Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects women of reproductive age, causing a range of symptoms and potential long-term health considerations. With a prevalence of up to 20% in some populations, PCOS is the most common endocrine disorder among women, making it a significant public health concern. However, many women seek effective ways to manage their symptoms and support their fertility potential.
In a recent podcast interview with Dr. Carrie Jones on "The Root Cause Medicine podcast," Dr. Felice Gersh, a renowned dual board-certified integrative gynecologist and a pioneer in the field of women's hormones, shared her extensive expertise and holistic approach to PCOS management. With a wealth of knowledge and a passion for empowering women, Dr. Gersh provided valuable insights and practical strategies for women seeking to navigate the challenges of PCOS.
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Understanding PCOS: A Comprehensive Approach
Dr. Gersh emphasizes the importance of a comprehensive workup to understand the root causes of PCOS and tailor management plans accordingly. "You can't really address a problem if you don't even understand and define the problem," she says. Her approach involves collecting extensive data through various laboratory tests, including hormone levels, thyroid function, lipid profiles, inflammation markers, autoimmune markers, gut health assessments, and nutritional status evaluations.
One crucial aspect Dr. Gersh highlights is the relationship between PCOS and insulin resistance. "If you have a high fasting insulin, that means you're chronically creating inflammation. You're chronically storing fat and making fat," she explains. While conventional medicine often focuses solely on blood sugar levels, Dr. Gersh stresses the importance of checking fasting insulin levels to detect early signs of insulin resistance, which is common in women with PCOS.
Recognizing the Multifaceted Nature of PCOS
PCOS is not just about irregular periods, excess androgens, or ovarian cysts; it is a complex condition with far-reaching implications. Dr. Gersh emphasizes that PCOS is associated with a higher risk for pregnancy complications, such as gestational hypertension, gestational diabetes, preeclampsia, preterm delivery, placental dysfunction, and macrosomia (excessively large babies). She strongly advises women with PCOS to optimize their health before conception to help manage these risks.
Furthermore, PCOS is associated with an increased risk of chronic conditions, including type 2 diabetes, cardiovascular issues, and metabolic concerns. Dr. Gersh likens PCOS to "accelerated aging" due to the chronic inflammation and metabolic challenges it may cause. She highlights the importance of addressing these underlying issues to support long-term health.
Addressing the Root Causes: A Holistic Approach
Dr. Gersh's approach to PCOS management is rooted in addressing the underlying causes through lifestyle modifications and targeted interventions. She emphasizes the significance of a nutrient-dense, plant-based diet rich in vegetables, fruits, beans, and fiber to nurture the gut microbiome and support essential nutrient intake.
"We want to nurture those microbes and you got to replete your body of the nutrients, the antioxidants," she says. "Even if you just ate the right foods and got a good probiotic, that's going to go a long way to really helping to support a good healthy gut."
Sleep is another crucial pillar in Dr. Gersh's approach. Women with PCOS have a higher incidence of sleep disorders, which can exacerbate hormonal imbalances and metabolic issues. She recommends establishing a consistent sleep routine, ensuring a dark and peaceful sleep environment, and considering melatonin supplementation if needed.
Physical activity and stress management are also essential to Dr. Gersh's holistic approach. She encourages women to exercise regularly, including resistance training, to build muscle mass and explore mind-body practices such as meditation, guided imagery, progressive relaxation, acupuncture, or cognitive-behavioral therapy to help manage stress effectively.
A Game-Changer: Timed Eating for PCOS Management
One of the most intriguing strategies Dr. Gersh shares is the concept of timed eating, based on a study conducted in Israel. The study found that women with PCOS who ate two-thirds of their daily caloric intake in the morning and one-third as a late lunch without snacking experienced notable changes in just one month.
"In one month, their testosterone levels fell by just over 50%. And also their 17-hydroxy progesterone went down by 40%, which means that they had less inflammation and their cortisol was going down too," Dr. Gersh explains. "They didn't measure directly cortisol, but that means when cortisol and DHS are linked together, if that went down, everything got better, let's put it that way. And their cycles came. In just one month, they got a spontaneous period."
This timed eating approach, combined with a plant-based diet and exercise, has the potential to support improvements in PCOS symptoms, hormonal balance, and overall metabolic health.
Enhancing Fertility: A Comprehensive Approach
For women with PCOS seeking to conceive, Dr. Gersh emphasizes the importance of a comprehensive fertility-focused program. Her book, "PCOS SOS Fertility Fast Track," provides a detailed 12-week plan to support fertility potential and promote a healthy pregnancy.
"It's a 12-week, week-by-week detailed program," she explains. "They're two really essential reads, I think, for all women with PCOS."
Dr. Gersh's fertility-focused approach encompasses addressing underlying hormonal imbalances, optimizing nutrient status, reducing inflammation, and promoting healthy ovulation through lifestyle modifications and targeted interventions.
Empowering Women: Knowledge is Power
Throughout the interview, Dr. Gersh's passion for educating and empowering women with PCOS shines through. She encourages women to take an active role in their health journey, emphasizing that lifestyle changes and self-care practices can profoundly impact their well-being and fertility potential.
"Don't listen to those naysayers. You have the power to do these things, to control your own destiny," she says, encouraging women to embrace the transformative potential of lifestyle medicine.
In addition to her books and clinical practice, Dr. Gersh hosted the "PCOS SOS Summit" on November 28th, 2023, featuring over 40 experts worldwide. The summit aims to provide a comprehensive educational resource for women with PCOS, covering a wide range of topics related to symptom management, fertility, and overall well-being.
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Conclusion
PCOS is a complex condition that requires a multifaceted and holistic approach to manage symptoms and support fertility potential. With Dr. Gersh's expert guidance, women with PCOS can explore ways to manage this condition and support their health, vitality, and fertility potential. With knowledge, self-care, and a commitment to lifestyle changes, women can take control of their destinies and live their lives to the fullest, free from the constraints of PCOS.
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