I’m combining all my other blogs’ content to this site. Please bear with me as I post older content. 🙂
A while back I stumbled upon a briefing in my email that led me to this study, which indicated that women with polycystic ovarian syndrome (PCOS) have an increased risk for developing type 2 diabetes. As a woman who was diagnosed with PCOS as a 17 year old (and as a woman with an egregious sweet tooth), this news alarmed me, but not just for the risk mentioned.
First off, PCOS is a reproductive hormonal condition that can impact fertility. With PCOS woman is thought to have at least two of the following: high levels of androgen, increased facial hair, multiple cysts in her ovaries, and/or infrequent periods. The risk of PCOS is also greater when a woman is obese.
When I was first diagnosed with PCOS, I was around 17, and went to the Ob/Gyn because I hadn’t had my period in 6 months despite not being sexually active. The doctor inquired on my lifestyle, and when he discovered I played on two soccer teams and ran track on the off season, he quickly decided that my period’s absence must be due to my high level of physical activity. For some reason, he still decided to do an ultrasound, and then proclaimed that I had cysts in my ovaries. He retroactively mentioned that they might be the reason for my errant hairs on my chin and below my belly button (as PCOS is known for causing hormonal fluctuates that result in increased androgen). He then had me get a blood test, the results of which showed that I had slightly lower levels of estrogen than is “the norm”. He prescribed me birth control pills to balance out my hormones and sent me on my way. And so I began my journey on “the pill” for about 3 or 4 years.
After that, every time I subsequently went to see a Ob/Gyn, in college and after, I dutifully marked down that I had PCOS on the medical intake forms. It was never remarked upon again as my body weight was normal, which at the time was the big red flag with PCOS. It wasn’t until I started going through what we later found to be topical steroid withdrawal that my PCOS became a problem. Because my skin was so bad, doctors believed it may have had something to due with my hormones, and so I had a gamut of tests, from blood and saliva draws, to MRIs. They found that my cortisol levels were high and decided it would be worth it to see if taking me off the pill alleviated said result (it was also discovered that I had a pituitary adenoma, which led to me having to see a neurologist, and in following years having to get an annual check-up MRI. This continued until one doctor said they weren’t sure I ever had the adenoma, but instead perhaps the imaging had been read incorrectly the first time. Such is the way with imaging readings, I’ve learned).
When I was pregnant, I dutifully told my new Ob/Gyn about my PCOS diagnosis, and he replied that many women were given the diagnosis of PCOS when they were young without it truly being the case. Rather, he elaborated, it was more likely the case that I was young and my body was still adjusting to its hormonal changes. So maybe I had a cyst or two temporarily but it was not the same thing as PCOS. He furthered that the diagnostic signs for PCOS are a bit outdated, a statement of which newer studies seem to agree.
With the uncertainty around correct diagnoses, how then would one know if they are at more risk for type 2 diabetes or not? After I pondered this for a while, and my mind wandered down such avenues of questions, I inevitably came to the same conclusion where I always end up. Does it really matter? Or are most of these conditions still the product of lifestyle? Is the answer still then to eat more vegetables, cut down on sugar and processed foods, don’t consume excessive calories, sit less and move more?
Whenever I get to this conclusion I start to wonder what cultures still follow these stipulations more closely, and if said cultures have been studied for their rates of lifestyle diseases. But that’s a post for another day.
Dewailly D. Diagnostic criteria for PCOS: Is there a need for a rethink? Best Practice & Research Clinical Obstetrics & Gynecology. 2016 Nov; 37: 5-11.
Kakoly NS, Earnest A, Teede HJ, Moran LJ, Joham AE. The Impact of Obesity on the Incidence of Type 2 Diabetes Among Women With Polycystic Ovary Syndrome. Diabetes Care. 2019 Jan.
Polycystic Ovary Syndrome. Office on Women’s Health. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome.