It's no secret that wedding planning can be overwhelming and stressful to say the least. But when you're dealing with a frustrating medical diagnosis, it can be even more difficult. Women with polycystic ovarian syndrome (PCOS) know this all too well.
For some expert insight into how to manage your symptoms while planing your big day, BRIDES spoke with Dr. Ana Cepin, ob/gyn at NewYork-Presbyterian/Columbia University Irving Medical Center for her best advice.
According to Cepin, women with PCOS can experience a variety of symptoms, as it is a syndrome. In fact, some might experience no symptoms at all while others experience many. And since PCOS effects 6% to 10% of women, there's a good chance it affects many brides-to-be.
The most common symptoms of PCOS:
1. Menstrual irregularity due to absence or decreased frequency of ovulation 2. Infertility 3. Hyperandrogenism, meaning signs of excess of androgen hormones such as acne, increased hair growth, male pattern baldness 4. Metabolic issues such as obesity and increase risk of diabetes and other related diseases
Here's what might be able to help
Dr. Cepin adds that, "Each these findings are managed in a variety of different ways and depend on desired outcomes, such as whether a woman is trying to become pregnant or not."
The birth control pill is usually the first line treatment option for women with PCOS," says Cepin, as it helps with menstrual irregularities, acne, and symptoms of PMS such as bloating and increased hair growth.
If there is no improvement while on the pill, Cepin says she refers to a dermatologist for issues with acne and increased hair growth. So, we spoke with Dr. Shari Marchbein, a dermatologist and clinical assistant professor of dermatology at New York University School of Medicine, about how she helps patients with PCOS. She explained, "Dermatologists work alongside OBGYNs and endocrinologists in treating patients and are often the first to diagnose patients with PCOS when they present with the sudden onset of severe acne or with adult female acne (acne primarily on the lower face/jawline that tends to flare with the menstrual cycle), or with concerns of hair growth in cosmetically sensitive areas."
In regards to the skin-based symptoms, she explains that treatments for PCOS focus on preventing the excess testosterone from stimulating oil glands that cause acne and, in particular, painful cysts. Therefore, she says, "In addition to traditional acne treatments which include creams containing retinoids, antibiotics and benzoyl peroxide, dermatologists use combination birth control pills (containing estrogen and progesterone) and Spironolactone (a pill which directly opposes the effect of testosterone on oil glands) to control acne associated with PCOS." She notes that as with all acne medications, results can take about three to six months and they may need to be continued for maintenance.
For women struggling with this, a solid skincare routine may also help. Dr. Marchbein recommends using gentle cleansers like Cetaphil or Cerave twice daily as they may help you tolerate potentially irritating prescription acne creams. "I also recommend a daily oil-free moisturizer with an SPF30+ (such as Neutrogena Healthy Defense or Elizabeth Arden City Smart) and a creamier moisturizer at night to help combat dryness if needed," noting that Cerave cream, Simple Waterboost and Neutrogena Hydroboost are some of her favorites.
Women with PCOS tend to have a higher increased rate of obesity. Whether you're a bride-to-be or not, Cepin says the same principles apply, and that diet, exercise, and referral to an endocrinologist can help if there is no improvement from the pill.
But what does this all mean for dress shopping? After all, brides tend to have multiple fittings leading up to the big day to ensure your dress is perfectly tailored.
According to Erica Chasco-Smith, Director of Stores for Lovely Bride, "Weight fluctuations are real, and unpredictable. Therefore, it's always best to order a size large enough to accommodate your largest potential measurement." She adds that wedding gowns are constructed to be reconstructed. In fact, she says almost 100% of gowns need some form of tailoring to get the perfect fit.
Luckily, Chasco-Smith says, "At Lovely, our stylists are trained on all of the technical aspects of fit and styling for different body types. More importantly, we also understand the emotional aspects of shopping for your wedding dress."
These qualities and characteristics are of course important, but even more-so for a bride-to-be who might be anxious, or even dreading dress shopping due to struggling with fluctuations as a result of PCOS.
Chasco-Smith shares a few basic "rules of thumb" for dress shopping that might be helpful in these circumstances:
1. A gown with standard seam allowance can often be let out up to 1 inch.
2. A strapless gown will be easier to take in and/or let out than a gown with straps or sleeves.
3. Princess seams in front and back allow for more contouring in the fitting process than side seams only.
4. An A-line, whether it be flowy or structured, slim or full with a cummerbund is a great option to show off the rib cage and high waist area which is a really flattering point on a woman's body.
Stress can affect nearly every aspect of your life, even your menstrual cycle, which may already be irregular due to PCOS, says Cepin. So while it may be difficult to do, stress management is essential, especially while wedding panning.
Another concern? She says that women with PCOS are at increased risk for mood disorders, which can be compounded during stressful times, too. Therefore, she says, "Stress reduction is always a good goal. Self-care, meditation, etc., are all good strategies."
For specific advice on to how to manage your unique symptoms of PCOS, be sure to consult your physician before making any changes.