So many people have been an integral part of my life and work, and I will always be grateful to them. I have received the utmost support and caring from my wife, Gloria, throughout my life and I would not have been able to persevere and continue my chosen career without her. I had wonderful childhood friends, Phil Mintz, Larry Turkell, and Burton Rabinowitz, whose baseball talk all day and our street games of punchball and stickball were a joyful part of my life. Frankly, I hope I finally convinced them that Pee Wee Reese of the Dodgers was a better shortstop than Phil Rizzuto.
As I continued along the path of my career there were many who made great contributions to my development. I wish to thank my mentors, friends, and colleagues who offered me the opportunity to exchange ideas, offered encouragement, and broadened my horizons and knowledge in many spheres. Many outstanding physicians and scientists in the various medical specialties, particularly the Department of Internal Medicine of The Mount Sinai Medical Center and Mount Sinai School of Medicine (MSSM), have been a source of inspiration to me. The standards of medical excellence and integrity of the institution have been ingrained in me since my Fellowship in the Division of Endocrinology and have served me well as a clinician and teacher of medical students and endocrine fellows. My colleagues of the Endocrine Division of The Mount Sinai Medical Center have been more than friends—they are my second family. First and foremost is my longtime friend Dr. Lester J. Gabrilove, Professor of Medicine and acclaimed endocrinologist, who was my first mentor and who spent so much of his time in guiding me as I started my endocrinology training. I will always treasure his humane qualities and the role he has continued to play in my career. It was a great source of regret that I and the field of endocrinology lost a gifted and excellent researcher and the Chief of Endocrinology at the MSSM in 1986, Dr. Dorothy Krieger. She will be missed, and I valued her encouragement and friendship. I wish to thank Dr. Terry Davies, Dr. Rhoda Cobin, Dr. Donald Bergman, Dr. Alice Levine, Dr. David Sirota, Dr. Robert Segal, Dr. David Jacobs, Dr. Edward Merker, Dr. Elliot Rayfield, Dr. Jeffrey Mechanick, Dr. Yaron Tomer. Dr. Stanley Mirsky, Dr. Robert Fiedler, and others for their friendship and advice when needed. Many other fine physicians and members of various departments of the MSSM with their gifted expertise generously devoted their time to help me undertake my research projects. Among these were the Departments of Radiology and Division of Ultrasonography (Dr. H.C. Yeh); Genetics, Statistics, Pathology (Dr. L. Deligdisch); Obstetrics and Gynecology (Dr. N. Kase); and Internal Medicine (Drs. Arthur Weisenseel, A. Unger, J. Zacks, and the late Chairman of the Department of Medicine, Dr. Richard Gorlin). Their friendship and expertise will always be treasured.
For many years Dr. Joseph W. Goldzieher published the basic research on the histology and the clinical features of PCOS. His review articles, which combined and analyzed diverse views of the abnormalities found in PCOS, remain classics of clarity and thoroughness to this day. I truly consider him my friend and inspiration in helping me understand the boundless expanse of the polycystic ovary syndrome. Joining him in the preparation of the Guidelines for Diagnosis and Treatment of Hyperandrogenic Disorders (male hormone excess) for the American Association of Clinical Endocrinologists (AACE) was a personally rewarding experience. My association and activity in AACE has allowed me further views and interchange of ideas on the polycystic ovary syndrome, and for that I am grateful to so many of my colleagues in the organization. Of particular importance to me were the numerous meetings and interplay with the members of the Reproduction Committee and other members of AACE, which include among others Drs. Rhoda Cobin, Neil Goodman, Steven Petak, Emil Steinberger, Joseph Goldzieher, Keith Smith, Geoffrey Redmond, Paul Jellinger, Donald Bergman, and Samuel Thatcher. It should also be noted that my dear friend and colleague Dr. Rhoda Cobin, the former President of AACE, and President of the American College of Endocrinology, asked me to join her in promoting national awareness of PCOS, via the Clinical Initiatives Campaign of 2004 and 2005, to fellow endocrinologists throughout the world, to media, and particularly to women with PCOS. This was an important step in the dissemination of important data suggesting the potential of cardiovascular risks in PCOS. Ongoing AACE Awareness Conferences on PCOS and the Insulin Resistance Syndrome and their potential risks were initiated by Dr. Cobin. This led to an important meeting and press conference, which was held in Washington, D.C., September 12-13, 2005, with the co-chairmanship of Dr. John Nestler and me. This was a memorable meeting in that Dr. Nestler has been in the forefront in the treatment of many aspects of PCOS with metformin. I truly value his accomplishments and his elegance, as I do his friendship and advice.
I wish to offer my deepest gratitude to Dr. Robert Rosenfield, of the University of Chicago, for his kindness, encouragement, and friendship over the years. His wisdom and comments at meetings have been always been a source of academic clarity and thoroughness. Similarly, many members with clinical interest in PCOS in the Endocrine Society, and my colleagues in the Androgen Excess Society (AES), have been more than helpful to me, and I value their friendship and outstanding expertise in androgen dysfunction. My present close association with AES and AACE has been rewarding for a number of reasons. The interaction with these organizations has allowed me the opportunity to participate with physicians and scientists who are dedicated to important research and the dissemination of information to the women in need of direction in diagnosis and treatment of PCOS. A special thanks to my colleague and friend Dr. Ricardo Azziz, the founder of the AES, whose untiring dedication to PCOS and other male hormone excess disorders in women has played an important role in its understanding and the dissemination of such findings to other physicians and the public. There are others whom I have known as friends and as active participants in AES: Drs. Enrico Carmina, Ann Taylor, Samuel Thatcher, John Nestler, Evanthia Diamanti-Kandarakis, Richard Legro, Andrea Dunaif, Maria New, Daniela Jakubowicz, Bulent Yildiz, Renato Pasquali, Robert Norman, Onno Janssen, Sharon Oberfield, Walter Miller, Geoffrey Redmond, and others. I have the highest regard for these fine scientists and researchers who have contributed such a vast array of knowledge in the unraveling of the dysfunction, the diagnosis, and the treatment of PCOS.
My special thanks for the kind efforts and enthusiasm of Dr. Lois Jovanovic in unselfishly affording me the benefit of her vast experience in the treatment of gestational diabetes (GD) and suggestions for potential risk reduction of GD in women with PCOS. Her vast experience at the Sansum Diabetes Research Institute, in Santa Barbara, California, has been globally instrumental in helping many women with this complication of pregnancy.
As the need for facilitating information on PCOS has become an important health issue, important organizations were formed, mostly via the Internet. Most importantly the emergence of the Polycystic Ovarian Syndrome Association (PCOSA), spearheaded by Mrs. Christine DeZarn and Board of Directors, has been at the forefront for information and guidance to women with PCOS for the last ten years. It offered a role to physicians dedicated to disseminating information on PCOS to participate in local and national meetings to discuss various aspects of the syndrome to women who need guidance and information. Much credit also must be given to my friend Mrs. Barbara Nesbitt, who unselfishly devotes almost all of her time to running the OBGYN.net Web site with the PCOS Pavilion section, a storehouse of information on the polycystic ovary syndrome. She has been instrumental in helping many women with PCOS and other obstetric and gynecological disorders obtain the important latest data on their condition, and I thank her for her enthusiasm and friendship. She has amassed a virtual encyclopedia of information from a number of experts on PCOS from the OBGYN.net editorial advisors and has made it easier for women with PCOS to understand more about their condition, including the newer modalities of treatment. I also wish to mention my association with a colleague at the AES, Kelly Leight, Director of the Congenital Adrenal Hyperplasia Research, Education and Support (CARES) Foundation, for her enthusiasm in the education of those afflicted with adrenal disorders.
I wish to offer my sincerest thanks to a very special person, dear friend, and renowned colleague, Dr. Stephen P. Gullo, who has been a very special person and friend in my life. He taught me much about the role of nutrition and change of lifestyle techniques in people with weight problems. His outstanding expertise in this field, his warmth and devotion to his patients, and his contribution to the field has earned him many awards, and three interviews with Larry King on CNN. They are well earned because his books (Thin Tastes Better and a new one called The Thin Commandments Diet) are innovative classics in the world of weight control. His interest and helpful advice in the formulation and intricacies involved in the writing of this book, including almost weekly phone calls, were very instrumental in planning virtually every phase of this book. His well-known reputation as an outstanding nutritionist and weight loss expert through a proper approach to weight loss has helped many of my patients. I value his major contribution to this book, which was specially written for women with PCOS and/or the insulin resistance syndrome. It took valued time away from his patients, and I am more than honored that he did this for the noble cause of helping women with PCOS and others, many of whom have hormonal reasons for their inability to lose weight adequately.
I also am grateful for the help of an excellent and experienced nutritionist, Martha McKittrick, for her unique and helpful dietary meal planning section for women with PCOS. Many of my patients have seen Martha and are pleased with her specific suggestions for dieting and the results that they achieve. I have been delighted to know her for six years, and she graciously agrees to talk at annual as well as local chapter PCOSA meetings. Her gracious personality and knowledge was evident and noted in several mutual TV interviews on CNN and Webcasts on Healthology.com. I am grateful to her, and for the enthusiasm and professionalism of her help. She has earned a special place in my esteem of her excellent ability to make patients with PCOS follow an adequate and appropriate dietary approach. With this dream team of Stephen and Martha, I felt more than assured that women with PCOS will get the special advice on achieving and maintaining weight loss that they were looking for. Their contribution to this book is a tribute to their dedication to the art of helping those who almost feel they cannot be helped. Each of the two, Dr. Stephen Gullo and Martha McKittrick, are special to me. The long periods of time they spent in helping me with this book will not be forgotten.
My sincerest thanks go to Chase Henry Mechanick for his thorough and helpful review of several sections. My thanks also to David Nayor, who helped me with the interplay of careful communications of all involved in the dietary chapters.
I also wish to thank my friend Mrs. Molly Shulman, who graciously assisted funding my genetic research for a PCOS candidate gene at the MSSM, and who has done much to further the understanding of teens with PCOS. Her work in helping teens with PCOS has been an important strategy in getting these young teens to cope with the syndrome. I truly appreciate her kindness and also her active work with PCOSA, where she unselfishly took time away from her duties with her San Diego Padres to be so active in the organization. Another special person who has been of immeasurable help in funding my research projects is Mr. Jaqui Safra. His interest in furthering research in metabolic disorders associated with PCOS has been another reason why so much new data has emerged in the understanding of this syndrome, and the potential benefits of new approaches in its management. Ken Sawyer, a special friend and gentle person dedicated to helping women with health disorders, including PCOS, deserves my respect and thanks for his noble efforts and contributions.
My gratitude to my wonderful office staff members, who have done so much for my practice. The professionalism and hard work of Luba Dronova, Roni Malinbaum, and Richard Weiss have made my office not only pleasant and efficient but friendly and patient oriented. They are a wonderful interpersonal group who makes every patient feel special and at times makes me wonder if the patient is here to see my staff or me.
I am also grateful to Allan Noel Taffet, whose expertise was of great help to me in unraveling the technicalities and legal details relating to this book. I am forever appreciative of his sound advice and friendship.
I also have been fortunate to have the cooperation as well as valued advice of Lynn Sonberg and George Ryan. They were always receptive and helpful, and the book owes much to their time-consuming efforts. My special thanks also to Henry Holt and Company, and Sam Douglas, who oversaw the development of the book. His helpful advice and enthusiasm was much appreciated. This book was written to educate and inform the woman with polycystic ovary syndrome, thus allowing her to benefit from my experience and association with other experts over the years. In so doing, the reader will be better educated to involve herself in a careful analysis and algorithm of choices for defining appropriate treatment. To see the patient feel better, more assured, self-confident, and eventually achieve her goals in life—that was my goal and aspirations in writing this book, and I hope it was achieved. It was a labor of love, and to you my readers I wish you all the best, and a healthy and happy life. Bon voyage.
WALTER FUTTERWEIT, M.D. F.A.C.R, F.A.C.E.
Clinical Professor of Medicine (Division of Endocrinology)
Mount Sinai School of Medicine, New York, NY 10029
Co-chief of the Endocrine Clinic
Attending in Medicine
The Mount Sinai Medical Center, New York City