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Hello. Hello. Welcome to another episode of four vaginas on Lee. This is Episode 13 and on today's episode, we're gonna talk about polycystic ovarian syndrome, also known as P C O s. Hello and welcome to four vaginas. Only the podcast about everything. Female. I'm your host, Dr Celestine, bringing you important information about understanding your health and body in the way you wish your doctor would actually explain it. All right. Hey, guys. Dr. Celestine here, your host of four vaginas only every two weeks. Welcome back to another episode. Like I stated in the intro earlier this episode is gonna be about PCOS or polycystic ovarian syndrome. So let's just jump right into it, Okay? So PCOS polycystic ovarian syndrome. What is it exactly? I guess I'll back up a little bit and talk to you guys about how it usually presents to my office. Either someone comes in complaining that they're having difficulty getting pregnant for an extended period of time or they come in complaining of irregular periods. I would say most commonly I see the lack of a period like maybe having one every three months every six months. But that's not the only way that it can present in terms of the irregular periods. They can also have heavy, heavy periods that last four days and weeks, which is really unfortunate and also like I talked about the Amen area, which means that you're lacking a period. I've seen somebody lack or not have a period at all for six months at a time, or even up to a full year Maur. So when someone comes in to my office complaining of these things, the first thing I do is kind of take a look at them because there's some signs of PCOS that are just apparent by looking at someone for one. Most patients with PCOS are obese now. That's not to say that if you're presenting with irregular periods or infertility issues that you also have to be obese and have PCOS because 20% of the population that have this condition are not obese. I've actually seen some very, very skinny girls and women that do have PCOS. In addition, you can also have excess hair, Um, except here on the phase, kind of like growing a beard or a moustache and waxing it a lot. So a lot of times when people come to my office, I asked him if they wax or shave because I won't actually see the hair. But if they have to do that very frequently, that gives me a little bit of an indication. Also, the hair grows in, I guess, an abnormal place for women on the chest, on the abdomen, things like that. Also, you can have a very severe acne like that. Deep, cystic acne that's not really responding well to other treatments can also be a sign of PCOS infertility like we talked about, which is kind of also related to the fact that you're not really having a regular period. And also I take a look at the back of the neck. I don't know if you guys have ever seen this like a dark kind of leathery, sometimes even a little shiny band that goes across the back of the neck. This is called a cantos. Isn Iger cans? I know big name. Basically, it means, or it's an indication that you have some sort of insulin resistance going on, so something similar to almost being a diabetic and that's an indication as well. So these are all the things that if you come in talking about certain symptoms, that I take a look at you and ask you about certain things that lead me to suspect that maybe we're dealing with polycystic ovarian syndrome. All right, Now what the hell causes this, right? I mean, I see so many people with it, and a lot of people ask me, you know, why do I have this? What's going on now? I'm gonna start out by saying that the underlying cause, the root of the issue is not really known. It's kind of a combination of things. One is the insulin resistance. So that kind of propensity or close to having diabetes or actually having diabetes also your hormones. You have very high what we call androgens, which there's different types of hormones similar to estrogen and progesterone and whatnot. And these particular hormones, called androgens, are usually elevated in women and girls that have PCOS. So what causes these things that happen? No one truly knows. But I have seen that it seems to be or have a genetic component. A lot of times, a young girl comes in with irregular periods and it turns out her mom also had irregular periods and problems conceiving and things like that. So I think there is a little bit of a genetic component to it as well. What the underlying gene is, what the underlying problem is. Like I said, I don't know which could be really frustrating, right? Because if we could find out what the underlying causes and we could save people a lot of heartache. But anyway, moving onto the part that I feel like is very important because a lot of women and girls come into my office either not knowing they have PCOS and then we have to talk about it or they come in knowing that they have PCOS and want to talk about mostly the infertility factor which, yes, very important. I agree. You know, if you want to start a family, you want to have babies. Being a little bit infertile or a lot infertile from PCOS is an issue. But there are also more dangerous issues that are also stated PCOs that I don't think many people really understand. So the first risk is the risk of having diabetes, right? So like I talked about, you kind of have a propensity towards having some insulin resistance having elevated glucose or elevated sugar levels, So you're also an increased risk of developing diabetes. I would say it's up to a 2 to 5 times the average population of an increased risk when you have PCOS. So that's significant because diabetes comes with his own full set of issues. The other risk of having pizza us is, Ah, heart disease, cardiovascular disease. One of the main things associated with that is having very elevated cholesterol levels and a lot of patients later on in life. They need to be placed on Staten Ends and things like that walk Watch out for heart blockages and stuff like that because of the high cholesterol that is related to the P. C. O. S. Another thing that's important with polycystic ovarian syndrome or something that we call Endo Mitri a ll hyperplasia. Now that's more back into my neck of the medicine woods, diabetes and heart disease. You know I deal with here and there, but endometrial hyperplasia is one of my bread and butter's. So what it is, is let's kind of paint the picture. You have PCOS, right? Let's say you're one of the women who are not getting their period regularly. So you have a period once every six months, once a year, or you haven't seen your period in years. That's a problem, because what your period is is the lining of the uterus that sheds, and that's where the blood comes from. Okay, now, if you are not shedding that lining of your uterus, it's sitting in there and building up and building up. All the cells are on top of each other. The lining is getting very, very thick, and that leads to disorganization of the lining. And any time you have any sort of thing that's building up uncontrollably without any regulating system, like having your period, that leads to an increased risk of cancer, Right? So you have this under mutual hyperplasia, hyper as in, like building up a lot of your lining if that's not controlled, and if you're not having your period regularly, that could eventually lead to cancer. So those are some big risks when it comes to PCOS. I know a lot of women want to talk about the baby part of it, Um, but there are also, you know, other things that you need to be aware of, and you need to have the proper follow up for as your aging and, you know, continuing to experience your life with this condition. So now that I have talked about all the grim stuff, let's talk about how we can treat it. The main thing, the easiest thing to do to treat PCOS is birth control pills, the combined birth control pills that have both estrogen and progesterone that you take every single day. And then you have a week off where you have your period. So it's all it's all a few issues. One is the hormones in that birth control pill actually decrease the hair growth that you have that you could possibly have on your abdomen, chest and face like we talked about. Also, it can decrease your acne. So improve that whole thing, which is great, especially for young girls with P. C. O. S. And I'm very sensitive to you know, the possible repercussions that can be with an acne ridden face two or three. If I could count, that would be a good three. It decreases your enemy trail cancer risk. So the birth control pills are forcing your body to have that period every month and shed that lining within the uterus, so you do not have that buildup of the lining. Therefore, you decrease and pretty much eliminate the enemy. Atrial cancer risk So mean those air great wins for birth control pills on four women and girls in a piece of us also, weight loss. So if you fall into the category of the person that is obese with PCOS, just simply attend to £15 weight loss can change everything that can regulate your periods. It could also improve your glucose levels and decrease that risk of transitioning to diabetes at least earlier on in life. And it can also improve your acne and decrease the amount of hair growth that you're experiencing. So all of those are great and those are the same. Responses are similar responses that you would get the with the birth control pill, but you're all doing it based on just weight loss alone, which I think is, you know, fabulous and something that you can control for yourself and take into your own hands to control this condition. The other thing I want to talk about with weight loss is the fact that when you're losing weight and you are now having regular periods which you didn't before, that also increases your chance of getting pregnant. Okay, so if you are not trying to get pregnant, but you are trying to decrease your symptoms, apiece us by losing weight. If your periods become regular again and you're actively going out there and losing the weight, you can get pregnant. So if you're not on birth control pills to protect or some sort of birth control to protect against pregnancy or you're not using condoms regularly and you do not want to have a baby at this particular time, you need to get on one of those birth control or condoms. Okay, Because I see a lot of women coming in and they're like, Oh, you know, all this time I haven't had any problems like I would do whatever I want sexually and, you know, not use any protection. I never got pregnant, but now I'm pregnant and I don't know. You know why all I've been doing trying to treat my PCOS well, that's why, okay, And last but not least, there are some medications that you normally would take if you had diabetes. Like, if you're If you have your grandma are Mom and they're taking medications like Met Foreman for diabetes. That's also used a little bit for PCOS as well, because it decreases those androgen hormones. It decreases your glucose levels. And it could also cause population, which means that you're gonna have a regular period again. And also, like I just mentioned, regular period equals increased fertility. So if you're on a medication like this, you could possibly get pregnant on it as well, simply because your periods are back and your ovaries are functioning properly again. Speaking of ovaries, the last thing that I kind of want to talk about is how your ovaries look with PCOS because I just realized I didn't talk about that in the beginning. So the whole name polycystic ovaries, right? Lots of cysts polycystic on your ovaries, ovary syndrome. So, basically, if you look at your ovaries on an ultrasound and your position might send you to get an ultrasound because it can be part of the criteria for diagnosing you on your ovaries, you will have many small cysts at least 12 or more assists on each ovary. And that's some of the indication or part of the diagnosis for a policy stick. Ovarian syndrome. Now I can't say that the ovaries themselves are the cause, but that is just one of the things that we see with the condition. So now you know why it's called polycystic ovarian syndrome. You know what some of the symptoms are? Nobody knows that the real causes. You know what the risks are and no mutual hyperplasia, cancer being a big one and some of the ways that your doctor might treat it. So I encourage all of you if you were having any of those symptoms you talked about in the beginning. Irregular periods, excessive hair, girls, severe and uncontrolled. Acme infertility, things like that. But you go and see a Europa July in and have a discussion with them on Dhe. Find out if maybe PCOS is what you have now. With that being said, there's a lot of other things that can cause thes symptoms, and it's not necessarily PCOS. But if you are having these symptoms and you haven't talked to any doctor about it yet, I would go in and at least start the conversation so you can figure out what's going on. All right, so that's my little spiel on polycystic ovarian syndrome. I hope you guys learn a little bit about it. And I hope you're encouraged to have well informed conversations with your doctor about things I might be going on with you. Thank you. So so much for staying with me and listening to another episode of four vaginas on Lee. I really, truly appreciate every single one of my listeners, every single person that follows me and interacts with me on social media. The four of Vaginas on Lee Instagram Page four vaginas only Facebook page. I truly love you guys and I hope that you know, I feel like we're building a relationship, even though I don't know each one of you individually. But I hope that you're also gaining a little knowledge from me as well and taking control of your health care and your body because that's what's truly important here. And that's the whole reason why I do this. So have a great day, guys, and I'll see you in the next episode.