5.11.2016

Dealing with Hirsutism

Synopsis: If your extra hair due to PCOS bothers you, here are some things you can try.

Women with PCOS often have excess hair growth (hirsutism) due to an overproduction of androgens. This results in sometimes dark, coarse hair growth, most commonly on the upper lip, chin/beard area, breasts, lower abdomen, inner thighs, and lower back, and less commonly on the chest, upper abdomen, and upper back. I know from personal experience that this hair growth can negatively impact one's self-confidence and body image! It can be challenging to look and feel feminine.

If your hirsutism bothers you, there are various solutions you might like to try.

Accept Your Body
While hirsutism can be annoying, it is not harmful in itself. It is certainly possible to love and accept your body and its appearance! Your hair growth may make you look different than some people's standards of beauty; however, the natural variance of human bodies lends to beauty! Do not be afraid to be different. Social pressure is not necessarily a reason to alter your appearance, and if you like the way you look, you will be confident, which is always an attractive feature. Hold your head high, be generous with your smile, and you will look and feel great!
Treat The Cause
Birth control pills can alter the hormonal balance in your body, slowing the growth of unwanted hair. Obviously this is not a good solution if you are trying to conceive.
Spironolactone is an anti-adrogenic prescription drug that can help treat hirsutism. It can take several months to see a noticeable difference in hair growth. It should not be used in pregnancy or breastfeeding. See the ASRM guide on Hirsutism and PCOS for other drugs that serve a similar purpose. 
Remove The Hair
Plucking unwanted hair is an option; however, in my experience, it often results in infection, causing acne. Waxing is a similar option with the same downside. 
Depilatories, which dissolve hair, may also be an option; however, they may irritate sensitive skin. 
You can bleach hair; this is most effective for small areas, such as the upper lip. The hair is not actually removed, but is less visible as a lighter color.
Shaving is another option; it may cause stubble, but is "probably the simplest and safest way to temporarily remove hair," according to the ASRM guide.  
Electrolysis permanently destroys hair follicles; however, this is done one hair follicle at a time, so may not be practical, and is fairly expensive.  
Laser hair removal is another option. I was told by a doctor that it was not a good option, because it is expensive and not permanent; however, the ASRM guide claims that it is effective (but not necessarily over the long-term). 
Ultimately, the best remedy for hirsutism is a combination of the three methods above: accepting your body, treating the cause, and removing unwanted hair. It may take some experimenting to figure out the right combination for you, but if you do not want to be a "bearded lady," you have options!

5.10.2016

Choosing a Fertility Specialist

Synopsis: Choose a doctor with good credentials, with success rates near the national average, and, most importantly, that you like!

Before we went to a fertility specialist, I had seen three different gynecologists and had had both positive and negative experiences with them. I knew I wanted a fertility specialist who would take my case seriously and treat me with respect; I did not want my treatment to be delayed or impeded any further!

Luckily, I found a wonderful doctor that was recommended by my gynecologist AND whose clinic was in-network on my insurance plan. She also listened to my concerns and made me feel like I mattered!

If I were in the process of finding a new fertility doctor, here is what I would do:
  1. Check my insurance network. I would see if there were any fertility specialists in-network for my insurance plan. Not all insurance policies offer coverage for infertility, but if yours does, it may be worthwhile to choose an in-network doctor.
  2. Get a recommendation from my primary care physician/family doctor/gynecologist. If you have been seeing a doctor for fertility-related issues, or for anything else, ask if they have a recommendation for a fertility specialist. Chances are, they will know of a good specialist in your area.
  3. Check the SART website. The Society for Assisted Reproductive Technology is a professional organization of doctors who perform IVF. Clinics that belong to this society meet high "meet the highest standards for quality, safety and patient care." You can compare the IVF outcomes of different clinics on their website. It is advisable to seek out a clinic with outcomes near the national average. 
  4. Seek out reviews and ratings for the clinics and doctors I am interested in. If nobody has anything nice to say about a particular doctor, that might be an indication that there is a problem! However, keep in mind that "you can't please everyone" -- even a doctor that might be perfect for you has probably not been a good fit for someone else. 
  5. Meet the doctor. I think it is extremely valuable to consult with your doctor face-to-face. Do you feel that he or she is concerned about your situation? Is the doctor willing to answer your questions in a way that you understand? Do you feel comfortable with the doctor and the staff? Do your personalities clash? This doctor and staff will be intimately involved in the creation of your family. It is worth finding someone that you like!