Episode 161:
Show Notes
In this emotional narrative, Dr Mary shares her personal journey with Polycystic Ovarian Syndrome (PCOS) and reflects on the challenging experiences she faced from a young age when she began to gain weight, becoming what she describes as "the chubby kid." Dr Mary emphasises that PCOS can manifest early in childhood for some girls, leading to a negative body image and low self esteem. These issues follow many girls throughout adolescence and early adulthood, contributing to a yo-yo pattern of weight loss and gain, further exacerbating the psychological challenges associated with the condition.
PCOS symptoms vary among women, and they can be broadly categorised into three groups: reproductive, metabolic, and psychological.
The reproductive symptoms include irregular menstrual cycles and the presence of polycystic ovaries, which are not cysts but rather immature egg follicles. These irregularities in ovulation can contribute to subfertility or difficulties conceiving. Additionally, PCOS is associated with an excess of androgens, the male sex hormones, which can lead to unwanted side effects in females such as acne and excess hair growth. PCOS is also a type of insulin resistance, wherein the body struggles to respond effectively to insulin, leading to elevated insulin levels and increased weight gain. This insulin resistance underlies many of the metabolic issues associated with PCOS, such as a heightened risk of cardiovascular disease, strokes, fatty liver, and type 2 diabetes. Furthermore, women with PCOS may experience a higher body mass index (BMI) trajectory compared to the general population due to the insulin resistance that leads to weight gain. The psychological impacts include depression, anxiety, negative body image and poor self esteem.
Dealing with PCOS involves a multifaceted approach to improve overall quality of life, addressing psychological wellbeing, and managing symptoms effectively. Understanding that PCOS management should be tailored to the individual, the significance of lifestyle changes and real food diets with lower carbohydrates is a powerful tool. While the evidence supporting low carb real food diets for PCOS is not yet fully integrated into official guidelines, studies have shown that reducing carbohydrate intake can significantly improve fertility aspects and metabolic issues related to PCOS. By managing insulin levels and insulin resistance, a low carb real food diet can lead to improved glucose intolerance, reduced hunger, and reversal of fatty liver, among other benefits.
In addition to lifestyle changes, various treatments are available to address specific PCOS symptoms. There are very effective medications available from your GP. There are also cosmetic interventions, such as laser treatments and topical medications, to manage excess hair growth and male pattern balding. For girls and women suspecting they may have PCOS, seeking medical advice is crucial to obtain accurate diagnosis and personalised management. Hope exists for effective treatment and lifestyle changes, with a variety of very effective tools available.
Episode 161:
Transcript
Dr Mary Barson: (0:11) Hello, my lovely listeners. I'm Dr Mary Barson.
Dr Lucy Burns: (0:15) And I'm Dr Lucy Burns. Welcome to this episode of
Both: (0:20) Real Health and Weight Loss!
Dr Mary Barson: (0:23) Hello, lovely listeners, Dr Mary here with this edition of the Real Health and Weight Loss Podcast.
Today, when we dive into real health, I want to talk about a subject extremely close to my heart. Polycystic ovarian syndrome. Something that has been in many ways a defining feature of my life and has affected me across my whole lifespan. And I have found a way to manage it that has been extremely helpful for me and I would love to have a chat about this incredibly important topic. Because it is the most common hormonal disorder that affects women, about one in eight women, that’s a lot of women, are estimated to be living with polycystic ovarian syndrome. And it has broad reaching ramifications for our health and wellness.
And I might get a little bit choked up. I might be blinking back the tears a little bit when I talk about this today. But they are both sad tears and happy tears, I will tell you. Because I have really managed to get my health into a fabulous place. And I feel really good about that.
So let's talk about my story a little bit here. So I was a pretty happy, active kid. And then around about eight or nine, I started to gain weight. And I became the chubby kid. It was really awful. I was teased, and I was ostracised, and far out that is terrifying for a child. To not fit in, to feel like you don't fit in, that you are other, that you are out, is quite literally terrifying for children. They feel like their life is being threatened. It is so traumatic for kids. And that is what I experienced. And I definitely believed, I really believed and internalised from a very early age, that because I was chubby and living inside this heavier body, that I was unacceptable. That I wasn't good enough, that I wasn't attractive, that basically I wasn't allowed, you know, to have all the things that the non chubby people had. And it was a pretty unpleasant way to live in my world. I had, in many ways a lovely childhood, you know, loving parents. I had friends, I had lots of good things. But I also had these really significant and quite traumatic body image issues that just got worse and worse. And we now know that polycystic ovarian syndrome can actually start manifesting at that very young age for children, not all girls, definitely not. But for some girls with polycystic ovarian syndrome, they do start to gain weight around that age 7, 8, 9. And I certainly was one of them. And then as I entered into my adolescence, again, struggling with my weight, at times, I would lose weight and be slimmer and then I would go back to being heavier, and then I could lose weight and be slimmer, you know, classic yo yo dieting. Couldn't keep it off. I was very active, I really was especially into swimming in particular. And I swam competitively at a very low, you know, local level, but still swam competitively. And I loved it, I was pretty fit. But I was still overweight and in a heavier body much of the time. And I had really, really irregular periods. So this is for me, one of the most difficult things that I suffered with throughout my 20s. The subfertility, really irregular periods. I also had excess hair growth, like a hairy chin, had problems with acne. And it really affected my mood and my sense of self. And the reproductive concerns were probably the most potent symptoms that I had in the early years.
You know not every woman gets the same symptoms with their PCOS. They can have a range of symptoms and basically they fall into three broad categories.
One is the reproductive, so you can get menstrual cycle irregularity, you get what's called polycystic ovaries. It's what the name comes from. And when you look at the ovaries with ultrasounds, it looks like they've got lots of cysts, but they're not cysts, actually what they are is normal egg follicles but just more of them. Egg follicles that are starting to develop but don't quite mature properly. So ordinarily, during a woman's cycle, during her fertile years, she’ll have one or two little egg follicles that will develop and one or two eggs will be released and may or may not get fertilised by sperm in the fallopian tubes. And may or may not then turn into a pregnancy that implants in the lining of the womb. So normally it's one or two, but in polycystic ovarian syndrome, polycystic ovaries, lots of these little follicles are developing and you can see it on ultrasound. So this can cause you know, decreased fertility, but also increased androgens. Androgens being the male sex hormones, which cause these delightful side effects for females like acne and hair growth on your chin, etc, which is not cosmetically appealing for many women. And certainly, I didn't like it. So that's the reproductive things. And that was certainly a major concern.
And that’s one thing that people will often think about with PCOS, but it's not the only thing actually, I think the most significant thing is the metabolic issues. So PCOS is a type of insulin resistance. And many women with PCOS have insulin resistance and actually have quite severe insulin resistance. And it's the insulin resistance at the level of the ovaries and reproductive organs that cause a lot of the symptoms. So along with the insulin resistance comes high insulin and excess weight gain. This was me. But also all of the problems associated with insulin resistance, you know, increased risk of cardiovascular disease and strokes and fatty liver, and decreased health and decreased lifespan. Pretty horrible. Also an increased risk of type two diabetes, and gestational diabetes. And I had gestational diabetes with my last pregnancy. I was 41 when I had Max. And I did actually get gestational diabetes with that pregnancy. But I did manage it mostly with diet. We've done another podcast on that so I won’t go into it now, beautiful people. So that's the reproductive and the metabolic.
But then there is also the psychological consequences of PCOS, which I think are really significant. You know, depression and anxiety, really negative body image and low self esteem, particularly for those who have got excess weight, or like me, who had excess weight as a gorgeous little kid. It was a lot to hang on. Lots of problems. It can result in all kinds of mental health issues, which really, essentially can relate to a poorer quality of life than I think, perhaps these beautiful women deserve. And like I said, it affects the whole health span. It is not just reproductive age, as some people believe. It's actually throughout your whole life. Weight gain as an early kid, psychosocial issues, infertility issues, problems with metabolic health and insulin resistance, and long term health consequences as we get older. And the BMI trajectories of women with polycystic ovarian syndrome are higher than that of the general population. It really does increase people's risk of being overweight. And that is due to the insulin resistance.
So gorgeous humans. If you have polycystic ovarian syndrome, or you know somebody with polycystic ovarian syndrome, what can you do about it? What could they do about it? What can we as a society do about this incredibly common condition? Well, I would say that the management of PCOS, there is hope, there is so much hope. And the management of PCOS really needs to be tailored to the individual. But generally what we want is we want to improve people's quality of life. So improve their psychological and emotional health. And I believe so strongly that if we can help people to accept themselves as they are, learn to love themselves as they are. You. Right here listening to this. Love yourself right now. You don't need to reach some particular weight goal or some particular health goal to be worthy of love. You can love yourself right now. And in fact, I really encourage you to start doing that. To start challenging the negative thoughts in your head and realise that even if you've got excess weight, even if you've got a hairy chin, if you’ve got grey hair, a bald patch, whatever you've got, you're worthy of love and you can love yourself. I believe that is absolutely key and has been such an important part of my healing journey. The next thing is we want to reduce the symptoms.
So we want to optimise fertility and improve pregnancy outcomes and we want to improve people's health. So how can you do this? Well, a really powerful way to improve metabolic health is, drumroll please, low carb real food. You probably can't be too surprised that I was going to say that as it is one of my favourite things to say. The evidence around PCOS and low carb real food is definitely there. I'd say it's not at the absolute highest level, so it hasn't quite made its way into the official Polycystic Ovarian Syndromes International Guidelines. However, there is data. There was a 2021 systematic review of randomised controlled trials looking at dietary interventions for polycystic ovarian syndrome. And it found that a low carbohydrate diet is very likely superior for treating the fertility aspects than other diets. There's been other smaller studies looking at a ketogenic diet for women with polycystic ovarian syndrome, obesity and fatty liver. And it found that the ketogenic diet created great benefits for improving PCOS symptoms and reversing many of the metabolic issues. So it definitely has got evidence that it works. And beautiful people we’re talking about a meat and vegetable diet here. A real food diet. It really is safe for almost everybody to go on a real food diet that is naturally lower in carbohydrates. And it can reverse the polycystic ovarian symptoms. It can reverse the insulin resistance that is behind that. Many fertility experts around the world use a low carb real food approach or a ketogenic approach to help patients experiencing infertility. Really, we’re just eating real food. It's amazing. The pleiotropic effects of real food. Pleiotropic, one of my favourite terms. Many benefits; many, pleio, benefits, trophic. The pleiotrophic effects of a real food diet that's naturally lower in carbohydrates can do wonders for so many aspects of your health.
I just can't unsee the fabulous things that I've seen, and I can't unsee my own personal changes as well. So reducing your carbohydrate intake can improve your insulin resistance and improve your glucose intolerance. And really, it is insulin that basically drives the whole process with polycystic ovarian syndrome. So if you reduce your carbs, you're going to reduce the amount of insulin that your body needs to make, you're going to be able to reduce your insulin resistance, and things can get better. That doesn't mean that you don't need other treatments as well. It just is a very powerful adjunct to managing your PCOS. And it is something that has made an enormous difference for me.
There are absolutely lots of other great treatments out there. Sometimes medication can be really helpful. If you've got excess hair growth, you can get special laser treatment, you can get threading. If you've got male pattern balding in your hair, there's treatments that you can take for that, both oral medications and topical medications. There's lots of cosmetic things that very clever people can do. And the acne can be managed. I say this to especially adolescents all the time that I see, that acne is a condition that really can be treated, you don't necessarily need to put up with it. Go see a doctor. Get some treatments. If the first one doesn't work, try another one and try again. Because we really can get a pretty good resolution. And for women with PCOS, that low carb real food diet, oh my goodness, it really just gets to the heart of the issue. And sometimes things like the combined oral contraceptive pill and metformin can be really really useful as well. In conjunction with that lifestyle treatment, and that just learning to love yourself as you are.
I have to say that I felt so hopeless about my weight. I really did. I felt helpless and hopeless. Because I had been overweight pretty much all my life. Short periods of time where I would be thinner with crash dieting, and really strict calorie restriction. But I couldn't keep it up because you can't keep it up. It's not keep-up-able, totally unsustainable. So when I went back to eating how I was before, I gained all the weight plus some more and I was just on this hideous diet roller coaster for so long. All throughout my 20s. And it really was just one day I stumbled across a low carb diet. And I have told this story many times before, but I just did. I just stumbled across it. It just slapped me in the face one day. In a good way. My colleagues at a hospital I worked at encouraged me to come along to this leaning challenge at the local gym. And it was a low carb diet. Essentially, that's what it was. And so I kind of you know, was pressured into it and I gave it a go. And I was absolutely floored by my own transition. This was like my conversion moment where I discovered all the great benefits of lowering my insulin. My hunger went away. My fatty liver went away. Not my hunger, my excessive hunger went away. My fatty liver went away. My periods normalised, my blood sugar normalised. I suddenly felt empowered and in control for the first time ever. And many of my PCOS symptoms went into remission and I managed to get pregnant, which was so so cool.
So beautiful people. If you think you could have PCOS, go chat to your doctor. Get some information, information is power. There is absolutely no reason to despair. There is much that can be done. We've got lots of tools both within the realm of lifestyle change, of managing your beautiful mind, of healing your beautiful body with low carb real food and learning to love yourself just as you are. Medical treatments are there and they can be so helpful and so powerful. Cosmetic treatments are there and they can be helpful and powerful too. And gorgeous humans, change is so much easier with the right support. And Dr Lucy and I have a fabulous program that gives you everything you need for that healthy change. It gives you everything you need to learn how to do low carb real food easily and well. How to feed your family, how to go out for dinner, how alcohol is involved, how you can include sweet foods if you want to, how you can make it work for yourself. And how you can manage your beautiful mind to overcome the fear of failure to overcome that all or nothing, I'm either doing it perfectly or I'm on a total bender and hit the stuff-it button because who can do it anyway I don't even care. Or to overcome that fear of missing out, or to overcome emotional eating, stress eating, all of these things that perhaps you have struggled with for a long time. We dive deeply into self kindness and self compassion and beautiful mind management, so that you can make these wonderful healthy changes and make them stick long term. For long term health, long term weight loss and to break free from chronic disease and to break free from the shackles of high insulin, insulin resistance, feeling hungry and stuck on that wretched diet rollercoaster. Get off the diet rollercoaster for good with our fabulous program. This program of course is our 12 Week Mind Body Rebalance and it is starting again on August 26. And you can join the waitlist now and get all these wonderful waitlist only benefits. They are all yours if you join the waitlist and get on board when we start the program in August. So to join the waitlist, head over to our website, www.rlmedicine.com. And you'll see a link there to our 12 Week Mind Body Rebalance. We'll put the link in the show notes. And this is a beautiful program to transform your body and mind for lifelong health and permanent weight loss and to just live your absolute best possible life.
Dr Lucy Burns: (18:35) So my lovely listeners, that ends this episode of Real Health and Weight Loss. I'm Dr Lucy Burns…
Dr Mary Barson: (18:43) and I'm Dr Mary Barson. We’re from Real Life Medicine. To contact us, please visit rlmedicine.com
Dr Lucy Burns: (18:53) And until next time…
Both: (18:55) Thanks for listening.
Dr Lucy Burns: (18:57) The information shared on the Real Health and Weight Loss podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide, individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
