PCOS and WLS

[mousecat88 2,280]

Does the diagnosis of PCOS have any affect on the rate of weight loss post-WLS? I've had numerous doctors from all fields tell me I have PCOS, but no one has ever tested my androgen levels so I just had those labs done today. I don't have really any excess facial hair or anything, but I do have jawline acne and generally severe acne.

Are there any medications they give to assist in weight loss after WLS if you have PCOS? I was on Metformin for what they thought was "insulin resistance" even though my glucose and A1C were always beyond perfect. I had started getting skin tags, and the Metformin made them stop appearing. They pulled me off Metformin when I had surgery last month, though, since my glucose is always normal.

UNRELATED: I don't know how to tag an admin (or who they even are?), but I need this deleted from "The Gal's Room". If someone could assist with that, please let me know!!! I posted about it in Website Assistance.

Edited December 12, 2018 by mousecat88

[DanceSmartly 20]

25 minutes ago, mousecat88 said:

Does the diagnosis of PCOS have any affect on the rate of weight loss post-WLS? I've had numerous doctors from all fields tell me I have PCOS, but no one has ever tested my androgen levels so I just had those labs done today. I don't have really any excess facial hair or anything, but I do have jawline acne and generally severe acne.

Are there any medications they give to assist in weight loss after WLS if you have PCOS? I was on Metformin for what they thought was "insulin resistance" even though my glucose and A1C were always beyond perfect. I had started getting skin tags, and the Metformin made them stop appearing. They pulled me off Metformin when I had surgery last month, though, since my glucose is always normal.

UNRELATED: I don't know how to tag an admin (or who they even are?), but I need this deleted from "The Gal's Room". If someone could assist with that, please let me know!!! I posted about it in Website Assistance.

Hi mousecat88:

I can't answer your question with respect to the population at large, but my personal experience was that PCOS did NOT result in slow weight loss after WLS. My nutritionist had warned me that my weight loss might be slower than normal due to being blessed (!) with both PCOS + hypothyroidism, but I ended up losing 78 lbs in 7 months following WLS.

I had many more PCOS symptoms than it seems you do: ultrasound-confirmed ovarian cysts, painful cystic acne on my back, neck and jawline, mild Hair growth on my neck and thinning hair on my head. I did not suffer the irregular menstrual cycles / infertility often associated with PCOS, leading me to believe my PCOS was more the result of excessive androgen production than insufficient estrogen. Also, like you, my blood glucose tests always came back normal.

With respect to medication, I was on Diane-35 for 10+ years before WLS to control my cystic acne (I didn't find it helped much with the other symptoms). I went off my medication for my WLS and thought, "That's the last I will ever see of that stuff!"

Not to scare you but it didn't quite work out that way. Though my weight dropped spectacularly quickly, my cystic acne flared up worse than ever within 2 months of WLS, especially on my back. The oil production from my skin following WLS was amazing: I could run my hand across my forehead after an hour of sitting at my desk and my hand would come away absolutely shiny with oil. My theory is that my stupid androgen-producing organs (ovaries or adrenal glands or both) didn't get the memo that there was less of me now and so they could reduce androgen production accordingly, thank you very much! After nearly 22 months of continuing to struggle with cystic acne post-WLS, I finally gave up and went back on Diane-35.

Fortunately, the story doesn't end there. After a year back on Diane-35, I had to quit again for reasons unrelated to WLS. At my gynecologist's recommendation, I started taking 400 IU/d Vitamin E instead. This change took place almost a year ago now and to my very great surprise, my skin has stayed beautifully clear. I don't know whether to attribute this to taking Vitamin E or to my lousy ovaries / adrenal glands FINALLY getting the message that I didn't need so many androgens anymore, but either way, I am happy!

All the best with your WLS journey!

Dance

[mousecat88 2,280]

7 minutes ago, DanceSmartly said:

Not to scare you but it didn't quite work out that way. Though my weight dropped spectacularly quickly, my cystic acne flared up worse than ever within 2 months of WLS, especially on my back. The oil production from my skin following WLS was amazing: I could run my hand across my forehead after an hour of sitting at my desk and my hand would come away absolutely shiny with oil. My theory is that my stupid androgen-producing organs (ovaries or adrenal glands or both) didn't get the memo that there was less of me now and so they could reduce androgen production accordingly, thank you very much! After nearly 22 months of continuing to struggle with cystic acne post-WLS, I finally gave up and went back on Diane-35.

Thank you so much for the detailed reply! Since surgery, my acne has actually gotten exponentially worse, like you mentioned! I have seen a dermatologist who put me on a topical right now. He wants me on Spironolactone but my surgeon said no for at least a year since it's a diuretic. My face is a cystic, painful nightmare!! I haven't noticed an increase in oil production; my hair is actually now quite dry where it used to be oily. But my face... man... I feel like a teen boy. I am new to this whole PCOS thing, so I haven't heard of Diane-35 before.

Edited December 12, 2018 by mousecat88

[mousecat88 2,280]

Ohhh just looked it up. I have a Mirena IUD in currently so couldn't take that simultaneously.

[Swanton_Bomb 522]

I have PCOS too. I am very early out, just over a month, but I have been losing better than I expected (19 lbs. since November 8th, keep in mind I am very short, so that is huge, especially when added to the 20lb. lost pre-op). I was on spironolactone before surgery and was cleared to resume it, but I decided to discontinue it for 2 weeks on my own, and the acne returned, so I am back on it, but on a reduced dose. I use Aczone topical as well, and that is a freakin' miracle cream (ask for samples because it is very expensive). I have not had a period since October 15th, but they were previously irregular because of the spiro, plus I am older (44). I am scared of the Hair loss because I am already thin, but it is too early to experience that just yet, so time will tell. I don't think anything helps the excess facial hair once it starts, but laser may be more effective now so I am going to go for it. The dreaded PCOS apple shape is probably not going to change for me.

[DanceSmartly 20]

Very interesting re: Aczone topical, Swanton_Bomb! Will keep that in my back pocket

Afraid I can't offer much comfort re: potential Hair loss after WLS; I experienced pretty severe hair loss. It started about two months after surgery, and lasted about six months. The good news is that my hair did grow back eventually (took about a year!), and now I am back to about what I had pre-WLS.

I am definitely a pear shape rather than the classic PCOS apple shape, which is yet another reason I think my PCOS is caused by excess androgens rather than lack of estrogen. Freakin' hormones: can't live with 'em, can't live without 'em.

[Swanton_Bomb 522]

2 minutes ago, DanceSmartly said:

Very interesting re: Aczone topical, Swanton_Bomb! Will keep that in my back pocket

Afraid I can't offer much comfort re: potential Hair loss after WLS; I experienced pretty severe hair loss. It started about two months after surgery, and lasted about six months. The good news is that my hair did grow back eventually (took about a year!), and now I am back to about what I had pre-WLS.

I am definitely a pear shape rather than the classic PCOS apple shape, which is yet another reason I think my PCOS is caused by excess androgens rather than lack of estrogen. Freakin' hormones: can't live with 'em, can't live without 'em.

How did you deal with the Hair loss?

[DanceSmartly 20]

I closed my eyes when I looked in the mirror, then climbed on the scale to remind myself why I was doing this!!!

Sadly, I really don't have any good advice re: Hair loss other than grit your teeth and get through it. I went on a vacation during the worst of it, which distracted me pretty well from my hair woes from almost a month (though I don't like looking at the pictures of myself from that trip very much). I read a lot about people being super careful when they washed their hair and doing it as infrequently as possible, but that was pretty much not an option for me given how oily my skin became after WLS. I confess I didn't look into wigs or anything like that; those simply weren't an option for me because of my job (I'm an engineer and have to wear a hard-hat at work when I'm in the plant).

Wish I had more practical tips to share with you!

Edited to add: I did take Biotin following WLS as prescribed by my surgeon. It certainly didn't prevent hair loss, but there's always the possibility that my hair loss might have been worse had I not taken it. I reduced my biotin dosage at one point and noticed that my hair did in fact seem to be breaking off more; my understanding is that biotin may make the hair you do have stronger and more resistant to breakage.

Edited December 13, 2018 by DanceSmartly

[mousecat88 2,280]

My surgeon said that if I experience Hair loss he will double my dose of bariatric Vitamins and increase my Protein requirements. I personally don't care about it either way. I take Biotin occasionally. I have an hourglass figure. I'm really not even sure I 100% have PCOS. All these docs just said that because I struggled so much losing weight and gained it VERY FAST. I don't really have any other signs except the acne. I guess we shall see when the labs come out. I had estrogen and testosterone tested a few months ago and those were normal.

[Krista27 341]

I have PCOS was diagnosed over 15 years ago. I have had fast weight loss according to my doctor. I had surgery 2/9/18 and to date am down to 145lbs. If you have any questions let me know. I have lost over 75% of my excess weight!

[mousecat88 2,280]

10 minutes ago, Krista27 said:

I have PCOS was diagnosed over 15 years ago. I have had fast weight loss according to my doctor. I had surgery 2/9/18 and to date am down to 145lbs. If you have any questions let me know. I have lost over 75% of my excess weight!

Yes I do have a question! lmao! HOW DID YOU DO IT!? lol! I am 6 weeks out and have only lost 30lbs. I feel like it's so slow!

[Krista27 341]

1 hour ago, mousecat88 said:

Yes I do have a question! lmao! HOW DID YOU DO IT!? lol! I am 6 weeks out and have only lost 30lbs. I feel like it's so slow!

At 6 weeks that is fantastic!! I don't think that is slow at all. I really just followed my Doctors orders. Protein based diet and I work out 3 times a week. I will be honest also do not prohibit a treat occasionally and that is promoted by my Dr.! That way I never feel deprived

[cck6757 1]

Yes, you may consider working with a Registered Dietitian on diet and supplements specific to you (and PCOS) to acheive the goals and results you are looking for. Another thought is, have you looked into the research on coq10 and PCOS? http://onlinelibrary.wiley.com/doi/10.1111/cen.13288/full