Dr. Silber Answers Patients’ Questions
How Does the Biological Clock Work?
Remember, women are born with all the eggs they are ever going to have, and they don’t make any new eggs during their lifetime. Women are born with approximately two million eggs in their ovaries, but about eleven thousand of them die every month prior to puberty. As a teenager, a woman has only three hundred thousand to four hundred thousand remaining eggs, and from that point on, approximately one thousand eggs are destined to die each month. This phenomenon is completely independent of any hormone production, birth control pills, pregnancies, nutritional supplements, or even health or lifestyle. Nothing stops this inexorable death of approximately one thousand eggs every month regardless of ovulation, ovarian inhibition, or stimulation. Whenever the woman runs out of her supply of eggs, the ovaries cease to make estrogen, and she goes through menopause. Despite a lot of journalistic hype, there is no similar phenomenon in men. Men continue to make sperm and testosterone at virtually the same rates, with only a very modest diminution as they age.
PCOS (Polycystic Ovary Syndrome)
COS, an abbreviation for polycystic ovary syndrome, is a very common cause of infertility in young women, but surprisingly is poorly understood by many infertility doctors. It is characterized by irregular periods, and infertility with either no ovulation or late ovulation of poor quality eggs. It seems to mystify many doctors and is often referred to as “metabolic syndrome”, indicating their lack of understanding its utter simplicity.
Adenomyosis is a condition where endometrial tissue, i.e., uterine lining cells, are dispersed within the muscle of the uterus. It is essentially “endometriosis” of the uterus. There is no capsule or line of demarcation between adenomyosis and the rest of the uterine muscle, like exists with the more common condition of uterine fibroids, benign muscle tumors of the uterus. Adenomyosis is an intensely painful condition, with incapacitating pain during menstruation, and prolonged menstrual bleeding. This is because normally when menstruation occurs, the uterine lining sheds and blood drains out of the uterus. But with adenomyosis, the uterine lining, or endometrial cells, that are trapped within uterine musculature, bleed but cannot drain out. So the uterus gets bigger and bigger and more and more boggy and enlarged and painful.