The Hemp Connection [Search results for acne] 

Hello everyone!

The last two clients I evaluated are struggling with acne. And recently, we were linked to an acne care website that is bringing in a whole new audience. So I thought it might be a good time to talk a little bit more about this topic.

First of all, thanks to Fran Kerr for linking to Susan Dopart's testimonial about flax and fish oil! It was a great way for our two organizations to become connected. I am going to put Fran's blog (http://www.highonhealth.org/) in our resource list because she has so much great information to offer. Not just on skin, but on living healthy in general.

Secondly, for those of you who are coming to us from Fran's blog/website, I'd like to ask you if you have ever heard about polycystic ovary syndrome (PCOS). It's the focus of this website, and many women find out they have it when they seek help for their acne. And…many women don't get that assessment. I actually had a dermatologist tell me she'd rather just give her patients birth control pills and end the appointment rather than get into it because it's such a complicated diagnosis.

A very common scenario is just that. A young girl goes to the dermatologist for her acne, gets birth control pills, takes them for 10 years or so, goes off them, tries to get pregnant…and can't. What happened was that the birth control pills treated the symptom…but essentially shoved the problem under the rug…where it continued to fester and create havoc elsewhere in the body.

So I want to take a moment to list the symptoms of PCOS for those of you who might have had this experience but either didn't have a doctor who wanted to deal with it, or who had a doctor who thought if you just"got your act together" you wouldn't have the problem.

Symptoms of PCOS include:
A family history of infertility, irregular periods, or diabetes
Being of an ethnic heritage that tends to have a high rate of diabetes
A history of early puberty (first period at 11 years or younger)
A history of taking medication for depression, bipolar disorder, seizure disorder, epilepsy, or migraine?
A history of gestational diabetes in any of your pregnancies.
An android ("apple shaped") body type (measure your waist to hip ratio; greater than.8)
Irregular periods (or none at all)
Dark velvety patches of skin on you neck, groin, or in your armpits
Hair loss or male balding spots
Difficulty losing weight
Intense cravings for carbohydrates or sweets
Problems conceiving
Decreased sex drive
Excess hair growth on your face, like a mustache or beard
Excess hair on your chest or back
Acne on your face, chest or back

If you see yourself painted in this symptom set, please print this out with your symptoms marked and show them to your physician. Ten percent of all women who have this syndrome will be diabetic by age 40, and with diabetes comes a whole other list of problems.

And keep checking back here. There are lots of ways to manage PCOS that do not involve medication, and we'd love to help you learn about them. In fact, the list of practitioners at the right is a list of registered dietitians who have taken the time to complete a 20 hour course in the management of PCOS. They are just waiting to hear from you.

For more information, please visit my web page on the topic: http://www.afterthediet.com/polycystic.htm

Have a wonderful week, it's a short one with the upcoming holiday!

As a skin care therapist I would often be the first one to recognize a serious hormonal imbalance based on the acne that a client might be struggling with. As nutritionist it’s clear that it’s an “inside-out” problem.

Women with PCOS often have elevated levels of free-testosterone, which is one of the markers of PCOS. When the body breaks down the testosterone, one of the by-products that can occur is DHT (Dihydrotestosterone). There are areas on our bodies that are particularly sensitive to the signals from DHT which are the face, neck, chest and back. The message is “make more oil!”.

We do need some oil on the skin in order to keep it protected and supple, but when it goes on overdrive, it literally backs up in the pore. The oil (sebum) we produce is very sticky so it doesn’t allow the dead skin cells to exfoliate easily so it becomes like have a tight lid on a pressure cooker.

The naturally occurring bacteria on the skin, along with dead skin cells and the oil end up creating a pretty nasty “stew” resulting in reddened, painful and pustular acne. If this material cannot get out of the skin, it can break the pore wall underneath the skin causing more acne (you might notice a little “family” of breakouts that always groups together). Most people, (men get it too for the same reason), focus only on trying to treat the skin externally — but the goal is to get the body back in balance.

Some basic strategies are as follows:

1. Try to eat organic and hormone free as much as possible, especially when it comes to dairy products. The hormones that the cows receive to keep them lactating as long as possible go right into the milk and it’s by-products (cheese, ice-cream etc.) which go right into you — creating a further hormonal imbalance.

2. Stress is a huge trigger for increasing DHT — it is critical to create your own menu of"stress-busters" that can be used throughout the day and work for you! A simple one is to just stop for one to two minutes and do deep breathing. This short-circuits the stress hormone release response.

3. Acne in all forms is primarily an inflammatory disease. Fish oils, which are also beneficial for neurotransmitter balance, do double duty since they help tremendously with inflammation.

4. Eat inflammation quenching foods, rich in antioxidants — fruits and vegetables. Remember when fried foods were believed to cause acne? They may not do it directly, but indirectly they are highly inflammatory.

5. Getting hormones especially your estrogen to testosterone ratio back in balance is the key to getting to the source of the problem. Work closely with your In-Cyst trained expert toward this goal.

Next blog I’ll share information on strategies for dealing with the skin from the outside in.

Carmina McGee, MS, RD, LE
Registered Dietitian/ Licensed Esthetician
805.816-1629 / Ventura, California
www.CarminaMcGee.com
Carmina@CarminaMcGee.com

I recently wrote about how much more attention horses get with regards to nutrition's importance in fertility than we humans do. Since so many of my inCYST friends also seem to be cat lovers, I thought I'd share some pertinent wisdom from the feline world.

You may already know my friend Kate, whose blog http://www.moderncat.net/ is famous world-wide for its information about stylish kitty accessories.

Today Kate has posted some information about handmade pottery dishes for cats. If you've ever had a cat with acne, you've probably been told to switch from plastic dishes to clay ones. The reason for this is that acne-causeing bacteria can grow on the plastic dishes.

Humans don't do so well with plastic, either. Not only is there a risk for bacteria, but some plastics can mimic estrogens. They're not really the kind of estrogen our body likes to use, and it confuses our feedback systems to have the wrong kind of estrogen floating around the body.

As it gets warmer, and we tend to carry water bottles around to stay hydrated, we have to be aware of how we transport that water. Plastic bottles left in purses, cars, etc, are simply not a good idea. Be sure you look for a metal bottle. You can find them in most stores these days, but if you're having trouble in your area, here's one I found at amazon.com: Eco-Friendly Wide Mouth 25 oz, 750 ml Stainless Steel Sports Water Bottle — BPA Free

Now you can keep kitty healthy, yourself healthy, and by keeping all those plastics out of landfills, you are keeping our planet healthy as well. A great and easy way to celebrate Earth Month!

Just thought I'd share some information on the nutrition and acne connection which you can find by clicking here.

Acne can be so challenging to manage. As a skin care expert I can tell you that you can treat the skin topically until the cows come home — but if you don't also work from the inside out it will be harder to get it under control.

Good luck!

Carmina McGee, MS, RD, LE

I can tell by looking at this blog's visitation statistics that a very high percentage of its visitors are looking for help with an immediate problem that has"hit them where it hurts", so to speak. You may have acne. Or want a child. Or be looking for a successful weight loss plan.

The fact is, however, that sitting in my seat, it is equally important to offer insight and solutions for those problems as it is to educate about the big picture.

The fact is, 10% of women with PCOS will be diabetic by age 40.

The fact is, PCOS increases your risk of heart disease and high blood pressure.

And…since diabetes is increasingly being associated with Alzheimer's disease, the fact is, you may end up being at risk for that as well if you're on this blog looking for help with your acne.

Fortunately, you don't have to do one thing for your fertility, another for your acne, and another to prevent Alzheimer's. All the suggestions you see here work to help all organ systems function better.

And the fact is, there is a whole lot you can do to decrease your risk of having any of the problems mentioned above.

The fact is, you can't decrease your risk if you don't take action. That part of the solution is totally in your control.

In this particular study, the alpha-linolenic acid (ALA)concentrations in fat tissue were evaluated in 1819 people. (ALA is a type of omega-3 fatty acid found in flaxseed, flaxseed oil, soybeans, canola oil, and nuts, to name a few.)

Individuals with higher levels of ALA had a lower risk of heart attack.

The fact is…if you cook more often with canola oil, eat more nuts, put some edamame on your next salad, and/or add some ground flaxseed to your next bowl of oatmeal, you just might experience the same benefits as the people in this study.

If it can't hurt and it might help, there doesn't seem to be a reason not to try at least one of those things!

Campos H, Baylin A, Willett WC. Alpha-linolenic acid and risk of nonfatal acute myocardial infarction. Circulation. 2008 Jul 22;118(4):339-45. Epub 2008 Jul 7.

Our own Dr. Susan Van Dyke, in this video, demonstrates Fraxel, a type of laser treatment that is helpful for acne scars and skin discoloration, issues many of you readers face with your PCOS.

Dr. Van Dyke's office is located in Paradise Valley, Arizona.

For more information visit www.vandykelaser.com

Polycystic Ovary Syndrome (PCOS) is a complicated, often frustrating condition that affects many women who are experiencing infertility, or may even be a primary cause of infertility. Symptoms typically include recurrent ovarian cysts, excess hair growth (or hair loss similar to male pattern baldness), acne, skin darkening, difficulty losing weight, and, of course, trouble getting pregnant. Often, the condition is not accurately diagnosed until failure to get pregnant results in referral to a reproductive endocrinologist, who has specialized training in PCOS and other endocrine disorders.

Any of these conditions taken singly are difficult to deal with – but the combination is often overwhelming for patients who have been diagnosed with PCOS. PCOS is particularly difficult because it’s under-diagnosed, so you may have years of vaguely troubling symptoms before the diagnosis is made and treatment begins. The physical side effects are unattractive and visible to the world — “I’m fat, pimply, and hairy,” as one of my clients stated tearfully. Friends and relatives may assume that you’re lazy or eat too much, and that’s why you aren’t losing weight. As a result, depression and low self-esteem are very common among women with PCOS.

I was diagnosed with PCOS in my early twenties, and, as both a patient and a professional, I have learned that there are many things you can do to improve the quality of your life and your health with PCOS. You can take control of your health and mood now by doing the following:

Get educated: Do some research on the web, ask your doctor a lot of questions, join a support group and use it, read the RESOLVE newsletter, and stay on top of developments in treatment.

Obtain skilled medical help: Although an internist or general practitioner may diagnose PCOS, it is more likely that a gynecologist, endocrinologist, or reproductive endocrinologist will do so. If you have PCOS, you will most likely want to have an endocrinologist who will prescribe appropriate medications, monitor you for the potential development Type II diabetes, and coordinate with your reproductive endocrinologist while you are trying to get pregnant. Because it is common to experience higher rates of thyroid disorder and heart disease when you have PCOS, it is a good idea to have frequent monitoring.

Your physician can also:

help you lose weight with the assistance of certain medications, and/or referral to a skilled dietician, who can teach you how to eat in a way that contributes to balancing your hormones and managing your symptoms;

refer you to a good dermatologist, who can help to control or eliminate skin conditions related to PCOS, such as skin darkening and acne, and even help with treatments for hair loss;

suggest a therapist or support group to help you cope with the stress of infertility, symptoms of depression, and frustration of dealing with a chronic disease;

Exercise: Yoga will resynchronize your brain, produce deep relaxation, reduce stress, and enhance your acceptance of your body, just as it is in the moment. The cross-lateral motion of walking is also highly effective in regulating PCOS-related insulin resistance, controlling weight – and, surprise! – resynchronizing your brain waves.

Look better so you feel better: In addition to seeking the help of a dermatologist for skin and hair conditions, you might want to actively manage excess hair growth cosmetically. There are many ways to do this, but electrolysis is the only method that has been proven permanent. A licensed electrologist will have a great deal of experience with PCOS patients. Your dermatologist can provide you with a reliable referral.

Although weight gain around the middle is frustrating and hard to overcome when you have PCOS, you can learn how to dress well, no matter your size or shape – and you deserve to do so! Seek out current fashions that are figure-friendly, and get help when you need it – if you’re just not good at putting outfits together, ask a friend who is good at it to go shopping with you, use the free services of a department store personal shopper, or spring for a stylist who will help you figure out what works on you.

Don’t forget your brain: Education is only one element of what your mind needs to effectively cope with the stress of PCOS. Sometimes friends, partners, and physicians aren’t quite enough to help you work through your anger, frustration, irritability, and sadness about having PCOS, not being able to get pregnant, or the difficulty you experience losing weight in spite eating well and exercising regularly. A licensed counselor or therapist can help you decrease stress, develop personalized coping methods, enhance your support group, and identify additional resources. Many therapists utilize mind/body methods that include meditation, guided visualization, mindfulness, and other ways of supplementing your good health practices.

By actively taking care of your physical and mental health and appearance, you can learn to feel better by knowing that you are doing the best you can with a challenging condition.

Dr. Gretchen Kubacky is a licensed clinical psychologist in private practice in West Los Angeles. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders. If you would like to learn more about Dr. HOUSE or her practice, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com.

Reprint permission granted by RESOLVE: The National Infertility Association, 2009. www.resolve.org.

I recently purchased a Clarisonic and it seems to be helping my acne. What do you think about Clarisonic for PCOS-related acne?

Dr. Van Dyke's answer:

It would be great, it doesn't spin so you don't get"abraded". It oscillates causing vibration that drives the cleanser into the pores to clean them out. I like using a glycolic cleanser with it (Vivite is good).

Dr. Van Dyke

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If you're not familiar with Clarisonic, cllick here for more information.

Have a skin question? Send it along and we'll get Dr. Van Dyke's perspective!

I'm posting inCYST's symptom checklist, developed by Mia Elwood, LCSW, of Healthy Futures in Scottsdale, Arizona. Mia's lecture on mood disorders and PCOS is part of the inCYST professional training. I like Mia's list because it addresses many of the food and mood aspects of PCOS that are not often written about. And in my opinion, when moods are not taken into consideration, their imbalances can generate many of the behaviors that make it hard to manage PCOS.

If you're new to this blog, or if you haven't seen this, take a moment and run through the symptoms. If this sounds like you, one of our inCYST providers is happy to help you figure out your personal action plan. You can also print this out and show your medical caregiver to give them a more complete picture of the issues you need help with.

If you wish to duplicate this for any reason, please include the copyright information at the bottom as Mia deserves credit for her original work. Thanks!

If you feel this profile describes you, stick around and read more! Pay particular attention to Ellen Reiss Goldfarb's post on lab tests you can get to monitor how your diet, exercise, sleep, and lifestyle changes are helping you to get back into balance.

Screening for Polycystic Ovary Syndrome and Other Hormonal Contributors
Name ________________________ Date _______________ Current Age _____

*Code answer with a YES(Y), NO(N), MAYBE(M), NOT APPLICABLE(NA), or HAVEN’T PAID ATTENTION(HPA).

Sometimes, hormones contribute to our symptoms. These questions help to explore whether hormones may be contributing to any of your symptoms.

When was your first period? Age ___ When was your last menstrual period? ___ What is your current height? ___ What is your current weight? ___

___Do you believe that you are perimenopausal or in menopause? If so, what symptoms are you experiencing that lead you to believe this?

___Have you had regular periods consistently throughout your life? Explain:

___Do your symptoms (that you are here for) change in any way according to your cycle? If yes, how do they change and when in your cycle do you notice a change?

___Has your menstrual flow become lighter/much heavier than usual for you?

___Have you ever gone more than two months without a period?

___Do you have skin that is dark or thick, especially on the neck, groin, underarms, or skin folds? ________

___Has your menstrual flow become lighter/much heavier than usual for you?

___Do you have any skin tags, teardrop-sized pieces of skin usually found in the neck area and/or armpits?

___Have you or any family members had bipolar disorder, an eating disorder, epilepsy, or migraines?

___Do you take any psychotropic medications? (antidepressants, mood stabilizers, etc.)

___Have you ever had trouble getting pregnant?

___Has your sex drive decreased?

___Do you feel you have excess hair growth? ___ Where? ___face ___back ___chest ___other____________

___Do you feel more irritable than usual?

___Have you lost/gained weight recently without your eating/exercise habits changing? _________________

___Is it hard for you to lose weight or maintain a genetically healthy weight?

___Do you have more mood swings than you used to?

___Do you have severe acne? (if adolescent) or adult acne?

___Is your waist to hip ratio greater than 0.8? Ratio _________

___Have you noticed your hair thinning or hair loss?

___Do you have strong cravings for sweets or carbohydrates?

___Do you or any family members have a history of PCOS, insulin resistance, diabetes, hypoglycemia, gestational diabetes? Who?

___Are you experiencing any other symptoms (emotional,physical, cognitive) that you feel may be related to hormones or your cycle (or lack of one)? Describe

Created by Mia Elwood, MSW/Healthy Futures-MSE, LLC, 2004/www.healthy-futures.com

Chaste-tree [Vitex agnus-castus] has the effect of stimulating and normalizing pituitary gland functions, especially its progesterone function. When working with Chaste-tree berries, I classify her as amphoteric type of herb, which means that she tends to have a balancing effect specific to the pituitary gland function, the reproductive system, and libido. An example of the amphoteric effects of Chaste-tree are best observed in libido changes: if the individual is prone to having a higher libido, one of the effects of using Chaste-tree that may be noticed is a decrease in libido, however, if the individual is more prone to a lower libido, Chaste-tree may act as a libido booster, which would then increase the activity desires of the user. It will always enable what is appropriate to occur in order to help restore the body or system back to homeostasis, which is the optimal balanced state.

Primarily, Chaste-tree is used to help normalize the activity of the female sex hormones but is also used regularly for assisting with symptoms like dysmenorrhea, PMS, and other disorders related to hormone function. It is especially beneficial during menopausal changes. In a similar way, it may be used to aid the body to regain a natural balance after the use of birth control pills or major changes in hormone levels. Chaste-tree may also be helpful with skin ailments like premenstrual herpes outbreaks or acne on the lower half of the face, premenstrual breast pain, fibrocystic breast disease, endometriosis, luteal-phase deficiency, infertility, spotting during ovulation, ovarian or uterine cysts or tumors, menopausal hot flashes, low progesterone, high prolactine, and low dopamine.

Recommended dosage: as an infusion – pour a cup of boiling water onto (1)tsp of the dried berries and let steep for 10-15mins. Drink 2-3 times per day. As a tincture – take one dropper full twice daily

ACTIONS:
--Warming
--Drying
--Hormone Balancing
--Galactagogue

CONTRAINDICATIONS:
-- concurrently with contraceptives, progestins, dopamine-receptor antagonists
--consult with a trained medical profession regarding use during pregnancy
--monitor usage and consult a trained professional if any abnormal changes occur with
menstruation (heavy flow, increased clotting, flooding, etc)

Luisa Evonne Valdez, AKA The Herbalista, is a formally-trained herbalist practicing in Phoenix, Arizona. She is a member of the inCYST Network and has conducted a training for our members about herbs for PCOS. She is on the schedule at Dr. Lundgren's upcoming PCOS Boot Camp. Visit her website and follow her on Facebook and Twitter.

--Tonic for the reproductive organs

I’ve recently been amused by a list of weird, wacky, and unusual holidays. Whole days, weeks, and months are devoted to the oddest things, and I’ll be writing about a few of them this month. Tomorrow, July 3, 2012, is National Compliment Your Mirror Day. I don’t really know or care about the origins of Compliment Your Mirror Day, but I’m going to tell you why I like the concept.

When you’ve got PCOS, when you think of the mirror, you’ve probably got negative associations. For many of you, your physical appearance fixations are typically:

• Being too heavy/problems losing weight
• Acne and other skin problems
• Hair loss
• Hair growing in strange places, with abundance

The mirror is not your friend; the mirror is your enemy. Mirrors may have become something to dread, a way to facilitate getting down on yourself, or even a way to practice some really damaging things, like skin picking or cutting (those are both mental health issues, by the way). Many of you avoid the mirror at all costs, even to the point of not having a mirror in your house except where it’s unavoidable, like on the medicine cabinet in the bathroom.

You may dress to hide your body, or your hairy arms. You may wear hats or sunglasses to distract from hair loss, or wear scarves to hide akanthosis nigricans on your neck. You avoid shopping, except online, where you don’t have to be tortured by the multiple mirrors in badly lit dressing rooms. You spend a fortune on potions to fix your skin, dermatologist visits, and special machines that are guaranteed to sweep everything clean. It’s exhausting having PCOS, and doing all of what’s required, if you really commit to it, to look “okay,” “acceptable,” or “normal.”

But the mirror, like the scale, is merely an inanimate object. It doesn’t have the power to make you miserable, or to dictate your behavior. Only you have the power to decide what your mood is, or what your behavior is. Next time you catch yourself starting a litany of denigration because you caught a glance of yourself in the mirror, turn it around (it’s all about reflection) and force yourself to say something positive. It may take time and practice. You may have to really push some boundaries, but you can find something. So instead of focusing on the thinness of your hair, focus on the fact that it’s actually kind of a nice color. Instead of focusing on your hairiness, focus on the beauty of your eyes. Instead of focusing on a roll of fat, take note of how good the color you’re wearing looks on you. Try hard. Be honest. Don’t just default to the garbage you’ve been telling yourself for years. Don’t give up.

If this seems like a real push, start by just exposing yourself to some mirror time. Set a timer on your phone if need be. Start with 15 or 20 seconds. Just look at yourself without judgment. Practice for 30 seconds, then a minute. Work your way up to two or three minutes of just looking at yourself calmly, examining what is, not wishing for what isn’t. Then you can move up to giving the mirror itself a compliment: “you reflect me so well,” “I like the way you cast light on my face,” and maybe, just maybe, you can actually give yourself a compliment. The mirror is a facilitator of self-love. With increased self-love comes increased self-care, and that’s what we’re all about here at inCYST.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.

You ever have one of those days where everything just seems to come together in the right way? Your hair looks good, your face is clear and bright, your outfit is colorful and flattering, and people are just responding to you in a good way. You’re looking good, and you know it! You FEEL good.

On the flip side, thought, PCOS is there to drag you down when it comes to appearance. We’ve got moustaches, partial and full beards, hair loss, hair in inappropriate places, excess weight (or sometimes not enough weight), acne, skin darkening, skin tags, and other cosmetic indignities galore. How on earth are you supposed to feel good in this body when it’s presenting you with these problems on a daily basis?! Moustaches and muffin tops, indeed!

And that’s just the external stuff. Inside, there are the imbalances that lead to mood swings, depression, and even thoughts of suicide. Insulin resistance, thyroid problems, and other health concerns lurk in the background. All of this can be physically and emotionally exhausting. And when you’re exhausted, it’s easy to give up on appearance. One thing I’ve learned about PCOS is that, although it threatens your physical appearance with masculinizing and unflattering characteristics, you can use positive attention to your appearance to lift your mood.

Part of what I always focus on with my clients is self-care. This may be emotional, spiritual, or physical in nature. I’ve observed that taking time to tend to your appearance as much as reasonably possible (because we don’t want the opposite problem of busting out your budget on shopping, or spending all of your play time at the salon!) results in feeling better. The American Cancer Society sponsors a program called “Look Good, Feel Better,” for women with cancer – it’s a day of make-up application instruction, wig and other hair tricks, and so on – sounds trivial in the face of cancer, but it’s miraculous in how the women respond.

PCOS isn’t cancer, to be sure, but the principles are the same – look good, feel better! I won’t go so far as to say that I “prescribe” pedicures, but maybe I should, and I have in fact recommended them, along with shopping days and other beauty services. Well-tended toes, a pretty top, or some dangly earrings will spark up the girly-girl in most women. For women with PCOS, this is a place that needs a little extra attention. You deserve it.

If there’s something you’ve been neglecting – a haircut, shopping for new bras (yes, you in the stretched out ultra-comfy bra that you haven’t replaced since last year – the one that isn’t doing your breasts any justice at all — I’m talking to you!), doing a wardrobe clean-out and ditching all the unflattering items – it’s a great time to do it. Right now, this very moment. Call your stylist, grab a bag to be filled and donated to Goodwill, or make a call to find out about laser hair removal in your area. Whatever it is, the action will make you feel better.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

…you've got to hear Carmina McGee's interview she did today! It's packed full of information on everything from acne to acanthosis nigricans to facial hair and what to do about it.

Simply click here for the link to listen.

Thanks for sharing your expertise, Carmina!

Source: Uploaded by user via Monika on Pinterest

“Dysmorphia” may not be part of your everyday vocabulary, but if I tell you that lots of people thought the late Michael Jackson suffered from it, you’ll probably know what I’m talking about. Body Dysmorphic Disorder (BDD, for short), is a complex psychological problem that results in obsessions with imagined defects in your personal appearance.

It drives people to exercise excessively, engage in extreme dieting, reshape their bodies through weight-lifting, get cosmetic procedures including plastic surgery, change their clothes often, engage in approval-seeking behaviors, and dress oddly in order to disguise imagined defects. It may also result in avoidance of mirrors, failure to seek medical help when necessary, refusal to participate in sports, sex, or other social activities, excessive beauty practices such as permanent make-up, dangerous chemical hair straightening, and the like. Many if not most of us have engaged in some of these behaviors at some point in our PCOS journeys.

In a group of people who have anxiety or depression, you’ll find BDD as an additional diagnosis in about 5 – 40%. This is quite a range, to be sure, but I think we’d find an even higher rate of BDD among women with PCOS. BDD is more common among women, actually, since we’ve already got a culture that is fixated on our likes as a central factor in our value. And, we’ve already got a much higher incidence of depressive and anxiety disorders, and our symptoms, while both internal and external, have particularly disturbing external manifestations. It can definitely reach an obsessive level of preoccupation when a woman is losing her hair, covered with excess hair in all the wrong places, erupting in acne, or dealing with stubborn, unbudgeable abdominal fat. The desire to be rid of THE PROBLEM can take an astonishing amount of time and energy.

I have clients who do all of the above, and more. If they’re not tackling the problem head-on (all discretionary funds go towards laser or electrolysis, they will not have sex unless and until they lose 50 pounds, they consider themselves complete failures at managing their bodies and tell themselves so regularly), they’re in avoidance mode. The avoidance usually affects social relationships, and further exacerbates depression – or being forced into a social situation will bring up anxiety.

It’s a complex condition that merits more than passing, gossipy attention from the media. It ruins lives. If you think you may suffer from BDD, please seek professional consultation to see how you can be helped. PCOS is complicated enough, without the extra layer of problems caused by BDD.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.

I actually came into working with PCOS through the back door, as someone who had specialized in eating disorders treatment first. I'd left my work at a treatment center, launched an eating disorder website, and women started calling me saying,"I used to have an eating disorder, now I have something called PCOS…do you know anything about it?"

It happened enough times that I started researching the syndrome, realized there was not a lot of good, standardized information about PCOS, saw the niche that needed filling…and there you have it, the Cliff's Notes version behind the inception of inCYST.

The correlation between the two conditions is so strong that I often wonder if it isn't the exact same problem being given a different name and treatment, depending on whether or not a physician or a mental health professional makes the initial diagnosis.

Because diagnosis and treatment can start in two completely different environments, there can be problems with outcome.

--Physicians accustomed to other diagnoses that respond to a simple medication or surgical procedure, may not have the interest in considering the emotional aspects of PCOS. A dermatologist actually said to me once,"I just want to take care of skin cancer. I really don't want to deal with all of those emotions."

--Even dietitians who work with diabetes and can assume they have expertise with PCOS, may not have the patience to delve through the layers of hormones and emotions and reactions to imbalances between the two, to help a client understand how all of these pieces fit together.

--Psychiatrists may be prescribing medications that exacerbate hormone imbalances and PCOS, and not consider that the weight gain and other side effects are a huge reason for medication noncompliance.

--Psychologists may not understand that anger, even rage, and depression, is very strongly affected by hormone imbalances, not entirely based on what's going on in a person's world. They also need to understand that a client can be absolutely, completely, 100% compliant with every single assignment they're given…and STILL have cravings and not lose weight. They need to not project that disappointment on the client, but take it as a cue that they may be missing an important part of what's going on.

--Eating disorder specialists I've worked with seem to be much more comfortable working with"thin" women with eating disorders. I remember when I worked in the treatment center, the women with binge eating disorder never seemed to get the same sort of attention. There seemed to be a size discrimination even coming from professionals who were supposed to be advocating for the opposite.

--Body image specialists may not completely understand that with PCOS, there are genuine and valid body image issues that are not distorted thoughts. There is facial hair. Acne scarring. Hair loss. And the cysts on the ovaries can create a feeling of bloating that is valid, not imagined.

My personal feeling is that you cannot effectively and successfully treat PCOS unless you are helping both mind and body.

If you're a physician, you need to be sure that your client has adequate emotional support rather and not just increase a medication dosage because you're not seeing progress on lab reports that you'd like to see.

If you're a dietitian, you need to have access to a size-neutral psychologist who understands the syndrome and not be afraid to refer and work together as a team.

If you're a mental health professional, you need to understand that just because your client has a disease with a physiological basis, your place in their treatment is not threatened…in fact, it is more important.

You just need to enhance the number and type of issues you can help them with.

All of us need to stop attaching symptoms and needs to a certain weight. To assume that if we get down to a certain weight the syndrome magically goes away. It's there no matter what. I just had an enlightening conversation with a dietitian who has gone through my training, is embarking on her PhD, is normal weight, and teaching at the university level. Even though she's doing all the right things, she says she STILL has times when her appetite is out of control and it completely frustrates her.

The link between eating disorders and PCOS is very, very strong. We need to embrace it and study it so we can help women tackle both and accomplish great things in their course of managing the syndrome. All of us are going to have to step outside of our personal comfort zones as professionals to be effective, and to stop thinking we can help women with PCOS all on our own outside of the structure of a team. inCYST would like to make that a rewarding risk for anyone who chooses to take it.

So 2011 has been designated inCYST's year of eating disorder outreach. We've got two learning opportunities for you who are interested in learning more.

This coming Monday, at 12:30 pm Eastern time, inCYST dietitian Janenie Wade and her business partner Ellen Shuman will be on our radio show sharing more about their collaboration with A Weigh Out, an online and phone coaching program specifically designed to help women with binge eating disorder and able to account for the presence of PCOS. Come tune in and get your toes wet, and see what they're doing! Maybe it will inspire you to want to do more as well.

This spring, in Scottsdale, Arizona, the Binge Eating Disorder Association is holding its annual conference. It's a great place to start learning more (in a beautiful climate, I have to add!).

Of course, we're always looking for mental health professionals to join us at inCYST as well. Our training is open to anyone who would like to take this on. Just let me know if you're interested.

The findings in this study are probably not news to you if you have PCOS, but it's nice to see your emotional PCOS finally validated with a scientific study.

480 women with PCOS participated in the psychological evaluation portion of this study.

Women who were not menstruating were more likely to have lower self-esteem, and to have a greater fear of being negatively viewed with regard to their appearance. These women also appeared to have an earlier onset of maturity.

High androgen levels and acne were associated with poorer body satisfaction. The greater the degree of hirsutism and BMI (body size), the lower the scores on psychological tests.

The obvious social explanations for these findings have been covered elsewhere. I believe that hormones have a huge part to play in these tendencies…I've worked in eating disorders and I've seen literally thousands of women lose the weight and remove the hair…and STILL be unhappy. Women with PCOS need help in understanding how hormones affect mood (and that hormones ARE mood) and to have access to qualified professionals who can help with that aspect of PCOS.

It's why I'm so happy Gretchen Kubacky and Anna Ahlborn are in the inCYST Network. They are here to help us better understand these conditions and what can be done to minimize any potentially negative influence they may have on your quality of life.: )

de Niet JE, de Koning CM, Pastoor H, Duivenvoorden HJ, Valkenburg O, Ramakers MJ, Passchier J, de Klerk C, Laven JS. Psychological well-being and sexarche in women with polycystic ovary syndrome. Hum Reprod. 2010 Mar 31. [Epub ahead of print]

It's 2010! It's also the time for reflection and resolutions. Don't forget to give yourself credit for the positive! Often times we try a new behavior, food, or activity, and because it didn't create a miracle or immediate change, we discontinue it and assume it didn't work. The truth was, we didn't give the new choice an opportunity to take hold and unfold.

We also tend to make the same old resolutions revolving around diet and exercise. Rather than fall into that trap here, I came up with a list of 10 other, less obvious, but equally important things you can do to help manage your PCOS.

Here's to another year of PCOS outreach. I am grateful for all of the wonderful people this blog has brought into inCYST's world, and I look forward to more good times and new friendships!

1. Prioritize yourself.

Most of my clients are highly intelligent, accomplished, passionate, and creative. But what strikes me is how easily they devote all of that energy to others…and have trouble using it to benefit themselves. Make time for healthy behaviors. They're appointments with yourself that are equally as important as any appointments you make with your doctor. Your body is trying to tell you that if you deserve anything, it's time for self-care. Make 2010 the year you agree and take action!

2. Be informed.

Over the year I've become busy with Twitter. I am disturbed at the number of tweets promising miracle supplements and cures for PCOS. Even moreso, I am disturbed to see that these tweets are the ones tending to be most often retweeted. The tweets with the most logical, evidence-based advice…sit there largely unread. If"fixing" PCOS was as easy as taking a pill, it wouldn't affect one in ten women. Don't get caught up with anyone promising a miracle or a pill. You deserve better than that. Be sure that any advice you try has research and evidence behind it to support its validity.

3. Be gentle with yourself.

I don't allow my clients to use self-deprecating language, and I confront them on self-punitive behaviors. Every single one of you is special. You deserve respect, and you deserve to celebrate the many positive things about you the rest of us see. You're not broken, and you don't need to be fixed. What you need is for the rest of us in your world to support a positive self-image and to see your goodness on days when you have a hard time with that. Expect more of that and less of the"broken speak" and see what comes into your life.

4. Take responsibility.
You can spend hours and hours on the Internet. You can participate in chat rooms and support groups and share your story. OR…you can take action. Many women I've tried to help have been more invested in sharing their story and their misfortune than they have in learning how to change their fortune. Are you suffering from what I call"PCOS Paralysis"? Is your time devoted to keeping you stuck, or are you consistently trying new things and working to be consistent with the behaviors that work? You can't see change unless you implement change. One step at a time is good enough. Those steps eventually add up to make a difference.

5. Create a support network.

inCYSTer Stacey Whittle (Santa Monica, CA) recently shared this quote on her Facebook fan page: "In 2010 CHOOSE your friends. Do the people you invest much of your time with sharpen you and amplify your happiness/productiveness? You will take on the habits, attitudes, beliefs and even mannerisms of the people you surround yourself with." Look around you. Are you surrounded by people who support healthy change and who help you to add those changes in your life? Or are you expected to be a lone wolf in the middle of people who are stuck in the lifestyle that helped make you sick to begin with? Look for people who live the way you would like to, and spend more time with them.

6. Try something healthy.

It does no good to read about it, tweet about it, debate about it. You have to live it!

7. Persist.

Remember, the days you need to take care of yourself the most…are the days you least feel like it.

8. Turn off your technology and live!

There is only so much the Internet can do for you. The life that will turn your situation around, is the one that exists off of your computer/iPhone/television screen.

9. Get some sun.

It will increase your vitamin D levels, improve your melatonin metabolism, increase your activity, improve your mood, and give you some nature-based inspiration. It really works.

10. Celebrate your beauty.

You are not broken. You do not need to be fixed. Your beauty is about who you ARE. Not about what you could be. Celebrate it. Be proud of it. Don't wait until you lose weight/conceive/resolve your acne to take care of yourself. Take care of yourself first, and see what happens to your weight/fertility/skin. Make 2010 the year you take care of the beautiful person you are, the way you deserve to be taken care of!

One of my goals in the near future is to pay more attention to skin problems associated with PCOS. They are many, and we have a great resource in our network, Dr. Susan Van Dyke. If you have any skin questions at all, please post them here and I'll forward them to her for answers to post.

The most widely recognized PCOS-related skin problems are acne, hirsutism, and melasmas. However, I've worked with quite a few women also struggling with problems like eczema and psoriasis, both related to diet, in particular, omega-3 fatty acid balance.

This past week I had a new client who wanted help for her eczema. I brought her samples of an Australian homeopathic remedy from the Expo, and she absolutely loves one of them. She shared that this product reduces the itching almost immediately, something the prescription creams she'd tried were not able to do. She also felt the redness started to go away quickly as well.

That's a pretty great testimonial!

I shared the product information with Dr. Van Dyke and she noticed that one of the ingredients in this product listed as"inactive", in Western (non-homeopathic) medicine, gamma-linolenic acid (aka borage oil) has been shown to help eczema. She suggested that it wasn't as"inactive" as the company realized!

Apparently some people with eczema do not convert omega-6 fatty acids well to the gamma-linolenic by-product that the skin needs. So the omega-6's build up and never get into the form that the skin needs.

My client is increasing the omega-3 content of her diet, reducing the omega-6 content, and using the cream…and if that doesn't correct the imbalance, we'll consider supplementing with GLA. We'll keep you posted!

The product I'm referring to is called Natralia. I did not see it in my local Sprouts store, and I did not see a store locator on their website. But I did find it on amazon.com. Here is the link to all of the Natralia products. (The products I'm sharing from the Expo are so new many of them can only be found online for now. Be sure to ask for them at your favorite store so they are more convenient to buy locally.)

Henz BM, Jablonska S, van de Kerkhof PC, Stingl G, Blaszczyk M, Vandervalk PG, Veenhuizen R, Muggli R, Raederstorff D. Double-blind, multicentre analysis of the efficacy of borage oil in patients with atopic eczema. Br J Dermatol. 1999 Apr;140(4):685-8.

I've recently been helping clients with skin issues such as psoriasis and eczema. These problems are annoying both cosmetically and comfort-wise, so it's super important to me, that my advice helps increase their comfort.

What we do is work from the inside out as well as outside in.

From the inside, the same diet you see me write about here, for infertility, is excellent for reducing the inflammatory process that is the root cause of these diagnoses. In fact, it was because women who were both infertile and suffering from eczema and psoriasis started telling me their redness and itchiness was gradually relieving after implementing dietary changes, that I realized there was a connection.

From the outside in, and this is important because no one wants to be red and itchy for a few months while they wait to feel better, simple oils from your kitchen can be very healing. If you've got olive oil, try that.

I'm partial to virgin coconut oil. It's already in many of your skin products and has a lot of healing properties. It moisturizes and heals and doesn't seem to cause acne like other products I've tried on my own skin.

Your skin tells you a lot about your internal inflammatory process. Hang in there! If you're making positive changes, you should soon experience positive feedback for the effort.

This abstract caught my eye because finasteride is sometimes used to treat the hirsutism (hair growth in women) that PCOS often causes. It has now been observed to have antipsychotic properties and is being proposed as a treatment for psychosis.

Antipsychotics are increasingly being used to treat depression, and at least 85% of women with PCOS have some kind of anxiety, depression, or other mood disorder associated with this diagnosis. If you have PCOS, please do not jump to the assumption that I am saying you are psychotic. What I am trying to point out here is that there is a huge mind-body connection in the syndrome that is often ignored. Physicians can be so compartmentalized with their treatments that they focus on the acne, the hair, the infertility…and completely ignore the moods, the mood swings, the associated disrupted eating patterns…and then they and their patients wonder why treatment is not successful.

I am posting this abstract to challenge anyone who treats PCOS to figure out what is going on in the brain of the woman with PCOS since it is, after all, the brain that controls hormones. Rather than mess with hormones and create even more problems, why aren't we going to the source and looking THERE for potential solutions? Let's make this the day we shift our thinking.

Bortolato M, Frau R, Orrù M, Bourov Y, Marrosu F, Mereu G, Devoto P, Gessa GL. Antipsychotic-like properties of 5-alpha-reductase inhibitors. Neuropsychopharmacology. 2008 Dec;33(13):3146-56. Epub 2008 Mar 19.

I chose the photo I did not to be funny, demeaning, or hurtful. I did it for the benefit of those who truly do not understand what many women go through because of their PCOS. Hair growth can be devastating and lead to horrible issues with self-image. Long ago it was often called"diabetes of the bearded ladies". If you can imagine what it's like to look in the mirror and feel as though you're losing your femininity, often at a time when you're trying to conceive and desiring to be attractive to your partner…it's a situation deserving of much more attention than it often gets by physicians.