“Basically, it’s a bit of a bummer,” Veronique told me two years ago. This talented interior designer was making light of the fact she has polycystic ovarian syndrome (PCOS).
Of course, I wouldn’t have known her ovaries were home to tiny fluid filled cysts unless she’d told me. But her shiny, spotty skin and overweight body were classic giveaways.
“I stopped having proper periods years ago,” Veronique went on. “I have a heavy one, and then nothing for maybe four months. And I get big black hairs on my neck and chin, which I have to pull out.” She looked sad. “Sometimes I think it’s ruining my life. I’ve hired escorts to take me to parties, because I’m sick of people asking if I have a boyfriend. Actually, I’ve never had one.”
A woman, or sometimes a girl (it often starts in adolescence) is labeled as having PCOS when a scan reveals swollen follicles on her ovaries, and a blood test shows peculiar hormone levels. There’s a selection of symptoms too—typically an unkind pick and mix of irregular periods (or no periods at all), acne, weight gain, depression, and infertility.
“You see, it’s all good news,” Veronique quipped sarcastically.
So far experts have established that PCOS—which affects up to one in ten women of childbearing age in vastly varying degrees and different ways—is triggered by imbalances in the hormones controlling the menstrual cycle, of which there are more than a few. There are hormones produced by the ovaries, namely estrogens, progesterone, and adrogens (of which testosterone is the biggie). Plus there are the two hormones that regulate them, produced in the brain by the pituitary gland—FSH (which stands for follicle stimulating hormone) and LH (luteinising hormone).
But the precise cause of this chemical mayhem? So far, no one can say.
“For years doctors didn’t bother to find out why I was fat,” Rosemary explains. “They just assumed it was my fault.”
Rosemary’s periods were troublesome almost from the day they started when she was fourteen. And they were astoundingly heavy. “I was just a kid and assumed everyone bled that way,” she says.
“Then one day my mum saw what I’d left in the toilet bowl and marched me to the doctor. I saw him when I was sixteen. I explained my periods came every three months and were awful. He just told me losing weight would solve it. I was 203 pounds at the time.”
That consultation sucked Rosemary into a destructive mental whirlpool of bulimia (she started throwing up after meals) and depression (because she blamed herself). “But my periods stayed the same,” she says. “And my skin was terrible.”
Finally, two years, and many doctors’ appointments and antidepressants later, one medic was smart enough to give her a scan. It showed lots of little cysts inside and on the top of her right ovary.
“The doctor diagnosed PCOS and told me it had triggered my weight problem and bad skin. Finally, I knew what I was dealing with. And that meant I could tackle it,” Rosemary recounts.
It’s thought that excess weight can make PCOS worse. One reason is the syndrome may be linked with insulin resistance (insulin is the hormone that moves glucose around the body).
It’s a bit of a chicken and egg situation. It’s unclear if the insulin resistance causes weight gain, or if the weight causes the insulin resistance. But whatever the case, studies show losing 5 to 10 percent of body weight can cause a significant improvement in symptoms.
There’s no getting away from it—the long-term impact of weight control is important too. Women with PCOS are at greater risk of infertility (due to lack of ovulation), diabetes, and high cholesterol. Losing weight can radically lessen the likelihood of all three.
“In the past few years, I’ve had hormone treatments to regulate my periods, cut out carbs, and walked miles. I’ve also taken a relatively new drug treatment called metformin, normally given to diabetics to reduce insulin resistance,” Rosemary says proudly. “I’ve lost twenty-eight pounds and feel more in control now.”
Rosemary, like Veronique, knows PCOS is an incurable condition. But at least it’s manageable. Both women have had electrolysis to remove unwanted facial hair.
But the treatment that really helped Veronique was the contraceptive Pill Dianette. “It’s really cleared my skin and for the first time in years I can wear makeup,” she says. “It feels great to be girly.”
She looked good too. The metamorphosis from the woman I’d known two years earlier and the one beaming in front of me was impressive. She was at least twenty-five pounds slimmer. Her hair was freshly washed and wavy. And I’d never seen her in snug, sexy jeans before.
But we all know there isn’t really such a thing as a happy pill. Contentment comes from inside. By finding treatments that helped control her PCOS, Veronique’s true attributes had been allowed to shine through.
“I don’t need an escort now,” she said giving me a wink. “Meet Pascal.”