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“Me first.” How PCOS Pushed One College Student to Redefine Wellness

By Jennifer Newell Jillian LoPiano, MD

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PCOS is a complicated condition for a Betty to have.

It often means that the body produces more male sex hormones like testosterone than the average female. (Yes, females produce smaller amounts of testosterone naturally.) But the truth is, doctors can’t really agree on a set of criteria to diagnose PCOS! Using the strictest definition, it is estimated that about 7% of people with ovaries have this diagnosis within their reproductive years.

A Betty wrote in to share her story. Watch below and you’ll see that not only is the diagnosis complicated, but so is the treatment.





Yes, PCOS symptoms suck

First, we don’t know why some have PCOS and some don’t. It seems to run in families, and obesity makes some of the markers of PCOS worse. Still, we aren’t sure what causes it. We do know that a person with PCOS produces extra male-type sex hormones, which can cause things like acne, facial hair growth, and hair loss that begins around the temples or the crown of the head (aka, male-pattern hair loss).

Also, a person with PCOS doesn’t ovulate in a regular pattern. Instead of releasing one egg per month according to a cycle, a person with PCOS may release no eggs. On top of that, the ovaries may produce multiple small cysts, but no actual egg. Without a regular ovulation cycle to keep everything on track, one may have irregular unpredictable periods or no periods at all.

Finally, people with PCOS sometimes have metabolic issues such as high blood pressure, high cholesterol, and difficulty regulating blood sugar. So, there can be a lot of both symptoms and medical concerns to deal with, and this is where treatment can become complicated as well.


A few recs for balancing your PCOS and your wellness goals

We have a few general recommendations for our Betties who are managing PCOS. First, let’s start with treating the metabolic issues that come with PCOS.

Maintaining a healthy weight can be one of the greatest struggles for people with PCOS. Our hormones affect how we gain and lose weight. So, hormonal imbalances like those caused by PCOS can make it super difficult to manage consistent and healthy levels of body fat. It’s really important, though, because finding the right balance of diet and exercise helps people with PCOS feel better and reduces their risk of those metabolic health conditions.

Monitor how the changes make

you feel, and make slow and

steady adjustments as needed.

PCOS is commonly tied to insulin resistance and type 2 diabetes, so a diabetic-friendly diet of higher fats and lower carbs is a good place to start. When we use the word “diet,” we aren’t talking about a fad diet with a lot of restrictions. It simply means an overall approach to what you consume. Start tracking your food intake in an app like MyFitnessPal which will calculate your macros – the percentage of carbs, fats, and protein – in addition to tracking your calories. Over time, work specifically on reducing carbs and supplementing those calories with healthy fats, like avocados and nuts. Most importantly, monitor how the changes make you feel, and make slow and steady adjustments as needed.

We also recommend moderate exercise every day. We don’t recommend spending hours at the gym unless it’s something you love to do. If you miss a day or two, that’s okay, just start again. You can also track your exercise in the same app so you know how many calories you’ve burned. Continue to make adjustments on what you eat, how much you eat, and how much you exercise and assess your results on a weekly basis by answering these three questions: Do I have more or less energy? Is my overall mood more or less positive? Is my weight consistent or is my weight buoying up and down?

If weight loss is your goal, we want you to take a slow-and-steady approach. Again, make minor adjustments to reduce your net calories (total calories consumed minus calories burned from exercise). We do not recommend going to extremes for a number on a scale. It’s not about how you look, but how you feel. If your diet and exercise routine aren’t helping you feel better, something isn’t right.


Now for the reproductive side of PCOS

Next, let’s tackle irregular cycles. Hormonal contraceptives (e.g., birth control) prevent ovulation, which is irregular for people with PCOS. This can help with some of the difficult physical markers and symptoms of PCOS, including heavy bleeding and intense cramping. But—and this is a big but—if the side effects of birth control are worse than the original symptoms, like in this Betty’s case, a different approach may make more sense. That approach may or may not include a different type of hormonal contraceptive.

Lastly, let’s consider fertility for people with PCOS. Our Betty is juggling a lot in her life, and she may not be ready to plan when or if or how she wants to get pregnant. Unfortunately, PCOS often goes undiagnosed and many don’t find out they have PCOS until they are trying to become pregnant. The news at that time can be pretty upsetting. However, for a Betty who isn’t trying to get pregnant, PCOS treatment needn’t focus on preserving fertility.

If the side effects of birth control are

worse than the original symptoms, a

different approach may make more sense.


You’re not alone!

As we mentioned above, about 7% of people with ovaries are estimated to have PCOS. That’s over 11 million people in the U.S. So, if you’re one of the 11 million, we want to encourage you to share your story in the comments below. What has your experience with PCOS been like? How do you manage it and what resources have helped you?

Of course, for you Betties who are within our Care zone, we would love to walk alongside you and help you manage your PCOS. Sign up to be one of the first to get care from Betty’s.


Join the conversation

Okay, your turn! Ask a question, share a story, or give some advice to your fellow Betties. We do our best to monitor all comments. As you engage with each other, please help us keep the Betty's promise to be a place for trust, inclusivity, and open dialogue by being kind to one another.

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