No answers, no hope.
That was where I found myself after 18 months of trying to figure out why I had periods that lasted 3 or 4 weeks at a time. For the next year, nothing really changed. I did, however, make some interesting discoveries.
The first discovery was food. At the recommendation of the naturopath, I had tried to eliminate simple carbs. I will be upfront and say I was not good at this much of the time. I struggle with binge eating and food addiction. My years of trying to conceive were weeks where I ate minimal carbohydrates followed by weeks where I ate far too many donuts and chips. Because of this cycle, however, I noticed something interesting. If I ate poorly for a month, the next month's period would be weird and too long. If I ate more cleanly, the next month I was more likely to ovulate (more on that in a minute) and have a normal, 7 day period.The food I ate certainly played into my periods
The second discovery was exercise. I have always hated exercise. Why get up and move, especially outside, when it is much more comfortable to sit curled up on the couch reading a book? Once I got married, my husband decided to take his health seriously and work out regularly. That meant I, too, had to work out regularly. It wasn't pretty. I whined and complained and tried to cajole my way out of it more often than not. We started with some body weight exercises and High Intensity Interval Training, or HIIT. We moved into running (which was worse). We transitioned back into HIIT. Finally, everything changed: my husband bought a barbell. He reasoned that, since my testosterone was high, it might be beneficial to do something with it. Maybe weightlifting would be good for me.
I did not immediately fall in love with the barbell. The first several months of Crossfit that we tried were weird and uncomfortable, learning new moves and a strange lingo. I still did a fair amount of complaining. One day, however, I realized that I didn't have to wait until the end of the day when my husband got home to work out. I could do it in the morning, get it done, and move on with my day. That made all the difference.
As my attitude was changing, so was my body. I didn't start popping out muscles everywhere, but my periods did continue to get shorter. While any amount of exercise was better than none, this new weight training seemed to have the most impact.
The third and most fascinating discovery was the Fertility Awareness Method of tracking a menstrual cycle. My mom lent me a book on it. I read the entire thing in just a couple days. Using this method, I was able to determine if (and when) I ovulated. By taking my temperature when I woke up in the morning, I could determine exactly when my period would arrive. By paying attention to bodily signals, I could pinpoint where I was in my cycle. It was enlightening and encouraging. I was—sometimes—ovulating. Maybe I could get pregnant after all!
Changing how I ate made a difference. Changing how I moved made a difference. Looking at the signals my body gave me, I could tell if my body was working the way it was supposed to. But I still had no answers. No name for whatever was wrong with me. No clear path to pregnancy, or even regular periods. Every doctor I had seen up to this point had no clear diagnosis.
After three and a half years of trying, of wondering, of confusion, I made an appointment with a fertility specialist. I clearly had a reproductive issue of some sort. Surely he, of all people, could put a name to what was wrong.
I was really nervous walking into the office that morning. In the waiting room there was a bulletin board full of birth announcements and Christmas cards, smiling faces holding sweet babies close. This doctor was good at what he did, at least.
I sat in a big, comfy armchair in the doctor's office and unloaded on the poor man. I had a file folder with the results of every test I had taken, period charts from the last two years, and fertility charts from the last several months. He asked about what my period had been like when it started. I told him it was pretty irregular, and I even skipped three months the first year. I could never be sure when my period would arrive (unless I had a dance recital coming up). I explained how everything had changed after I got married. How I was sure I had miscarried even though I had not taken a pregnancy test, and maybe that had thrown my hormones out of whack.
He glanced at all my test results, and disregarded my fertility charts completely (that irked me quite a bit). He considered my history, my symptoms, and my situation. Then he said the words that changed my life forever: “I think you have Polycystic Ovarian Syndrome.”
In that moment, it didn't mean very much. I didn't have a clue what it meant.
“We will have to do an ultrasound to make sure. Let's have you go in the other room and get ready. We have to look at your ovaries and see if we can find the 'string of pearls',” the doctor explained. I didn't know what that meant, either, so I complied.
Once he found my right ovary, the doctor manipulated the wand so he could get a closer look. Ultrasounds pictures are hard for me to interpret, but once he pointed it out, I could clearly see the “string of pearls”, the immature follicles clogging my ovary. It is these “cysts” (that aren't actually cysts) for which the condition is named. Repositioning the wand again, he showed me the same on my other ovary.
I had my official diagnosis: Polycystic Ovarian Syndrome. We returned to the first room to discuss this condition and what it meant. I was confused, though. “I had had an ultrasound over a year ago. Why hadn't they seen the ovarian abnormality then?” I asked.
“The technician was probably only measuring your organs and looking for extra masses, like tumors,” the doctor explained. “They aren't trained to look for extra follicles unless specified by the doctor.” He went on to discuss some of the specifics of my condition. I had been diagnosed because I had two of the three necessary symptoms used for that purpose. The three were excess immature follicles, excess male androgens (like testosterone), and insulin resistance. The extra follicles we had seen. The testosterone had been tested, but I also had some extra male pattern body hair (called hirsutism), and carried all my extra weight in my stomach. These are also indicators of high testosterone. The doctor ordered a hemoglobin A1C test to check for insulin resistance by way of my blood sugar level. That test came back high, but not quite pre-diabetic.
But what was this PCOS? Basically, I am insulin resistant, similar to a type 2 diabetic, but less severely. My body requires extra insulin to process carbohydrates. A “normal” amount doesn't trigger an appropriate response. The extra insulin doesn't get used up, and floats around until it gets to the ovaries. It triggers them to overproduce testosterone, which in turn hinders the release of the eggs. It is typically treated by addressing the symptoms. There is no cure.
After explaining the condition, the doctor handed me a textbook chapter on the condition to which he had contributed. Then the doctor began to talk about medication. He recommended Metformin to help resensitize my body to insulin. This drug, frequently used to treat diabetics, has also been shown to be helpful for women with PCOS. He also recommended starting on Letrozole sooner that later, to help force ovulation. His opinion was that it was more effective than Clomid (another commonly used medication for ovulation) in women with PCOS. I thanked him for the information, but opted to talk to my husband before agreeing to medication. In my head, all I could think was, That's it? Pills for the rest of my life? There has to be a better answer!
To say I was shell-shocked would be an understatement. Leaving the doctor's office, I was numb. Confused. Heartbroken. I was the problem. I was the reason we couldn't have children. What were we going to do? The more I thought about all of this, the angrier I became. All I ever wanted was to be a mom, to have a big family. Plenty of people had kids, no problem. Why me? It's not fair!
I drove straight to my husband's office. I climbed out of the car and into his arms, sobbing, “It's my fault! I'm broken!”
We finally had an answer. It was devastating. I would face this condition for the rest of my life. How would we address my PCOS, my broken reproductive system, my insulin resistant body? Medication, or...what?
**Disclaimer: The information in this post is not intended to diagnose or treat any condition. If you have questions or concerns about what you are experiencing, please discuss them with your healthcare provider.
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