Paula Puffer

The scalp hair lives         between two and five years. However some women aren't so lucky. It         is scary and frightening to be able to look into the mirror and see your         scalp when you started out with a nice thick head of hair. Many women         wonder why this is happening and seek medical help. Others live with it         and try to come up with ways to hide the thinning hair, known medically         as alopecia. This article looks at what alopecia is, how it is diagnosed         and The treatment options available to patients.          

Alopecia is the medical term for hair         loss. PCOS women can suffer from several different kinds of alopecia.         The main form of alopecia, 

, occurs in many         women with PCOS and is due to an excess of androgen ("male")         hormones. However, thyroid problems, low estrogen levels, anemia,         pregnancy, and many other medical problems can contribute to hair loss.         Hair loss can be worsened by 

 Traction alopecia         occurs when the hair is pulled out by any means such as ponytails,         excessive hair styling, brushing and even nervous pulling of the hair         (Thatcher, 2000, 111). 

Alopecia in women exhibits itself differently than in men. It is characterized by thinning of hairs on the top of the head. Unlike male pattern baldness, there is no bitemporal and frontal recession.

The average human loses about 75 hairs         a day for the 100,000 to 150,000 hairs he or she may have. A PCOS         patient is the first to notice that her hair is getting thinner. She may         notice more hair on her hair brush or that the drain in her sink or         bathtub has a lot of hair in it. By         the time that a causal observer can start seeing the scalp, a hair loss         of as much as 50% may have already occurred.

Like hirsuitism, many physicians do not         notice the problem because women become adept at hiding the thinness of         the hair. However, if you have noticed thinning of the hair, contact         your doctor so you can receive medical treatment or get a referral to a         dermatologist for diagnosis and treatment.

         Minoxidil         is a medicine used to treat high blood pressure which when applied to         the skin causes hair growth in some individuals. One out of ten people         who use minoxidil will grow hair. Five out of ten patients will see a         reduction in the the rate of hair loss. The other four out of ten will         see no results and need to discontinue the use of minoxidil. Side         effects of minoxidil can include dryness and irritation of the         scalp.          

There is some suggestion that         finasteride can help with androgenic alopecia. Finasteride decreases the         the serum and scalp male hormone levels and inhibits the reduction in         size of the affected follicles and helps to restore miniaturized hair         follicles to regrow visible hair. Finasteride should not be taken or         handled by women who are pregnant or are trying to get pregnant since         they can be harmful to the fetus.

Spironolactone can also reduce hair         loss because it suppresses the amount of male hormone that is         circulating in the body. Like finasteride, it can can be harmful to a         developing fetus so it must be stopped if you are pregnant or trying to         get pregnant.

A number of ways exist to help make         your hair appear fuller and thicker besides using medical         treatments. 

Phillip Kingsley, MIT,MRIPHH, one of the         speakers at the International PCOSupport conference in San Diego recommended that women         with PCOS wash their hair daily. The accumulation of dirt and oil on the         hair weighs hair down and makes it look limp instead of full and         healthy. 

There are a number of shampoo and         styling products on the market that also help the hair. The Nioxin Line         contains minoxidil as an ingredient to help encourage hair growth. The         Toni & Guy Salons have a hair care product line called TIGI. Their         shampoo for fine hair and thickening cream products roughen the cuticle         of the hair shaft and make the hair appear thicker and fuller.

Hair structure can also be altered         through the use of perms and coloring. These processes make the hair         cuticle rough and make the hair appear fuller. However, overuse of perms         and coloring can damage hair and make it prone to breakage.

Thatcher, Samuel S. Polycystic Ovary Syndrome: The Hidden Epidemic. Perspective Press. 2000. 111-12.

Articles

The scalp hair lives between two and five years. However some women aren't so lucky. It is scary and frightening to be able to look into the mirror and see your scalp when you started out with a nice thick head of hair.

Another Hairy Issue: Dealing with Hair Loss

In his book, "In         Pursuit of Fertility," Robert R. Franklin, MD stated, "Over         the years, I have observed that women with PCO are in high gear most of         the time -- their minds are constantly racing ninety miles an hour"         (1995). When I posted this quote on one of the lists that I am one,         several women wrote back that they agreed with this doctor's assessment.         They felt that their minds were racing ninety miles a minute.          

The question becomes, how do we learn         to slow our minds down to decrease the amount of stress we have placed         on ourselves? According to Franklin, slowing down is something that the         PCO patient must do since excessive stress can lead to excess androgen         production. Learning to slow down is not easy but it can be done. This         article gives several different ideas on how to slow down and and reduce         the amount of stress in our lives. 

One way to slow down is taking time         each day to exercise. In addition to helping the woman reduce stress,         exercise also has the added benefit of reducing the amount of insulin         circulating in our blood by creating additional receptors on the cell         walls of muscles. Since many women with PCOS have problems with their         weight, walking is an easy way to start taking time to slow down and         focus on our bodies. It is non-jarring and easy on the joints,  and         can be done just about any where. All you really need to get started is         a comfortable pair of walking or running shoes. If you aren't used to         walking, start slowly. Walk for five to ten minutes, for half a block or         block, or for however long you feel comfortable with. Slowly increase         your time and distance as your body becomes more accustomed to         exercise. 

Yoga is another way to calm yourself         while getting the benefits of exercise. The slow movements and poses of         yoga help to tone the body and increase flexibility while learning to         focus on how the body feels. There are several good tapes out there for         beginners. One of my favorites comes from Living Arts and is called 

Yoga         Conditioning for Weight Loss.

  The good thing about this tape         is that the instructor has three women with her who have very different         body shapes and sizes. They show not only full yoga poses but also         modified poses for a variety of different levels of fitness. 

is also a very good tape for larger women. 

There are other ways to relax besides         exercise. Treat yourself to a professional massage. It is time that you         can devote to relaxing. The cost of your massage will depend on what         area of the country you live in and how long the massage lasts. You can         also take time to do an activity you enjoy. So many times we in our         hectic schedules we forget that there are many things that we enjoy         doing such as needlepoint, gardening, or just sitting and enjoying a         good piece of music or a good movie. Apply a facial then soak in the tub         with candles lit, a nice cold drink on hand,  and possibly a good         book. 

These are just a few ideas on how to         relax and reduce stress that may be affecting us. It is very important         that PCOS patients take some much needed time and relax. It never hurts         to pamper yourself once in a while.  

Franklin, Robert R. and Brockman, Dorothy Kay. In Pursite of Fertility: A Fertility Expert Tells You How to Get Pregnant. 2nd Edition. New York: Henry Holt and Company. 1995:131-140 

In his book, "In Pursuit of Fertility," Robert R. Franklin, MD stated, "Over the years, I have observed that women with PCO are in high gear most of the time -- their minds are constantly racing ninety miles an hour" (1995).

Taking Time to Relax

Recently, I went to see my new care physician for a regular check up. She did a very thorough job. She did an EKG while I was in her office because there is a history of heart disease in my family on both sides. My mother had a stent inserted after angioplasty back in January almost 6 years to the day that my father died of a heart attack. My doctors also did the EKG because of the risk of heart disease with PCOS. The EKG came back borderline irregular and I have to go have a visit with a cardiologist sometime in the next month.

So often PCOS patients focus on the fertility aspect or the diabetes aspect or the hair aspect of PCOS. We forget there are other systems that are affected by PCOS as well. We forget that PCOS can cause heart disease and affect our circulatory system. We don't see our heart pumping or our blood going through our veins like we see our hairy chins or thinning hair.

Before my father died, my biggest fear, irrational as it seems, is that I would be at my own wedding and my dad would have a heart attack and nothing I could do would save him. I don't want my children (when I have them) to worry that mommy might have a heart attack or see my color change as an angina attack hits me. It is not an acceptable option.

My choice is to make the commitment to take better care of my entire self. Not just the diabetes, not just hair on my neck and chin, and not just my reproductive health.  This change in focus means that I have to change my habits. I find the time to exercise. I eat good, whole foods in moderate quantities. I watch the amounts of fats and carbohydrates I eat. I drink plenty of water (with a twist of lemon or lime to keep it from getting too boring). I got rid of the diet sodas. It's not an easy choice and there will be times that I mess up. But the rewards of a healthier me will be worth it.

My doctor's visit was a very sobering experience. Having an EKG done was my wake up call to make sure that I don't end up like my father. He had three heart attacks--the last one fatal--and severe angina for the last 20 years of his life.  It's made me take a very hard look at what I am doing to stay healthy and what I am putting in my body.

Recently, I went to see my new care physician for a regular check up. She did a very thorough job. She did an EKG while I was in her office because there is a history of heart disease in my family on both sides.

Taking PCOS to Heart

PCOTeen, A division of the PolyCystic Ovarian Syndrome Association, is launching Project HEART -- Helping Educate And Reach Teens. This program will provide support and education to young women in high school and college who are dealing with PCOS. Project Heart focuses on increasing PCOTeen's Membership; creating a  Big Cyster Program; hosting special events at PCOSupport Membership Conference;  creating more media attention in magazine's target at teens and young women;  doing community outreach to high school, college, and university healthcare  professionals; creating a PCOTeen newsletter; and hosting online chats.

Project HEART is the brainchild of PCOTeen Director Heather Lubinsky. Lubinsky, a system administrator in a San Francisco Area company, has been an active volunteer member of the PCOSupport community for several years.

"Project HEART is something I had been thinking about for a long  time.  Because of the upcoming PCOSupport Conference and the teen-related events  happening there, I decided to write down my goals for the project, " said Lubinsky. "I started with approximately 40 goals and condensed them down into the 7  goals that are the core of Project HEART."

It took Lubinsky a while to figure out a name. She came up with HEART on Valentine's Day. 

"I wanted a name that was easy to remember but stood for a lot more - I wrote  down information that described parts of what I was doing and what I wanted  to do."

Although all aspects of Project HEART are important to her, the Big Cyster program excites her the most. Similar to Big Sister Programs in other organizations, the Big Cyster program will team an older woman with PCOS with a teen or young woman who is just beginning to work on her PCOS-related health issues. Lubinsky herself wishes she would have had a big cyster to talk to when she was a teen.

Lubinsky herself remembers what it was like to be a teen dealing with PCOS issues.

"The weight gain was awful. I gained 40 lbs. in 3 months. In one year, I went from about 120lbs to 175 lbs. It was depressing.  I had severe mood swings - and really had a hard time dealing with  anything.

"My poor mom didn't know what to do" stated Lubinsky. "I started cutting school - lying and  all sorts of stuff.  My mom was really afraid I was on drugs.  I did try them  at times.  I even tried to smoke because I had heard smoking helped you stay  thin.
  
 "I drank, stayed out late, and eventually started other, more  destructive behaviors.  Looking back - I can see that some of these  behaviors happened because I needed to feel like I was good-looking and was an  attractive, feminine, young woman.
  
 "I kept spiraling downward.  I lost parts of my memory.  There are times I could not tell you what I did all day. I hadn't been at school but had I had no idea what I had been doing. I started thinking about death or running away a lot - I just couldn't deal with anything.
  
 Lubinsky's story had a happy ending. At 17, she met and fell in love with her husband, Mathew.  He helped her to start putting her life in perspective. Having someone who loves you no matter how I look helped to raised my self esteem. I was able to stop my self-destructive  behavior.

"He  listened and occasionally gave advice, guiding the way for me. But most  importantly he supported me and listened.  That is how I started getting  my life  back together. I want to help others do the same.

PCOTeen was founded in 1998 after Lubinsky,  helped a young woman who was having difficulties and contemplating suicide because of her  on-going problems with PCOS. Lubinsky realized that the complaint that she often  heard from the adult women "I wish someone would have paid attention to what  I was saying about how my body was working," was still very much an issue of young women with PCOS. She decided to do something to meet the needs of these young women. PCOTeen was  created.

Lubinsky created the PCOTeen list and started a PCOTeen website. Young women with  PCOS started coming to her site and PCOTeen has been growing steadily since then.

In October 1999, PCOSupport's Oregon Chapter hosted a regional conference at which  PCOTeen hosted a teen breakout session.   "The Breakout session was great. It was mostly attended by mothers of PCO Teens," says Lubinsky, "but we had a couple of teens there.  Moms had the opportunity to talk  to each other and figure out the best ways to help their daughters.

"That is where I first met Molly. Her daughter, Rachel, is now our Teen   Newsletter Editor."

PCOTeen will have other projects in the future as its membership  grows. In addition to the online resources PCOTeen already offers, Lubinsky envisions local PCOTeen support groups, meetings and resources to help young women get the information they need to cope.
  
  PCOTeen is planning an outreach program to Medical and Education professionals. Lubinsky would also like to see PCOS become a regular topic in sex education  courses.

"These courses already  talk about STDs, pregnancy, cramps and pubic hair. Why not also explain  the top  10 menstrual problems that woman can have and talk about what a young   woman needs to do if she does not a "normal" menstrual cycle?"

PCOTeen, A division of the PolyCystic Ovarian Syndrome Association, is launching Project HEART -- Helping Educate And Reach Teens. This program will provide support and education to young women in high school and college who are dealing with PCOS.

Paula Puffer

Articles

Another Hairy Issue: Dealing with Hair Loss

Taking Time to Relax

Taking PCOS to Heart

Project Heart - PCOSupport Reaches out to Teens