Hey there thomasinam
I'd like to say welcome to the PCOS board but err...I guess we'd all rather we weren't here ^_^;;
But anyhow, I've had confirmed PCOS since I was 16 and have gleaned a lot of information over the years between doctors I've badgered and books I've bought and research I've done here and there so hopefully I can help with some of your questions.
First of all, I'm sorry to hear that you have been suffering so badly with your periods. Unfortunately women with PCOS tend to go to extremes with their menstruation; with me, it just doesn't happen, I haven't had a period since I was 19! But for others, like yourself, periods can be horrible, painful and highly emotional experiences.
Doctors usually prescribe one of two contraceptive pills for the treatment of the symptoms of PCOS, those being Dianette and Yasmin. I can't comment on Yasmin as I've never been on it and never looked much into it, however I've been told they work in much the same way; they contain androgen (male hormone) blockers, so your body no longer "responds" to, for example, testosterone in your blood. It is generally conceeded that the slightly increased levels of testosterone in the blood of women with PCOS are responsible for acne and increased body hair, hence why these pills are prescribed for PCOS.
But beware; once again, I'm not strictly sure about Yasmin, but Dianette should not be used long term as it contains a high ammount of oestrogen which can cause more blood clotting and lead to DVT, heart attacks, strokes etc. If you are very overweight your doctor may not put you on it at all.
Another thing to be wary of is that this only treats the visible symptoms, not the cause of the PCOS. It will not treat the cause of it, it will not help you loose the associated weight, and above all, whilst it may help to regulate your monthly cycle it is still a contraceptive, and will not at all in any way shape or form help you regain any fertility you may have lost due to having PCOS. It will simply help you to manage your acne, body hair and possibly your irregular periods if your body responds to it positively, and so given the risks that come with it you may wish to think carefully before pursuing this course of treatment.
That leads me on to your question about fertility. The thing about PCOS is that, since it is a syndrome and not a clear and defined disease such as cancer for example, the symptoms vary from woman to woman. For me, it's the weight, body shape, body hair, lack of periods and lack of fertility. However, contrary to my very own belief up until about two years ago when my cousin who also suffers the syndrome became pregnant naturally, PCOS does not render you infertile. It can make you subfertile, however, which means that your chances aren't as good as "healthy" womens are. This is because instead of releasing an egg each and every month on time, your cycles are all over the place and sometimes that egg becomes a cyst on the ovary (hence the name of the syndrome!). It is important to note that these cysts are not, in fact, the cause of the syndrome, merely a really common and easily detectable symptom. The cause of the syndrome is not entirely known, though it is thought to be linked to weight and hormone imbalances. Which causes which is still very much a question of chicken or egg, as there are women out there with a perfectly "healthy" weight who still suffer as much as someone like me who is morbidly obese.
Anyhow, the point is it may well affect your fertility, but it may well not. From experience, my cousin tried for years, had pretty regular periods, and nothing happened (she was having the periods, but was not ovulating) but when she lost the weight she concieved perfectly naturally and without other medical help.
Studies have shown that many women who have PCOS can readily become pregnant once their symptoms are controlled; said study shows that over 70% will do this naturally, and that 20% will have succesful fertility treatment. Usually the doctors say to actively try for a baby for a year before asking for treatment, as the chances of even a healthy woman falling pregnant during any given cycle are suprisingly small. And treatment doesn't necessarily mean invasive IVF; many women respond well to a drug called Clomid, a pill which stimulates the ovaries to release eggs.
As for your diet concerns, there is an absoloutely HUGE ammount of evidence linking PCOS with insulin resistence, which is absoloutely not the same as diabetes, however can be a precursor to it and is linked to it. This is why your doctor is testing your insulin. This is also why you will hear of women with PCOS being treated with Metformin (or Glucophage; same drug but different name). Some have been known to respond so well to this form of treatment that they will call from the rooftops that every woman with PCOS should drop Dianette and demand this instead. Be warned however; in the UK, Metformin is NOT licensed for the treatment of PCOS, and so will not just be dished out willy nilly. Also, if your insulin levels are fine it wouldn't do anything to help you in the first place. Do not be disheartened if you hear about this "miracle" drug helping other people with PCOS getting their weight under control but your doctor will not prescribe it to you; if you aren't insulin resistant then it's best not to be taking unnessecary medication.
I know that doesn't answer your diet question, but I'm getting there ^_^
Because of this link with insulin resistence, the low carb and gi diets are thought to be very beneficial. GI in particular was developed to help diabetics choose foods which wouldn't cause their blood sugar/insulin levels to spike or crash. Low carb of course is related to this way of thinking, but it is my opinion (and opinion only, so don't quote me on this one) that if you want your body to regain a natural balance and work to its optimal level of fertility then we really shouldn't be trying to cut out entire food groups. I'm currently doing Weight Watchers to loose weight, and its working (slowly, because that is yet another symptom of PCOS, but it's definitely working!) but I'm trying to incorporate aspects of GI into it so that I'm choosing foods which keep my blood sugar levels stable. As anyone can tell you one of the big selling points of Weight Watchers is that you could in theory live off of chocolate cake if you really wanted to, but I'm sure that would not help me balance my hormones and regain fertility!
Finally, as to your digestive problems, I've not heard a terrible ammount about this as a designated symptom, but I have heard some, and I have dealt with it myself. For whatever reason it does seem to be linked in with it. What little I've seen about it suggests trying to get pleanty of fibre into your diet (a good, healthy idea anyway) to help your gut along its sweet way
Hope that answers some of your questions. There are a lot of myths surrounding PCOS, I like to debunk them and I'm always looking for ways to help improve my own symptoms (chiefly the fertility issue, which currently seems to be best treated with healthy, steady weight loss from a healthy, balanced diet and good old fashioned exercise).
If you have any other questions I'd be more than happy to help you find answers to them
Lith
xxx
