Pursuit of Wellness - POWerful Moment: 002 - What is PCOS & How it Impacts Fertility? Dr. Shahin Ghadir

Episode Date: October 9, 2024

In this POWerful Moment from Episode #46, Dr. Shahin Ghadira, double board certified obstetrician and gynecologist, breaks down PCOS, hormonal imbalances and ovarian cysts. Dr. Ghadira shares his extensive experience and highlights the spectrum of symptoms women may face, along with practical advice for managing the condition.  Listen or watch the full podcast here:  On Apple click here!  On Spotify click here!  On Youtube click here!

Thank you guys for joining me for another powerful moment from one of my favorite episodes. This is a highlight clip to enhance your week. I hope you enjoy. I want to ask about PCOS. I had so many questions. How much does PCOS affect fertility? So I was very fortunate. The chairman of obstetrics and gynecology when I was a fellow at the Cedars-Sinai medical program was Dr. Ricardo Aziz. He is one of like the grandfathers of polycystic ovary syndrome, who dedicated his life to research and doing lots of areas of research. So during my three years of fellowship, I learned a lot. I did my own thesis in the area of polycystic ovary syndrome, and I've

had hundreds, if not maybe thousands of patients that have consulted with me about it. It's a stubborn, stubborn disorder. The way I like to describe it, that it's really a spectrum. There's this extreme of PCOS and this extreme. For people that don't really know what PCOS is, it's polycystic ovary syndrome. One of the characteristics of it is that your ovary, when you do an ultrasound, it has little bubbles all over. Those are called follicles. In the polycystic ovary patient, we just look at them as lots of poly, you know, ovarian cysts. Generally, they are at the periphery of the ovary. They sometimes have been called a string of pearls. A healthy young woman with lots of

follicles all over the ovary is a little different than that polycystic patient that has a lot of ovary in the center and a lot of cysts all around the edge of the ovary. So that's one characteristic. Other characteristics are if your blood work shows that you have elevated male hormones like testosterone, like DHEAS, those are male hormones if they're elevated. Or your blood work doesn't even have to show it, but if you have symptoms of it, like if you have hair growth on your chin, the upper lip does not count because in many different cultures and nationalities, it's normal for women to have hairier upper lips, so that's not part of it.

But the chin, for most women, is not part of the normal growth of hair. And on the body, it's not as well. And also male pattern baldness. And if you're losing hair kind of in the male pattern areas, those are all signs that you have excess levels of male hormones. So the ovary thing is one thing, and then the male hormonal abnormality is another, whether it's in your blood or you can just see the symptom. And then the third characteristic is also just having abnormal ovulation and abnormal periods. So if you have two of those three things I described, by definition, you're diagnosed with polycystic ovary syndrome. Now, here in LA, you know, the typical woman that I would see from a mile away and I could tell

has thinning hair, acne, abnormal hair growth, is generally overweight, some darkening of the skin around the neck, maybe under the arms, under the breasts, anywhere where the skin touches the skin and it looks kind of dark. It's not dirt. It's just that their insulin isn't working well and that's one of the first signals of someone having abnormal insulin sensitivity in their body. Polycystic ovary syndrome, the root of it is from insulin receptors not working well. And the insulin receptor and the testosterone receptor are very similar so there begins

to be an overlap. And that's where we get all of this problem. So I see a lot of patients that you could never tell. That woman that I just described to you who gets irregular periods, overweight, hair loss, acne, you know, all of the things I just described and on ultrasound has lots of little follicles. And you can see this woman. Everyone's seen someone that looks like that and has polycystic ovary syndrome. And then there's a woman who is absolutely the normal

weight, no acne, no abnormal hair growth, or has done something about it so you can't tell, and also has it. So it's a big spectrum. Some people respond very easily by giving them some medications like a Clomid or a Letrozole, which help you ovulate. You ovulate, you're pregnant, and you're good. And some women, no matter what you do, have a very, very, very hard time with fertility and ovulation. Thanks for listening to this powerful moment. If you want to hear the full episode, click the link in the show notes. Love you guys. Bye.