A Mysterious Ailment.
How to spot a hormonal disorder
For now, doctors must work with the symptoms and other signs
they notice, says Caren Solomon, MD, MPH, associate director of women's health
research at Brigham and Women's Hospital in Boston. "There's not even a
universal consensus on the definition of the syndrome," she says.
"There is a sense, among physicians, that you know it when you see
That doesn't mean that getting the right diagnosis is easy,
however. On the contrary, without one test to definitively diagnose PCOS,
getting answers remains difficult. Many times, doctors end up pointing to PCOS
when they've exhausted other possibilities, says David Ehrmann, MD, an
associate professor of endocrinology at the University of Chicago.
"To some extent, it's a diagnosis of exclusion," he
says. "You have to exclude a number of conditions that can masquerade as
Concocting a cure
Once doctors have finally arrived at the diagnosis, women like
Henninger have yet another long road ahead to find the right treatment.
Many doctors, like Ehrmann, design a treatment plan for each
patient, depending on the woman's symptoms and her age and stage of life. They
may begin by suggesting a regular exercise regimen and a low-fat,
low-carbohydrate diet for weight loss. For women who are markedly overweight
and have irregular periods, Futterweit sometimes prescribes metformin, a
diabetes medication. It helps the body's cells become more sensitive to
insulin's signal to convert sugars into energy. This insulin insensitivity is
often associated with PCOS.
To normalize the body's hormones, doctors usually recommend
oral contraceptives along with a medication that counteracts male hormones.
Women who want to get pregnant wouldn't take these medications. Instead, they
can undergo fertility therapy with other drugs or try in vitro
While the condition requires lifetime management, Futterweit
says, women can indeed go on to live a normal life. Henninger, now a member of
the board of directors for the Polycystic Ovarian Syndrome Association, lost
138 pounds after going on a low-carbohydrate diet for 13 months. Her diabetes,
cholesterol levels, and high blood pressure are all under control.
And after fertility treatments didn't work, she and her
husband, who was her high school sweetheart, began a family together by
adopting three children. Then, in 1998, they were handed the surprise of their
lives: Henninger found out that she was pregnant. "We weren't even
trying," she says. "This baby was a miracle and a wonderful
Stacey Colino is a freelance writer in Chevy Chase, Md.