Professionally, Melissa Christie is a singing teacher, but personally, she's teaching women to use their voice in a very different way.
The 32-year-old mum has self-published a journal to empower women with polycystic ovary syndrome (PCOS) to better work with health professionals on controlling the condition – and her motivation is highly personal.
Melissa has a two-year-old son now, but it wasn't so long ago that she was adrift in a sea of grief after a miscarriage, a devastating event which she believes PCOS contributed to.
"I wanted to cure my PCOS so I never lost another baby again," says Melissa, who lives in NSW's Northern Rivers region. "And I wanted more control and clarity around my treatments and symptoms.
"I've tried things that are working wonders for other women and did nothing for me. And I've tried things that have done incredible things for me but don't do things for other people. It's about finding what's triggering it in your body and reversing that, and finding the medicine for you."
After going off the pill to give her body a break, Melissa, then aged 25, missed a period. Figuring she was "either pregnant or there was something wrong", she went to see her GP.
A pregnancy test was negative, but because she had acne, weight around her middle and up-and-down moods, Melissa was tested for PCOS, a hormonal disorder that is the leading cause of infertility. Although she hadn't heard of the condition before, being diagnosed was a step forward.
"I was actually pretty happy to have found out about it because there was something I could do," recalls Melissa, who has no family history of PCOS.
"I started reading about PCOS and the thing I read everywhere was that I should be on a low-GI diet, although that's not necessarily what people say now. I started doing that and I lost a few kilos, but nothing really happened."
Turning to naturopathy, then Ayurvedic medicine in turn, made a noticeable difference to her symptoms, regulating her menstrual cycle and balancing out her hormones. But in 2015 when Melissa and her husband went travelling overseas for 10 months, her PCOS symptoms re-emerged with a vengeance.
"A couple of months into travelling, I had put on heaps of weight, my acne was really bad and my moods were really bad," she says. "We were in China so I saw a traditional Chinese medicine doctor. She prescribed this really intense tea. I drank that and – bang! – I ovulated, and – bang! – I got my period. I'm not saying Chinese medicine works for everyone but it did work for me."
So regular was Melissa's cycle that she and her husband decided to try and conceive a baby.
"I got pregnant straight away – it was amazing!" she remembers.
Sadly, it was not to be. At her 12-week scan Melissa received the heartbreaking news that her baby had died. Doctors in India, where she was at the time, made their assessment.
"They said, 'You probably lost this baby because you have low progesterone,'" she says. "It might not have been that, but it seems likely. They did a biopsy of the baby and there were no chromosomal issues or reasons for it to have miscarried."
Progesterone – a hormone that plays a part in supporting a foetus' development – then became pivotal in Melissa's own research into PCOS. She learned that in India, it's common for doctors to test progesterone levels of expectant mums, supplementing those who have low levels. But after Melissa returned to Australia and became pregnant again, she found many medical professionals here take a different approach.
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Gynaecologist Dr Elizabeth Farrell, medical director of women's health organisation Jean Hailes, explains, "Progesterone is produced by the corpus luteum [a hormone-secreting body formed in the ovary] in early pregnancy, which is important to maintain the embryo until the developing placenta starts producing its own progesterone.
"It's not common to supplement progesterone in pregnancy [in Australia] because in most cases it's not necessary," explains Dr Farrell.
Adamant that her progesterone levels had a role to play in miscarriage, Melissa sought out a gynaecologist who would prescribe her progesterone. She believes her ability to carry son Koji to full term is because this treatment helped balance her hormones.
"There's this real misconception that when you have PCOS the hard part is getting pregnant, but the reality is that women with PCOS are more likely to miscarry their baby."
Melissa's 2019 PCOS journal was driven by her a desire to help women deal with PCOS not just when it comes to fertility, but for day-to-day wellness.
"My intention is to empower women and help them take ownership of their health," she states. "Our health professionals are essential – I am a big believer in having a practitioner in your corner – but they're also not you. No one cares about your health as much as you do, because they don't have to experience it. Women need to feel like we're the queens of our bodies and we need to take the lead."
Her main message for women with PCOS is that there are many ways to manage the condition.
"We're all different," she says. "A lot of women with PCOS have got insulin resistance and are overweight but there are women with what they call 'lean PCOS' – they don't have insulin resistance and they're not overweight at all. It's about learning what your version of PCOS is so that when you go to your doctor you can say, 'Rather than treating the syndrome, treat me – this is how I'm presenting.' [With the journal] you've got evidence of how your symptoms have been tracking and what treatments have and haven't worked for you, what you eat and what your triggers might be.
"We each need to find our own treatment path and not lose hope if something doesn't work for us."
To purchase Melissa's 2019 journal or learn more about her PCOS journey, visit her website here.
There is no cure for PCOS, as such, but the condition can be managed.
"If there is excess weight, lifestyle changes are recommended, such as dietary adjustment and increased exercise," says gynaecologist Dr Elizabeth Farrell.
"There is no one diet that is recommended, but lowering caloric intake, reducing portion size and lowering carbohydrate intake may all help. Even a five to 10 percent loss of weight, for instance, can be useful for improving fertility and regulating menstrual cycles. For regulating periods, acne or excess facial or body hair growth, the oral contraceptive pill can be effective. Other strategies will depend on the symptoms."
Dr Farrell says most women with PCOS won't need to see a gynaecologist.
"PCOS can be easily managed by GPs but sometimes there may be added challenges, such as fertility issues – in these situations a specialist referral is necessary."
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