Guest post by Dr. Nancy Dunne Byington, ND
My husband, a massive guy with a full beard and the weather roughened skin of an outdoorsman, has never been mistaken for female. Despite his silky smooth, essentially hairless chest, arms and legs, he has never experienced himself as unattractive or unmanly because of the genetics that put all his hair on his head and face and below his belly and nowhere else. In a hierarchal culture where value is assigned according to how well an individual fits narrow definitions of gender, my spouse has never had to artificially alter his appearance to be accepted as a successful male.
On the other hand, I, like most high androgen women, have been fielding remarks people feel free to make about my natural self since 7th grade. Like hearing, “Hey! You have a mustache! Look, Joey- she has a mustache!” mid-slow dance with the dream-boat 9th grade boy. Or, at age 28, bringing my first-born to meet the old-world grandfather on his death bed and receiving not loving congratulations but rather, “Why don’t you get a razor, take care of that mustache…” Ouch.
As high androgen, inherently insulin resistant females, we have spent countless, precious hours managing body hair and acne in order to protect ourselves from the belittling biases of our community. We spend significant resources battling a powerful tendency to become obese, as well. Since the 1970’s a new wave of feminism has been the beginning of push-back against the limiting ideas and lop-sided value system responsible for the unspeakable suffering and under-valued contribution of women the world over. Now is a better time for us to be supported in developing self-love and enjoyment of diversity in human form. The mental and spiritual wealth of women with PCOS depends on each of us developing and sharing authentic appreciation for all the ways there are to be human. High androgen, inherently insulin resistant (HAIIR!) women have much to enjoy and benefit from related to our marvelous physiology. Young women are leading the way for all of us to grow our capacity for happy interest in and curiosity about what it is like to live were we are on the continuum of ways to be human.
As a woman diagnosed with polycystic ovary syndrome, you are undoubtedly familiar with the experience of being considered ‘different’; too often these differences are considered undesirable. In fact, we are not diseased, dysfunctional, or by nature, undesirable. There are two essential points I want you to remember:
- High androgen, inherently insulin resistant women are normal human females with genetically inherited traits that were essential for ancient human survival and continue to offer benefit in the modern world.
- Research scientists and healthcare professionals are human beings who bear the same sorts of unconscious biases and stereotyped thinking as everyone they grew up with. Many, if not most, work from a certainty that is in fact a cultural bias, and not grounded in fact. Especially when judging female value- that is, attractiveness as a mate or as a contributing community member- researchers are only recently admitting that many presumed standards for measuring health and social status as related to body dimensions and attractiveness, are not consistent among all human groups AND can be tracked as having changed through time, as physical and economic circumstances change.[i]
Therein lies the jewel of our search for peace with ourselves and our inherited physiology- humans come in an endless variety of genetic expression, all of which exist because of features that have proven essentially beneficial to human survival for thousands of years. Your high androgen, inherently insulin resistant body is a gift from your many times great-grandparents; you have stronger muscles and bones, you are a quick thinker and a competent problem solver, because your body and mind are designed to allow you to maximize your ability to take care of your children, and other people’s children, through chronically challenging times that tend to kill off lower androgen women and their unassisted offspring.[ii]
The traits that define your strengths are negatively impacted by our increasingly abnormal global environment; it is not you that needs “fixing”. Rather it is our physical and cultural environments that are in need of healing. As long as we are subject to hormone-disrupting environmental pollution, as long as we join in mistaken ideas about what is valuable about any individual, we will experience the anxiety and depression that accompanies health challenges and social rejection. Standing up for ourselves and the contributions we make thanks to our inherited physiology is to be part of a world-wide movement to leave behind outdated thinking that destroys the natural environment for profit while dividing humans into artificial and destructively competitive categories.
Since the beginning of time, humans have depended simultaneously on the accumulated wisdom and competence of women and the systematic subjugation of women’s economic and social power. We owe human survival, literally, to women like us with enough physical, mental and emotional strength to mature into successfully protective problem solvers whose children were likely to survive even the absence of a contributing male parent.[iii] Anywhere from 4% to 25% of every human community are women like you and me. We exist on a continuum, like all humans, some expressing very little of the potential of our genetic gifts and some expressing so much that their health is indeed threatened without specific adaptations to counter environmental challenges.
The prevalence of anxiety, depression and other mental health challenges experienced by 21st century HAIIR women is inextricably linked to being considered a cosmetic minority. Although obesity is not universal among HAIIR women, modern refined-food diets, sedentary life styles and hormone-disrupting chemical pollution combine to make obesity and its consequences a major contributor to our negative experiences. Obesity intensifies androgen effects, contributing to the cosmetic, reproductive and health issues we struggle with. The majority of global cultures still value females primarily for features related to their reproductive capacity. Any development of additional capacities by an individual woman is ultimately evaluated in relation to her reproductive contribution. Many young women’s hearts are broken and their sense of self terribly damaged because of a lack of appreciation for the benefits of fertility that peaks as much as 10 years later than that of other women[iv]. Many suffer shame and self-hatred because of biases inherited from world domination by Euro-centric cultural values.
Remember this- medical doctors and research scientists are humans burdened by the same cultural biases all people have. These usually unconscious biases reliably pervert what questions they ask and which conclusions they reach in their work. For instance, you will read repeatedly that women with PCOS suffer heart disease, adding yet another burden to your self-concept. However, it has become clear that we do not develop cardiovascular disease, or die from it at any greater rate than all women, because women with no history of PCOS will “catch up” after menopause.[v] That is to say, as with fertility, we are all fundamentally in the same human-life process, just on different time schedules. Similarly, when it comes to childbearing, HAIIR women do have more pregnancy complications when obesity is part of a pregnancy; and, not all obese women have PCOS, and these obese women will also have higher risk pregnancies. It is very important to know that, in the end, we have the same number of children as women who do not have high androgen physiology.[vi] Our fertility peaks later in life, and lasts on average 2 years and 8 months longer than women whose fertility peaks in their early twenties.[vii];[viii]
High androgen/inherently insulin resistant women are presumed to be diseased, disordered, inevitably dysfunctional. That is simply not true. A less biased look at long term health outcomes suggests we have strengths and vulnerabilities in similar measure when compared with other humans. Each of us must take responsibility to learn how to successfully compensate for the impact of chemical pollution on our health. When it comes to questions of fundamental value, of our beauty and well-being, remember this-
The mental and physical wealth of HAIIR women with PCOS is generated from the interaction of our androgen-influenced body systems and our fundamentally feminine emotional hearts with profound cultural bias inherent to social systems of males on top and women in successively lower positions of power.[ix] Thankfully, that system of male dominance has finally begun to transform to more egalitarian norms around the world. Young women bear the brunt of the imposed distortions of perception, and are also a leading force of social activism that demands respect for and appreciation of the grand diversity of humanity. The mental and spiritual wealth of PCOS is met in these young women who are refusing to participate in their own oppression. Young women activists extend our capacity for inclusion, acceptance and care.
I teach high-androgen, inherently insulin resistant women diagnosed with Polycystic Ovary Syndrome (PCOS) to maximize the many advantages we are born with & to minimize aspects that cause distress. In consultation, women living with PCOS are guided to learn behaviors that help create optimal well-being. As a postmenopausal woman with PCOS, having raised a peaceful, positive, thriving daughter who has PCOS & successfully treated hundreds of other women, I can assure us all that the rewards of naturopathically-informed self-care are profound & utterly reliable. I have served in a variety of volunteer leadership roles in the naturopathic medical profession with passion & gratitude. I earned my medical degree at National College of Naturopathic Medicine in 1989 & a Master of Arts/Applied Behavioral Science from Bastyr University in 2002. Before that I was an obstetrical RN & a homebirth midwife. I am fascinated with aging & dying & what comes next! I can be found at: www.PCOSConsultations.com
[i] Bovet J, Raymond M. Preferred Women’s Waist-to-Hip Ratio Variation over the Last 2,500 Years. 2015, PLoS ONE 10(4): e0123284. doi:10.1371/journal.pone.0123284
[ii] Azziz R, Dumesic DA, Goodarzi MO. Polycystic Ovary Syndrome: An Ancient Disorder? Fertil Steril. 2011 April;95(5):1544-1548.
[iii] Cashdan E, Waist-to-Hip Ratio across Cultures: Trade-Offs between Androgen- and Estrogen-Dependent Traits. Current Anthropology 49 (2008), 6, 1099-1107
[iv] Tehrani FR, Solaymani-Dodaran M,Hedayati M, Aziz F. Is polycystic ovary syndrome an exception to reproductive aging? Human Reproduction, Vol.25, No.7 pp. 1775–1781, 2010
[v] Welt C, Carmina E. Lifecycle of Polycystic Ovary Syndrome (PCOS): From In Utero to Menopause The Journal of Clinical Endocrinology & Metabolism 2013 98:12, 4629-4638
[vi] Joham AE, Boyle JA, Ranasinha S, Zoungas S, Teede HJ. Contraception use and pregnancy outcomes in women with polycystic ovary syndrome: data from the Australian Longitudinal Study on Women’s Health. Hum Reprod. 2014 Apr;29(4):802-8. doi: 10.1093/humrep/deu020.
[vii] Marca, A La; Sighinolfi, G.; Radi, D., et al. Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010; 16:113–130. [PubMed: 19793843]
[vii] Tehrani FR, Solaymani-Dodaran M,Hedayati M, Aziz F. Is polycystic ovary syndrome an exception to reproductive aging? Human Reproduction, Vol.25, No.7 pp. 1775–1781, 2010