Most helpful critical review
155 of 156 people found the following review helpful
Good overview but some misleading information
on January 21, 2005
I have to say this was a good book because PCOS is a lousy and misunderstood disorder, and anything that helps get the word out about what it is and how to treat it is a GOOD BOOK. This book does cover the basics, such as how PCOS is thought to stem from insulin resistance and how diet, exercise, and certain medications can work to help relieve this puzzling and distressing syndrome. It also gives a very nice overview of alternative/complimentary/natural therapies.
There is probably nothing good to be said about this book that hasn't been said, so I will focus instead on the things that alarmed me. In no particular order:
1. The author claims that it is not understood why women with PCOS have higher miscarriage rates than healthy women. In fact, it is often the case that pregnant women with PCOS have low progesterone rates. It is imperative that a woman with PCOS have her progesterone levels tested should she become pregnant, and that she use supplementary progesterone under her doctor's care if need be. This is of course only one cause of miscarriage but is very common among women with PCOS (who have low progesterone as a general rule), it is easy to check, and has the potential to save a pregnancy. (I am editing this point to point out that many years and many fertility treatments later - I am no longer a believer in the progesterone theory. I think weak ovulations leads to low progesterone and therefore m/c. Supplementing with p4 does work sometimes but in most cases I think low p4 indicates an unhealthy pregnancy rather than something than can be fixed)
2. The author claims that after the first few weeks of pregnancy (actually once he says few and once he says 12) a woman should go off a metformin. In fact many women stay on metformin throughout their pregnancies and have perfectly healthy babies. Some doctors believe this can help prevent gestational diabetes (which women with PCOS are more prone to) and can help control excess weight gain. (I personally stayed on metformin throughout my pregnancy and continued on it while nursing. I believe 100% that my health was the better for it and my baby's was none the worse for it)
3. In mentioning birth control pills, Yasmin is not mentioned. This pill is made with a derivitive of spironalactone (a drug with anti-androgen effects which is mentioned) and is the only pill with such a feature available in the US. As such, a lot of women with PCOS have wonderful symptom relief on it. Other countries have Diane 35 which for some reason is not approved here. Yasmin has been around for a few years and this is a new book, so I am really surprised it wasn't mentioned.
4. At least one BCP that is suggested is a tri-phasic pill... however most other literature suggests that women with PCOS avoid tri-phasic pills. Of course no one pill is right for all women, with or without PCOS, but I found this curious.
5. The author states that there is no benefit to combining the insulin medications, such as using metformin and Avandia together. In fact, many women do not respond to one or the other but respond quite well when the two are combined. (Check some message boards with medication forums)
6. I feel that at times the author lends false hope to the belief that by lowering your androgen levels via diet, exercise, and insulin meds, the "hair" issues (excess body hair, loss of head hair) will be reduced. In fact... sadly, not many women seem to experience much relief from these symptoms without additional therapies such as laser (for excess hair) or other medications (spironalctone, etc).
All in all this is definately good reading for any woman with PCOS and/or the people who care about her... but as with all things, it must be read with a grain of salt and not taken as the absolute core of truth about this condition. The number one thing a woman with PCOS can do is educate educate educate, both herself and her loved ones. This book definately has a role there, but do not stop with just it. Read other books and definately check out internet forums to learn what has and hasn't worked for other women living with PCOS.