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What Nurses Know... PCOS 1st Edition Full PDF Download

The book 'What Nurses Know...PCOS' provides comprehensive information on Polycystic Ovarian Syndrome (PCOS), including its diagnosis, management, and the various challenges women face. It emphasizes the importance of lifestyle changes and medication in managing PCOS and offers insights into the mental health implications and long-term health risks associated with the condition. The narrative includes personal stories from women living with PCOS, highlighting their struggles and resilience.

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347 views14 pages

What Nurses Know... PCOS 1st Edition Full PDF Download

The book 'What Nurses Know...PCOS' provides comprehensive information on Polycystic Ovarian Syndrome (PCOS), including its diagnosis, management, and the various challenges women face. It emphasizes the importance of lifestyle changes and medication in managing PCOS and offers insights into the mental health implications and long-term health risks associated with the condition. The narrative includes personal stories from women living with PCOS, highlighting their struggles and resilience.

Uploaded by

gu.anngomphoa.ttuong
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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What Nurses Know...

PCOS 1st Edition

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Contents
Foreword vii
Introduction: Living With Polycystic
Ovarian Syndrome ix
1 What Is Happening and Why? 3

2 Getting a Diagnosis 17

3 Management of PCOS: The Basics 31

4 Lifestyle Changes 41

5 Management of PCOS: Medications 57

6 Dealing With Body Image Issues 71

7 The Big Three: Diabetes, Cardiovascular Disease,


and Cancer 89
8 Mental Health 103

9 Becoming a Family 119

10 Looking Ahead 137

Sample History Form 141


Glossary 145
Index 149

• • • V
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Foreword

Women living with polycystic ovary syndrome (PCOS) con-


front numerous questions about their diagnosis and treatment
and often have a difficult time getting the answers they need.
Realizing that something is wrong, but not knowing what, many
women find themselves receiving a diagnosis in stages. Often
they don’t get a diagnosis of PCOS until after a number of other
possibilities have been eliminated through testing and refer-
ral to yet another specialist. Management of PCOS has lifelong
implications and can be as challenging as obtaining the initial
diagnosis. Lifestyle changes and medications are basic to living
well with PCOS. There is life after a diagnosis of PCOS. As the
author of this volume suggests, you can learn to manage PCOS—it
doesn’t need to manage you.
This book is a valuable source of knowledge for women fac-
ing a diagnosis of PCOS and also for women who have lived with
the condition for many years. The issues that women face, such

• • • VII
VIII • • • PCOS

as accepting their bodies, dealing with the potential health risks


associated with PCOS, understanding some of the possible men-
tal health consequences of life with PCOS, and the challenges of
having children, can be overwhelming. This book is an outstand-
ing source of information for any woman whose life is touched
by PCOS, as well as family and friends who seek a better under-
standing of this condition.
This book is a wonderful resource that women living with
PCOS will read and refer to again and again. It is a book that cap-
tures the wisdom amassed by a nurse whose practice undoubt-
edly has helped many women to live life well!
—Nancy Fugate Woods, PhD, RN, FAAN
INTRODUCTION

Living With Polycystic


Ovarian Syndrome

I want to introduce you to two young women, both living with


polycystic ovarian syndrome (PCOS). In some ways their stories
are similar; in other ways they are dramatically different. This is
not unusual in this most frustrating of disorders: there are many
common characteristics, and yet PCOS can take many different
shapes.
You’ll be hearing from Stephanie and Amy throughout the
book. If you are living with PCOS you will recognize their strug-
gles and understand their frustrations. At times you will see
yourself reflected in their words. You will know you are not alone
out there. And you will know that you are not going crazy, you
are not just lazy, and you are not less of a woman because of this
disorder. Like Stephanie and Amy, you are strong, resilient, and
brave. Like them, you feel tired and angry at times. And that is
okay, because you have not given in to those emotions. If you had,

• • • IX
X • • • PCOS

you would not be reading this book. You persevere; you continue
to pursue health and the best of life for yourself.
I hope this book helps you in that quest.

How It Began
STEPHANIE’S STORY
The struggling with PCOS started about ten years ago, but I think
it all really started when I was growing up. When I was nine years
old I had torsion of the ovary and had to have major surgery. They
left my ovary in and said everything would be normal. That’s all
I really know. A year later my mother died; she was killed by a
drunk driver. I was too young to really know what was going on,
so all the information about what happened was lost with her.
And I’ve never had her to help with what I’ve been going through
with this.
Things were pretty normal all through junior high and high
school. I was average size, had normal periods. No extra hair or
weight or anything like that. Then about ten years ago, when I
was twenty-one or twenty-two, I started noticing I was gaining
weight. I didn’t think that much of it, thought it was because I
wasn’t as active as I had been in high school. So that went on for
a couple of years, and then it was like I was exploding all of a sud-
den, just getting so fat.
Things just got so out of control so fast. I didn’t have a period
for one and a half or two years. I was married already, and even
though we weren’t using birth control I didn’t get pregnant. At
first I wasn’t concerned; we weren’t necessarily trying to have a
baby. Then I started getting hair on my chin and my chest; that’s
when I realized something wasn’t right.
I went to see an endocrinologist. She said I had PCOS and gave
me Clomid. That’s all I knew, nothing about what was happening
to me. She was just into fertility and didn’t tell me anything else.

AMY’S STORY
I remember in high school my periods were really, really pain-
ful, so painful to the point that I had to stay home from school.
I couldn’t get out of bed. And I had no energy. No one knew what
Introduction: Living With PCOS • • • XI

was going on; they checked me for mono and anemia and stuff.
People said I was lazy. I wasn’t lazy; I was so tired I couldn’t even
stay awake.
I was always overweight. My mom would get mad at me, say-
ing I wasn’t active enough, and make me go for bike rides or go
rollerblading. I was on the field hockey team, and I was running
as much as all the other girls on the team. I would do the same
things they did at practice and then go home and run extra miles
on the treadmill. Who wants to be the biggest, slowest one on the
team? But I was, no matter what I did.
Then I started having really bad acne. I went to a dermatologist
and he said I needed a blood test. No explanation why, just sent
me for a blood test and gave me some acne cream to use. When
he called my mom with the results her jaw dropped. She couldn’t
believe how incredibly out of whack my hormones were.
So next we went to an endocrinologist who did a whole bunch
of blood tests. He asked me about my symptoms, and I told him
about being tired all the time, having no energy, how I really didn’t
eat a lot and I was so much heavier than I should have been. He
said, “I think you have PCOS,” and sent me to an OB/GYN to get
an ultrasound to look for polycystic ovaries. I had no idea what
PCOS was. When the results came back, she said, “Yep, you defi-
nitely have it.” It was right before my eighteenth birthday.
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WHAT NURSES KNOW . . .

P C O S
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1

What Is Happening
and Why?

The endocrinologist said, “You have PCOS. You’re going to have to


take these medications every day. You’re going to have to live with
this and deal with it through diet.” That was it. I didn’t under-
stand what it was. Even now, it’s hard to understand. There are
so many things going on. It’s this, this, and this causing this and
this and this! AMY

PCOS is a disorder of questions. For those experiencing its


symptoms it can seem as if no one really knows what’s going on.
Even the experts can’t seem to agree on a definition. Just getting
a diagnosis can be a challenge—often the first of many. Some
women have to fight for tests to be performed; others feel as if
their life is one round of never-ending tests. And answers may
never seem . . . well, like answers.
Science hasn’t yet come up with many of the answers to the
questions of PCOS. The underlying cause is still unknown. The

• • • 3
4 • • • PCOS

role of genetics is not well understood. The interactions between


the reproductive system and the endocrine system are complex,
so it’s still unclear what causes what or where it all starts.
Another reason answers can be hard to come by is that the
disorder has many different faces. There is no one right answer
for everyone. Some women struggle primarily with reproduc-
tive issues; for others it’s the metabolic problems or the physi-
cal signs, and for some it is every symptom that PCOS can throw
at them. Coming up with best-practice recommendations across
such a spectrum of presentations is a challenge: what is “best”
for some women is not “best” for others.
But there is good news. We know much more today about the
complex, interrelated hormonal and metabolic processes involved
in PCOS, and this understanding is continuing to increase as a
result of the considerable amount of PCOS-focused research tak-
ing place. More and better treatment options are available for the
various symptoms. Attention is being paid to possible long-term
effects of the disorder so that women with PCOS can enjoy good
health throughout their life span. And health care providers
know more about PCOS than they did in the past and are better
prepared to manage women with the disorder.
Another positive development is the amount of information
and support available to women with PCOS. There are numer-
ous resources for women to turn to: support groups, online

What Nurses Know . . .


As with any chronic condition, one of the most important
things any woman with PCOS or PCOS-related symptoms can
do is become an active participant in the management of her
condition. This starts with getting the information she needs
to ask the right questions and make informed decisions.
What Is Happening and Why? • • • 5

chat rooms and newsletters, and books. Learning how to man-


age PCOS gives women back a sense of control over their life.
Understanding what is happening is the first step on the path to
managing PCOS instead of it managing you.

What Is PCOS?
It was in 1935 that two doctors in Chicago, Irving Stein and
Michael Leventhal, first described, in seven women, a group of
symptoms that included amenorrhea (no periods), abnormal hair
growth, infertility, and enlarged ovaries with multiple cysts. For
many years these symptoms remained the hallmark of a condi-
tion that came to be known by many names: Stein–Leventhal syn-
drome, hyperandrogenic chronic anovulation, functional ovarian
hyperandrogenism, and polycystic ovarian disease. Now it is
most commonly called polycystic ovarian syndrome, or PCOS.
PCOS is a disorder found in women of childbearing age. The
main features are menstrual irregularities and increased levels
of androgens that can’t be explained by other conditions. Women
with PCOS often also present with infertility, insulin resistance,
obesity, and polycystic ovaries. The type and severity of symp-
toms vary widely among women with the disorder.
Today PCOS is recognized as the most common endocrine
disorder in women of reproductive age. It affects 5 to 10 percent
of all women between puberty and menopause. It is the underly-
ing cause of 90 percent of cases of infrequent menstruation and
30 percent of cases of amenorrhea. It accounts for 80 percent of
cases of hirsutism (male-pattern hair growth in women).
Although the group of symptoms originally identified by
Stein and Leventhal remains associated with PCOS, we now rec-
ognize that there’s much more to the story. Until recently, PCOS
was viewed as a disease of the reproductive system. Treatment
focused almost exclusively on regulating the menstrual cycle
and ensuring pregnancy. We now know that PCOS is also a meta-
bolic disorder, and some experts believe that its metabolic com-
ponent may be the central feature and hold the key to finding the

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