New PCOS Diagnosis and Questions

Hello!  I am still pre-op and a regular on the Vertical Gastric Sleeve boards.  I have just been diagnosed with PCOS based on my testosterone and DHEA being high.  The doctor said this and ONLY this:  "I think she has PCOS.  Put her on Glucophage and I"ll see her in 4 months."  That's it!  So, I am trying to learn all about it on my own.  My questions so far are: What are these terrible side affects associated with glucophage I keep hearing about? Is PCOS associated with depression?  I have heard that 5 HTP (which is what my practitioner has me on to combat depression) is the WORST thing to be on for PCOS.  Does anyone know anything about this and what depression drugs are acceptable for PCOS?  I know you aren't doctors, but your opinions and experiences are very valuable to me! Is it possible to control PCOS simply by losing weight?  My bloodsugar is within normal limits, so what else will they evaluate to see if the PCOS is controlled?  I don't want to be on glucophage for the rest of my life if I can control it another way. I know RNY is the accepted best treatment for PCOS because of the faster loss rates, but my question is:  Is the RNY better because of the weight loss itself or for some other reason?  My patient representative at my surgeon's office said RNY was more effective for PCOS but I didn't understand her explanation (and it was more than just because of the weightloss).  I am truly only interested in the Vertical Sleeve Gastrectomy but she is now trying to encourage me to have the RNY done.  And she said my surgeon doesn't know anything about PCOS so not even to ask him! Thanks so much in advance.  You folks have an awesome board here.  OH rocks!  Truly!  I could never have learned so much about WLS than from all of you on this website! Becky

A fantastic site that I researched PCOS on a lot when I was first diagnosed is www.pcosupport.org.  Another one is www.soulcysters.com. My suggestion is find a reproductive endocrinologist.  I live in Iowa City, home of University of Iowa Hospitals and Clinics and am blessed by a wonderful PCOS clinic.  They were very supportive of me having the surgery before getting pregnant and said the rates for getting pregnant were much better after I'd lost the weight.  I'm only four months out.. but I'm already ovulating on my own.  From my understanding, glucophage is used to treat the insulin resistance part of PCOS.  I was on it for awhile to try to get me to ovulate. The RNY is the "gold standard".  There's been a lot more of them and the surgery has very low complication rates when performed by a competent surgeon.  I don't know a lot about the VS.. but maybe someone else her will.  Remember.. it's your choice which surgery you have.  If you need to switch doctors to get it, you may have to.

Thank you so much for the websites and information, Iowa Girl!  Off topic, I was born in Iowa City because my mom and dad (and others in our family) graduated from there.  I know they have such excellent healthcare up there.  I live in a small resort town in NC and have to go "off the mountain" for almost all of my healthcare since no one here is obese, with PCOS, and with glaucoma like me.  Oh well!  So, learning about my health has been a long process.  I will enjoy those websites;  thanks again!

Hi Becky!  I'll try to answer your questions as best I can...btw - I had RNY...and am thrilled with my results!  Anyway... What are these terrible side affects associated with glucophage I keep hearing about? Gastric issues...the most common is abdominal cramping and diarrhea...if you start at a high dose it can be worse...people tend to do better with a low dose and work their way up.  Glucophage aides in insulin resistance and type II diabetes by helping the cells to be more sensitive to the insulin being produced in the body. Is PCOS associated with depression? Yes...many women with PCOS have depression.  I'm not one of them...but on www.soulcysters.com there's an entire forum dedicated to depression. Does anyone know anything about this and what depression drugs are acceptable for PCOS?  Not sure since I've not delt with depression....sorry!  But maybe the depression forum on SC.com? Is it possible to control PCOS simply by losing weight? Yes...loosing weight helps bring the hormone levels into normal ranges which in turn makes the symptoms of PCOS subside. My bloodsugar is within normal limits, so what else will they evaluate to see if the PCOS is controlled? My glucose levels were normal for years before I eventually became diabetic.  They can do a fasting insulin level to determine if you're insulin resistant.  They can also do the FSH/LH ration blood test...if it's off by I think 3:1 or more you have PCOS...I could be wrong on that one though (for the result).  They can also do an u/s of the ovaries to check for the 'string of pearls'...all the small cysts that look like a string of pearls...thus the name poly (many) cystic (cysts). Is the RNY better because of the weight loss itself or for some other reason? From what I've seen yes...because of the intestinal bypass associated with it, it has something to do with the way the pancreas reacts to glucose & insulin production...I can be wrong on this...but it's what I've heard.  I do know that the RNY is considered the 'gold standard' for WLS and results are good, the majority of patients loose >75% of the excess weight. I hope that helped! Kristy

Kristy, Thank you so much for your response!  I'll ask my Endocrinologist about the FSH/LH ration blood test.  And your toddler is adorable!  I have one too and he is the cutest little boy I have ever seen - everyone says so!  Of course I am biased, but that's okay!  Thanks so much.

No problem!  Another test I forgot to mention is a check of your testosterone level...many women with PCOS have abnormally high levels of it...which is why we get the male pattern hair growth & some women get hair loss (male pattern).  I think it should be <25...it's been a long time since I had my labs drawn.  But I'll never forget my highest level was 74...wayyyyyy high.  Good luck & thanks about my little girl!  She's my WLS miracle...because without WLS...she wouldn't be here. Kristy

I was diagnosed with PCOS several years ago and was given about as much info as you got from my doctor.  Just last year I read a comment on one of the WLS forums that her weight gain had been a result of her PCOS.  The one off handed comment got me digging for research.  I blogged about what I found and my feelings about the treatment (or non-treatment) I received from my doctor.  You're welcome to read what I've written.  Here's the posts: http://pamtremble.blogspot.com/search/label/PCOS I'm currently 4 weeks out from RNY and was just thinking the other day how many of my PCOS symptoms have decreased dramatically.  For instance I had really bad dry scalp and dandruff before surgery - but that has all but disappeared.  Also my acne hasn't reared is ugly head either. All those annoying little symptoms of PCOS (which I never even realized was associated with each other) I love that they are going away.  Love it. I was also on Glucaphage for a while.  I couldn't deal with the side effects, so I stopped.  Different people have different reactions, I guess. Pam

Thank you for your post and for the link to your blog.  I am going to go read it right now.  I appreciate all the support I have received here.  You are a great group.

Okay, Pam, so I just read some of your blog and will continue reading the rest.  I have to say that it is the best and most well-written Blog and even website I have ever encountered on PCOS!  Great job on it.  I forwarded it to my Mom and Husband to read as well because they are learning along with me all about PCOS.   I do think I need the weight loss surgery to help me lose all of this weight.  I have tried so many times and am still morbidly obese with it getting worse every time I try to diet.  I did know about the low carb diet being the most successful - not from my doctor, of course, but from my previous knowledge of the syndrome before I even knew I had it.  Thank you, thank you for your great Blog.  I am so glad you have found a supportive group of true friends in your WLS support group.  I have just started going to one in my town and I agree;  it has been a God-send.  Before, I didn't have a lot of close relationships (due to moving quite frequently in the last several years - we are settled now, thank God) and didn't go out at night much.  Now I look forward to these monthly meetings and I know it is a new beginning of true friendships for me, too.  Sincerely,

I was diagnoised back in May with little information.  I was put on glupapage (sp) at first.  I quit taking it.  It made big red spotches all over my face.  Since June I have been on metformin.  So far so good.  About two months ago I quit eating gluten and sugar.  So far I have lost 21 lbs.  I really believe I was gluten intorlerable (sp).  My IBS is gone,  I have more energy.  I saw a doctor on tv and he said if you are obese then you are allergic to flour and sugar.   I buy everything gluten-free now.  I make pizza's with gluten-free baking mixes.  I don't eat anything with soy either.