This morning, I'm sitting drinking my coffee, checking facebook, (Sincere congratulations to my newly preggers friend!) and I have a sharp pain in my low pelvic area. I've had these pains before, but this time is the first time I've been aware that the pain is a cyst either bursting or twisting. It just makes me think differently about the pain.
In high school, I would get sick every time I started my period. Cold compress, heating pad, cold sweats, couldn't wear a tampon, delirious, throwing up, searing pains, passing out in the high school bathroom sick. My father carried me out of school and brought me home once a month for about six months.
Now, I have had six OBGYNs since I was in high school. I have full disclosure told every one of my doctors about these extreme episodes. Each and every one of them told me "Some women have more painful periods than others" and proceeded to prescribe me pain killers and muscle relaxers. Excuse my language, but that was bullshit! It took Dr. P one vaginal sonogram to discover that my ovaries were full of cysts. The other doctors were just as capable as her, but did not take the extra step. Maybe they did not suspect me of PCOS because I am so thin. Anyway, what was happening was not normal.
I've read (skimmed) several library books on PCOS in the past few weeks. The best one I have found is What to Do When the Doctor Says Its PCOS by Milton Hammerly and Cheryl Kimball. Also, Taking Charge of Your Fertility has a short and informative section on PCOS. All of the books I have found suggest exercise, diet, and weight loss to bring back regular cycles. The typical PCOS patient tends to be overweight, or gains weight easily and has difficulty loosing weight because of the insulin resistance that is associated with PCOS. In fact, I've been reading that insulin resistance is actually at the core of PCOS. Because the body is insulin resistant, the pancreas produces more insulin, which signals other hormones including the male hormone androgen to over-produce, which prevents the egg from being released. Ta-da!
So...long story short. I charted. I may or may have not ovulated. We did it. I prayed. I took pregnancy tests. I charted some more. I may or may not have ovulated. We did it. I prayed. I charted. I spotted, and spotted and spotted. After 22 days of bleeding and spotting, I was back in the doctor's office. One ultrasound later, Dr. P discovered that I have a large cyst on my ovary.
The next development makes me want to cry. Dr. P asked me to get back on BC for one month to suppress the cyst, since it is unlikely I'll ovulate with such a large cyst. If all goes well, the cyst will shrink, and when I start my cycle after the BC, we'll be able to start Clomid. Ugh. This is not going according to plan.
Clomid (clomiphene) is used to induce ovulation; it works similarly to estrogen, a female hormone that causes eggs to develop in the ovaries and be released. Clomiphene comes as a tablet to take by mouth. It is usually taken once a day for 5 days, beginning on or about day 5 of the cycle. If you are going to be successful with Clomid, it is most likely to happen in the first three months. Most doctors take patients off of Clomid after the fourth month, as it increases the risk of ovarian cancer. There is a slightly higher risk of twins (about 10%), and a smaller risk of triplets or more. (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000752)
Dr. P is not a fertility specialist. She's an amazing OBGYN that I stumbled across. She promises not to waste my time, and let me know when what's going on is beyond her knowledge. I have an appointment with the big fertility endocrinologist in town in October. I've heard he is amazing, but hope I'll be able to cancel that appointment. :)
Now, I have had six OBGYNs since I was in high school. I have full disclosure told every one of my doctors about these extreme episodes. Each and every one of them told me "Some women have more painful periods than others" and proceeded to prescribe me pain killers and muscle relaxers. Excuse my language, but that was bullshit! It took Dr. P one vaginal sonogram to discover that my ovaries were full of cysts. The other doctors were just as capable as her, but did not take the extra step. Maybe they did not suspect me of PCOS because I am so thin. Anyway, what was happening was not normal.
