How to Manage Polycystic Ovarian Syndrome (PCOS)

Amanda Newman (00:00):

What lifestyle changes may improve PCOS symptoms? Should you do a DUTCH test? Which supplements are best for hormonal support? All that and more on this episode of The Healthiest You.

(00:13):

Your period, whether it's heavy, light or has gone missing, can tell you a lot about your health. Having irregular periods, unwanted hair growth and weight gain are some common symptoms of polycystic ovarian syndrome or PCOS.

(00:30):

Welcome back to another episode of The Healthiest You podcast, where we focus on women's health and wellness. I'm your host, Amanda Newman. Whether you're on your way to work or enjoying a cup of coffee, take this time to focus on your health. Here to talk about how to manage PCOS is Dr. Emily Brophy, OB-GYN with Lehigh Valley Health Network, part of Jefferson Health. Dr. Brophy, welcome to the show.

Emily Brophy, MD (00:58):

Thanks so much for having me.

Amanda Newman (01:00):

So periods are a real pain for many women, and if you have a condition such as PCOS, it can make it even worse. So could you talk about what PCOS is and the cause?

Emily Brophy, MD (01:13):

Yeah, for sure. So PCOS is polycystic ovarian syndrome. That's what it stands for. Actually, about 10 percent of women will have PCOS. And there's three different things we think about with the diagnosis and organization of PCOS. So the first is having irregular periods. And so that's greater than 35 days between a menstrual cycle, which the typical menstrual cycle is about 28 days. The other is signs of hyperandrogenism. So that can be acne or abnormal hair growth. And the third is polycystic ovaries on ultrasound. So those are kind of three of the things we think about. And the hallmark of all of PCOS is really insulin resistance, so your body doesn't use that insulin in the right way to help with glucose uptake.

Amanda Newman (02:05):

So is PCOS considered an inherited condition? Are there any genetic connections?

Emily Brophy, MD (02:12):

Yeah, it's a great question. There's some interesting data out there about what percentage of women have a genetic link. And there's a genetic association. There's actually a fivefold increase to daughters who are born to mothers that have high androgen levels in their system at the time of their conception.

Amanda Newman (02:32):

Oh, wow.

Emily Brophy, MD (02:33):

Yeah, that's pretty cool to think about, right?

Amanda Newman (02:35)

Yeah.

Emily Brophy, MD (02:36):

And there's over 500 potential genes that they're currently studying to see what kind of association there is with genetics with PCOS.

Amanda Newman (02:46):

Although PCOS is a common condition, up to 70 percent of women remain undiagnosed. What are the challenges with diagnosing PCOS, and what symptoms may mean you have it?

Emily Brophy, MD (02:59):

Yeah, I think it's a great question and very challenging for women, especially when they don't feel like their concerns are maybe being heard by their health care clinicians. And it can be challenging for us too. We often thought, or I was trained in medical school, that women with PCOS have beards of hair and lots of abnormal hair growth as well as lots of acne, and that's just not the case anymore. Up to 3 percent of women with PCOS can actually have a normal BMI [body mass index]. So we have to think about the whole picture when diagnosing PCOS. I think the other limitation is kind of some of the research that's surrounding PCOS is certainly lacking because of how complex the condition can be.

Amanda Newman (03:41):

And one of the common symptoms of PCOS is having an irregular period. And I think you had said that would be anything greater than 35 days.

Emily Brophy, MD (03:50):

Yeah, for sure.

Amanda Newman (03:51):

OK.

Emily Brophy, MD (03:52):

I brought my picture of my uterus today. I don't know how you feel about me drawing a picture for you.

Amanda Newman (03:57):

Yes, please do.

Emily Brophy, MD (03:58):

So listen, normal ovaries kind of have regular amounts of follicles in them, and you ovulate regularly in a 28-day cycle. When you're having PCOS, you have lots of follicles in your ovaries. So, that looks like a PCOS ovary. And it's not really regularly ovulating to give you that menstrual period like you would think you could have. So that's why you go a longer amount of time in between your cycles. So that can be a hallmark symptom. Certainly there are the two others, which are the hyperandrogenism and the ovaries on ultrasound.

Amanda Newman (04:32):

Well, that was an excellent visual. I'm so glad you brought that with.

Emily Brophy, MD (04:37):

I love my uterus picture, my patients will tell you.

Amanda Newman (04:38):

So tracking your cycle, especially if it is irregular, can be a bit of a challenge. What do you recommend?

Emily Brophy, MD (04:45):

Yeah, for sure. It can be a challenge. There's a really great app called Natural Cycles, which I think is a great opportunity to use to really track how often you're getting your cycle and what that might look like. Some women might think, I'm only going to do this if I'm trying to get pregnant. But the reality is tracking your cycle is a great way to know your overall health and how your body's kind of reacting to the hormones that you have. So I definitely recommend that. And then showing up to your clinician to kind of review what your cycles have been over the span of a few months. We're not just looking at one cycle here or there, but over the span of six to 12 months.

Amanda Newman (05:22):

And your period is such a marker of health, it's important to have that check-in every month. I know for me, I use the Tempdrop app. And so it's like this armband that I wear overnight, tracks basal body temp. And then it has everything nice and organized in my app. And OK, so when I go for my appointment, I'm like, yes, this is what things are looking like. And that's so important. Because I think sometimes if we aren't tracking it, we can find ourselves in those appointments and then we're like, uhh, when was the last time I had a period?

Emily Brophy, MD (05:49):

Yeah, absolutely. And I really empower my patients and women to really know that information about their health and bring it to their health care clinician, for sure.

Amanda Newman (05:58):

That's great. With hormone testing on the rise, a common question is whether you should get a DUTCH test or a dried urine test for comprehensive hormones. What exactly is this test and how does it relate to PCOS?

Emily Brophy, MD (06:15):

Yeah. So the DUTCH test does give a detailed analysis of hormone levels and their breakdown products to give us kind of a deeper insight into the imbalance of those potential hormones. I reached out to a couple of LVHN colleagues, an endocrinologist, a family medicine doc, to see who's using these tests. Is anyone in our community using them? I, for one, am not using it because we don't have standard guidelines as an OB-GYN clinician to really have validated reference ranges to know what is normal or abnormal, and then what to do with that information. And the colleagues I spoke to as well are also not using it. However, there's some great functional medicine and integrative medicine clinicians in the community that are certainly resources if needed.

Amanda Newman (07:04):

So if you are interested in doing a DUTCH test, just to see, it's a different kind of test. And since there is this wave of hormone testing, taking our health into our own hands, perhaps pursue taking this up with a discussion with a functional medicine clinician.

Emily Brophy, MD (07:19):

I think that sounds like a great idea. Yeah.

Amanda Newman (07:21):

OK. Now, if you have already been diagnosed with PCOS, what treatment options are there and how do you develop a plan that aligns with a woman's goals?

Emily Brophy, MD (07:31):

Well, thanks so much for bringing that up because that's such an important question to us OB-GYN clinicians. And we think about women with PCOS, we think about a couple different things. Number one, are you trying to get pregnant? Are you trying not to get pregnant? And so that's kind of our first thing. Then we think about protecting the endometrium. So, uterus again. When we think about the protection of the endometrium, a lot of women who have PCOS have excess estrogen in some of their fat cells. And that can actually stimulate the uterus to cause this lining of the uterus to be abnormally thickened. And if you're not cycling every month, you're not shedding those cells. So we think about protecting the uterus in order for us not to develop that fourfold increase of endometrial cancer we see with women with PCOS. So certain things might be birth control pills or an IUD or progesterone IUD, which acts as like a blocking agent to that estrogen for the uterus to help support your uterine health. We also think about comorbidities associated with PCOS. And I think it's really important for women to know that cardiovascular disease, diabetes, impaired glucose tolerance, hypertension, hyperlipidemia or high cholesterol and even sleep apnea can be a part of the picture of PCOS.

Amanda Newman (08:53):

How important is it for a woman who may have been diagnosed with PCOS to share that with other doctors she may see?

Emily Brophy, MD (09:00):

So incredibly important. Because of all those comorbidities associated with PCOS, it really is such a nice opportunity to have comprehensive health care across the spectrum of a woman's life. Because PCOS isn't only going to affect you when you're trying to get pregnant. It can follow you into your midlife and even your menopausal transition. So I really encourage women to share that information. I'm also really excited to share that there is a new Women's Health Center at Tower Place. Which is going to be such a nice opportunity for OB-GYN clinicians, as well as dermatologists, family medicine physicians and even some counselors, to get together to really help women with their diagnosis of PCOS, as well as other conditions.

Amanda Newman (09:46):

That's very exciting. And when is that coming?

Emily Brophy, MD (09:49):

July of '25.

Amanda Newman (09:50)

Wow. That's awesome.

Emily Brophy, MD (09:52):

I can't wait. It's going to be a really great step forward for women's health care in the Lehigh Valley. I'm just so excited to share this opportunity for awesome GYN health.

Amanda Newman (10:03):

And it's another way that women can really feel empowered to take charge of their health.

Emily Brophy, MD (10:08):

Absolutely.

Amanda Newman (10:08):

Now, we touched on some of the medications that can help with managing PCOS. But could we also talk about what lifestyle changes may help manage your PCOS symptoms?

Emily Brophy, MD (10:21):

That's a really great question because people may or may not know that up to 2 to 5 percent of weight loss can actually improve your menstrual period and even help you ovulate better with PCOS. So lifestyle modifications are a huge part of management of PCOS symptoms, as well as trying to conceive. And so I'm a really big believer in the Mediterranean diet. It's very low inflammatory, high fiber, whole grains, which are really essential to the process of PCOS.

Amanda Newman (10:51):

Mediterranean diet. OK, that's good to know. I will have to give that a try. I've heard of the Mediterranean diet.

Emily Brophy, MD (10:57):

I really love it. I think it's awesome.

Amanda Newman (10:58):

All right, ladies, listen up. Give it a try. And that's a perfect segue into our next question. We know that food is a form of medicine. So what diet changes may help women who have PCOS?

Emily Brophy, MD (11:13):

Yeah, so the Mediterranean diet with those balanced macronutrients, low-glycemic foods, fiber-rich foods, anti-inflammatory, lots of protein, are really essential to balancing the symptoms you have with PCOS. Limiting the processed foods that are in our diet, also very important. It's hard to do though. We're not perfect. OK? So you got to give yourself grace. I think women really need to listen to their bodies and try to do the best they can. We have support for that, and so happy to have it come full spectrum and really incorporate those elements into your health care.

Amanda Newman (11:50):

Because we still want to have fun. Go to restaurants occasionally.

Emily Brophy, MD (11:53):

Of course.

Amanda Newman (11:54):

And staying hydrated is also important. So we've talked a lot about food, but how essential is it for women with PCOS to stay hydrated?

Emily Brophy, MD (12:04):

Yeah, so one of the symptoms I hear a lot about from my patients with PCOS is feeling bloated and kind of having fluid retention. And I think for a lot of women, it doesn't make sense. I have to drink more water, I'm going to feel more bloated.

Amanda Newman (12:16):

Yeah, that's what you think.

Emily Brophy, MD (12:17):

You think, right? But that's actually not the key. So it actually can be linked to dehydration if you're feeling bloated, because your body's trying to pull all that extra water. So by staying really nice and hydrated, it really helps you feel less bloated, decreases your heart rate and your blood pressure too.

Amanda Newman (12:34):

So those giant 40-ounce cups of water…

Emily Brophy, MD (12:37):

Let’s go. Cheers!

Amanda Newman (12:37):

So there are several supplements on the market for hormonal support. Could you talk about some of the most popular ones for PCOS management? I think, as women, it can become overwhelming. Like, try this option, try that. What do you do?

Emily Brophy, MD (12:55):

It is so overwhelming. So the first thing I'll share is that I actually did a degree, a master's program at Georgetown, in complementary and alternative medicine. So while I have some experience with integrative medicine, I think not all clinicians do. So while you want to tell your clinicians what supplements you're taking, for sure not all of them will have the knowledge, and that's OK. Find ones that do. I think before we kind of get into the specific supplements for PCOS, I'd love to talk a little bit about the resources that are out there. So the National Center for Complementary and Integrative Medicine, complementary alternative medicine, is a site where you can actually look up every supplement, and it gives you information regarding the research surrounding those supplements. So I really do believe if you're going to integrate supplements and herbs into your regimen, that you should have some data supporting them.

(13:45):

It's also important to note that many nutrients and supplements that you may think you need to take are actually already in your diet. And so be careful about how much you're taking to make sure you're not overdoing it with some things. And so as we think about that, the other thing to consider is the source of where you're getting your supplements. Because, as people may or may not know, supplements are not regulated, like pharmaceutical prescription drugs are in this country. They're not tested and scrutinized as much. So with that being said, let's jump in. So I think B vitamins are super-important for anti-inflammatory. Fish oils are also really great. Keeping them in the freezer kind of takes that fishy taste away. So I tend to tell women that it helps to have the taste be better. Certainly vitamin D3 both improves ovulation induction as well as improves your metabolic profile. And taking about 1,000 of D3 daily can be helpful with that. So those are some of the ones I generally recommend. Specifically, too, with eating, I also know that my women with PCOS do pretty good if they do one to two teaspoons of vinegar before they have a meal. It actually decreases the glycemic load of the meal.

Amanda Newman (14:57):

OK, good to know. So as we're continuing to talk about these different supplements, one of them is evening primrose oil. Is that beneficial? What are your thoughts on that?

Emily Brophy, MD (15:08):

Yeah, I mean, so there's some data to suggest that maybe the fatty acids can support with PMS symptoms and maybe some assistance with high cholesterol and maybe improve your hormone levels. There's not super-great data for it though. But up to 500 a day hasn't been found to be harmful. So that is something you can do to support your body.

Amanda Newman (15:28):

So can taking inositol help women who have PCOS?

Emily Brophy, MD (15:32):

The bottom line with this is we thought it had a lot of promise for PCOS, and the reality is the data does not support it, unfortunately. There's some really good data out there that shows that it doesn't change your hormone levels. And so it's not one that I'm suggesting right now.

Amanda Newman (15:47):

What about magnesium?

Emily Brophy, MD (15:49):

So I love magnesium supplementation. So women with magnesium deficiency are actually about 19 times more likely to potentially have PCOS. And magnesium does play an important role in glucose and insulin regulation and to help glucose enter cells. And there are also some really awesome added benefits of magnesium. It can help with sleep, helps a little bit with anxiety. And also if you have constipation issues, it can also help with the ease of constipation. So I love magnesium. I love people taking it at night, up to 500 to a thousand milligrams. It may make your stools loose, so just be careful, slowly uptight, trade it. But yeah, I love it.

Amanda Newman (16:29):

Hey, and if you're going to the bathroom well, that helps everything else.

Emily Brophy, MD (16:31):

All the things, correct. We don't talk about poop enough as women, but it's so important.

Amanda Newman (16:40):

But we're going to talk about it today.

Emily Brophy, MD (16:41):

Let's go.

Amanda Newman (16:43):

Yeah. Because when you're constipated, you're grumpy.

Emily Brophy, MD (16:46):

You are. Yep. And when you think about women with PCOS who also feel bloated, right? Constipation is added on to that. So I really think we need to be talking more about digestive issues and pre- and probiotics to assist with that as well as magnesium to really help patients, and young girls and women all ages, to really feel better about their health.

Amanda Newman (17:08):

Yeah, I agree. I take a probiotic every day and I notice a difference if I'm not taking it or I'm getting a little lax on taking my vitamins. Makes a difference in how I feel and how things are going in the bathroom.

Emily Brophy, MD (17:21):

Yep. Absolutely.

Amanda Newman (17:24):

So research suggests herbs may be beneficial for managing symptoms of PCOS, naturally. Some of those herbs are vitex or chasteberry, licorice and turmeric. Can they help?

Emily Brophy, MD (17:37):

Yeah. So in preparing for this, I was kind of getting up to date for some of the most recent literature, and there was actually a review article from 2014 which looked at some of these natural herbs for PCOS support. And chasteberry is the one that kind of stands out. So 500 milligrams of the crude herb daily can be supportive for women of PCOS. Also found some interesting literature on black cohosh to kind of help with support as well. But again, these are all things that you should do some research on, talking with your integrative clinician to make sure they're working with the other medicines that you're taking.

Amanda Newman (18:12):

So first step, do your own research, and then work hand in hand with your clinician to determine if maybe this is a good option for whatever your condition may be.

Emily Brophy, MD (18:20):

Yeah, absolutely.

Amanda Newman (18:21):

Now, what is the link between chronic inflammation and PCOS?

Emily Brophy, MD (18:27):

Yeah, so more research to come, but there was actually an interesting review in 2021 of 10,000 participants with PCOS. And they actually found that there are elevated inflammatory markers in their bloodstream with the diagnosis of PCOS. So I think there's certainly a link with inflammation that we are just now beginning to discover and will continue to work on.

Amanda Newman (18:50):

That's fascinating. So what do you recommend for addressing inflammation in the body?

Emily Brophy, MD (18:56):

Yeah, so certainly an anti-inflammatory diet, which is really that Mediterranean diet, again. I'm a strong believer and supporter of exercise, stress management, meditation if you can, as well as medication and supplements if needed.

Amanda Newman (19:11):

Another management technique for PCOS is exercise. The right movement can boost your metabolism, help with weight loss and may even regulate your cycle. What kinds of exercise are most helpful for women who have this condition?

Emily Brophy, MD (19:26):

So I think any exercise is good exercise. I think the hardest part for women is getting motivated to do that exercise, right? So finding ways to be motivated, whether it's finding a friend to be a commitment to go to to the gym. Or doing something fun instead of 30 minutes of running; maybe do six stations and you rotate what you're doing. Squats at one, weights at the other, pushups at the other to kind of keep it fresh. So I think any amount of exercise is good, but I'd love to see women with PCOS do 30 minutes a day.

Amanda Newman (19:58):

OK. All right. Well, I did my 30 minutes this morning. So my husband got me a walking pad that I have really gotten into using, and I'm trying to build it as my new habit in the morning to do 30 minutes. That's it. That's my exercise right now, because that just works for this phase of life, and it's so satisfying when I do that. And I notice such a difference in how I feel when I take that time and do that.

Emily Brophy, MD (20:22):

So thanks for sharing that, because I think when we can get motivated and feel that difference, it helps women feel better about the work they're doing. So that's awesome.

Amanda Newman (20:30):

Now, one of the pesky symptoms of PCOS is chin hairs or any unwanted hairs that pop up, which can make you feel self-conscious. Why does this happen and do you have any suggestions for addressing it?

Emily Brophy, MD (20:44):

Yeah, it can be very frustrating for women with PCOS. So this is one of the signs of PCOS, having that hyperandrogen state. As we think back to those three diagnostic criteria, as you might've remembered, I didn't say anything about lab work. So it's not necessarily any lab value that's giving you that diagnosis. But that hirsutism comes from those high androgens in your system, which actually have you grow male pattern hair growth. So many women, it's the upper lip, the chin, midsection of the belly. These are common places. So up to 70 percent of women with PCOS will have hirsutism, but not all women with hirsutism have PCOS. So it's really important to talk to your clinician. We have medications that can help. Being on something like a birth control pill, if that works for you after a discussion with a clinician, can help support decreasing those androgens in your system and therefore decreasing that unwanted hair growth. And there's other medications, too, that can kind of block testosterone and decrease hair growth.

Amanda Newman (21:45):

Well, it's good to know that there's some medications out there that can work and help this issue. Because it is something that many women have to deal with, and it's annoying.

Emily Brophy, MD (21:55):

Yes, for sure.

Amanda Newman (21:57):

It's like one other thing. I'm like, oh, great. Do I have a hair on my face?

Emily Brophy, MD (21:59):

Yes. And it can also get really expensive. For some women, they're doing laser treatment or waxing, and there's no insurance coverage for that. So it can be frustrating.

Amanda Newman (22:11):

I read something online about spearmint tea has the potential to lower those androgen levels. What is your take on this?

Emily Brophy, MD (22:19):

It's hard to know. I don't think there'll ever be a study from the spearmint tea industry for women about PCOS. But there is some literature in phytotherapy studies that shows that potentially drinking two cups of spearmint tea a day consistently can decrease androgen levels.

Amanda Newman (22:38):

Well, maybe I'll have to swap my matcha for some spearmint tea instead.

Emily Brophy, MD (22:42):

There you go.

Amanda Newman (22:43):

How does PCOS impact ovulation and fertility?

Emily Brophy, MD (22:48):

So this can be a big problem for women who are trying to get pregnant. I often tell my patients, we go our early part of our lives, after we get our period, not wanting to be pregnant. And then as soon as we want to be pregnant, we want it right away. And so women who have PCOS have trouble because they're not ovulating as efficiently and effectively. So, not to go back to my uterus, but with a normal ovary, you ovulate an egg every 28-day cycle that travels through the fallopian tube, lands in your uterus, meets a sperm, forms a baby. With a PCOS ovary, the follicles don't have any idea how they're supposed to ovulate. They're not ovulating well. And so it can be challenging because women don't know whether or not they're ovulating, when they're ovulating, how good they're ovulating, and if that's going to achieve a pregnancy. So I always encourage women to really talk to their health care clinician to see whether or not they're a candidate for medications to help them ovulate better.

Amanda Newman (23:45):

As you alluded to there, tracking ovulation can be tricky, especially if you have PCOS. So what tips do you have for women who may be trying to become pregnant?

Emily Brophy, MD (23:55):

Yeah, for sure. So it can be challenging for any woman. I often tell people, too, only 25 percent of couples who are trying to get pregnant every month will actually conceive. So that level is a lot lower than we think it is. Women with PCOS, it's even harder because you don't know when you're ovulating all the time to be able to get the best, most optimal intercourse to achieve pregnancy. So what I recommend are LH urine strips. You can get a bunch of them on any kind of website where they sell a lot of them. And what that does is that gives you the opportunity to know whether or not you have what's called an LH spike, which reveals that you will ovulate within 24 to 36 hours. Now women with PCOS might be saying, well, how do I know when to pee on these sticks? I don't know if I'm ovulating. So it's really hard to know. So what I do recommend is that you test your urine daily, 10 to 14 days after your last period. And so that leads you up to the window that you might be ovulating.

Amanda Newman (24:56):

OK. So 10 to 14 days after your last period, test daily.

Emily Brophy, MD (25:00):

Correct.

Amanda Newman (25:01):

OK.

Emily Brophy, MD (25:01):

And if you're not ovulating, you really need to get into an OB-GYN clinician to talk to them because can help you. You shouldn't have to suffer with that alone.

Amanda Newman (25:09):

Right, because we want women to know they're not alone in this. And there are many people out there that are struggling with the same thing.

Emily Brophy, MD (25:14):

Absolutely.

Amanda Newman (25:16):

As we've covered so far, PCOS can have a significant impact on many areas of your health. Research shows that more than 50 percent of women with PCOS have a mental health disorder. Which conditions are the most common, and what do you recommend for support?

Emily Brophy, MD (25:34):

Yeah, I think this brings up such an important point that I'm really glad we're talking about, because women with PCOS struggle with a lot. So we touched on the hirsutism concern, the abnormal hair growth. And that can not only be overwhelming to deal with, but also a confidence ...

Amanda Newman (25:49):

Confidence crusher.

Emily Brophy, MD (25:52):

Confidence crusher, indeed! And so I think that's very challenging for women. I think the obesity and the weight loss, that's really the weight gain, rather, that's challenging with PCOS can also be a confidence crusher. And I think also as you delve into trying to get pregnant with PCOS, it creates a lot of stress for women who aren't ovulating effectively to really achieve that pregnancy. So, of course things like meditation and exercise and working with your clinician are really important. But I don't want to undermine the benefits of medical therapy for depression as well, in addition to counseling and therapy as needed.

Amanda Newman (26:34):

You've covered a lot of different ways that we can treat PCOS and the many different conditions that can come along with it, whether that be physical issues, mental health concerns. But are there any alternative treatments that may help with managing PCOS? So acupuncture and acupressure are two techniques that some women with PCOS are trying.

Emily Brophy, MD (26:56):

Yeah, for sure. So I think that acupuncture and acupressure, we don't fully understand how they work yet, but they've been around for hundreds of years. And women and men have been using these techniques to supplement their health care and sometimes treat a health condition without any other conventional medicine. There's actually an article in a Journal of Endocrinology looking at specific receptors on cells for sugar uptake using acupuncture. And there is data to suggest that the use of acupuncture may help those cells actively uptake that glucose and make your insulin work better. So I cautiously recommend it because we're never going to have a really awesome study to tell that it works or to show that it works. And I also don't want women spending thousands of dollars on something if they're not getting benefit. So I'd encourage them to really do their research to find an acupuncturist who specializes in PCOS and could really talk them through this part of the process.

Amanda Newman (28:00):

Well, that's good to know that there are alternative therapies out there if it's something that you want to give a try.

Emily Brophy, MD (28:04):

Absolutely.

Amanda Newman (28:04):

What would you recommend to women who may have had their symptoms dismissed in the past?

Emily Brophy, MD (28:11):

Well, first of all, my apologies go out to all those women, because I feel for you if you have had your symptoms dismissed time and time again. And I also just want to reiterate how we diagnose PCOS. It doesn't have to be a lab test, right? We can have those irregular, prolonged menstrual cycles. So greater than 35 days between a period. We can have signs of hyperandrogenism, meaning really bad cystic acne or abnormal male pattern hair growth. And then signs of polycystic ovaries on ultrasound. So I really encourage you to continue to work with your clinicians and even seek a different one if you're not finding the answers that you really need to have for your health. And I also just want to reiterate this awesome opportunity for Women's Health Center at Tower Place to really give comprehensive care to women in the Lehigh Valley. I mean, we're bringing around specialists together – gynecologists, internal medicine physicians, dermatologists – to kind of work together to really heighten the experience women have with their health care.

Amanda Newman (29:14):

That's wonderful because that's going to give women access to every kind of physician that they need.

Emily Brophy, MD (29:20):

It's going to be absolutely remarkable. And I'm so proud of Lehigh Valley Health Network, in association with Jefferson Health, to really build this opportunity for women in the Lehigh Valley. How great is it going to be as a 45-year-old, maybe you have PCOS, to go in and have your mammogram done? Also, get your annual GYN care. Maybe you have some genetic risks that you need to talk to a genetic counselor about, and also talk to our weight-management specialist. It's going to be an awesome opportunity.

Amanda Newman (29:47):

Wow, that's amazing. So to wrap up today's episode, what's the most important thing you'd like women with PCOS to know?

Emily Brophy, MD (29:57):

Yeah. Listen to your body. And I think knowing that the process is long and hard, both for weight loss and achieving pregnancy sometimes, is important to know. But it's worth the struggle, right? And to make yourself healthier, to decrease those comorbidities, to achieve pregnancy. And to really have that shared decision-making with your clinician to talk about all elements of your health care, including supplements and integrative medicine that are important to you.

Amanda Newman (30:26):

Well, Dr. Brophy, this has been such a fantastic episode. Thank you so much for being here today and sharing so much great information with our listeners.

Emily Brophy, MD (30:34):

Thank you so much for having me. It's been a joy.

Amanda Newman (30:38):

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