PCOS Awareness

By
Shannon M. Clark, MD
|
October 20, 2021
PCOS Awareness

September was PCOS Awareness Month!

I couldn’t let the month of September pass without discussing PCOS or polycystic ovary syndrome--an important and often misunderstood diagnosis. PCOS is the most common endocrinopathy affecting reproductive-aged egg-producing persons, with a prevalence of between 8% and 13% depending on the population studied and definitions used. Like many health diagnoses, PCOS is complex with reproductive, metabolic and psychological features. It’s not a disease so much as it is an alternate state of being. Every person with PCOS will have a different range of symptoms and experiences.

However, two of the following criteria must be met to actually be diagnosed with PCOS:

  1. High levels of androgens (testosterone)
  2. Lost or irregular periods
  3. Polycystic ovaries

Look for a physician who understands PCOS

Because of the nature of PCOS, it is important to work with a physician who has a strong knowledge and understanding of it, especially if you are looking to conceive.
Previously, and even still, some physicians will automatically tell one that they cannot conceive if they have PCOS. However, as I discussed with Dr. Lucky Sekhon, a reproductive endocrinology and infertility specialist, PCOS does not automatically mean an individual will not be able to conceive or have a healthy pregnancy. It might mean, though, that you may need to work with additional types of medical providers collectively to address the different components of your overall health.

PCOS with Dr. Lucky Sekhon

In this conversation with Dr. Lucky Sekhon, we discuss the following:

  • diagnosis of PCOS
  • irregular cycles and ovulatory dysfunction
  • biochemical and clinical hyperandrogenism
  • role of pelvic ultrasound in PCOS
  • workup for infertility in someone with PCOS
  • role of letrozole, clomid, metformin, gonadotropins and IVF in a fertility treatment plan for someone with PCOS
  • adverse pregnancy outcomes in those with PCOS
  • does getting pregnant fix PCOS
  • PCOS in those over age 35
  • role of OCPs in PCOS
  • dietary recommendations
  • supplements and PCOS
  • beware of the influencers who are selling fertility and supplement products for PCOS!

Irregular Menstruation

Teens and those in their early 20s can be diagnosed with PCOS, but remember, an irregular period is just one of three criteria for diagnosis. About 3 years after the onset of menstruation is when you can begin to see irregular menstrual cycles. Before that time, the body is still working to understand hormonal signals and so there might be irregular periods. If someone is having an irregular cycle (less than every 21 days or longer than every 35 days), then this is something to speak with a healthcare provider about, regardless of if that individual is trying to conceive or not. An irregular menstrual cycle can indicate an underlying condition that may need further monitoring or treatment, including things like PCOS or hypothyroidism.

High Levels of Androgens

One should know that even if you get a blood test that says you have normal levels of androgen, you might still display the clinical signs of high androgen levels. Having a provider who will not dismiss your clinical symptoms even though your bloodwork is normal is important. There are types of birth control pills that are anti-androgen, which can help reduce the signs and symptoms that come with high androgen levels, including body hair in unwanted places, male pattern baldness, or very bad acne, especially acne around the mouth and chin that is also cyclical.

Support For Your Wellness

My friend, Dr. Mary Claire Haver, has an excellent anti-inflammatory nutrition program called The Galveston Diet. The program is designed for those in midlife, but she has had many clients with PCOS find success in reducing their symptoms via the nutrition program. As mentioned in the discussion with Dr. Sekhon, nutrition can play a huge role in supporting the health of someone with PCOS and reducing symptoms. Click here to learn more about The Galveston Diet.

I also love Aluma for mental wellness! Aluma is a mental wellness and self-discovery program with immersive audio, and new issues every 3 months for less than the cost of a therapy session. You get a workbook with 45 unique activities, and general mental health information from a board-certified perinatal psychiatrist. Click here to learn more.

Summary

PCOS is common, though the experience is unique for each individual who has it. There is a real association between PCOS and mental health, which can be exacerbated by some of the unwanted physical manifestations that occur. Having a healthcare provider who can partner with you to help support your overall health and well-being is ideal.

To learn more from Dr. Sekhon, connect with her on Instagram @lucky.sekhon and visit her blog at The Lucky Egg!

Shannon M. Clark, MD

Shannon M. Clark, MD

Shannon M. Clark, MD, MMS is a double board certified ObGyn and Maternal-Fetal Medicine Specialist, and founder of Babies After 35. In her roles as a clinician, educator and researcher at UTMB-Galveston, she focuses on the care of people with maternal and/or fetal complications of pregnancy. Dr. Clark has taken a special interest in pregnancy after the age of 35, which according to age alone, is considered a high-risk pregnancy.

Follow Shannon on TikTok @tiktokbabydoc, Facebook @babiesafter35, and Instagram @babiesafter35.

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