Overweight and Infertile
Even in this age of advanced medical knowledge, many women still struggle with the prejudices that come with being overweight. We're often treated as inferior - socially, professionally, certainly by the fashion industry, and even in the medical community.
While being overweight is a medical condition, it is still perceived by many people, including some physicians, as a character flaw. We're told by many different sources that if only we would just exercise some self-discipline, all our problems would go away, including our health problems.
Unfortunately, this is still a common response when an overweight woman seeks medical treatment for infertility. It is a recurrent scenario that a woman is dismissed out-of-hand by the very person she is seeking help from, often being told to "come back when you've lost 25, (50, even 100) pounds, then I will treat you." If this happens to you, you don't have to take it lying down. There are many options now that weren't available to our overweight sisters, even as recently as a few years ago.
Dr. Edward Przasnyski, M.D., a Tacoma, Washington endocrinologist, offers the following counsel if you find yourself in this situation. "My first piece of advice would be to find another physician. Losing weight in and of itself certainly can help some women become more ovulatory, but it is not always the answer for every woman. Most women who are overweight have tried to lose weight and have been unsuccessful for one reason or another.
"Many of these patients have insulin resistance, which means that they have elevated insulin levels, which makes it very difficult for them to lose weight. They often need the help of an endocrinologist or a specialist in weight reduction, known as a bariatrician, who is experienced with patients who have had difficulty in losing weight. The help of a good nutritionist would also be beneficial for those women who have difficulties with weight loss. First of all, the patient should be evaluated for hormone abnormalities including the insulin resistance states and ovarian dysfunction states, which means something is malfunctioning in the ovaries to begin with which has resulted in both obesity and lack of ovulation."
Dr. Przasnyski offers a list of several conditions that can cause both obesity and infertility, which should be investigated by your physician. These conditions include Polycystic Ovarian Syndrome, an endocrine disorder resulting in irregular ovulation; Insulin Resistance Syndrome, which affects the body's inability to use insulin properly; Partial Adrenal Insufficiency, a glandular disorder; Cushing Syndrome, a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol; pituitary gland abnormalities; and obesity itself.
While being overweight isn't generally the root cause of infertility, it can be related. Dr. Przasnyski feels there is a strong correlation between increased fat stores and infertility. Fat tissue can cause metabolism of estrogens and can even produce its own estrogen, causing a hormonal imbalance leading to infertility and other medical problems.
He concludes: "My best piece of advice is to find a physician who will treat you, the patient, as a human being, being sympathetic to your plight and work with you to help isolate any severe causes and, if none are found, also help the patient to lose weight in a healthful fashion."
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