What This Gynecologist Wants You To Know About PCOS

Our guests today are Doctor Tayis Alibadi, also known as Doctor A and Mary Alice Haney and Dr. A, If you have not heard of her before, is a world renowned OBGYN based has Cedar Sinai.
0:33
She is known for caring for royal families and celebrities.
She’s appeared on the Kardashians.
I have seen every single episode of Kardashians and I have seen her on there.
She’s also appeared on the Doctors, Doctor Phil.
She has a huge platform and it’s one of the leading voices for Women’s Health and a strong advocate for women being heard and taken seriously in medical spaces.
0:54
And also along with Doctor A is her Co founder of she MD, Doctor Mary Alice Haney who is a fashion designer, TV host and Women’s Health advocate.
And it’s always so much fun having doctors on our podcast because as you all know, when you go into the doctor’s office, it’s very rush, rush.
1:11
You barely get a word and because you’re in and you’re out within 10 minutes.
So I love this episode because we were able to ask a lot of pressing questions that we had on our minds.
But like we just never have the opportunity to really sit down with a doctor and like talk through these things.
1:30
So in this episode, we talked about PCOS.
It seems like more and more women are getting diagnosed with PCOS.
So we talked a little bit about that.
How common is it really?
How do you diagnose PCOS?
What are some risk factors?
We also talked about GLP 1, which I mean, as you all know, we talked about in the podcast like they have become so much more popular and Doctor A has actually been working with GLP ones for a very long time.
1:57
So she had some interesting insights about that.
We talked about insulin resistance and fertility as they relate to PCOS and a lot more.
Yeah, and definitely stay until the end because she gives a lot of amazing tips on breast cancer too, specifically and how to know your risk.
2:16
She talks about some of her patients who got breast cancer younger and why she would recommend screening early for certain people.
I thought it was just amazing.
And the the breast cancer test that she recommends people take is one that I have also heard other people say that that test specifically saved their life knowing their risk and then knowing that oops, I need to like actually start getting mammograms earlier.
2:39
So stay to listen till that.
And I also feel like we have a very nuanced conversation on all these things.
Of course, GLP 1s are a hot topic and we talk about the symptoms like is it just malnourishment via starvation or is it something that is really helping people hormonally and metabolically as well as like longevity on those meds.
2:59
What she is seeing in her practice, if people stop taking the GLP ones and they were taking them for weight loss, do they gain the weight back?
We also talked about our thoughts on the body image of it all, the intuitive eating of it all, and Mary had interesting insight that I had not heard before that kind of like opened up my mind a little bit on this topic.
3:18
Now I do want to say that if you are someone who does not want to hear about weight loss, then this may not be the episode for you because these are things that we talked about in this episode, which I just want to let you know, take care when listening.
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But if you are someone who this is interesting and you want to have some of those nuanced conversations and hear about a doctor in the field who is using these meds, this is definitely going to be an interesting episode for you.
Welcome to the Diabetes Digital Podcast.
I’m Wendy.
And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.
3:53
Through our telehealth platform, Diabetesdigital.co, we offer accessible and personalized virtual nutrition counseling for people with diabetes and pre diabetes.
Visit diabetesdigital.co that’s Co to book your first appointment.
We accept insurance and offer affordable self pay options.
4:09
Now let’s get into today’s episode.
Welcome to the podcast.
We’re so excited to have you.
Thank you for.
Having us, we’re excited to be here.
We we’re so excited ’cause we had y’all on our podcast and now we get to come on yours.
So this is.
4:26
Yeah, great.
Pod swap, Pod swap.
We are so excited to talk about PCOS because I know it’s something that you’re both really passionate about and a lot of our patients come to us with PCOS.
And I’m not sure if it’s social media or like I feel like I’m just seeing more and more information out there about PCOS.
4:47
It’s us.
I’m.
Like does everyone have PCOS?
Like what’s going on?
Because I, I feel like even amongst like my friends circles, a lot more of my friends are like, oh, I got diagnosed with PCOS.
So what do you think is happening where it seems like more people are being diagnosed?
5:07
How common is it really?
Who is most at risk?
So that’s a very good question.
PCOS in general effects 15% of women in this country.
If you go to Middle Eastern countries, that number can go north of 20%.
So it’s extremely common, and that’s why you’re starting to hear more and more about it.
5:25
The issue with PCOS is 70-75% of these women are never diagnosed.
And if they’re diagnosed, they’re not being treated correctly.
And but with, you know, with these podcasts, with social media, with ChatGPT, more and more people are either self diagnosing or asking, bouncing from doctor to doctor, demanding for someone to basically diagnose them.
5:52
So there’s more awareness of it.
You know, we have so many amazing influencers now that talk about PCOS, that share their journeys, celebrities who’ve come on our podcast on different podcasts, they talk about PCOS, mostly the symptoms of PCOS.
The problem with PCOS is there’s not a single test for diagnosing it.
6:13
So you can’t go to your doctor, do a blood test and say, oh, I have PCOS and different PCOS patients present differently.
So, and the symptoms vary so much that it makes it confusing for doctors to diagnose it, for patients to connect all those symptoms.
6:29
And we honestly don’t get enough experience with it, even in our residency program.
So that’s part of the issue, educating doctors and educating women about it.
Yeah, One thing that I have noticed too, and I think this is part of this, more people getting diagnosed.
6:49
And I, I think I first was seeing this a lot on your podcast because you guys do have a lot of celebrities, well known guests.
And I’m seeing these guests who are in smaller bodies, right, Or what I would consider smaller bodies like Lori Harvey, for example, who open up about their PCOS journeys.
7:07
And I feel like in the media, historically, PCOS has been linked to people in larger bodies, right?
And it’s always like, oh, I have PCOS and you know, it’s it’s struggle with weight and body image and things like that, which I know body image can affect people in all bodies, right?
But is that perception accurate with PCOS?
7:25
I’m very curious on your guys take.
It’s a very good point.
So 75% of PCOS patients gain weight and they’re the typical PCOS patients that most of us think of, right?
Patients might have acne, facial hair, body hair, hair thinning, irregular period, but 25% of PCOS patients are lean PCOS patients.
7:46
What does that mean?
They’re actually very, they could be underweight, but they have all these other symptoms of PCOS.
That’s why it’s so important to know the criteria for diagnosing PCOS because weight is what not one of them.
So when comes to diagnosing PCOS you need to meet two out of the three criteria. 1 is history of irregular cycles. 2 is PCOS looking ovaries on ultrasound.
8:13
Polycystic ovary syndrome is not cyst on the ovary, which a lot of doctors look to your at the ovaries and say, oh, you don’t have any cysts, so you’re not you don’t have polycystic ovary syndrome.
It’s not true.
PCOS is a bad name.
Basically we look for follicles.
8:29
It’s a certain look of these ovaries full of these follicles, not cysts.
And it’s very specific to PCOS.
So that’s criteria #2 and criteria #3 is symptoms of high testosterone or high testosterone in the blood.
8:47
You do not need to have a high testosterone in the blood to get the diagnosis of PCOS.
So you need to have symptoms of high testosterone, facial hair, body hair being the most common, facial acne, body acne, hair thinning, hyperpigmentation, under the arm skin tag.
9:04
So these are symptoms you look for symptoms of high testosterone and you need to meet two out of the three criteria.
So weight is not part of this criteria.
So that’s why it’s so important to learn the criteria for diagnosis for teenagers.
9:21
We do not use the second criteria which is the PCOS looking ovaries on ultrasound because a lot of teenagers have a lot of follicles and that can throw off the diagnosis.
So for teenagers, you need to meet the 1st and 3rd criteria.
But generally speaking, PCOS patients have mood disorders, they have anxiety, depression, body image issues.
9:43
A lot of them have family history of diabetes, PCOS, insulin resistance.
PCOS patients are at a higher risk of having eating disorders.
We see more of the binge eating in this group of patients and it’s one of the leading causes of infertility.
9:59
One, because the ovulation is not optimum and some of them don’t ovulate regularly, so they have a harder time getting pregnant.
But they also, they have all these follicles in their ovaries, but the quality is not optimum.
And that’s why they sometimes get the wrong message when they go to A to A, your gynecologist at age 35 and someone does an ultrasound and says, oh, don’t worry about it.
10:22
You have so many eggs.
Well, you should worry about it.
If you have that many exit qualities, probably not as good.
So these are patients I usually recommend freezing their eggs earlier on even though they have tons of follicles.
And we, you know, we started the podcast about a little over a year now and it was with the sole intent to make every woman their own health advocate to give them, I mean, you guys came on give the most amazing information.
10:48
I love that podcast.
But.
Women can watch SheMD and whether it’s a celebrity talking about their own health journey and an amazing doctor like Doctor A or another expert comes on so that they can be armed, the knowledge and tools to be their own health advocate.
And we talk about everything, but what happened at the beginning of this Ties and I were starting the podcast and she said, you know, PCOS is my passion.
11:11
I have two passions. 1 is to have every woman know her lifetime risk of breast cancer.
And we’re going to talk about that in a minute.
And two is polycystic ovarian syndrome.
And I was like, what is PCOS?
I’ve never heard of PCOS.
You know, I felt I’m very educated in the woman’s health space and she explained to me that 705% of women don’t know that.
11:29
They have it and that there were actually supplements that you could take that will work on the symptoms of PCOS that will get your ovulation going, that will make your insulin resistant, more insulin sensitive, that will help with all of these symptoms that we just talked about.
11:45
And she has a list of questions that she gets every single patient that comes into her office for PCOS.
So we built OV, our company.
We built them at this you know, launch two companies at the same time, which is always not.
A really good idea, but.
12:01
So women can go on ovii.com, OVII,.com and take the exact questions for free that she gives every patient that walks into her office.
And then we can’t diagnose you, but we can say you have the likelihood.
You don’t have the likelihood now.
Oh, and then you can we gave you the solution, which is OV.
12:19
It’s a once a day, you know, you drink it.
I created.
This calculator that helps women find out whether or not they have the likelihood of having PCOS.
The problem with PCOS is you can go to your doctor even when you know you have it.
You know there’s a 25% chance that you leave your doctor’s office and get the correct diagnosis.
12:41
So it’s good to have a place for women to go answer a few questions and we can tell them whether they have the likelihood of having PCOS.
The problem right now with PCOS is still patients go to the to go to their gynecologist, primary care doctors, family practitioners.
12:59
And even when they get diagnosed, the solution is what they give them birth control pill, where actually birth control is not always.
It might be a great solution for some patients with PCOS, but because of their mood disorder and anxiety and depression, sometimes they don’t do well with birth control pills.
13:17
So sometimes they get prescribed birth control, they go home, they don’t do well, they stop it, and then they think that’s the solution.
Yeah.
So PCOS is actually one of the conditions that has a lot of underlying pillars that drive the symptoms of PCOS.
13:36
It could be stress related, it could be inflammation related, it could be insulin resistance.
Genetic plays a role in it.
Sleep and activity plays a role in it.
The food we eat plays a role in it.
Gut this biosis is an issue.
So you have to address all of these underlying pillars for patients to actually start are feeling better.
13:57
That’s why so many patients are so frustrated because they get thrown this birth control pill.
And yeah, it might help with their acne and hair loss and facial hair and body hair, but it does not really address their all these other symptoms that they’re experiencing.
14:14
And that’s why, you know, we, you know, with this and their PCOS is one of those conditions where supplements actually make a difference.
And but you have to hit all these underlying pillars with the supplements.
14:30
And that’s what Ovii does.
I used to give so many supplements to so many of my patients.
You, I would literally give them 7 to 8 supplements.
So when I met Mary Alice, I said it’s so easy to make one supplement where patients can take it once a day and it’ll address all these underlying conditions, not just their insulin resistance, not just masking their symptoms of PCOS, not just dealing with the inflammation, not just dealing with their gut dysbiosis.
15:00
So you have to address all of these and that’s how they start feeling better.
Yeah.
I mean, and with the birth control, that’s something that I personally experience and I think a lot of women experience that when they’re experiencing abnormal periods, whether it’s like endometriosis or PCOS and it’s like they throw birth control on and it’s really masking like what might actually be going on.
15:22
And I’m wondering ’cause you mentioned insulin sensitivity, we see a lot of people that have pre diabetes, diabetes and PCOS.
Would you recommend like a certain kind of specialist, like would it be an endocrinologist or like for someone that has PCOS, especially if they do have some kind of insulin resistance, what kind of medical specialist would you recommend?
15:42
Because usually a PCP, you might have to go through like several PCPS to finally get a diagnosis or you know, they’re not really validating the information that you’re giving them.
You know the sad part is PCOS should be treated by gynecologists, right?
15:58
It should be treated by family practice, by primary care doctors.
Everyone should be able to diagnose it.
I mean, I just gave you the criteria.
Anyone sitting at home can diagnose themselves right now.
But because these doctors don’t do it, my personal experience has been, at least in Los Angeles, that endocrinologists are a a bit more versed in PCOS.
16:23
And you’re more likely not to be dismissed by your endocrinologist when it comes to PCOS than you are by your gynecologist or maybe other doctors.
So I would say start with your gynecologist, maybe Google if you think you have polycystic ovary syndrome, Google some you know near you a PCOS specialist.
16:42
And if you can’t find that PCOS specialist, you can start with your gynecologist or your or an endocrinologist, right?
The problem is unless the physician is familiar with PCOS, the symptoms of it will get dismissed, right?
16:58
So as I was describing it, PCOS has multiple underlying drivers of the symptoms.
The main one is insulin resistance, right.
So these are patients who, when they eat carbohydrates, their body does not process the sugar the way others do.
17:17
And insulin resistance means their cell at a cellular level, their body is resistant to the insulin.
The job of insulin is it opens up the receptors on the surface of our cells so they can grab the sugar, put it into the cell and turn it into energy.
17:32
This is what’s supposed to happen.
But a lot of PCOS patients have insulin resistance.
So when they’re, they have, let’s say their body breaks their carbohydrate into glucose, glucose stimulates their pancreas to release insulin, but their cells don’t respond to this insulin.
17:49
So sugar doesn’t, not all of the sugar goes into the cell to turn into energy.
It bounces in the blood and pushes their insulin to go up.
And that’s why eventually as we get older, you start seeing their hemoglobin A1C, which basically tells us what the blood sugar has been doing over the past three months.
18:05
It starts bumping higher and higher and higher.
And eventually these patients are at risk of becoming pre diabetic or diabetic if you don’t address their underlying condition.
But high insulin also stimulates their ovaries to secrete to stop or androgens.
And it is because of that that their periods become irregular.
18:24
They get acne, facial hair, body hair and different symptoms of high testosterone.
So in this pillar, addressing insulin resistance is very important.
You can help patients at a cellular.
I mean, we that’s why we always start with diet, right?
18:39
Exercise is very important.
When we exercise, we open up these receptors on the surface of our cells.
Walking after each meal is very important for patients who are insulin resistance, who are PCOS.
I always say go walk 10-15 minutes after each meal and you can significantly reduce the amount of sugar in your blood, which makes a huge difference.
19:00
A lot of PCOS patients, we give them metformin.
Why do we give metformin?
Because metformin makes us more insulin sensitive.
So by making us insulin sensitive, our body starts responding better to the insulin.
So this is just one pillar of PCOS, which is insulin resistance.
19:20
PCOS patients generally speaking tend to have more chronic inflammation and that inflammation drives their ovaries to secrete testosterone and cause all these irregular symptoms, irregular periods and high testosterone symptoms.
19:37
So lowering that inflammation is very important.
The next pillar has got dysbiosis.
PCOS patients have food sensitivities and they complain of 40%, half of them almost complain of bloating with certain foods.
19:52
And it’s important that their gut microbiome is bound.
Genetics play a huge role, you know, family history of diabetes, PCOS, insulin resistance, gestational diabetes, you know, a lot of us have it hidden in our DNA and epigenetics is also very important.
20:11
You know, our lifestyle is very important.
What food we eat, how much processed food we’re eating, how much are we exercising, are we sleeping well, what’s our stress level?
So and then there’s the.
This other main pillar, which is the brain ovary axis I call it, which basically the hormones in the brain are not secreting in a normal pattern and it affects our ovulation.
20:34
So all these pillars work together and they, you know, that’s why so many PCOS patients present differently.
So it’s so hard to diagnose.
That’s why it’s so hard to diagnose.
And that’s why throwing a birth control pill at them is not the solution.
20:50
PCOS patients, last thing I want to say is PCOS patients also tend to have lower sex hormone binding globulin.
It’s this protein in the blood that grabs the free testosterone in the blood.
And by taking birth control pills, we stimulate this sex hormone binding globulin, which starts grabbing the free testosterone in the blood.
21:11
And by doing that, what it does, it lowers our free testosterone.
And that’s why the acne, our acne gets better, hair loss gets better, the periods become more regular.
So birth control pills work really well, but they’re working in the, in this by suppressing the symptoms of PCOS, right and lowering that testosterone.
21:32
Birth control pills do not address your gut dysbiosis, your insulin resistance, the inflammatory inflammation, you know, in the body.
So and your, you know, sleep and stress level.
And on top of that, because these PCOS patients tend to have a lot of mood disorder, sometimes they don’t do well with birth control.
21:51
So I love birth control pills, but it’s important to educate patients why they’re taking it.
Otherwise you’re clients goes way way down.
Yeah, you mentioned GLP ones, which I’m happy you did because there’s more and more people that are using them for a range of different conditions, especially like we work in pre diabetes and diabetes.
22:13
So it’s very big in that space.
And because you’ve been using it for such a long time, I wonder what your thoughts are on people like adequately nourishing when on a GLP1?
Because something that we see as dietitians is that because of the delayed gastric emptying and the side effects, it’s really hard to for people to meet their nutritional needs because they just don’t have much of an appetite.
22:38
They are barely getting enough calories in.
And so then they’re at risk for like different nutrient deficiencies and things like that.
So like, what are what are usually like?
What would you advise those patients who are struggling with nutrition intake?
22:55
I think first of all, I would adjust their dose.
I always say you’re not supposed to not eat all day.
I think the second problem is a lot of these patients are getting these compounded GLP 1 from websites without their doctor’s knowledge, right?
23:13
But it’s so important for patients to feel comfortable to let your, their doctors know because you need, it’s good to work with a nutritionist.
I think that’s critical for these patients to have a nutritionist and you need to make sure that your electrolytes are fine, that you’re drinking enough, and that’s why it’s so important to have an experienced healthcare provider follow these patients.
23:38
Yeah, it’s so it’s, it’s very unfortunate too, because yes, we do have a lot of patients on GLP ones as well.
And it’s, I think people are stuck between a rock and a hard place because they’re, the drugs can be so expensive, especially if somebody is using it outside of diabetes, right.
23:58
So let’s say someone with PCOS or somebody who is trying to lose weight, it’s like $1000, you know, maybe $500 A. 1000, it should be 1000, but you’re right, it is even like $500 a that’s a lot.
That’s a lot of money.
24:14
Yes, 100% and.
It should be covered.
Honestly for all these patients with PCOS, pre diabetic, you know diabetic patients, it really should be covered.
Yeah, and that’s like to the point of even if it is 500, cuz I know they have the coupons or whatever, that’s still for the average person, right?
24:31
That’s so much money a month.
And so I just from that point of view, I can see it creates a dangerous situation, right?
Because then people are like, oh, I need this, you know, for whatever reason.
And now I’m going to go on these compounding websites and get a version that has maybe fillers or whoever who knows what it is that’s not the studied version.
24:53
And so I think that could be tricky.
And then also, I think one of the other tricky things like you’re saying is for many providers don’t know that their patients are even on it because it’s not their primary care provider or their OBGYN or their endocrinologist who is following up with them regularly and knows their history and maybe has seen them in person before.
25:13
And sometimes even if it is your provider, like one of my friends is a nurse in an endocrinology clinic, and they can’t see that.
They’re so impacted that they can’t even see the patients like more than once every few months.
And as we know with these medications, it’s tricky because big changes can happen.
25:32
Symptoms can happen like very quickly.
And so that is where I think a dietitian does come into play is like, we’re able to see them weekly and make sure that they are trying to strategize ways to still eat, get the protein like you’re saying.
But yeah, we ask our dietitians all the time and they say that a lot of their patients on GLP ones can’t even, you know, it’s hard for them to even hit two meals a day.
25:55
And so trying to really strategize with them.
OK, well then how are we going to figure out your?
Protein and you you say that that’s too much and they’re just I drop.
Their dose, yeah, Remember it’s I always tell them you want to be able to stay on it long term.
I always do a check in always at four months.
26:14
But it’s important for them to know eating is if you can’t not eat.
And one of the side effects of these medications is fatigue.
I’m sure you guys have heard about that.
Patients sometimes feel exhausted.
I drop the dose for that.
I drop the dose if they’re nauseous.
26:30
I drop the dose if they’re very constipated.
I drop the dose if they’re not eating.
I drop the dose if they’re losing too much weight too fast.
So it’s so good to be monitored by someone who’s, you know, you can’t just do this on your own at home.
26:46
But I’m telling you, most, a lot of women are doing this.
I know.
And it’s another, it’s like just so interesting because it’s so in the news and I’m happy we’re bringing this conversation up and that you have the experience.
Because another thing is if you are with the compounded companies, they have an interest in you increasing the dose because the more you increase and stay on it, then they’re going to get paid.
27:09
So it’s like, I don’t know, it’s just interesting bringing in tech companies and for profit with like healthcare.
It’s tricky.
I always encourage my patients to use not the compounded medications, but the one the medications that are FDA approved.
27:28
And I always say you don’t know where the raw materials are coming from in these compounded medications.
So be safe and use the FDA approved medications unless there’s a shortage.
This is a fascinating conversation.
We, we’re just going to ask you a couple more questions just to respect your time.
27:45
But one question I have, and I know, Mary, when we were on your pod, we talked about, I think like body image.
And I know like you’re very familiar with intuitive eating and all those things like how do we reconcile this new drug, right?
28:01
And that can have that weight loss result for people when I feel like we were just getting to a place where we were, you know, like, just as a culture, like encouraging people to accept their bodies as they were.
So I feel just so I feel like it’s a personal choice, obviously.
28:18
And I think they’re like, like there’s a lot coming out about these medications that can be very helpful.
There’s also the side effects and other things that, you know, we’re still studying.
But yeah, I would love your guys thoughts on how do we reconcile that like the body image of it all, the intuitive eating of it all with these medications?
I think it’s really, it’s not one in the same in my opinion.
28:39
Like these amazing medicines, you know, GLP ones, Metformin, you know, these are over here and they’re very specific.
So this they’re helping you, you know, they’re they’re either treating a disease or they’re helping inflammation, whatever it is, they’re over here.
28:55
You can still need to work on that over here, which is your body image and your self worth.
And on all the things that we talked about and eating correctly, like working with people like you guys, because they feed each other.
And I think that it’s, and I always ask Tais this question and I say this, you know, all these studies comes up come out about GLP ones, which is it’s it’s amazing.
29:16
And I’m like, well, is that because of the GLP ones that, you know, the ingredients that yeah, I didn’t quite know the answer to that.
Yeah.
I think there’s a lot more research that needs to happen, but I think that, you know, when I first met Doctor A and she, and if you, if you listen to a beautiful podcast that we did with Phoebe Hancock and her mom started beauty counter and just the, the trials and tribulations that she went through.
29:41
And you look at this young woman who just dealt with, you know, hospitalized for eating disorders, you know, all of these things that, that, that young girls deal with.
But then you put on a, you know, a PCOS, you know, all the symptoms that come with PCOS.
29:56
And then it’s just, it’s just they’re, they’re, they can work together and they should work together.
And if you have a patient or a child who’s suffering from an eating disorder or self-image and body image, you have to, I hate to say holistic, we talk about that so much, but you have to really hit it from all angles.
30:14
You have to hit it from her mental health.
How in the world is she supposed to feel amazing and empowered and good within her body because her body’s not working correctly.
And that’s why when we met and started the podcast and she said, I want to change the world for PCOS.
And there are solutions.
30:31
There are there are things that you can do that will will help them and support them.
So I think it’s really a conversation.
We live in LA, You know, this, this body dysmorphia body image factory that we have is, is, is something that we combat all the time.
30:47
But that’s very different than having somebody whose body is not working correctly and, and feeling terrible.
And no matter what you do, you know, some of these people are, you know, like, so it’s, I think that’s when why it became such a, a passion for both of us because we, you know, sort of seeing, seeing them, seeing both of those things and.
31:08
I think I we live in a world of social media when everyone’s face tuning and changing their bodies.
And here you have these teenage girls and it’s really hard to be them and for them to go to a pediatrician, get dismissed.
31:24
And you remember this.
Majority of these patients are not diagnosed with PCOS and what they hear at their pediatrician’s office is, well, honey, eat less and you need to start exercising more.
And you know, this gaslighting needs to end.
31:40
We need to start diagnosing these patients.
And it’s really, really sad.
I have a patient, she’s in her 20s, and she came a few months ago to my office and she walked in with such confidence.
And when she saw me, she started crying and hugging me and said what happened?
She’s like, I wanted to tell you this, but this is the first time in my life I know what it means to be happy.
32:04
Yeah, that’s.
Powerful.
I mean, that’s do you know what I’m saying?
They feel validated.
They feel hurt.
Their body, like Mary Alice was saying, is starting to function like everybody else’s body.
It’s I’m happy because my body’s working and it was not working and no one would believe me and there wasn’t anything I could do about it.
32:25
And so that’s why it’s been our mission to change this.
And that’s why I love being on podcasts like yours.
And the work that you guys are doing is so important and incredible too.
But there are some things in life that you cannot change.
This is not one of them.
And if you’re educated and if you have the right resources, and that’s why we wanted to provide, you know, on OV, a place where you go where, you know, sometimes you’re, you’re not being treated by your doctor correctly.
32:49
And we love doctors, doctors for the best.
But here’s an here’s a place that you can go to, you know, to try to figure this out yourself.
And then we offer a solution.
So even.
Imagine if you’re 30 years old, your skin is covered with acne.
You’re losing hair.
Every time you go in the shower and you brush your hair, you lose tons of hair, right?
33:09
You’re constantly lasering your facial hair and it comes back eventually.
It’s it, it, it affects your confidence, you know, it’s anyways, my heart is full for these patients.
And I just want them to know that there’s a hormonal imbalance that’s causing all this and there is a solution.
33:32
But in order to get to the solution, you need to be diagnosed correctly.
So if you’re being dismissed, if you go to your doctor and you feel like you have PCOS and you’re not being diagnosed correctly, then either Google the PCOS doctor near me or go on ovii.com.
33:49
I created this calculator, it’s free of charge and you know, listen to podcasts like yourself.
We have many podcasts on GMD.
Just educate yourself.
You can honestly go on ChatGPT right now.
Punch in your symptoms and 9 out of 10, probably higher than that, you’ll get a very accurate diagnosis.
34:11
Use the tools that are available to you.
Yeah, that was my last question.
You kind of answered it in terms of your resources.
So I know that you mentioned you have your site now your site helps people to just see if they might have PCOS or the symptoms, right?
34:30
Is there also a breast cancer component or you were we had to mention that at the top like screening wise?
Yes, let’s talk about breast cancer.
So we have our breast cancer information on the SheMD podcast.
Ovii is only for PCOS okay, that’s my baby over there and SheMD is just educational.
34:50
So, you know, I always say if you know your first name, last name, date of birth, you need to know your lifetime risk of breast cancer as A and that should be mandatory.
And that number should be calculated by age 30.
Why?
Because an average American has a 12.5% chance of getting breast cancer.
35:08
One out of eight women gets breast cancer.
Less than 5% of breast cancers are genetic. 85% of women who get breast cancer don’t have anyone in their family with history of cancer.
To this day, women come to my office and they say I don’t need a mammogram because no one, I don’t have breast cancer in my family.
35:28
I didn’t have breast cancer in my family.
I didn’t have any cancers in my family, and I was diagnosed with breast cancer.
One out of eight is real, but why is it important to know your lifetime risk of breast cancer?
For women with family history of breast cancer, for women who’ve had a abnormal biopsy of their breast that shows atypia, these two subgroups of women, their lifetime risk of breast cancer shoots up right to sometimes above 20 percent, 20% and more.
35:57
You fall into the high risk category for screening if you have dense breast, 50% of women have dense breast tissue.
Some of those patients have extremely dense breast tissue.
If you have extremely dense breast tissue, it pushes your lifetime risk of breast cancer up.
36:14
Then there are little factors that also affect it, early period, late menopause, fewer children in life, not breastfeeding, being on hormone exposure.
So and that number, you can’t sit here and say I don’t have my left hand.
36:34
Risk is real.
You really need to punch in that information.
The formula I use is the tyracusic formula.
We have it on SheMD podcast.
You have to answer a few questions.
You need to know your density of the breast to get a better, more accurate diagnosis.
You need to know your family history, the breast density.
36:52
You get that information from your mammogram or your breast MRI if you’ve had it.
But you want to know your lifetime risk of breast cancer.
If that lifetime risk of breast cancer is 20% or more, you have to start your breast imaging as early as 30, not 40.
37:09
So this idea of that people always talk about and doctors talk about that mammogram should start at 40.
It’s completely misleading.
Mammogram starts wet depending on your lifetime risk of breast cancer.
37:24
If that lifetime risk is 20% or more, you might have to start as early as 30.
And it in addition to mammogram and ultrasound, you might, you want to ask your doctor for additional imaging like breast MRI.
Mammograms alone diagnose a four out of five breast cancers.
37:42
So by adding the ultrasound and MRI, you become you start getting closer to that accuracy of diagnosing cancers early.
When it comes to breast cancer, remember it’s curable, but you have to diagnose it early.
Even though 5% of breast cancers are genetic, if you have family history of ovarian cancer, breast cancer, pancreatic cancer or other cancers, you might qualify for genetic testing.
38:09
And if you qualify insurance, we’ll cover it most of the time.
So it’s important to do these ask your doctor for these genetic testing A to make sure you have a genetic mutation B to have your doctor or have yourself go on GMD and give.
38:24
Lots of podcasts on it, but she saved a living a month’s life from breast cancer so you can just go on SheMD Doctor.
AI saw in a magazine or something that you were Rihanna’s doctor, and they asked Rihanna what was her favorite thing about living in LA and she said her gynecologist.
38:42
So are you seeing new patients?
Like, I know you work with the celebs, but I’m sure there’s going to be people listening who want to get in on your care.
Like how does that work?
Majority of my patients are not celebrities for me.
When you come into my office and you wear that pink, you are my patient.
38:59
You become my family, and I’ll give you the highest level of care that I provide.
I love, love, love my patients.
Who, you know, I spend a lot of time with my patients, so I don’t take insurance.
Unfortunately, because with insurance I didn’t have this amount of time.
39:14
I can’t spend the amount of time that I want to spend with them.
That’s why we started the podcast.
That’s why we started the SheMD podcast because really, if they listen to our podcast, I share everything I do in my office topic by topic with these patients on this podcast.
So they really don’t need to come to my office.
39:32
And when they do, I love them and I take care of them.
But I just want to clarify, I love Rihanna.
She’s the most incredible, most loving, most down to earth human ever.
And but all my page I love you.
Love them all.
39:47
Yeah, I.
Love women, period.
Well, thank you guys so much and for being generous with your time.
We appreciate it.
Definitely.
Everyone check out the SheMD podcast, check out Ovii see it has anositol, which has been very well studied for PCOS.
40:04
So yeah, we’re we’re so excited for this episode to come out.
Thank you both.
Thank.
You for having us.
Thank you for taking us.
Bye.
Thanks for joining us for today’s episode.
If you’re interested in nutrition counseling with one of our expert dietitians to help improve your pre diabetes or diabetes, visit us at diabetesdigital.co.
40:24
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