Je hebt samen met je partner eindelijk de knoop doorgehakt: we gaan beginnen aan kinderen. Een spannende en geweldige tijd! Nouja, dat hoop je natuurlijk. Soms blijkt dat het niet zo simpel is en dat het helemaal niet zo vanzelf gaat als je had gehoopt. En dat het zelfs in plaats van spannende en leuke tijd een periode kan worden van onzekerheid en teleurstellingen. Het idee van kinderen krijgen krijgt een hele andere betekenis.
Ik wil graag mijn verhaal delen om anderen met vruchtbaarheidsproblemen een steuntje in de rug te geven dat het allemaal toch nog goed kan komen. En om dit veelvoorkomende probleem wat meer toe te lichten. En ook om mensen inzicht te geven wat voor impact zoiets kan hebben. En dat er ook nog hoop is!
Hoe kwamen we daar nou achter?
Na bijna 9 jaar stopte ik met de pil. De reden was niet direct dat we toen al aan kinderen wilden beginnen, maar omdat ik al jarenlang vage klachten had waar de huisarts niets mee kon. Ik kwam op een forum een onderwerp tegen over mensen die gestopt waren met de pil en de gunstige effecten die dit kon hebben. Het zette me aan het denken waarom zoveel mensen klakkeloos elke dag opnieuw hormonen in hun lichaam stoppen, grotendeels uit gemakzucht. Je leest vaker dat het wel een jaar kan duren voordat je lichaam haar eigen balans weer gevonden heeft en een regelmatige cyclus op gang brengt. Ik was dus aangenaam verrast dat die cyclus meteen regelmatig op gang kwam. Toch?
Nee dus. Na een keer of drie bleef de cyclus weg. Na bijna 3 maanden wachten kreeg ik het vermoeden dat er iets anders aan de hand was dan het simpelweg “ontpillen” zoals ze dat dan noemen. Nee ik was niet zwanger, zo wees een bloedtest uit, en ik had geen diabetes (dat zit in de familie). De huisarts stelde voor om eens naar de gynaecoloog te gaan. Ik had gehoopt om daar voor het eerst te komen tegen de tijd dat ik een echo kon laten maken omdat ik zwanger was. Een echo kreeg ik ook, maar de reden was heel anders: het bevestigde dat ik pcos had. Nou. Daar ben je dan mooi klaar mee.
Wat is PCOS?
Pcos is een aandoening die bij maarliefst 1 op de 10 vrouwen voorkomt. Je zou denken dat het een algemeen bekende aandoening is maar dat is het dus niet. Bij pcos is je cyclus niet regelmatig doordat er vochtblaasjes op de eierstokken zitten. Die komen daar natuurlijk niet zomaar, ze worden veroorzaakt door een hormonale onbalans. In de meeste gevallen komt deze aandoening voor bij vrouwen met (ernstig) overgewicht, waardoor het lichaam uit balans raakt. En in veel gevallen bij mensen die te veel (ongezond voedsel) eten en te weinig bewegen, waardoor zij een risicogroep zijn om op den duur ook een vorm van suikerziekte te ontwikkelen. Bij deze vrouwen komt de cyclus regelmatig spontaan weer op gang als zij wat afvallen en hun leefstijl verbeteren. En soms komt het dus voor bij mensen die een normaal gewicht hebben, gezond eten en voldoende bewegen.
De behandeling van pcos is bij zo’n 80% van de vrouwen heel simpel: je krijgt eerst een kuur die je hele lichaam weer op nul zet en daarna pillen die ervoor zorgen dat je lichaam teveel van het hormoon aan gaat maken wat je eicellen laat groeien en daarmee je cyclus dus weer opstarten. Als ze niet werken neem je weer een kuur om je lichaam te resetten en neem je een dubbele dosis en eventueel een driedubbele dosis. Simpel toch? Ik zag het niet zo zitten, het klinkt als een hoop kunstmatig spul in je lichaam stoppen zonder dat je het echte probleem aanpakt. Want als je hormonen niet in balans zijn dan moet je dát toch oplossen in plaats van een hormoonkuurtje erin stoppen als symptoombestrijding?
Natuurlijk ben ik daar wel mee begonnen. Inmiddels waren we ruim een halfjaar verder en nog niets opgeschoten en kwam die kinderwens steeds vaker bovendrijven. Wat wat bleek: de pillen werkten niet bij mij. Ik kon langskomen op het ziekenhuis voor meer ingrijpende alternatieven: hormooninjecties of zelfs een operatie. Ik besloot om dat voorlopig niet te willen en eens gewoon te kijken hoe het zou lopen.
Hoe kom je aan PCOS en hoe kan je de symptomen verminderen?
Ondertussen ben ik zelf het een en ander uit gaan zoeken en me gaan verdiepen in wat ik nou eigenlijk had en wat de symptomen precies waren. En nog belangrijker: hoe je het op kan lossen, of in ieder geval kan verminderen. Er bleken nogal wat kenmerken te zijn buiten het onregelmatig of bijna nooit hebben van een cyclus. Conclusie: waarschijnlijk had ik hier al veel langer last van, maar was het niet opgevallen omdat ik aan die pil begonnen was. Waarschijnlijk was er sprake van een soort erfelijke gevoeligheid.
Maar daarnaast zijn er dus ook andere factoren naar voren waar je wel direct invloed op kunt uitoefenen: voeding, stress en beweging. In Amerika komen pcos en aanverwante aandoeningen vaker voor dan in Europa, waarschijnlijk door de leefstijl daar. Er is daar ook veel meer onderzoek gedaan en hierbij is het verband tussen pcos en insulineresistentie duidelijk aangetoond. Dit is een voorloper van diabetes type II, waarbij je lichaam minder gevoelig is voor insuline. En insuline is weer nodig om suikers (glucose) uit je bloed in de lichaamscellen te krijgen. De hoofdoorzaken zijn overgewicht/ongezond eten en onvoldoende lichaamsbeweging. Daarnaast kan er een erfelijke factor in het spel zijn. Doordat je lichaam niet goed om weet te gaan met grotere hoeveelheden suikers kunnen je hormonen uit balans raken met als gevolg bijvoorbeeld cyclusstoornissen.
Daarnaast speelt stress een zeer belangrijke rol in je gezondheid, wat meer dan alleen een verstoorde hormoonbalans tot gevolg heeft. Volgepropte dagen en steeds maar meer plannen die uitgevoerd moeten worden, ja die zorgden voor stress. Stress hoeft niet altijd negatief te zijn, het gaat erom dat je lichaam in stressmodus staat in plaats van in rust. Ik probeerde de dagen in ieder geval wat minder vol te plannen en niet teveel van mezelf te eisen.
Je voeding aanpassen, dat is me uiteindelijk nog meegevallen. Het allerbelangrijkste was om weinig tot geen (geraffineerde) suikers en niet teveel producten met snelle koolhydraten te eten (wist je trouwens dat suikers ontstekingsreacties kunnen veroorzaken, met alle gevolgen van dien?). En om zo puur mogelijk te eten. Dat geldt eigenlijk voor iedereen, maar het ene lichaam kan beter overweg met minder gezonde keuzes dan het andere. Iedereen zou er baat bij hebben als alle voeding zo vers mogelijk is en geen onnodige kleur- geur- en smaakstoffen, conserveringsmiddelen en weet ik wat voor rommel er in de meeste producten gestopt wordt bevat. Want als je erop let zal je zien dat nog maar weinig echt eten te verkrijgen is in de supermarkt. En veel water drinken houdt je lichaam ook gezonder. Wanneer je je erin verdiept kom je zo nog meer interessante dingen tegen, zoals het feit dat cafeïne ook invloed kan hebben op je hormoonhuishouding.
En hoe gingen we toen verder?
Al met al waren we bijna een jaar verder sinds die diagnose. Het was heel moeilijk om elke dag geconfronteerd te worden met het feit dat je gewoon niet weet of er ooit wel kinderen zullen komen. Ondertussen krijgen vrienden kinderen, gebeuren er in de familie “ongelukjes” en is het maar weer wachten tot het volgende stel aankondigt dat ze een kindje verwachten. Hoewel je het iedereen van harte gunt is het moeilijk om van dichtbij te zien en horen hoe de kinderen het doen. En ondertussen zeggen mensen vrolijk dat je nog jong bent en dat je nog alle tijd hebt. Klinkt heel troostend misschien, maar als je niet weet waar je aan toe bent kan je daar niet veel mee. En zeker als anderen wél zonder problemen zwanger raken. Ook mijn partner wilde niets liever dan kinderen en dan voelt het soms echt alsof je faalt. Hij ging er zelf gelukkig heel nuchter mee om, veel beter dan ik, en was ontzettend begripvol. Maar toch.
En toen, een jaar na de diagnose, kwam er zomaar spontaan een nieuwe cyclus op gang, voor het eerst sinds het halfjaar nadat ik besloot geen pillen meer te nemen van het ziekenhuis. Ik was verrast en toen trots: er zat verandering in de zaak, ik had toch iets goed gedaan! Weer contact opgenomen met het ziekenhuis en gevraagd of ik toch een nieuwe kuur kon starten. Dat was gelukkig mogelijk, maar helaas bleek de kuur ook nu niet aan te slaan. En ook de volgende deed niets.
Toen hebben we alsnog de vervolgafspraak gemaakt om te kijken welke opties er nog waren. Gelukkig konden we een week later al terecht. De opties waren in mijn ogen vrij simpel: hormooninjecties die een eicel laten groeien of een operatie om de vochtblaasjes op de eierstokken door te prikken. Ik had van tevoren al besloten dat ik geen operatie wilde dus kwamen we op optie 1 uit. Enkele dagen later werd mijn naalden-fobie overwonnen tijdens de prikinstructie, want die injecties moet je natuurlijk elke dag zelf zetten. Vervolgens kreeg ik een nieuwe kuur om alles weer op nul te zetten. Maar de verwachte effecten van die kuur bleven uit. Na enkele dagen toch maar een zwangerschapstestje gedaan en die was positief!!!
Maar toen…
Dolgelukkig en o zo trots werd de eerste echo met 7 weken gepland. Ik was zo blij. Maar tegelijk ook zo bang dat er iets niet goed zou gaan. Je leest wel dat het bijna altijd goed gaat, maar ja. Bijna altijd betekent nog altijd soms ook niet. Twee dagen voor de geplande echo schrok ik me kapot: er was bloed. Bloed was meestal geen goed teken. Het ziekenhuis verzekerde me dat een beetje bloed geen kwaad kon. Maar helaas werd het erger. En toen we eindelijk de echo kregen bleek waar ik zo bang voor was waar: het vruchtzakje was leeg. Er zat geen baby in. In de week erna kondigde zich een miskraam aan.
Inmiddels waren we twee jaar verder sinds ik gestopt was met de pil. Twee jaar lang onzeker en verdrietig over iets wat spannend en leuk zou moeten zijn. Toen heb ik ervoor gekozen om toch te beginnen met de hormooninjecties, want er zat simpelweg geen vooruitgang in en elke keer was ik weer teleurgesteld in alles.
Maar toen!
Achteraf gezien ben ik blij met die keuze. Het lost het probleem dat je hebt misschien niet op. Maar het grote voordeel van die injecties ten opzichte van de hormoonpillen is dat je precies weet waar je aan toe bent. Je moet vaker langskomen op het ziekenhuis en de behandeling is daardoor intensiever, maar daardoor weet je precies hoe je ervoor staat. De injecties ondersteunen ook niet je lichaam om zelf de juiste hormonen aan te maken, maar zijn deze hormonen en werken dus veel directer. Je begint met een standaarddosis die je dagelijks injecteert en dan wordt gecontroleerd of er een eicel groeit. Is dat na enige tijd niet zo, dan wordt de dosis verhoogd. Groeien er teveel eicellen uit (ofwel is deze dosis voor jou te hoog) dan wordt de behandeling stopgezet en begin je opnieuw met een lagere dosis. Want het risico op een heel-veel-meer-ling is natuurlijk ook aanwezig. Als de eicel (of eventueel twee) volgroeid is wordt hij met een andere injectie aangezet om tot een eisprong te komen (en dan moet je even aan de slag natuurlijk). Je weet dan twee weken later dus ook precies of de behandeling aangeslagen is en of je zwanger bent.
We hadden deze keer het geluk dat de “standaarddosis” precies goed bleek te zijn, want er groeide keurig volgens het boekje één eicel. Enkele weken later konden we ons geluk niet op: de behandeling was niet alleen aangeslagen, we waren opnieuw zwanger!!
Leuke tijd, die zwangerschap?
Toen brak opnieuw die periode van “genieten” aan. Ik kon het niet. Ik was zo bang dat het weer mis zou gaan dat ik meer bezig was met “positief blijven” dan dat ik het leuk vond. Eerst was er weer die echo met zeven weken, ik zag er eigenlijk behoorlijk tegenop. Maar deze keer was er wel degelijk iets te zien! Het was niet groter dan een speldenprikje, maar er klopte zelfs een piepklein hartje. Wat een opluchting!
Toch bleef ik onzeker. Eerst tot die 12 eerste weken, die toch net wat meer risico met zich meebrengen op een miskraam. Toen kwam de periode tot de 20-weken-echo: het moment waarop ze beter kunnen zien of je kindje bepaalde afwijkingen heeft. Gelukkig was alles perfect. Vanaf dat moment begon ik er wat meer vertrouwen in te krijgen, zeker toen die kleine begon te bewegen. En dat deed ze héél veel. Ook de bezoeken aan de verloskundige lieten zien dat er voor zover bekend niets mis was met onze dochter. En zo kreeg ik er steeds een beetje meer vertrouwen in en lukte het om me geen zorgen te maken. Het feit dat ik totaal geen last had van kwaaltjes (oké, de laatste weken maar dan is die buik ook zo zwaar geworden!) was natuurlijk helemaal een cadeautje. Ze is uiteindelijk ruim 40 weken blijven zitten en dus perfect voldragen.
Inmiddels is onze dochter na een ietwat lange maar probleemloze bevalling geboren. Ze is kerngezond, alert, lief, leuk…… Alles wat we ons kunnen wensen <3
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