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Why Do Some Doctors Find It Difficult To Diagnose PCOS?

And other PCOS-related questions, answered.
PCOS questions: woman holding her stomach

Irregular menstruation, sudden often unexplainable weight gain, male pattern hair growth, acne breakouts are among the most common symptoms of polycystic ovary syndrome or PCOS. But even with these symptoms, trying to find answers to PCOS often leads to more questions—even for doctors.

Why is PCOS hard to diagnose?

We asked Dr. Zoe Arugay-Magat of LifeScience Center (LSC) why that's the case: "It's because there is no single test to diagnose PCOS. Instead, there is a long list of symptoms and test results that generate a PCOS profile. PCOS is a multi-organ disease, not just gynecological, which adds to the difficulty. You may have diabetes, cardiovascular disease, irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), sleep issues, or a mood disorder. The usual consequence is you have a number of specialists looking at all these conditions before it becomes apparent that PCOS is existing, too."

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At LifeScience Center, where they specialize in functional medicine, they focus on identifying and addressing the root causes of disease. Dr. Arugay-Magat explains, "We start by identifying infections, allergies, or we uncover any toxicities. We test for any deficiencies and then give the necessary nutraceuticals. We work on lifestyle factors like nutrition, sleep, exercise, stress, and relationships. Then, we track your progress." She continued, "The beauty of functional medicine is that the info we gather puts more value to your diagnosis. It helps the care team and the patient understand why and how each symptom developed. If we pinpoint when in time this may have started, then we uncover triggers and mediators that we can avoid. Knowing your root causes starts you on your path to healing."

Can exercise actually improve PCOS symptoms?

Many women who have the condition experience weight gain, which is why exercise is often recommended. We're sure you know that with or without PCOS, exercise has many benefits. For those who suffer from PCOS, though, there are specific exercises you can try. Dr. Arugay-Magat recommends aerobic exercises because it "improves insulin sensitivity and blood sugar levels, which are vital in the PCOS puzzle. It reduces anxiety, lowers blood pressure, and lowers inflammation. It benefits you even if you haven't lost weight yet."

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You can start by incorporating more movement to your daily routine: taking the stairs, carrying your groceries, doing some gardening work, and more. From there, you can work up to working out for 150 minutes a week. She says, "Each woman is unique and so exercise prescription varies, too. And we can't also just assume that exercise plans for men can apply to us because we're just wired differently ('cause of hormones!). It would be ideal to have a plan that promotes strength, cardiovascular fitness, flexibility, and balance. Our fitness coaches and doctors can work together to come up with a plan for you."

Outside of taking birth control pills, what are some treatment options available for people with PCOS?

"The important thing to remember is that PCOS is driven by insulin resistance and inflammation, which may be the same root causes for your other conditions. Insulin resistance means your body can't react to insulin and your blood sugar levels fluctuate, while inflammation is your body's response to protect your from infection or a foreign body," Dr. Arugay-Magat says. 

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"So your treatment plans should target what caused these in the first place. For instance, what is it in your food choices that drive insulin resistance and inflammation? Do you have a hidden infection somewhere? Are we getting quality sleep? Do we have enough movement and recovery from it? How is stress affecting you? Are there toxins present? Or are there substances that mimic estrogen and add even more to the imbalance? It allows us a broader range of treatment options from a food-first approach, mind-body medicine, an exercise prescription, perhaps even talk therapy. At LSC, these will be addressed by a care team composed of a doctor, nurse, nutritionist, and health coach. And depending on your needs, we may even add a fitness coach and a psychologist."

What are the long-term effects if PCOS is left untreated?

To put it simply, Dr. Arugay-Magat says, "If PCOS is left untreated, then it also means that insulin resistance and inflammation are left untreated, too. This can give rise to problems such as diabetes, infertility, cancers, or osteoporosis. And because it is a systemic disorder, then your other diseases may also worsen.

PCOS doesn't have to be permanent. There are many areas that you can work on to turn things around. I see PCOS as a message from your body to return to what nature intended us to do—eat natural food, get in touch with our body rhythm, to move, to reconnect with ourselves and to recharge."

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For more information, you can visit LifeScience Center's website


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