Lumps Under Your Skin?

If you have pea-sized or larger lumps above and beneath the skin in places where the skin rubs together such as under the arms, thighs, groin, under breasts, and between buttocks, you may have Hidradenitis Suppurativa (HS). This chronic inflammatory skin condition is believed to be both autoimmune and hormone related. Those who have HS not only suffer from the physical pain but emotional pain of this chronic condition as well. HS can be a very embarrassing and frustrating condition to cope with. Newer research is showing the impact of an anti-inflammatory diet in managing this condition.

What’s in Those Follicles and Should You Be Worried There Are so Many

A follicle is a fluid-filled sac that contains one egg and the cells that prepare the egg for early embryo development. Women with PCOS typically have an endocrine disorder that results in many small antral follicles at the start of every period.

Due to an imbalance of sex hormones, the eggs inside those follicles do not grow and as a result, the follicles (mistakenly called cysts) stay small the entire cycle. According to Dr. Isaac Sasson, a Reproductive Endocrinologist with Shady Grove Fertility in Chesterbrook, Pennsylvania, “without follicular growth, ovulation does not occur and typically women will have an irregular cycle.” Sasson doesn’t think you should be worried about the number of follicles. “From a fertility perspective, having too many follicles is a fantastic problem to have,” says Sasson. “It means, that there will be many more eggs to work with. The challenge is getting them to grow.” Medications can be used in most instances to help one or two follicles grow in size and induce ovulation.

Even Your Liver Is Fatty! What’s Going On?

Being told you have a fatty liver is never fun. Having a fatty liver is pretty much what it sounds: you have a lot of fat in your liver. Non-alcoholic fatty liver disease (NAFLD), commonly referred to as fatty liver, is highly prevalent in women with PCOS, affecting 5% to 18% of women depending on the diagnostic criteria used. NAFLD occurs as a result of excess triglycerides (fat) stored in the liver which causes damage and inflammation. The liver isn’t meant to store fat; its role is to serve as the detox organ for the body filtering out harmful substances. While there are many causes of NAFLD, it can be reversed with a healthy diet and lifestyle.

Will PCOS Ever Go Away?

PCOS sure is associated with some embarrassing symptoms! Unfortunately, PCOS won’t ever go away for good. The good news though is that with a healthy diet, regular physical activity, medications, supplements, and other lifestyle changes, PCOS and its embarrassing symptoms can become manageable.

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