Barbell Medicine Podcast Episode #364: Polycystic Ovarian Syndrome (PCOS)
Sep 8, 2025
Dr. Lorraine Baraki, a board-certified obstetrician-gynecologist and Army lieutenant colonel, takes listeners on a deep dive into Polycystic Ovarian Syndrome (PCOS). She unpacks the complexities of diagnosis, emphasizing individualized care paths. The conversation touches on the hormonal dynamics of PCOS, weight management strategies, and the impact of lifestyle changes. Dr. Baraki also discusses fertility options, underscoring the importance of early intervention and a tailored approach to treatment, making sure to empower women with knowledge about their health.
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Rotterdam Criteria Define PCOS Broadly
- PCOS is defined by the Rotterdam criteria: two of ovulatory dysfunction, hyperandrogenism, or polycystic ovarian morphology.
- Diagnosis requires ruling out other conditions and individualizing the workup.
Ovulatory Dysfunction Explains Irregular Bleeding
- Ovulatory dysfunction in PCOS shows as oligomenorrhea or amenorrhea and means fewer than 12–13 ovulations per year.
- This can cause absent, irregular, prolonged, or chaotic bleeding patterns.
High Androgens Drive Visible Symptoms
- Hyperandrogenism produces acne, oily skin, hirsutism, voice deepening, and clitoral enlargement in some cases.
- Clinical signs may prompt lab testing, but lab and exam don't always align perfectly.