What you need to know about PCOS

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In 2008, microbiologist Sasha Ottey saw her OB-GYN because she had missed some periods. The doctor ran blood tests and gave her an ultrasound, diagnosing her with polycystic ovary syndrome (PCOS). She also told her not to worry, referred her to an endocrinologist (a doctor who specializes in hormones), and told her to come back when she wanted to get pregnant. 

“I found [that] quite dismissive because that was my reason for presenting to her,” Ottey tells PGN. “I felt that she was missing an opportunity to educate me on PCOS, and that was just not an accurate message: Missing periods can lead to other serious, life-threatening health conditions.” 

During the consultation with the endocrinologist, Ottey was told to lose weight and come back in six months. “Again, I felt dismissed and left up to my own devices to understand this condition and how to manage it,” she says. 

Following that experience, Ottey began researching and found that thousands of people around the world had similar experiences with their PCOS diagnoses, which led her to start and lead the advocacy and support organization PCOS Challenge

PCOS is the most common hormonal condition affecting people with ovaries of reproductive age. In the United States, one in 10 women of childbearing age have the condition, which affects the endocrine and reproductive systems and is a common cause of infertility. Yet, the condition is significantly underdiagnosed—especially among people of color—and under-researched

Read on to find out more about PCOS, what symptoms to look out for, what treatments are available, and useful resources. 

What is PCOS, and what are its most common symptoms? 

PCOS is a chronic hormonal condition that affects how the ovaries work. A hormonal imbalance causes people with PCOS to have too much testosterone, the male sex hormone, which can make their periods irregular and cause hirsutism (extra hair), explains Dr. Melanie Cree, associate professor at the University of Colorado School of Medicine and director of the Multi-Disciplinary PCOS clinic at Children’s Hospital Colorado. 

This means that people can have excess facial or body hair or experience hair loss. 

PCOS also impacts the relationship between insulin—the hormone released when we eat—and testosterone. 

“In women with PCOS, it seems like their ovaries are sensitive to insulin, and so when their ovaries see insulin, [they] make extra testosterone,” Cree adds. “So things that affect insulin levels [like sugary drinks] can affect testosterone levels.”

Other common symptoms associated with PCOS include:

  • Acne
  • Thinning hair
  • Skin tags or excess skin in the armpits or neck 
  • Ovaries with many cysts
  • Infertility
  • Anxiety, depression, and other mental health conditions
  • Sleep apnea, a condition where breathing stops and restarts while sleeping

What causes PCOS?

The cause is still unknown, but researchers have found that the condition is genetic and can be inherited. Experts have found that exposure to harmful chemicals like PFAs, which can be present in drinking water, and BPA, commonly used in plastics, can also increase the risk for PCOS

Studies have shown that “BPA can change how the endocrine system develops in a developing fetus … and that women with PCOS tend to also have more BPA in their bodies,” adds Dr. Felice Gersh, an OB-GYN and founder and director of the Integrative Medical Group of Irvine, which treats patients with PCOS. 

How is PCOS diagnosed?

PCOS is diagnosed through a physical exam; a conversation with your health care provider about your symptoms and medical history; a blood test to measure your hormone levels; and, in some cases, an ultrasound to see your ovaries. 

PCOS is what’s known as a “diagnosis of exclusion,” Ottey says, meaning that the provider must rule out other conditions, such as thyroid disease, before diagnosing it. 

Why isn’t more known about PCOS?

Research on PCOS has been scarce, underfunded, and narrowly focused. Research on the condition has largely focused on the reproductive system, Ottey says, even though it also affects many aspects of a person’s life, including their mental health, appearance, metabolism, and weight. 

“There is the point of getting pregnant, and the struggle to get pregnant for so many people,” Ottey adds. “[And] once that happens, [the condition] also impacts your ability to carry a healthy pregnancy, to have healthy babies. But outside of that, your metabolic health is at risk from having PCOS, your mental health is at risk, [and] overall health and quality of life, they’re all impacted by PCOS.” 

People with PCOS are more likely to develop other serious health issues, like high blood pressure, heart problems, high cholesterol, uterine cancer, and diabetes. Cree says that teenagers with PCOS and obesity have “an 18-fold higher risk of type 2 diabetes” in their teens and that teenagers who get type 2 diabetes are starting to die in their late 20s and early 30s. 

What are some treatments for PCOS?

There is still no single medication approved by the Food and Drug Administration specifically for PCOS, though advocacy groups like PCOS Challenge are working with the agency to incorporate patient experiences and testimonials into a possible future treatment. Treatment depends on what symptoms you experience and what your main concerns are.

For now, treatment options include the following:

  • Birth control: Your provider may prescribe birth control pills to lower testosterone levels and regulate your menstrual cycle. 
  • Lifestyle changes: Because testosterone can affect insulin levels, Cree explains that regardless of a patient’s weight, a diet with lower simple carbohydrates (such as candy, sugar, sweets, juices, sodas, and coffee drinks) is recommended.

    “When you have a large amount of sugar like that, especially as a liquid, it gets into your bloodstream very quickly,” adds Cree. “And so you then release a ton of insulin that goes to the ovary, and you make a bunch of testosterone.” 


    More exercise is also recommended for both weight loss and weight maintenance, Cree says: “Food changes and better activity work directly to lower insulin, to lower testosterone.”


  • Metformin: Even though it’s a medication for type 2 diabetes, it’s used in patients with PCOS because it can reduce insulin levels, and as a result, lower testosterone levels. 

What should I keep in mind if I have (or think I may have) PCOS?

If your periods are irregular or you have acne, facial hair, or hair loss, tell your provider—it could be a sign that you have PCOS or another condition. And ask questions.

“I call periods a vital sign for women, if you’re not taking hormones,” Cree says. “Our bodies are really smart: Periods are to get pregnant, and if our body senses that we’re not healthy enough to get pregnant, then we don’t have periods. That means we’ve got to figure out why.” 

Once you’re diagnosed, Ottey recommends that you “don’t go through extremes, yo-yo dieting, or trying to achieve massive weight loss—it only rebounds.” 

She adds that “when you get this diagnosis, [there’s] a lot that might feel like it’s being taken away from you: ‘Don’t do this. Don’t eat this. Don’t do that.’ But what I want everyone to think of is what brings you joy, and do more of that and incorporate a lot of healthy activities into your life.” 

Resources for PCOS patients:

For more information, talk to your health care provider.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Here’s how to help protect your family from norovirus

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What you need to know

    • Norovirus is a very contagious infection that causes vomiting and diarrhea.
    • The best way to help protect against norovirus is to wash your hands often with soap and warm water, since hand sanitizer may not be effective at killing the virus.
    • If someone in your household has symptoms of norovirus, isolate them away from others, watch for signs of dehydration, and take steps to help prevent it from spreading.

    If you feel like everyone is sick right now, you’re not alone. Levels of respiratory illnesses like COVID-19, flu, and RSV remain remain high in many states, and the U.S. is also battling a wave of norovirus, one of several viruses that cause a very contagious infection of the stomach and intestines. 

    Although norovirus infections are more common during the colder months—it’s also called the “winter vomiting disease”—the virus can spread at any time. Right now, however, cases have more than doubled since last year’s peak.

    Read on to learn about the symptoms of norovirus, how it spreads, and what to do if someone in your household gets sick.

    What are the symptoms of norovirus?

    Norovirus is a very contagious infection that causes vomiting and diarrhea, which typically begins 12 to 48 hours after exposure to the virus. Additional symptoms may include stomach pain, body aches, headaches, and a fever. Norovirus typically resolves within three days, but people who are infected may still be contagious for up to two days after symptoms resolve.

    Norovirus may cause dehydration, or a dangerous loss of fluids, especially in young children and older adults. See a health care provider if you or someone in your household shows signs of dehydration, which may include decreased urination, dizziness, a dry mouth and throat, sleepiness, and crying without tears.

    How can you help protect against norovirus?

    You can get norovirus if you have close contact with someone who is infected, touch a contaminated surface and then touch your mouth or nose, or consume contaminated food or beverages.

    The best way to help protect yourself and others against norovirus is to wash your hands often with soap and warm water, since hand sanitizer may not be effective at killing the virus. Other ways to help protect yourself may include cooking food thoroughly and washing fruits and vegetables before eating them.

    You can get sick with norovirus even if you’ve had it before, since there are many different strains.

    How can families help protect against the spread of norovirus at home?

    If someone in your household has symptoms of norovirus, isolate them away from others and watch for signs of dehydration. If you are sick with norovirus, do not prepare food for others in your household and use a separate bathroom, if possible.

    When cleaning up after someone who has norovirus, wear rubber, latex, or nitrile gloves. Then wash your hands thoroughly.

    Clean surfaces using a solution containing five to 25 tablespoons of bleach (that’s 12.5 fluid ounces, or just  over ¾ cup), per gallon of water. Leave the bleach-water mix on surfaces for at least five minutes before wiping it off.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • The Energy Plan – by James Collins

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    There’s a lot of conflicting advice out there about how we should maintain our energy levels, for example:

    • Eat fewer carbs!
    • Eat more carbs!
    • Eat slow-release carbs!
    • Eat quick-release carbs!
    • Practise intermittent fasting!
    • Graze constantly throughout the day!
    • Forget carbs and focus on fats!
    • Actually it’s all about B-vitamins!

    …and so on.

    What Collins does differently is something much less-often seen:

    Here, we’re advised on how to tailor our meals to our actual lifestyle, taking into account the day we actually have each day. For example:

    • What will our energy needs be for the day?
    • Will our needs be intense, or long, or both, or neither?
    • What kind of recovery have we had, or do we need, from previous activities?
    • Do we need to replace lost muscle glycogen, or are we looking to trim the fat?
    • Are we doing a power-up or just maintenance today?

    Rather than bidding us have a five-way spreadsheet and do advanced mathematics for every meal, though, Collins has done the hard work for us. The book explains the various principles in a casual format with a light conversational tone, and gives us general rules to follow.

    These rules cover what to do for different times of day… and also, at different points in our life (the metabolic needs of a 13-year-old, 33-year-old, and 83-year-old, are very different!). That latter’s particularly handy, as a lot of books assume an age bracket for the reader, and this one doesn’t.

    In short: a great book for anyone who wants to keep their energy levels up (throughout life’s ups and downs in activity) without piling on the pounds or starving oneself.

    Click here to check out The Energy Plan on Amazon and fuel your days better!

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  • More research shows COVID-19 vaccines are safe for young adults

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What you need to know

    • Myocarditis, or inflammation of the heart muscle, is most commonly caused by a viral infection like COVID-19, not by vaccination.
    • In line with previous research, a recent CDC study found no association between COVID-19 vaccination and sudden cardiac death in previously healthy young people.
    • A COVID-19 infection is much more likely to cause inflammation of the heart muscle than a COVID-19 vaccine, and those cases are typically more severe.

    Since the approval of the first COVID-19 vaccines, anti-vaccine advocates have raised concerns about heart muscle inflammation, also called myocarditis, after vaccination to suggest that vaccines are unsafe. They’ve also used concerns about myocarditis to spread false claims that vaccines cause sudden deaths, which is not true.

    Research has consistently shown that cases of myocarditis after vaccination are extremely rare and usually mild, and a new study from the CDC found no association between sudden cardiac death and COVID-19 vaccination in young adults.

    Read on to learn more about myocarditis and what the latest research says about COVID-19 vaccine safety.

    What is myocarditis?

    Myocarditis is inflammation of the myocardium, or the middle muscular layer of the heart wall. This inflammation weakens the heart’s ability to pump blood. Symptoms may include fatigue, shortness of breath, chest pain, rapid or irregular heartbeat, and flu-like symptoms.

    Myocarditis may resolve on its own. In rare cases, it may lead to stroke, heart failure, heart attack, or death.

    What causes myocarditis?

    Myocarditis is typically caused by a viral infection like COVID-19. Bacteria, parasites, fungi, chemicals, and certain medications can also cause myocarditis.

    In very rare cases, some people develop myocarditis after receiving a COVID-19 vaccine, but these cases are usually mild and resolve on their own. In contrast, a COVID-19 infection is much more likely to cause myocarditis, and those cases are typically more severe.

    Staying up to date on vaccines reduces your risk of developing myocarditis from a COVID-19 infection.

    Are COVID-19 vaccines safe for young people?

    Yes. COVID-19 vaccines have been rigorously tested and monitored over the past three years and have been determined to be safe for everyone 6 months and older. A recent CDC study found no association between COVID-19 vaccination and sudden cardiac death in previously healthy young adults.

    The benefits of vaccination outweigh any potential risks. Staying up to date on COVID-19 vaccines reduces your risk of severe illness, hospitalization, death, long COVID, and COVID-19-related complications, such as myocarditis.

    The CDC recommends people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Chorus or Cacophony? Cicada Song Hits Some Ears Harder Than Others

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    ST. LOUIS — Shhhooo. Wee-uuu. Chick, chick, chick. That’s the sound of three different cicada species. For some people, those sounds are the song of the summer. Others wish the insects would turn it down. The cacophony can be especially irritating for people on the autism spectrum who have hearing sensitivity.

    Warren Rickly, 14, lives in suburban south St. Louis County, Missouri. Warren, who has autism, was at the bus stop recently waiting for his younger brother when the sound of cicadas became too much to bear.

    “He said it sounds like there’s always a train running next to him,” his mother, Jamie Reed, said.

    Warren told her the noise hurt.

    Starting this spring, trillions of the red-eyed insects crawled their way out of the ground across the Midwest and Southeast. It’s part of a rare simultaneous emergence of two broods — one that appears every 13 years, the other every 17.

    The noisy insects can be stressful. People with autism can have a sensitivity to texture, brightness, and sound.

    “I think the difference for individuals with autism is the level of intensity or how upsetting some of these sensory differences are,” said Rachel Follmer, a developmental and behavioral pediatrician at Lurie Children’s Hospital in Chicago.

    “It can get to the extreme where it can cause physical discomfort,” she said.

    When a large group of cicadas starts to sing, the chorus can be as loud as a motorcycle. Researchers at the University of Missouri-St. Louis this year crowdsourced cicada noise levels as high as 86 decibels, about as loud as a food blender.

    That can be stressful, not melodic, Follmer said.

    To help children cope, she suggests giving them a primer before they encounter a noisy situation. For cicadas, that could mean explaining what they are, that they don’t bite or sting, and that they’ll be here for just a short time.

    “When something is uncomfortable, not having power in that situation can be very scary for a lot of individuals, whether you’re on the spectrum or not,” Follmer said.

    Jamie Reed’s family has been using this and other strategies to help her son. Warren wears noise-canceling headphones, listens to music, and has been teaching himself about cicadas.

    “For him, researching it and looking into it I think grounds him a little bit,” Reed said.

    Fatima Husain is a professor and neuroscientist at the University of Illinois Urbana-Champaign and studies how the brain processes sound. She said people with tinnitus may also struggle with cicada song.

    Tinnitus, a ringing or other noise in the ears, is a person’s perception of sound without an external source.

    “Some people say it sounds like buzzing, like wind blowing through trees, and ironically, quite a few people say it sounds like cicadas,” Husain said.

    For most people with tinnitus the cicada’s song is harmless background noise, according to Husain, but for others the ringing can prevent easy conversation or sleep. Those with tinnitus are also more likely to have anxiety or depression. A loud persistent sound, like singing cicadas, can make someone’s tinnitus worse, Husain said.

    It’s not always bad, though. The cicada’s song can also be a relief.

    For some, tinnitus gets worse in a quiet environment. Husain said she’s seen reports this year of patients saying the cicadas’ song has been like soothing white noise.

    “The sound is loud enough that in some ways it’s drowning their internal tinnitus,” Husain said.

    As loud as the cicadas can be, they won’t necessarily damage anyone’s hearing, according to the Centers for Disease Control and Prevention. Hearing loss builds up over time from repeated exposure to loud sounds. Cicadas aren’t loud enough for long enough to do lasting damage, Husain said.

    Everyday sources of noise come with a higher risk. Husain said constant exposure to loud highways, an airport, industrial sites, or household appliances like blenders and hair dryers can be a concern. And they can take a toll on someone’s emotional well-being.

    “If you are being exposed to very loud sounds for a part of your school day or your working day, it may make you more stressed out; it may make you more angry about things,” she said.

    Unlike the highway or an airport, cicadas won’t be around long. Most of the current brood will be gone in the next few weeks. Just in time for another noisy summer event: the Fourth of July.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Seven and a Half Lessons About the Brain – by Dr. Lisa Feldman Barrett

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    We’ve reviewed books about neurology before, and we always try to review books that bring something new/different. So, what makes this one stand out?

    Dr. Lisa Feldman Barrett, one of the world’s foremost neuroscientists, starts with an overview of how our unusual brain (definitely our species’ defining characteristic) came to be, and then devotes the rest of the book to mostly practical information.

    She explains, in clear terms and without undue jargon, how the brain goes about such things as making constant predictions and useful assumptions about our environment, and reports these things to us as facts—which process is usually useful, and sometimes counterproductive.

    We learn about how the apparently mystical trait of empathy works, in real flesh-and-blood terms, and why some kinds of empathy are more metabolically costly than others, and what that means for us all.

    Unlike many such books, this one also looks at what is going on in the case of “different minds” that operate very dissimilarly to our own, and how this neurodiversity is important for our species.

    Critically, she also looks at what else makes our brains stand out, the symphony of “5 Cs” that aren’t often found to the same extent all in the same species: creativity, communication, copying, cooperation, and compression. This latter being less obvious, but perhaps the most important; Dr. Feldman Barrett explains how we use this ability to layer summaries of our memories, perceptions, and assumptions, to allow us to think in abstractions—something that powers much of what we do that separates us from other animals.

    Bottom line: if you’d like to learn more about that big wet organ between your ears, what it does for you, and how it goes about doing it, then this book gives a very practical foundation from which to build.

    Click here to check out Seven and a Half Lessons about the Brain, and learn more about yours!

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  • Two Things You Can Do To Improve Stroke Survival Chances

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    Dr. Andrew’s Stroke Survival Guide

    This is Dr. Nadine Andrew. She’s a Senior Research Fellow in the Department of Medicine at Monash University. She’s the Research Data Lead for the National Center of Healthy Aging. She is lead investigator on the NHMRC-funded PRECISE project… The most comprehensive stroke data linkage study to date! In short, she knows her stuff.

    We’ve talked before about how sample size is important when it comes to scientific studies. It’s frustrating; sometimes we see what looks like a great study until we notice it has a sample size of 17 or something.

    Dr. Andrew didn’t mess around in this regard, and the 12,386 participants in her Australian study of stroke patients provided a huge amount of data!

    With a 95% confidence interval because of the huge dataset, she found that there was one factor that reduced mortality by 26%.

    And the difference was…

    Whether or not patients had a chronic disease management plan set up with their GP (General Practitioner, or “family doctor”, in US terms), after their initial stroke treatment.

    45% of patients had this; the other 55% did not, so again the sample size was big for both groups.

    Why this is important:

    After a stroke, often a patient is discharged as early as it seems safe to do so, and there’s a common view that “it just takes time” and “now we wait”. After all, no medical technology we currently have can outright repair that damage—the body must repair itself! Medications—while critical*—can only support that and help avoid recurrence.

    *How critical? VERY critical. Critical critical. Dr. Andrew found, some years previously, that greater levels of medication adherence (ie, taking the correct dose on time and not missing any) significantly improved survival outcomes. No surprise, right? But what may surprise is that this held true even for patients with near-perfect adherence. In other words: miss a dose at your peril. It’s that important.

    But, as Dr. Andrew’s critical research shows, that’s no reason to simply prescribe ongoing meds and otherwise cut a patient loose… or, if you or a loved one are the patient, to allow yourself/them to be left without a doctor’s ongoing active support in the form of a chronic disease management plan.

    What does a chronic disease management plan look like?

    First, what it’s not:

    • “Yes yes, I’m here if you need me, just make an appointment if something changes”
    • “Let’s pencil in a check-up in three months”
    • Etc

    What it actually looks like:

    It looks like a plan. A personal care plan, built around that person’s individual needs, risks, liabilities… and potential complications.

    Because who amongst us, especially at the age where strokes are more likely, has an uncomplicated medical record? There will always be comorbidities and confounding factors, so a one-size-fits-all plan will not do.

    Dr. Andrew’s work took place in Australia, so she had the Australian healthcare system in mind… We know many of our subscribers are from North America and other places. But read this, and you’ll see how this could go just as much for the US or Canada:

    ❝The evidence shows the importance of Medicare financially supporting primary care physicians to provide structured chronic disease management after a stroke.

    We also provide a strong case for the ongoing provision of these plans within a universal healthcare system. Strategies to improve uptake at the GP level could include greater financial incentives and mandates, education for patients and healthcare professionals.❞

    See her groundbreaking study for yourself here!

    The Bottom Line:

    If you or a loved one has a stroke, be prepared to make sure you get a chronic health management plan in place. Note that if it’s you who has the stroke, you might forget this or be unable to advocate for yourself. So, we recommend to discuss this with a partner or close friend sooner rather than later!

    “But I’m quite young and healthy and a stroke is very unlikely for me”

    Good for you! And the median age of Dr. Andrew’s gargantuan study was 70 years. But:

    • do you have older relatives? Be aware for them, too.
    • strokes can happen earlier in life too! You don’t want to be an interesting statistic.

    Some stroke-related quick facts:

    Stroke is the No. 5 cause of death and a leading cause of disability in the U.S.

    Stroke can happen to anyone—any age, any time—and everyone needs to know the warning signs.

    On average, 1.9 million brain cells die every minute that a stroke goes untreated.

    Stroke is an EMERGENCY. Call 911 immediately.

    Early treatment leads to higher survival rates and lower disability rates. Calling 911 lets first responders start treatment on someone experiencing stroke symptoms before arriving at the hospital.

    Source: https://www.stroke.org/en/about-stroke

    What are the warning signs for stroke?

    Use the letters F.A.S.T. to spot a stroke and act quickly:

    • F = Face Drooping—does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
    • A = Arm Weakness—is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
    • S = Speech Difficulty—is speech slurred?
    • T = Time to call 911

    Source: https://www.stroke.org/en/about-stroke/stroke-symptoms

    Last but not least, while we’re sharing resources:

    Download the PDF Checklist: 8 Ways To Help Prevent a Second Stroke

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