Dr. Randi R. Protter is the medical director at Women's Health & Counseling Center. As an active member in the medical community, Dr. Protter was named the Outstanding Woman of the Year in Medicine in 2003 by the Somerset County Commission on the Status of Women, and she was honored with the Susan G. Komen Hero Award in 2001.

Most women experience occasional irregularity in their menstrual cycle – perhaps there has been a particularly stressful life event, an illness, or a medication change. These episodes generally do not persist beyond one or two cycles. If however, your menstrual cycle appears less frequently than every three months, or, less than nine times annually, you may have Polycystic Ovarian Syndrome (PCOS). The syndrome, which affects more than 10 percent of American women, has numerous hormonal changes. These changes ultimately place women at risk for infertility, diabetes, heart disease and endometrial cancer.

Early in the disease women may feel that their hormones are confused: menstrual cycles are almost never a monthly event, and they tend to last long when they do finally appear. This is due to an imbalance of the female hormones LH (luteinizing hormone) and FSH (follicle stimulating hormone).

Many women become aware of their PCOS during child bearing years when despite repeated attempts, they are unable to become pregnant. Some medical studies have also linked PCOS to a higher miscarriage rate.

The male hormones androstenedione and testosterone are elevated in women with PCOS, resulting in abnormal hair growth. Bristly hair may appear on the upper lip, chin, around the nipples, and in a line or patch from the belly button to the pubic area. Ironically, some women have thinning of the hair on their head. The elevation of these hormones can also cause mild acne.

The most alarming hormonal abnormality is that of insulin. Heart disease, the leading cause of death for women, is elevated in women with PCOS due largely to elevated insulin levels. The body develops a type of tolerance to these levels, in much the same way that the body can become tolerant to the effects of certain medications when taken daily for long periods of time. The phenomenon is called hyperinsulinemia.

Untreated hyperinsulinemia leads to pre-diabetes, diabetes and high levels of “bad” cholesterol. It is also associated with high blood pressure and obesity. Indeed, obesity affects more than 50 percent of women with PCOS. The combination of these factors also defines the Metabolic Syndrome. Women with this syndrome have a three-fold increase in heart disease and a 24 fold increase in diabetes!

Endometrial cancer rates are higher in women with PCOS than in the general population. This increase is due in part to the irregular menstrual cycles and abnormal hormone levels that are so common to PCOS sufferers.

PCOS is no longer a problem solely of menstruation. It is a potentially dangerous syndrome that must be treated. Contact your doctor if you suffer with one or more of the symptoms -irregular menstrual cycles, infertility, abnormal hair growth, and/or obesity.. Your physician will take a thorough history, perform a physical examination, and check blood tests to aid in the correct diagnosis. Once diagnosed, PCOS can be treated with oral medication and creams.

Treatment for PCOS is simple and lifesaving.

Most people think of muscles in the context of the heart, responsible for pumping blood throughout the body, or the skeleton where they are responsible for posture and walking. In fact, muscles have many health benefits and can actually reduce your risk of many chronic diseases and reduce or eliminate your need for medication.

Health benefits increase as we increase our muscle mass and strength. This can be achieved through exercise at any age and is especially important as we get older because at that time our muscles naturally tend to get smaller. An increase in muscle mass even at the microscopic level has tremendous health benefits. You do not need to have muscles that protrude from your arms or your abdomen to enjoy these benefits.

Muscles help to regulate blood sugar. After a meal, your pancreas, an organ in your abdomen, releases the hormone insulin. Muscles are sensitive to insulin, and react by taking in and utilizing the sugar in the blood. As we age, this sensitivity decreases which can result in elevated blood sugar and ultimately diabetes. Exercise, at any age, increases the muscles’ sensitivity to insulin and will therefore lower blood sugar.

Diabetics who begin exercising may need less medication, “pre-diabetics” may have their blood sugar return to normal, and those with a tendency toward “adult-onset” diabetes may prolong the time until they need medication.

Osteoporosis, also known as thinning bones, commonly occurs as we age. It is painless and often has no symptoms until a fracture occurs. Osteoporosis-related fractures commonly occur in the hip. These fractures require surgery to repair followed by a period of rehabilitation often in a special hospital. Some elderly patients never recover from a fractured hip. Osteoporosis can be prevented by weight bearing exercises such as walking, jogging, hiking and tennis. Your muscles will massage your bones, which will help improve and maintain bone strength throughout your body.

Muscles store energy and larger muscles can store more energy. Energy “reserves” enable you to increase the duration of exercise, which in turn allows your muscle mass to increase. Exercise itself has many health benefits.

Obesity has reached epidemic proportions. Compared to adults with normal weight, obese adults are more likely to be diagnosed for diabetes, high blood pressure, high cholesterol, asthma, and arthritis. Regular exercise burns calories, which in turn will cause weight loss when food consumption remains the same or is reduced. Many of the health risks associated with obesity can be eliminated.

Elevated cholesterol is a risk factor for heart disease. Cholesterol has many components, including the “bad” cholesterol, known as LDL and the “good” cholesterol known as HDL. Healthy cholesterol profiles have low (bad) LDL and high (good) HDL cholesterol patterns. You can increase your “good” HDL cholesterol through exercise.

High blood pressure often has no symptoms. Untreated, it plays a large role in heart disease and stroke. Exercise can prevent the development of high blood pressure and can reduce blood pressure in people who are being treated for the condition.

Heart disease, the number one killer of both men and women, is caused by many factors including diabetes, elevated cholesterol, high blood pressure and obesity. You can modify these factors through exercise.

The Metabolic Syndrome, which affects over 25 percent of adults, causes a significant increase in the risk of heart disease and diabetes. It is a combination of any three of the following: abdominal obesity, high triglycerides, low HDL, high blood pressure and high blood sugar. Increases in muscle mass and exercise can eliminate many of these risk factors.

Your muscles can change your life. You can reduce your risk of many chronic diseases and reduce or eliminate your medication. All you need is a comfortable pair of sneakers.

Do you find yourself singing the jingle on a daily basis? You know the one: “Gotta go, gotta go, gotta go right now, gotta go, gotta go, gotta go...” If you do, you are not alone. The jingle, which tends to resonate with greater intensity as we race to the nearest bathroom, refers to our need to urgently urinate. The condition, urinary incontinence, affects as many as 15 million people in the United States.

Urinary incontinence is the inability to hold your urine until you get to the toilet. It affects women more often than men, and older people more than young. It is present in all socioeconomic and ethnic backgrounds. It often leads to embarrassment, isolation, depression, and can predispose sufferers to other health problems. Incontinence is never normal, at any age, and is treatable and often curable.

There are several reasons why a disproportionate number of women experience incontinence. Do you notice that one week before your menstrual period a simple sneeze will cause you to leak urine, yet at other times you are fine? Perhaps you are in menopause and a sneeze at any time will cause urine loss. Both of these situations are related, in part, to a lowering of your estrogen level, which occurs one week prior to a menstrual period and to a significant extent after menopause. This female hormone is thought to help strengthen the muscles that hold urine in.

The structure and location of the female urinary tract account for the statistical difference between genders as well. Women can experience incontinence during pregnancy or immediately after pregnancy due to changes in anatomy and trauma to the region of the urethra, the tube that carries urine outside the body. Women who have had multiple pregnancies are more likely to have incontinence due to permanent physical changes in the area where the bladder and its associated structures live.

There are four major types of incontinence. You may have one or a combination of two or more:
· Urge incontinence – you have a sudden and imminent need to urinate, usually large volumes of urine
· Stress incontinence – you cough, sneeze, laugh, exercise or the like and lose a small amount of urine
· Overflow incontinence – you suddenly leak a small amount of urine without realizing that you needed to urinate
· Functional – you know that you need to urinate but you can not get to the toilet in a timely manner often due to a disability such as arthritis.

Many people are surprised to learn that many common medications can cause incontinence. In general terms, these are medications for high blood pressure, heart failure, heart disease, kidney problems, allergies, congestion, depression, anxiety, gastrointestinal problems, and pain. A consultation with your physician could help determine if your medication is problematic.

Incontinence can also be a symptom of a larger problem such as a urinary tract infection, heart disease, diabetes, arthritis, multiple sclerosis, menopause, prostatism, and cancer or brain abnormalities.

Treatment of incontinence is directed at the cause and type. Medications causing incontinence may be switched to a different product. Medical conditions causing incontinence should be treated. You may find that special exercises or biofeedback are helpful, while others may need discreet external devices. You may need medication: a tablet taken one or more times daily or a patch that is applied to the skin twice weekly. Sometimes surgery is necessary.