Dealing With PCOS: Live Class with Dr. Shi Armero (Part 1)

Last July 2021, we held our first Facebook live class and a virtual health talk here at Blue Bee One with Dr. Shi Armero. She discussed how to deal with PCOS or Polycystic Ovarian Syndrome. Read this article to learn more about our first live class! 

What is PCOS?

Dr. Shi explained that PCOS is a very common endocrine disorder and the common cause of infertility in women. In PCOS, hormones that are involved affect the reproductive system and cause abnormality thus further causing irregularity or absence in ovulation. 

That’s why women with this condition are unable to produce mature eggs. She added that 4-12% of women are affected by PCOS according to statistics. Also, there are 1 in 10 women who are affected with PCOS. 

Some Cases of Polycystic Ovaries

In this part, Dr. Shi introduced PCOS-related cases that many women in the audience might be able to relate to as they can type their comments in the chat during the live class, especially if they can relate to the cases. 

• MA, 23 years old, constantly visits her Dermatologist due to severe acne. She’s having irregular menstruation so she was referred to a Gynecologist. Upon examination, there were dark hairs on the upper lip and she had a lot of hair on her body. When she had her transvaginal ultrasound, it revealed that she has polycystic ovaries.
• NB, 32 years old, she’s having difficulties getting pregnant. She has an inability to conceive after 2 years of trying. Also, she noticed that her menstruation was getting irregular. As she went to the doctor’s clinic, the doctor saw she had some pimple scars. When the transvaginal ultrasound was performed, it was revealed that she has polycystic appearing ovaries. 

So, what are polycystic ovaries? Dr. Shi explained that the normal ovary has a common pattern of growth of follicles which eventually matures. While in a polycystic ovary, instead of growing to become a mature follicle, it ends in a follicular arrest and too immature follicles. That’s why in polycystic ovaries, there are multiple immature follicles. 

Polycystic Appearing Ovaries vs. PCOS

But, are polycystic-appearing ovaries similar to polycystic ovarian syndrome? Dr. Shi told the online audience that polycystic appearing ovaries are different from polycystic ovarian syndrome (PCOS). She added that PCOS has to have two out of the three criteria for it to be PCOS. 

The first thing is the irregularity in menstruation. Second, there are signs of male hormones or elevated amounts of total testosterone.

If you are noticing that you have hirsutism or have thick dark hair on your face and body, it is one of the clinical signs of hyperandrogenism. Additionally, this sign remains to be one of the crucial factors in a diagnosis of PCOS.

The presence of insulin resistance happens to be another aspect of PCOS. Too much food intake or overnutrition can affect the insulin receptors as it greatly contributes to insulin resistance. 

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Moreover, she mentioned that if you are too stressed, a woman does not menstruate for a while. If you are trying to get pregnant but you have overnutrition, poor diet or unhealthy food, keep on eating processed foods, smoking, and other bad lifestyle practices, these factors immensely affect PCOS. It is important that we know what to do next after determining the problem.

Steps to Follow If You’re Seeking Fertility

Next, she added that if the problem is more of depression if you’re a little irritable and always crying, you need to take the transvaginal ultrasound and if there is no problem other than Polycystic ovaries. And if there is no problem with the lining of the uterus as well as the fallopian tube, you need to take a thyroid screening test. The thyroid organ is an essential organ of metabolism. If you have a problem there even though you’re skinny, the screening test for that is the thyroid-stimulating hormone and lipid profile. 

If you’re still 20 years old and not ready to get pregnant, doing the screening tests like these can help you to be aware of your fertility in the early stages. It is not just about taking pills to make the process faster for you to be cured, but lifestyle modification is the top method, and you should strengthen the modification of your current lifestyle.

So, if you feel that you usually vomit or you have body pain that is getting worse during your menstruation, it can be due to one of your manifestations either because of PCOS or because of hyperandrogenism or maybe you have a different problem. 

PCOS, Pregnancy, and Infertility

Dr. Shi said that it is very important to discuss PCOS and pregnancy because both of these factors can affect you either if you want to get pregnant or if you don’t want to get pregnant. If you want to get pregnant, many people ask:

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Can PCOS cause miscarriage?

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The answer to this question is yes because it can cause miscarriage according to some studies.

Also, what is infertility? If it takes too long trying to conceive the actual pregnancy, she said that we will expect a lot of obstetric complications or we become high-risk. She explained that she’s not just an OBGYN but she’s also a lifestyle medicine specialist as she usually monitors her patients monthly. Those who want to get pregnant and for those who are not, she’s trying to manage them and always to follow up with them monthly. 

Because, she needs to look at the blood pressure, the weight, and the food. Interaction should be patient-centered and individualized, especially because we have diverse cultural backgrounds, lifestyle preferences, socioeconomic and ethnic variations, especially here in the Philippines we have different practices. 

“Don’t be too critical of yourself,” she advised the audience, especially the women who are having difficulties in their reproductive health. “We should look at areas where we see quick success. If you love to dance, you want to do Zumba, let’s strengthen that and we’ll work out on the areas that are weak, especially on the food. If you can eat veggies only with no meat but can’t exercise because you’re too tired at work, we can start with the food, and then after that, we transition at least on your workout or exercise schedule.” 

Here are some of the tips she mentioned for the prevention of weight gain and the maintenance of good health:

• At ages 18-64, min. of 150 minutes per week of moderate-intensity physical activity. 
• Eat nutritious foods and have a balanced diet.
• Sleep well and avoid too much stress.
• Avoid smoking and too much alcohol intake. 
• These issues can be addressed and can be managed as long as your management is right.

CONCLUSION

If you are having some issues in your menstruation or getting pregnant, we recommend that you read this article about dealing with PCOS, especially if you want to have a successful pregnancy. To know more about maintaining good health for better fertility, Dr. Shi shares some of her medical knowledge and insight for couples and education women in her YouTube channel, Doc Shi TV. You can also watch the full video on youtube. 

Next Topic: Causes of Infertility and Ectopic Pregnancy (PART 2)