6 Reasons Why Your Doctor Can’t Help Reverse Your PCOS
By Clare Goodwin
Last updated: September 3, 2020
“I just had an appointment with my doctor/gynae/endocrinologist and I’m so frustrated! They just told me lose weight, but didn’t give me any information about how to. I was given the contraceptive pill and sent on my way.”
I’ve been in this situation and I know how frustrating it is. It’s important for us to understand that we need to seek the right advice from the right professional.
Our society teaches us that doctors know everything about all conditions but that’s simply not the case. They cannot be experts in everything and they don’t claim to be. Our doctors and medical professionals are amazing at saving lives and treating symptoms. If I got hit by a bus, there is nowhere I would rather be than the hospital. But the attention given at medical school is to prepare doctors to be competent and save lives, not treat chronic conditions like PCOS.
Asking a doctor for nutrition advice for PCOS is like asking a builder where all the wiring and electrics should go in your house. Most builders know a bit about electrics but are certainly not qualified in this area. If they do give it a go then you’re not going to end up with the correct information.
Similarly, doctors aren’t educated and qualified in nutrition. They have so many life threatening diseases and conditions to learn about that they only get a few hours of nutrition training (if any). So when you ask your doctor diet and exercise advice you’re only going to get a very generic response: “Eat better and exercise more”. This is because that’s all they have been taught. In order to reverse your PCOS you need specific diet and exercise protocols, as well as other lifestyle modification. So you need to get this information from someone who’s spent more than four hours learning about it.
When a doctor reached out for help in our Facebook group I thought that it would be really eye-opening for you to see what a doctor’s actual job is and find out what they are taught at medical school about PCOS. I hope it helps to understand how you can utilise your doctor’s expertise and then seek help from others who have more training in PCOS and lifestyle modification.
Clare: What Got You Interested in Medicine?
H: I’ve always enjoyed reading and understanding anything related to health, and I also really enjoyed all forms of sciences growing up. Not only was medicine a great blend between health and science, but also a great platform to help others in something I was passionate about.
I’ve just completed my medicine degree at the University of Queensland and am employed in a local hospital located close to Brisbane, Australia.
Clare: When Did You Find Out You Had PCOS?
H: 3rd December 2016 was the day we first found out I was pregnant. We were in a bit of shock, as it was our first attempt trying to conceive, thinking it would take some time to fall pregnant. Sadly, our baby had lost its heartbeat at 8 weeks. I went in for a surgery in early January 2017, rested over the weekend, then went back on to my final year of medical school.
I was 15 when I first got my period. I was the latest to start my period out of 3 sisters. However, my cycles were never regular. All the way into my early 20s, my periods were hard to predict. I knew when I had gotten married that I always wanted to be a mum, so I went on to see my GP in the hope of finding some answers. Everything in medical school taught me that my cycles were not normal. My GP proceeded to do some bloods and an ultrasound, all of which came back “normal”. My GP concluded that some girls were just “irregular” and that was probably my regular. I accepted it, feeling like I knew that at the back of my mind that pregnancy was gonna be hard for me to achieve.
Fast forward to early 2017, after our first pregnancy and miscarriage. We carried on trying to conceive without success. My periods had range from 32 days to 42 days. Suddenly I started breaking out in the worst acne I’ve ever had and my period came late (57 days to be exact). At first I thought that I could have been pregnant, but several pregnancy tests week after week were negative, and I knew something was wrong.
I booked an appointment with my gynae, he did some blood tests and revealed the results to me. Good news: I ovulated on my own. Bad news: my AMH levels were extremely high (53), indicating that I had PCOS. His words were “unfortunately you are the thin type of PCOS and it can be trickier to treat”. PCOS: for some reason I had suspected it but everything in medical school taught me I didn’t fit the classic picture.
Clare: How Did You Feel About Your Treatment In The Medical Model?
H: I was started on 1 cycle of letrazole (2.5mg). I took it with high expectations and confidence that it was going to work. Unfortunately it didn’t and I felt myself spiraling down that road of what seemed like never ending doctor’s appointments, blood testS, investigations and medications. Plus the crazy emotional rollercoaster that came along with it! I broke down so many times (too many), maybe because of my type A personality of always wanting to be in control. After all, I had entered medicine because of the confidence I had in it, but I felt that confidence slowly slipping away.
Was medication the only answer? If I were to get pregnant again with medication then would I be able to carry to term? I knew now, with my diagnosis of PCOS, that my risk of miscarriage was much higher. For those who have ever gone through a miscarriage, the guilt and blame is something that’s so hard to brush off. My heart goes out to all those who’ve experienced it one way or another. I wanted more answers and ways of treatment. More than just medication and artificial hormones. I started asking, talking and researching.
Five Reasons Why Your Doctor Can’t Help You To Reverse Your PCOS
During our conversation it became apparent that there were five main reasons why this doctor felt that she was ill equipped to balance her own (or her PCOS patients’) hormones:
1. Your doctor only gets a few hours of PCOS training
H: Medical school was great at teaching us the basics of common conditions. But like many chronic diseases, PCOS was a quite a “touch and go” topic. The in-depth understanding of specific diseases really comes about when one specialises within that field.
The field of medicine is SO LARGE and the amount of work and study we have to do is so immense. You can imagine how being able to grasp specific diseases/conditions can be very challenging. Take PCOS, for example. It’s a condition that’s so complicated and take many years for someone (like Clare) to master. Then think about how many thousands of complicated diseases/conditions be squeezed into a 4-year postgraduate curriculum. The main focus of medical school was to prepare us to be competent and safe doctors. A lot of this focused around ensuring stability of patients in acute emergencies situations.
PCOS was taught in its very classic form. The typical obese female with features of hyperandrogenism, irregular periods and infertility. Treatment of PCOS was based a lot on guidelines, many of which would suggest symptomatic management (i.e. COCP, ovulation induction, etc). We were also taught that the typical classic PCOS could be managed with weight loss and lifestyle changes, but we weren’t taught how to equip patients with the skills to help them with that.
2. GPs only have a maximum of 20 minutes to understand your case
H: Time is the one of the main constraints for any GP. A 15-20 minute session is not going to be sufficient for someone to fully understand the key contributing factors to someone’s PCOS.
Clare: I can’t even imagine what this must be like for doctors. It’s impossible to understand a complex case in 20 minutes. I spend 1-2 hours looking through a patient’s symptom reports and blood work and writing up their case report. That’s before we’ve even met! I then get to spend 60-90 minutes with them explaining this all and guiding them through the changes they need to make.
3. GPs get very little (if any) training in nutrition
H: In medical school, we had about 3-4 sessions of 1 hour lectures on nutrition. Half of the class didn’t even turn up for them. We learnt about the general food groups and a “balanced” diet. That was basically it.
Clare: To add some context here, my double degree in Nutrition and Exercise Physiology took 5 years. Although this equipped me with a good base knowledge, it wasn’t until I spent a year studying Functional Medicine (treating the root cause of chronic illness) and reading all the scientific literature on PCOS, that I felt I even started to understand it.
4. GPs are taught to be very sceptical of “natural” treatments
H: PCOS needs a holistic approach. You are bound to stumble upon some differing opinions one way or another, be it your doctor, TCM physician, nutritionist, acupuncturist or naturopath. It is hard to decipher who or what to listen to. For me, I see a TCM physician, a naturopath and my GP. I seek all of their opinions in the most objective way possible. I go home, do my research, listen to my own body and go with what I feel most comfortable with.
Many doctors aren’t fans of “natural” treatments. Scepticism around natural/functional medicine is slowly changing and will hopefully be the future for chronic diseases. For now, the best way to work with your GP is to be honest about what you are doing and seek their objective opinion. Do your own sound research (if you don’t know how to, seek help from someone who does) and listen to your body. When things work for you, doctors will learn from their one experience with you as the patient who “reversed her PCOS”.
Clare: It’s good to be sceptical, but just because something is natural it doesn’t mean that there’s no science behind it. You’ll see that I cite a lot of research in my articles so read the research paper and find out more information. However, I’d caveat that by saying that a lack of evidence doesn’t equal evidence against. It’s very expensive to do the gold standard randomised controlled trials and someone needs to pay for it. Generally, this funding comes from institutions that have a vested interest in this research, like pharmaceutical companies who make a lot of money from their products. So just keep that in mind as well.
5. GPs are taught that there is only one “healthy” and one “PCOS”
H: I’ve always been pretty health conscious. I thought that I ate “healthily” and I exercised regularly (often long runs). It wasn’t until I got diagnosed with PCOS, started researching, and meeting people like Clare that I understood that the concept of “healthy” can be very different for different people. That being said, there are general things that many of us should avoid (i.e. dairy, gluten, sugar). But at the same time, nutrition and lifestyle changes have to be catered for that specific person.
I’ll use my case as an example. I’ve been a psoriasis suffer for more than half my life. I never knew that psoriasis could be related to my PCOS. Even though I am a doctor, I saw it as separate entities. There are a few things I’ve learnt during my journey:
- I’m not only dairy and wheat intolerant, but egg intolerant too. I was having lots of eggs for breakfast, which wasn’t helping my symptoms.
- Secondly, I wanted to combat my psoriasis at the same time as my PCOS. I learnt that nightshades (i.e. eggplants, tomatoes, potatoes, peppers) were psoriatic trigger foods, so I had to avoid them.
- Hormonal health is really engrained in your overall health. Focusing on your overall health is much more important than just that on PCOS alone.
- There are general principles that we can apply to everyone with PCOS, but your specific needs can be very different from someone else’s. The concept of one type of diet and one type of exercise for all PCOS should be taken with caution.
6. We (patients) demand quick fixes
H: Our culture has become so fast-paced and we often want quick results, not only from the doctor’s point of view, but a patient’s too. I’m not saying this is the case for everyone, but many patients with chronic diseases are not always willing to make the necessary changes to better manage their conditions. Many chronic conditions, if not all, are actually greatly influenced by lifestyle. From diet to alcohol to smoking. Doctors want to help patients, but not all patients want to change their lifestyles completely. As such, pharmaceutical means are the best way forward (they’re also the quickest). In my opinion, medication still has a significant role to play, but not without targeting the root cause of the disease.
When it comes to hormones, it isn’t not as straightforward. The endocrine system is affected by not just diet or exercise alone, but also stress, environmental toxins, autoimmunity, etc. Apart from our basic knowledge of exercise and diet, doctors aren’t equipped with skills to advise patients on natural ways to balance their hormones.
Clare: How Is Your Journey Of Healing Your PCOS Going Now?
H: I’m still in midst of healing (3 months in, to be exact). I questioned myself a lot about whether I should be patient and wait or whether to go down the fertility track. Healing can be such a long and frustrating process and I would love to give you all a success story, but I would rather give you an honest one. My acne has cleared completely, my psoriasis is looking much better, my energy levels are great and I sleep sooo much better now. As for my menstrual cycles, unfortunately they are still not regular. Well… I’m not sure how long it’ll take, or what will happen from here on. But I trust God and His plans, and continually pray for patience and peace in this journey.
I hope that this interview has given you some context into why you might not be getting the answers that you want from your doctor.
If you’re looking for the next steps to take and a plan to help balance your hormones then my The PCOS Protocol is your best place to start. The program helps you understand your PCOS ‘type’ or ‘cause’, then gives you the best diet, exercise and lifestyle strategy for you. It guides you through the changes you need to make over 90 days.
I give you all the practical tools like recipes, meals plans, shopping lists and workout videos. But I also teach you WHY you’re doing what you’re doing. Because I’ve learnt that women who understand why are much more likely to stick with it, even during the tough times.