Changes in appearance may cause distress, sometimes depression.
• Changes to the shape of an acromegalic's face are common. The jaw and chin may protrude in a manner like that portrayed in many fairy stories about witches.
"I go to great lengths to avoid a sideways-onphotograph."
• With Cushing's the face shape changes and facial hair often has to be contended with.
"I am left with the problems of being overweight and having facial hair."
• Acromegalics have difficulty finding shoes, gloves, and hats to fit, which can be very frustrating, time consuming, and distressing. You are "abnormal."
• Weight gain is common, even without the impact of steroids.
• Learning to cope with the ups and downs of cortisol replacement is not easy. Handling stressful situations, such as being ill, and needing at times to carry emergency steroids can be frightening.
• Other changes caused by this condition that can add to the distress are urinary urgency and the inconvenience and embarrassment provoked by diabetes insipidus.
• Infertility may be a real distress.
• The occurrence of sexual problems may not be volunteered but it may have a major impact on relationships. Treatment and reassurance can be provided for impotence or loss of libido.
• When you do feel out-of-sorts it is easy to blame your endocrine situation or to start worrying that something might be wrong, when in fact you may be having an "off-day" like everyone else does.
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