Candida. Estrogen promotes the growth of yeast in the gut, sometimes causing a condition called Candida overgrowth. Candida is a fungus (a form of yeast) that occurs naturally in small amounts and aids in digestion. If an overgrowth occurs, symptoms like brain fog, fatigue, digestive and skin issues, mood swings, and fungal infections occur. In addition, it breaks through the intestinal wall and allows byproducts into the surrounding area, triggering systemic inflammation. Since the major ingredient in the pill is estrogen, the risk of Candida overgrowth increases; it also causes sugar and carb cravings.
Metformin
After the birth control pill, metformin is the most commonly prescribed drug to “treat” PCOS. The purpose of metformin is to decrease the amount of glucose (sugar) and insulin produced by the liver and pancreas, and increase sensitivity to insulin in muscle cells. Getting insulin resistance under control is critical to thriving with PCOS, so it makes sense to take a pill and get quick results, right? Unfortunately, according to a National Institutes of Health 2012 study: “Metformin decreases androgen levels but has demonstrated only modest effect on fertility and has little effect on insulin action.” Here are a few of the problems with metformin:
GI issues. Metformin doesn’t only work in the liver; it takes action in the gut. It effectively adds to the protective mucus layer and stimulates pathways for fat burning and cellular rejuvenation, which should lead to more effective glucose regulation. In the process, many women (like me) find that it causes more GI distress (nausea, cramping, diarrhea) than it is worth.
Nutrient depletion. Metformin is widely acknowledged to deplete vitamin B12. A shortage of B12 is associated with nerve pain (neuropathy), cognitive dysfunction, and anemias.
Band-Aid effect. Like so many medications, metformin does not fix the underlying problem. Poor diet and lifestyle choices are usually the root of insulin resistance. Failure to change those will limit the effectiveness of this drug, and if it is ever stopped, the symptoms will return.
Spironolactone
Spironolactone (Aldactone) is a diuretic often prescribed to treat symptoms associated with high levels of androgens such as acne, hirsutism, and thinning scalp hair. It is not meant to treat insulin resistance, the cause of high levels of androgens in women with PCOS. Reducing the level of androgens in the body with a pill instead of addressing the root cause is a Band-Aid at best. The moment a woman stops taking the drug, symptoms will return.
Flutamide
Like spironolactone, flutamide works as an anti-androgen. In fact, its intended purpose is to reduce testosterone in the treatment of prostate cancer. In women, it has been found to be an effective drug for treating hirsutism and mild to moderate acne. Some studies indicate it works better than spironolactone. Like all of these drugs, flutamide is a Band-Aid treatment and does not attempt to resolve the root cause of the condition. In addition, there is risk of serious liver problems and birth defects if taken when pregnant. In fact, many doctors will not prescribe flutamide to women at all.
Although you cannot cure PCOS, you can manage your symptoms through diet, exercise, and other lifestyle approaches.
What Can I Do?
So now that you know why you feel lousy, what can you do?
You can heal and thrive! Although you cannot cure PCOS, you can manage your symptoms through diet, exercise, and other lifestyle approaches. Doctors and researchers agree that lifestyle therapy should be the first line of treatment for women with PCOS. Managing diet, lifestyle, and emotional health will lead to better health, restore hormonal balance, and help get your insulin levels back on track. Before you know it, your symptoms will begin to ease and your risk of diabetes, heart disease, hypertension, sleep apnea, anxiety, depression, and infertility will decrease. Therefore, a holistic approach is required to tame the symptoms of PCOS and improve your quality of life. Above all, we need to be thoughtful about the foods we use to fuel our bodies, the exercise we choose, the toxins we are exposed to, and, just as important, the emotional and mental care we take of ourselves.
But I Really Just Want to Take a Magic Pill
Good news. There is a magic pill. It’s you. The moment you decide that you deserve to be healthy and happy, you will begin to make the changes necessary to heal. You will wake up every day and make choices that nurture yourself, and you will feel better. As you feel better, you will make even more upgrades, and the cycle will continue. You are the magic pill that makes it all possible.
Everyone has a rock bottom. I remember mine clearly. My husband came home from work one day to find me lying on the couch listless and hopeless, my boys, ages four and one, running wild. I could not muster the energy to play with them, these babies I loved so dearly, had wanted so badly, and worked so hard for. My fatigue and other PCOS symptoms had drained the life out of me. I wasn’t the mom and wife I wanted to be and knew I could be.
I saw myself through my husband’s eyes that afternoon. I saw myself and knew it was time to take control of my health and my life. This woman on the couch was not me. Moreover, I didn’t want to be her.
Until that moment, I had followed my doctors’ advice. I took the tests they suggested and the drugs they prescribed. But nothing was working. At this “aha” moment, I realized that I had to stop being passive about my care. I needed to take control of it and educate myself about PCOS, so that I could make informed decisions. I needed to become my own advocate, and to do that I knew that I first needed to change my frame of mind. I had to want to feel better; I had to know in my heart that I could heal and that I deserved to feel better. Realizing that I was worth saving changed the way I thought about my life, my body, and my PCOS. Once my mindset shifted, I began my journey of thriving with PCOS.
Choose to Be a PCOS Diva
You may be asking yourself why “Think like a PCOS Diva” comes before “Eat like a PCOS Diva.” You are wondering why you can’t just exercise, eliminate gluten, and be all set. You cannot. Here’s why. If you do not think like a PCOS Diva, you cannot be a PCOS Diva (not for long at least).
Being a PCOS Diva involves a conscious manner of thinking that is the key to making the PCOS Diva lifestyle sustainable. In order for diet and lifestyle changes to work, you must believe that you can feel better and know that you deserve to feel better. With this mindset shift, you will eliminate the chance for failure or self-sabotage. When you expect to succeed, you will find a way to overcome any minor setback, because you are on your chosen path. Setbacks (although frustrating) become an opportunity to learn.
Imagine it like this. You and your friend are on your way to dinner at a restaurant you’ve been wanting to try. On the way, you find that the bridge to get there is washed out. You can still go, but