Wow, it’s been so long since I checked in on this blog. The past year and a half has been so transformative for my business. I closed my brick and mortar practice indefinitely and transitioned my services online. I stopped providing 1:1 coaching and now work with clients in group settings. And most importantly… I started specializing in PCOS. I’ve actually counseled patients with PCOS for years prior but it was a big step for me to say that these were the *only* clients I worked with. Hence the new name of my website!
I’ve really enjoyed getting more involved in PCOS advocacy work and one amazing organization I’ve been privileged to get involved with is PCOS Challenge. They held their amazing PCOS Awareness Symposium over the weekend and I’m here today to provide a recap!
About the PCOS Awareness Symposium
Here is how the PCOS Challenge describes their symposium on their website:
“The PCOS Awareness Symposium features world-leading experts on polycystic ovary syndrome and brings together clinicians, researchers, women with PCOS and their supporters for a day of sharing experiences, insights and the latest updates about the condition.”
Why the PCOS Awareness Symposium is Important
I think it’s not secret that there’s very little awareness and education when it comes to PCOS. Actually, women’s health in general doesn’t really feel like a research / education / awareness priority unless it has to do with reproduction.
The PCOS Awareness Symposium is a great place to hear all about what’s going on with PCOS – they do a great job on providing a comprehensive experience that touches on everything from the latest PCOS Research, best clinical practices, patient experiences and how advocacy is moving the needle forward in PCOS care.
My Presentation on Body Positivity and PCOS
I was asked to present a virtual session this year on taking a Body Positive Approach to PCOS. On the one hand, as someone who has always lived life in a straight-sized body, I sometimes feel like it’s more appropriate to hear these types of conversations from someone who has experienced life in a fat body. Nevertheless, I’m really thankful to Sasha and everyone at PCOS Challenge for giving me the opportunity to present such an important message. Here are a few highlights from my presentation:
- The body positive movement actually began as a way to represent marginalized groups and focused on fat liberation and fat activism.
- I reviewed some of the ways people in larger bodies are discriminated against in the U.S. (ex: less likely to be hired for a job)
- I discussed how size discrimination is associated with a 60% increase in mortality
- The presentation transitioned into talking about PCOS by discussing medical weigh bias, something I think everyone with PCOS has experienced at some point (ex: not being believed by your provider, being denied labs or tests because you “just need to lose weight”)
- I ended the presentation by giving some tips for feeling more comfortable in your body. A few tips I gave: wear clothes that fit your body (you deserve it!), try not to focus on body talk when with friends and family, and remember that your body deserves care and respect, even on days when you don’t love your appearance.
I highly recommend following Bri Campos if you struggle with body image. I’ve done body image supervision with her and she’s a wealth of knowledge!
Panel: Lived Experiences with PCOS
The day started out with a panel of people with PCOS. They shared their lived experiences and it was such an important reminder that no one is alone with PCOS. I loved that actress Lauren Ash took time out of what I’m sure is a busy schedule to share what it was like struggling with PCOS symptoms while working in a field that is very focused on aesthetics. She shared how frustrating it was to hear so much unsolicited advice around her PCOS symptoms – something I’m sure we can all relate to!
There is so little large-scale research with PCOS compared to other chronic conditions – so listening to your lived experiences should really be helping us guide treatment and care.
Panel: Addressing PCOS Across the Lifespan – Childhood, Adolescence, Reproductive Years and Post Menopause
The next session I watched was a physician panel with Anuja Dokras, MD; Rachana Shah, MD; Katherine Sherif, MD. I jotted down some questions that were asked an summarized some answers:
Q: What are your thoughts on the different “types” of PCOS (insulin resistance, inflammatory, post-pill, adrenal) that are mentioned so much in the functional space?
A: The physicians on the panel did not medically recognize this categorization of a “type” from this aspect and said it’s difficult to put PCOS into a box like that. Someone can have more issues in one area that another (ex: someone may have a stronger degree of insulin resistance) but often times these areas overlap.
They did discuss the different phenotypes referenced in the Rotterdam criteria but also mentioned that treatment is not dependent on why phenotype you fall under.
Q: How can a mom support her adolescent daughter with PCOS? The mom mentions that her daughter is thin.
The physicians recommended NOT putting her daughter on a diet and rather modeling a healthy relationship with food and exercise. They also mentioned that many people at lower weights with PCOS do have some degree of insulin resistance in glucose challenge tests even when their fasting glucose is normal.
Follow-up conversation about the above question about the “best diet” for PCOS.
One of the physicians went on to discuss that there’s no 1 specific diet that is best for PCOS. She recommended focusing on whole foods because we know that fiber and diversity in the gut microbiome are so important for PCOS.
Note: I also wanted to mention that stress, anxiety, and stress around food can also affect the gut microbiome.
Q: What are your thoughts on getting a COVID booster vaccine with PCOS?
The panel recommended following guidance and recommendations for those who have type 2 diabetes for getting the booster. Even if you don’t have type 2 diabetes, many of the metabolic issues that come along with PCOS make the syndrome more “high risk”. They referenced this study which found that those with PCOS are more at risk of COVID-19. If you’re not into reading studies then you can read a summary of the study here.
Q: Can someone have PCOS if they don’t meet the Rotterdam criteria? Is the Rotterdam criteria outdated?
The Rotterdam criteria has been reaffirmed as the standard for diagnosing PCOS in 2018, so it is more confidently the standard for a PCOS diagnosis. It will be reviewed every 5 years.
Q: Someone mentioned their testosterone was normal…
Testosterone is highest in the morning and at the very beginning of your cycle. So if your lab was normal and you had labs drawn when it wasn’t the first day of your period or it was the afternoon then the lab result isn’t an accurate picture of what’s going on.
Q: Is anyone considering patients’ relationship with food or preoccupation with food in overall health? Psychology and emotional health play such a role in overall health.
The panel voiced that they completely agreed that more focus needed to be placed on this area when discussing PCOS treatment. One physician mentioned how depression is associated with an increased risk of cardiovascular disease. There was an overall discussion that more emphasis needs to be made on lifestyle and overall well-being with less with left focus on weight.
Another tidbit from one of the sessions…
Someone mentioned that she had a cyst that ruptured prior to diagnosis. A physician clarified that the types of cysts that ruptured are not associated with PCOS, although they can certainly occur in addition to having PCOS.
Overall thoughts from the symposium
I was only able to watch the beginning of the symposium since my presentation was in the afternoon and I had to be in my virtual meeting room 30 minutes early. I’m hoping to go back and watch the sessions that I missed.
I really loved how the sessions seemed to bring up overall well-being and not as much emphasis on weight. It is also comforting and reassuring the hear other physicians talk about poor medical care for PCOS, as this is my clients’ biggest obstacle and sometimes I feel bad for mentioning this so much on my instagram account (especially during the pandemic when doctors are having to deal with so much).
I continue to have hope that there will be better care for PCOS, that everyone will be treated equally independent of their weight, and that every person living with PCOS will not feel like their symptoms are decreasing their quality of life. I’m looking forward to PCOS advocacy day in March to continue in this effort.