PCOS with Felice Gersh, MD (Part 1): Physiology and History
Dec 12, 2023
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Dr. Felice Gersh, a women's health physician, and host Jaclyn Smeaton, ND, dive into the physiology and evolutionary benefits of Polycystic Ovarian Syndrome (PCOS). They discuss the causes and types of PCOS affecting women, including the role of adrenals, metabolic factors, and improving treatment plans. The episode is split into two parts due to the extensive exploration of PCOS.
PCOS may have evolutionary benefits linked to leadership qualities due to slightly elevated testosterone levels.
PCOS can be influenced by environmental factors like endocrine disruptors and in utero exposures impacting hormone receptors and enzyme efficiency.
Deep dives
Prevalence of PCOS and Diagnostic Challenges
PCOS affects 10% to 20% of reproductive-aged women, with a global incidence increase. The diagnostic criteria for PCOS have evolved, from androgen excess to clinical manifestations like acne or hirsutism, to irregular cycles, and polycystic ovaries on ultrasound. PCOS is a diagnosis of exclusion, requiring ruling out other conditions like ovarian tumors and adrenal gland issues.
Evolutionary Perspective on PCOS and Environmental Influences
PCOS may have had evolutionary advantages, with women showing leadership qualities due to slightly elevated testosterone levels. However, modern factors like endocrine disruptors, specifically BPA, and in utero exposures can impact receptor function and enzyme efficiency, leading to hormonal imbalances. Women with PCOS experience malfunctioning estrogen receptors and reduced enzyme function, resulting in excess testosterone and insufficient estradiol.
Understanding PCOS from childhood to adulthood
PCOS manifestations can be traced back to in utero exposures affecting hormone receptors and enzyme activity, leading to metabolic disruptions even in young girls. These early influences can impact organ systems, particularly the brain, fat tissue, and gut microbiome, causing a range of symptoms from puberty onwards. Acknowledging the genetic predisposition and environmental factors can shift the focus from self-blame to proactive lifestyle adjustments for optimal management of PCOS.
Polycystic Ovarian Syndrome (PCOS) affects between 10%-20% of reproductive-aged women. While this can be a very difficult diagnosis for women these days, there are evolutionary benefits that may have led to its proliferation.
Host Jaclyn Smeaton, ND, unpacks the physiology and human history of PCOS with guest Dr. Felice Gersh, MD, in this groundbreaking episode of the DUTCH Podcast. They dive into the possible causes of PCOS and the various “types” of PCOS that are affecting female patients today. In fact, there is so much to uncover about PCOS that we had to split it into two episodes! Check back next week to hear part two of this interview.
Show Notes
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