Female Hormone Health, PCOS, Endometriosis, Fertility & Breast Cancer | Dr. Thaïs Aliabadi

Key Symptoms

Thaïs Aliabadi highlights the complexity of PCOS, a prevalent hormone disorder affecting 15% of women in the U.S. and even more in some regions 1. Symptoms include high testosterone levels, irregular periods, and specific ultrasound findings, often leading to misdiagnosis or inadequate treatment 1. Aliabadi notes, "If you're older than 25 and struggling with acne, something's not right," emphasizing the persistence of symptoms like acne and hair thinning 2. The hormonal imbalance in PCOS is marked by an excess of LH, disrupting ovulation and affecting fertility 3.

   

Diagnosis Challenges

Diagnosing PCOS presents significant challenges due to misconceptions and a lack of comprehensive screening. Aliabadi explains that many gynecologists fail to perform pelvic ultrasounds, a critical diagnostic tool, leading to a high rate of undiagnosed cases 4. She stresses the importance of not labeling teenagers prematurely, as their symptoms can mimic normal developmental changes 5. "Pelvic ultrasound should be mandatory," she asserts, highlighting the need for better diagnostic practices 4. Despite these challenges, awareness of PCOS is gradually increasing, though the condition's name still causes confusion 6.

   

Treatment Approaches

Treatment for PCOS involves a multifaceted approach, addressing both symptoms and underlying causes. Aliabadi discusses the use of birth control to manage symptoms like acne and irregular periods, though she notes its limitations due to potential mood side effects 7. Metformin and GLP-1 medications are highlighted for their role in improving insulin sensitivity and reducing inflammation, crucial for managing PCOS 8. "Metformin makes us more insulin sensitive," she explains, emphasizing its safety and effectiveness in long-term management 9. Lifestyle changes, including diet and exercise, are also essential components of treatment 7.

   

PCOS and Fertility

PCOS significantly impacts fertility, but there are strategies to improve outcomes. Aliabadi recommends medications like Letrozole and Clomid to regulate ovulation, with success rates of 60-70% for inducing ovulation 10. She observes that over 50% of PCOS patients may also have endometriosis, complicating fertility further 10. "The quality of the egg is bad, but also the environment is not ready for it," she notes, highlighting the multifaceted challenges in achieving pregnancy 3. Addressing both PCOS and potential co-occurring conditions is crucial for improving fertility outcomes 10.