PCOS UK (Verity)
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PCOS – my first treatment

About 10 days ago I went to see a specialist gynaecologist who wanted me to go for a TVS scan and run more bloods for prolactin, sex hormone binding globulin, testosterone and finally androstenedione (check out my post “Seeing my gynaecologist for the first time!” here).

After seeing my consultant yesterday, here is what we are trialing for 4 months:

My pill has been switched from cerezzette to dianette. She said that dianette would help tackle the testosterone levels and should help with hair growth.

Secondly, I am going to go on metformin. I have heard of metformin, a pill used for insulin resistance in diabetic patients, so I guess it makes sense for PCOS. She is hoping it helps me with trying to lose weight. I would love for this to work as surgery has been suggested by my GP and well…I would rather not! Happy to keep up my gym and diet habits if it will work.

Thirdly, although I already eat between 1,400 to 1,500 calories a day, I need to cut this to 1,000 to 1,200. This means really looking at where I am spending my calories and what I can cut vs keep.

If you have had any expriences good or bad with these drugs or tips on how to get to 1000 calories a day I would love to hear from you!!!

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You were recommended to be on 1000 calories even though you are exercising ??

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Yes, well how I see it is I track the calories burned in my exercise and so if I burn 300 then it would be 1,300

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oh that's good so you not eating 1000 and still exercising and not taking it into consideration - think your body would go into starvation mode if you were as we are very efficient at doing that!

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I did that once! Lost a lot of weight but obviously piled it on the minute I ate remotely normal :)

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For me I dont lose at all when I eat too little, it just seems to store it somewhere!! You have to do something you can stick to otherwise you wont be able to keep up the motivation which can be slow at the best of times.

Sadly so many gynae's, nutritionists are not clued up at all about weight loss and pcos which doesnt help!

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Have you been able to find someone who has helped? I have only been to my gp and a gynae so far, so maybe there is someone else I should go to?

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I just did a diet that I could stick to - tried loads over the years - the only one I have found that really worked is the Norah Lane diet. I'm currently on the high fat low carb - I've only lost half a stone but lost 3 inches off my waist and 3 off my belly button area so it is working- another 13lb to go and probably another 2-3 inches off

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That is awesome, well done!!!! I am hoping all these changes and the medications work, my GP isn't hopeful as I was already exercising and eating well, but I am trying to stay positive!

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Hi, I put this reply on another post so copied and pasted! I discovered I had PCOS when I tried tocome off the pill aged 27, after being on the pill since 16 years old. I didn't realise but it had been masking my PCOS.

I experienced stomach pains, rapid weight gain - 4 stone! hair loss, Hair growth, cystic acne and very low mood, it was awful. I went back onto yasmin pill in desperation, which helped to control some of the symptoms. In January I was given spironolactone - which helps to control testosterone levels. I had never heard of it before so thought would post here for you. It has helped me so much with severe cystic acne and hair growth, hair loss, my skin is so much better and I'm feeling better in general. I was on 50mg to start for a month or so and just gone up to 75mg. For me it has been life changing, it has really helped. You have to have spiro in the morning as it is a diuretic and makes you wee alot at first. Like you I was recommended to go down to 1200 cals and have lost just over a stone in 8 weeks- about 2lbs a week. I think most people without PCOS would lose a lot more than I have on that amount of cals but as you probably know it’s hard to lose weight with PCOS so actually it is an achievement. I do feel a lot better. I could prob go down to 1100 and lose a bit more.

Initially my GP said to really lose weight but didn't offer any support at all. I tried but was losing nothing. I hated being told repeatedly to lose weight when it was so difficult, however I had enough and did a lot of research and have really tried with a paleo/ low carb diet, dairy free (apart from eggs) and losing this has helped with my symptoms so so much, I've still got more to lose to get to a healthy bmi and you do have to really persevere. Do look into this, ask to speak to a nutritionist to help with weight loss specifically for PCOS.

I use a calorie counting app MyFitnessPal. It makes you realise how much Cals is in everything. Cut out processed food and white complex carbs- white bread, white pasta, white potatoes, white rice is very difficult for people with pcos and insulin resistance, to process (even though I love them!) I also cut out gluten- so wheat in general, as again refined food is difficult to process with insulin resistance. I now really notice when I eat white carbs how much it affects me. And of course cut sugar in take right down. PCOS does not like sugar.

It doesn’t sound exciting, but it does work. I wish someone had told me all this, because cutting these out and having lots of veggies and good protein instead is the way forward, I am no longer sluggish and bloated ( i do still have the odd chocolate most days cos I find it very difficult lol - but just a little square for a fix). I eat sweet potato and brown rice if I need carbs, or a slice of gluten free German rye bread get it in most supermarkets- but high in cals, so just one slice.

A typical breakfast is 2 poached eggs, 1/2 slices bacon with fat trimmed (I know processed but it’s worked lol) and tin tomatoes or 1/4 tin beans. No toast! Or boil an egg and take to work with slices of ham. Eggs are so good for breakfast, fill you up! Or an apple with a tablespoon of peanut butter.

Lunch I have leftovers from dinner, or a healthy ready meal under 400 cals, or meat/tuna and salad.

Dinner I often have chicken and loads of veggies- spinach and kale. Or mince with roasted veg, without pasta. Just replace the carbs you would normally have with non starchy vegetables. Or fish and sweet corn and baked sweet potato.

Snacks- nuts - just a handful, raisins, olives, gherkins, slices of sandwich ham/chicken, satsumas, strawberries, blueberries, seafood sticks.

Beware of cals in sauces. Eg. Mayo is massive. Get light mayo. And coffees like lattes- so many cals. If you need one get the smallest size.

Oh drink lots of water and herbal tea to stop constipation if you are eating a lot of protein.

I log it all including tea and coffee. The past 2 weeks I’ve gone over a bit up to 1500 cals and I have plateaued and not lost anything, but not gained. It shows how little calories I should have though, before I was eating so much! So need to get back on. Some days I get proper hangry but I only give in a bit, I don’t go full on blow out. I did have a maccy ds one day though! It’s so rubbish that PCOS increases our appetite more than average person, but that we actually should have less calories than other people- double edged sword. See this as nourishing your body to make it strong and healthy and not as starvation.

Sorry massive post! But all that info was from a lot of hours of researching so tried to pack it in for you. This is just my personal experience and you should speak to professionals about good nutrition/diet. I think everyone with PCOS should be referred to a nutritionist. Food and diet has huge implications. By th way disclaimer - some people do not react well to the pill and spiro, but it's important you know what is out there as these are things you can explore with the endo to see if they are suitable for you. Good luck, I hope it goes well.

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Coral, thank you so much for your post! I am in a little bit of a dilemma as I already don't eat any bread, potatoes, pasta, rice.....I either roast some sweet potato or butternut squash. Usually for breakfast I eat homemade egg, bacon and spinach muffins (just egg, bacon, spinach and a sprinkle of cheese), for lunch I either do a taco bowl or turkey breast with veg and dinner usually chicken/fish with roasted veg. I also cut down completely on drinking alcohol and I drink about 3 litres of water a day. I also don't drink tea or coffee....never liked them! I am already using MyFitnessPal and I work out 3 to 4 times per week. I have also been to private trainers and nutritionists in the past. REALLY really frustrating. This is why my GP has recommended surgery, but the gynaecologist wants to test metformin to see if it helps first. I would rather not go through surgery so happy to try her approach first! Going to go down to under 1200 and see how that goes too : fingers crossed!

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Wow! Sounds like you are doing everything you can. That must be frustrating for you, but sounds like you are on it! I know now I don’t lose weight at 1300- 1500 calories at all. I think I could go down further to 1100 is prob best for me. It’s ridiculous. When I don’t eat any carbs I really do drop a bit quicker. I was getting energy from protein and veg and snacks like a handful of walnuts. Portion control is another thing, I have to have much smaller portions, including smaller portion of veg. So difficult when I love my food! lol. When I have sweet potato, I only have a small one and I only have one half of it. But I do notice if I eat carbs. Oh and if you don’t already, take a multi vitamin. I did cut out dairy apart from eggs cos I had read cutting out milk which has hormones in might help my skin. So I don’t eat cheese either anymore which was pretty calorific. I have oat milk instead now. And violife vegan cheese slices if I need a fix. Not the same at all though!

I think one thing to be careful of is that I do find myself tired from lack of cals by end of day, so careful exercising. Do give an update on how you are doing and anything you find helpful as im interested too! I do find all this a bit hard sometimes as no one else I know needs to do this! So good to have found this forum, where we can share :) I hope going down below 1200 helps you too. All the best! I hope it goes well for you.

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Thank you Coral! So hard as there is no set answer, all about finding what works for the individual and I am so early on in the process......a long way to go! :)

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Hi. Ive been trying the paleo diet. I managed to lose 5lbs in 1 wk. There are no calorie restrictions but you eat when you are hungry and stop when you are full. I’ve also stared taking berberine. My hunger pangs have stopped. But still get irritated and anxious. Hopefully that will change with time on the paleo diet and berberine.

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Hi - If you are insulin resistant or even just insulin sensitive try changing when you eat and the gap between eating. Intermittent fasting can help get your body back to reacting better to insulin changes which will help with the weight loss. Try to leave a good 12-18 hrs of not eating most days.

The Obesity Code by Jason Fung is a great book (although it can get a bit technical) it explains how our bodies are designed to use sugar and insulin and how modern eating habits go against it.

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