Many of us older women have gone untested and undiagnosed with regard to PCOS. Although the syndrome was first identified in 1935, it wasn't on the radar for most doctors when I was a young woman. Whenever I would complain of irregular menses, I would be brushed aside with a pat answer, 'It's because you're so young," or, "It's the stress of medical school," or "It's because you're travelling," or "It's perimenopause." The fact that my hair had thinned, I had facial hair and was infertile (all important markers for PCOS) were similarly ignored, perhaps because I never complained of infertility, choosing to experience it as God's particular blessing for me. Excessive menopausal weight gain was of course brushed aside as quite typical.
It wasn't until I met recently with an endocrinologist specializing in women's concerns, Vinaya Kamath, that the topic of PCOS and insulin resistance was brought up, although I had suspected it myself for a long while. After some research on the Internet, I now appreciate that PCOS may remain both symptomatic and problematic for post-menopausal women. In fact, because of its relationship to insulin resistance, PCOS is a dangerous condition. After a lifetime of ignored PCOS, I now have the key markers of metabolic syndrome: elevated fasting plasma glucose, central obesity and hypertension. The other two markers are elevated triglycerides and low HDL with three out of five markers required for a diagnosis. In general, my lipids have stayed pretty good, perhaps a testament to diet and lifestyle efforts.
Insulin resistance syndromes like PCOS and metabolic syndrome are dangerous because they are associated with increased likelihood of stroke, heart disease, non-alcoholic fatty liver disease, diabetes mellitus and breast cancer. And insulin resistance is a vicious cycle, with heredity leading to insulin resistance syndromes including central obesity and obesity itself leading to insulin resistance.
The best chance of reversing
some of these changes include diet, exercise and weight reduction, along with
either metformin, a drug that improves insulin sensitivity, and/or herbs with
similar actions. Medical literature recommends chocolate for its beneficial effects
on this syndrome, but as I mentioned in a previous blog, sugar isn't helpful,
so choose wisely how you eat your cacao.