PCOS in a Nutshell: What You Need to Know in 10 Minutes

• OT Pioneers: Intro to Pelvic Floor Therapy  opens Jan 13-17, 2025
• Introducing the Functional Pelvic Practitioner Levels and Certification - for OTPs Craving a Structured and Recognized Path to Specialize in Pelvic Health

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Transcript

Lindsey Vestal Today we're doing one of my favorite things, taking a brief dive, and I am promising to keep it to ten minutes or less into a diagnoses that so many of our pelvic health clients deal with. And it's one of those lesser known conditions that I think can have a really profound impact on people's lives. And if you're in the field, you've likely heard of it. I am talking about PCOS or Polycystic Ovary syndrome. Now I know what you're thinking, right? I've heard of PCOS, but do I really know the ins and outs of it? So by the end of today's episode, you're going to have a much clearer understanding of this condition, how it affects your clients on so many levels physically, metabolically and mentally. We're going to go over the symptoms, the diagnostic criteria and even touch on what we can do as pelvic health therapist to make a real difference. All right. Grab your coffee or tea and let's get started. 

Lindsey Vestal So what exactly is PCOS? It's a complex syndrome that affects so many aspects of a person's life their reproductive health, their metabolic functioning, and even their mental health. It influences so much, but often in ways that aren't immediately obvious. And this is where we come in because we spend so much time with our clients and we're often able to connect those dots in that beautiful, holistic way that as occupational therapist we are so well versed in doing. I think we need to first start with how it's diagnosed. Right. So how is PCOS diagnosed? When our client comes to us with this basically right there, there referring physician used something called the Rotterdam criteria. Don't worry. I'm not going to quiz you on this later. Right. But a person needs to have two out of three key characteristics. Polycystic ovaries, hyperandrogenism, which is essentially elevated male hormones and menstrual cycle disruptions. But here's the thing, right? PCOS does present differently for everyone. So what I mean by that super quick example, some people may have regular menstrual cycles, but higher levels of testosterone, while others might struggle with irregular or even absent periods and not have elevated testosterone at all. Right. This variability makes it tricky to diagnose. But once we know what we're dealing with, we can start addressing the symptoms and challenges head on. One of the things I always emphasize when talking about PCOS is how it's not just a reproductive issue. It's a whole body condition. So I want to start with the metabolic aspect. Many of our clients with PCOS also have something called insulin resistance. Now, insulin for those of us who need a quick refresher is like a key that helps glucose get into our cells for energy. When someone has insulin resistance, it's like that key doesn't quite fit in the lock, so the glucose doesn't get in as easily and they end up with higher blood sugar levels. And this is exactly why people with PCOS often have an increased of risk of developing type two diabetes, cardiovascular disease and even strokes. It's kind of like if you leave a small leak in your sink untreated, right? It could lead to bigger plumbing issues down the line. And while we don't have all the answers about why PCOS develops, we do know that addressing insulin resistance early on can prevent some of these more serious complications. Okay. One of the key things to remember is that insulin resistance can exacerbate other symptoms of PCOS, especially those related to elevated testosterone. So things like facial hair growth or male pattern baldness. The connection here is important because if we can help our clients improve their insulin sensitivity, we might be able to help them reduce some of the other symptoms. Now, a question I get all the time from my students in O.T. Pioneers, where we do go over the top 12 most common pelvic floor diagnoses is, is there a specific diet for PCOS? And the answer is not really. There's no one size fits all diet here. But what we do know is that certain dietary strategies can help improve insulin sensitivity, right? So, for example, some research shows that a low glycemic index may be beneficial. And there's also evidence that reducing carbohydrates for certain parts of the day, something called carbohydrate bunching, can actually help regulate insulin levels. But again, it is all about what works for the individual client. And since we're talking about practical tips, let's touch on exercise resistance training, high intensity interval training. And improving metabolic flexibility can be helpful for clients with PCOS. All right. Picture it like this. Your body is your body is a hybrid car that can run both on gas. Think about that as glucose and electricity. Think about that as fat. And if your client's body isn't switching gears properly between these two fuel sources, helping them improve their metabolic flexibility is so key. So think about it like this. If you're taking a leisurely walk around the block, you're mostly burning fat for fuel. But when your ten year old decides to start sprinting and you suddenly have to keep up, that's when your body switches to glucose for energy. People with PCOS often struggle with this fuel switching process, which is one of the reasons why weight loss and energy management is more challenging. And then there's the mental health component of PCOS. It's common for clients to experience anxiety, depression and a reduced quality of life. So our work as Pelvic health therapist extends beyond the physical and the thank goodness for that, right? We love the bio psychosocial approach where we take into account the physical, the bio, but also the social and psycho psychological components, right? And so this is where developing coping strategies and nervous system regulation techniques like mindfulness, stress management and even better, sleep hygiene. Speaking of sleep hygiene, sleep is a biggie. Lack of sleep can throw off hunger hormones, making people feel hungrier. Right? And then eat overeating, which absolutely just further complicates PCOS. I like to remind my clients that it's not just about managing symptoms. It's about reclaiming a sense of control in their lives. And sometimes that is the most empowering thing we can offer. Okay, so today we covered the complexities of PCOS. Two Practical Tips to Help Management. I hope you found today's episode helpful. And remember our role in helping clients manage conditions like PCOS goes far beyond symptom relief. It's about supporting their whole person health physically and emotionally. 

Outro Thanks for listening to another episode of OTs and Pelvic health. If you haven't already, hop on to Facebook and join my group OTs for Pelvic health where we have thousands of OTs at all stages of their Pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and posted to IG Facebook or wherever you post your stuff and be sure to tag me and let me know why you like this episode. This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic health podcast.