Polycystic Ovarian Syndrome (PCOS) is the most common cause of female infertility. I’m joined by Dr. Felice Gersh, a leading OB-GYN treating patients with PCOS, to talk about the signs, symptoms, and long-term effects of the syndrome. Felice also shares some of the benefits of PCOS when you have it under control.
Listen to the Episode
You Need to Have Two of These Three Symptoms for a PCOS Diagnosis:
- Irregular menstrual cycle
- High levels of Androgens in a blood test
- An ultrasound showing tiny cysts in the ovaries
About Dr. Felice Gersh
Felice Gersh, M.D. is a multi-award-winning physician with dual board certifications in OB-GYN and Integrative Medicine.
She is the founder and director of the Integrative Medical Group of Irvine, a practice that provides comprehensive health care for women by combining the best evidence-based therapies from conventional, naturopathic, and holistic medicine.
She taught obstetrics and gynecology at Keck USC School of Medicine for 12 years as an Assistant Clinical Professor, where she received the highly coveted Outstanding Volunteer Clinical Faculty Award. She now serves as an Affiliate Faculty Member at the Fellowship in Integrative Medicine, through the University of Arizona School of Medicine, where she lectures and regularly grades the case presentations written by the Fellowship students for their final exams.
Felice Gersh, M.D. is the bestselling author of PCOS SOS and the PCOS SOS Fertility Fast Track, and she has published articles in peer-reviewed medical journals.
She is a prolific lecturer and features in several films and documentary series, including The Real Skinny on Fat with Montel Williams and Fasting with Valter Longo, Ph.D.
What Exactly is PCOS?
Dr. Felice Gersh is a leading expert on Polycystic Ovarian Syndrome (PCOS). She explains what PCOS is and how common it is among women, affecting between 6% – 12% of Americans.
A woman must have two of three specific symptoms of PCOS in order to have a diagnosis. However, there are so many other symptoms related to the syndrome, including excess facial hair, weight gain, and acne outside of puberty.
Felice says that one of the leading causes of the rise in PCOS is our reliance on plastics. Plastic, even BPA-free plastic, is toxic. It’s an endocrine disrupter that impacts women of all ages. There is no safe amount of plastic at any point and the risks are higher during pregnancy.
Society, Women, and PCOS
Felice explains that PCOS existed in women throughout history. The excess testosterone had biological benefits, allowing for extra strength and stamina when needed. As society and culture changed, however, and the introduction of chemicals, this excess testosterone leads to health complications.
Society’s reliance on pollutants and toxins, from plastic bottles to chemical cleaning products, has a negative effect on women with PCOS. Felice shares why this is and how you can start reducing your exposure to these pollutants.
PCOS increases your risk of a number of long-term health issues, such as diabetes, and Felice recommends seeking out treatment. She does not recommend the birth control pill for women with PCOS as it disrupts hormones more than they already are, simply masking a bigger problem.
Do you have irregular periods? While it might feel nice not having to deal with a regular menstrual cycle, it is damaging for your health. Call the Integrative Health and Hormone Clinic today and schedule your first appointment at 319-363-0033.
“There’s no safe plastic. That’s important to know. If it’s made out of plastic, it’s got something in it that is an endocrine disrupter and is toxic to you. There’s nothing out of plastic that you can put any label on that is going to make it safe.” [11:55]
“We now know, unfortunately, that BPA in pregnancy concentrates in the fetus. The amount that’s circulating in the maternal blood is significantly less than what’s actually in the fetus. It gave people the wrong idea. There’s really no safe level of poison. It’s just safer. Less is better than more. Not to mention the interactions with all the other endocrine disrupters in the body.” [12:17]
“Estrogen is the glue that glues metabolic functions of the body to reproductive functions so it all works together to create one whole, healthy female. So she can safely reproduce and stay healthy.” [16:46]
“Women with PCOS, unlike women with menopause, do have estrogen, they just don’t have enough. Whereas with menopause, ultimately their ovaries make no estrogen, women with PCOS just don’t make enough. But we have poor women with PCOS because they’re now producing all this testosterone. Now, why would they make all this testosterone? It’s because it’s part of the assembly line to make estradiol, the estrogen from the ovaries. If the brain is saying, ‘I don’t have enough estrogen,’ it puts out the signal, called luteinizing hormone, via the pituitary gland, which triggers the ovary to make the precursor to estradiol: testosterone. Now, you’re making all this luteinizing hormone, it goes high, and now you’re making all this testosterone, but you have this block so you can’t go down the assembly line smoothly to turn it into estradiol. So the brain keeps saying ‘more estrogen’ which makes more LH, which makes more testosterone. It’s a comedy but without the fun part. You have this assembly line and you can’t get from this step to this step properly.” [19:08]
“There are innate benefits of being PCOS. If we can take our bodies back to their origins, back to their original healthy state, without all these chemicals or toxic food, we can recreate the health and vibrant life of a woman with PCOS without all the negative stuff.” [25:03]
“It doesn’t make sense to give birth control pills to women with PCOS. We have to have better ways to deal with both contraception and all the manifestations of PCOS.” [38:46]
In This Episode
- What PCOS is and what the symptoms are [5:15]
- How common PCOS is among women [9:15]
- How much plastic to use [11:00]
- The connection between pregnancy and BPA plastic [13:00]
- What the problem with excess testosterone is [20:15]
- How our modern society, pollutants, and toxins negatively affect women with PCOS [24:00]
- What PCOS increases your risk of [27:00]
- The problem with birth control pills [35:00]
Links & Resources
Additional Resources Mentioned
Dr. Felice Gersh 0:04
By looking through all the different types of research and looking at everything that goes into what consists of a woman diagnosed with PCs, I was able to come up with a much clearer understanding of what's really going on in the bodies of women with PCs. And then to formulate a real lifestyle approach with pharmaceuticals are always in the wings. You know, if I have to I can prescribe pharmaceuticals. But that's not my first line approach. And in the vast majority of cases, I don't even have to prescribe any pharmaceuticals.
Dr. Stephanie Gray 0:38
Welcome to the longevity blueprint podcast, I'm your host, Dr. Stephanie gray. My number one goal with the show is to help you discover your personalized plan to build your dream health and live a longer, happier, truly healthier life. You're about to hear from Dr. Felice Gersh. She wrote the book pcls SOS so today we're going to dive into that topic amongst other important recommendations for balancing your hormones. Let's get started with part one of this two part series on PCs. Thanks for joining me for another episode of The your longevity blueprint podcast. today. My guest is Dr. Felice Burch. She is a multi award winning physician with dual board certifications in ob gyn and integrative medicine.
She's the founder and director of the integrative medical group of Irvine a practice that provides comprehensive health care for women by combining the best evidence based therapies from conventional naturopathic and holistic medicine. She taught obstetrics and gynecology at Keck USC School of Medicine for 12 years as an assistant clinical professor, where she received the highly coveted outstanding volunteer clinical faculty award. She now serves as an affiliate faculty member of at the fellowship in integrative medicine through the University of Arizona School of Medicine, where she lectures and regularly grades the case presentations written by the fellowship students for their final exams. She's the best selling author of pcls SOS, which we're going to talk about today and the pcls SOS fertility fast track, and she has published articles in peer reviewed medical journals. She's a prolific lecturer and has been featured in several films and documentary series, including the real skinny on fat with Montel Williams and fasting with valter Longo, PhD. Welcome to the show Dr. Gert, and I say your name right. Dr. Green, you said it perfectly.
Thank you so much for inviting me. Well, I'm excited to talk about pcls. Because as I mentioned, before we started recording, I said, I've had a lot of patients request that I bring on a guest like you to talk about ACLs. And there just aren't a lot of experts on PTs, Chapter Six of my book, Your longevity blueprint is all about hormones, but I don't really dive into pgls. So that's why I'm bringing you on the show today. So before we define kind of what pcls is, I want to hear your story. So tell me more about you. And what drove you to write this book pcls SLS?
Dr. Felice Gersh 2:54
Well, it was a book that had to be written. And I started it quite a few years before the end product was produced. And that's because I was got tied up caring for my elderly parents. But in a way, it was a destiny thing, because I actually learned a lot during those years about PCs, and I've sort of reformulated a lot of my approach. So in the end, I didn't have to have a second book that was contradicting my first book, because it's really been an evolving science about PCs. And fortunately, there have been more researchers around the world less in the United States more in other continents and other countries that have taken the lead in terms of doing some of the pcls best research out there. And so we understand more about what is really going on with it. So I saw in my practice, as you're obviously seeing in yours, that more and more women were not only having pcls, but they were having more severe manifestations. And it's like what is going on here, it's I, I can't believe what I'm seeing, you know, so many women suffering from this condition.
And so I had to do my own deep dive and looking and I call myself a synthesizer. So I read across all types of publications in terms of even veterinary research, and I look at environmental research and all kinds and then I put it all together to create a comprehensive approach and of course, understanding and solutions to the medical problem at hand. So by looking through all the different types of research and looking at everything that goes into what consists of a woman diagnosed with PCs, I was able to come up with a much clearer understanding of what's really going on in the bodies of women with PCs. And then to formulate a real lifestyle approach with pharmaceuticals are always in the wings. You know, if I have to I can prescribe pharmaceuticals, but that's not my first line approach and In the vast majority of cases, I don't even have to prescribe any pharmaceuticals. That's a great Well,
Dr. Stephanie Gray 5:06
I want to hear about both lifestyle and and the drugs. Well, let's go back and let's define PCs. So for the listener, if they're wondering, do I have PCs,
Dr. Felice Gersh 5:14
and you define what that is, the definition is actually a very simple one in terms of making the diagnosis. That's why it's so shocking when they actually had a published research study recently, that showed that the average woman with PCs has like 11, doctor visits, you know, different types of doctors before they actually get their diagnosis. And, and that is really amazing. When you hear what it takes to get the label of PCs. Sure, you need to have the following three, you need irregular menstrual cycles, you need to have lab tests showing elevated androgen so that would be like the androgens from the adrenal gland, dh a cell fe or testosterone, which comes from both of those organs, the ovaries and from the adrenal gland. And or the third manifestation is pcus ovaries on ultrasound, which is the appearance of lots and lots of little cysts around the outer rim or cortex of the ovaries. So in order to get the definition for you as a diagnosis, you need to have two of the three.
Now this was controversial, because typically, classically, PCs always included androgen excess that you always had more of the male type hormones like testosterone or DJ sulfate, with testosterone being the dominant, and you had manifestations like you had excessive facial hair or body here and places that women typically don't get or one body here, you also have hair thinning, and we call that androgenic, alopecia. And often very recalcitrant, stubborn and difficult to treat cystic or like hormonal acne and the lower part of the face and jaw. And those would be like the clinical manifestations. And in lab testing, you would have elevated levels that were well outside of the upper part of the reference range. But in this particular definition, it doesn't mandate that you have that as part of your clinical presentation. But that was controversial. So actually, technically speaking, you can have PCs and not have any androgen excess at all. But for me, that's a different problem.
It just should. Because when you look at the mechanism, that really is a different manifestation, it's a different problem. So whenever you tack on the word syndrome, like pcus, polycystic ovary syndrome, that's also that should raise red flags. That means that the medical establishment typically doesn't have a real clue as to what's going on. It's sort of a clinical observation that came up with this diagnosis, and also that it's going to be a spectrum and sort of a grab bag of different types of people that fit into that, that whole spectrum of the syndrome. So that's why not everyone, not every woman at all with PCs will be the same as another woman with pcls.
Dr. Stephanie Gray 8:07
Sure, so I have to ask if you have a lot of experience. So do you feel like the majority of your patients with PCs do have some of those high androgen symptoms? Or do you see just as many cases who don't have those symptoms?
Dr. Felice Gersh 8:19
I would say that almost 100% of my patients with PCs, have androgen excess, I think I could count on one hand, all the patients that have absolutely no clinical or laboratory evidence of androgen excess.
Dr. Stephanie Gray 8:36
Okay. Do you feel like cases of PCs are increasing? Or are we just more aware? So we're finding it more? What's your
Dr. Felice Gersh 8:44
know, they are definitely increasing, absolutely increasing. And if you look through the literature, you'll see at one point in the past, they would say pcls, occurs in 5% of reproductive age women, then it went up well, 10%. And then well, maybe it's higher. and India where I was just over a year ago, just before the whole COVID thing kind of shut everything down across the world with travel, they were talking about as high as between 35 39%, wow, female reproductive age population have some clear manifestations of PCs, but they don't actually like to report it. If as the women don't, they've tried to hide it. It's really sad, because, you know, it's not a condition that people like, not that you brag about your medical conditions, but it's not something that everyone even wants to share. They are shy and like, they don't want to talk about it. And so we have very poor data collection.
So a lot of our estimates of the numbers are always going to be under estimates because we get a lot of the data from insurance data because you know, that's where they collect. Everyone has to have a diagnostic code and it makes be coded as something like infertility or? Yeah, yeah, right. You have any of the symptoms, but they don't mean. That's right is there's so many symptoms, so they don't actually put down PCs, so it gets missed. But some people in the USA think it could be as high as a quarter of all women have some degree of PCs manifestation. So and it's really, really increasing. There's no question about it, that it's increasing. And you know, we want about it, that will help me I love it. Let's just go right to it. All right, Secrets Revealed, it's because we live in a world that is filled with endocrine disruptors, those ubiquitous chemicals that interfere with all sorts of aspects of our hormonal system, the production of hormones, the distribution, the elimination, the degradation, all these different aspects. So hormone receptor functions, all of these things are interfered with by these endocrine disruptors. And of course, the ones that are talked about a lot, we're the most are the ones that interfere with estrogen.
So they call it xeno estrogens. But it goes beyond that. I mean, they're for any hormone, there's an endocrine disruptor out there. But because estrogen is such a dominant hormone in females, that there's so much disruption with these chemicals. And when you present a pregnant woman with these chemicals, and the one that's been studied the most in PCs, women, but this is just because it's been studied the most. And it's ubiquitous, meaning everyone has this in their system. I mean, it's unfortunate, but it's like in all of us, and it's BPA, it's been a now a lot of plastics are switched, and they say BPA free, and you think Hooray, but that is now usually a plastic filled with BP s or p p s, exactly. Now, we think may be actually more toxic than BPA. So there's no safe plastic, I mean, it's important that if it's made out of plastic, it's got something in it that is an endocrine disruptor, and is toxic to you. So when you have bottles, please make them out of like glass or ceramic or stainless steel, because there's no nothing at a plastic that you can put any label on that is going to make it safe. We now know unfortunately, that BPA in pregnancy concentrates in the fetus.
So the amount that is eternal, I know it's like a sponge, it sucks it up into the fetus. So the amount that's circulating in the maternal blood is significantly less than what's actually in the fetus. So we gave people the wrong idea. Now there's really no safe level of poison. It's, it's just like, safer, like less is better than more. But the idea that well, you know, a little bit is okay. And plus, they're not even thinking about the interactions with all the other endocrine disruptors in the body, the satellites and the the pesticides, the herbicides, the heavy metals and the flame retardants. I mean, you can go on and on, they're all toxic, and they all have endocrine disruptor aspects. But when you just even look at just the levels of the maternal levels of BPA, they're substantially less than what's in the fetus. And so they were women were told it's okay, you know, the amount you have in you is not enough to be dangerous. By the way, they also recently found that the testing method was actually incorrect. So it was under estimating a mother. No, it's like another level of problem. So it was even under estimating what was actually in the mother. But the bottom line is that now we know that it's multiple times that in the fetus. So what happens when you put an endocrine disruptor that interferes with all of these different aspects of endocrine functioning and production everything into a fetus during the very time in the fetal life when the endocrine system is actually being created? Exactly. So your receptors and your organs are just developing in terms of we're using these hormones?
Well, it's disastrous. So we now know that the receptors for estrogen and there's different types of estrogen receptors, there's alpha and beta. And another type that's a membrane receptor called Jeepers, alpha and beta are complex, but they're predominantly nuclear receptors. So they do their action in the nucleus of the cell. but not exclusively, everything is more complex than we first thought. But it turns out that the alpha and beta receptors of women with PCs are not functioning properly. So it's like if you people all know about insulin, and so they say, well, you have insulin resistance. So what the heck is that? It means that the receptors for the hormone called insulin are not functioning properly. So in order to get the proper effect, you have the body pumps out more insulin to use higher to try to get what you should only need a much smaller amount to accomplish the same goal, which is transporting glucose into cells. Well, the same problems happen in Women with pcls their estrogen receptor isn't working right. So it's, you know, you can have estrogen. But what difference does it make if it can't get into a receptor and then create the desire to fit? Well in the body of a diabetic in the beginning at least it ultimately burns out and a lot of type two diabetics ultimately need to take indiginous insulin to order in order to function. But in the beginning, their pancreas can just bump up production and make more so it can maintain the glucose level at the expense of stressing out the pancreas and having higher levels of insulin.
But if women with PCs we don't have that even as an option. The ovaries actually are inherently having a problem in producing the estrogen. All estrogen in the ovary and elsewhere comes from androgens in the ovaries. It comes from testosterone. So testosterone is a precursor hormone to Astra dial and the way it's converted is through the action of an enzyme called aromatase. Well, it turns out an aromatase in order to function requires the function of another enzyme called a polymerase, it needs follicle stimulating hormone at the right amount and the right time. And that's all off so it's not working right. And so the action of aromatase is deficient in the ovaries of women and PCs. So you don't make up the slack by just making more estrogen for your estrogen receptors. So you have this double whammy of having lowered production of estrogen in the ovaries of women with PC with and lowered functionality of the estrogen receptors, which are located everywhere. So that's the thing that a lot of people don't know is that estrogen receptors are present on every organ system. So estrogen is like the glue that glues metabolic functions of the body to reproductive assumptions. So that all works together to create one whole healthy female so that she can safely reproduce and stay healthy, because pregnancy is a very metabolically stressful state for a woman.
That's why we now know taking histories of what happened to women during their pregnancy is very foretelling of what's going to happen to them as they cross into the menopausal years, which is another metabolically stressful stage for women. So what happens is women with PCs, essentially, are living in a very metabolically stressed body because they don't have enough estrogen produced and they don't have enough function of the estrogen that they do have, which that's why there's so many similar metabolic manifestations not talking about reproduction, that type of thing. But just looking at metabolic issues that are so similar between menopausal women and women with PCs, the etiology of the problem is different. Other issues like relating to fertility, testosterone, they're different.
But if you just look at the metabolic issues, which are related to lowering amounts of estrogen in the body, you can see similarities like insulin resistance, more prone to diabetes, more prone to mood problems, sleep problems, sleep apnea, Hypertension, cardiovascular disease, acid reflux and things like that. There's a lot of similar manifestations also, obesity with the visceral fat, you know, the belly fat occurs in women in the menopausal transition, and thereafter, and women with PCs, because it turns out that there are very critically important estrogen receptors on mitochondria, the little organelles that create energy that burn fat, so women after menopause have decreased ability to create energy and burn fat. And the same thing with women with pcls. So once you understand that estrogen is important for all aspects of metabolic health, then you can understand the metabolic problems that women with PCs face, they're related to insufficient amounts of estrogen, insufficient functionality of estrogen. But then of course, women with PCs, unlike women with menopause, they do have estrogen they just don't have enough with with menopause. Ultimately, their ovaries make no estrogen. Women with PCs just don't make enough. But we have poor women with PCs because they're now producing all this testosterone. Now, why would they make all this testosterone because it's part of the assembly assembly line to make extra dial the estrogen from the ovaries.
So if the brain is saying I don't have enough estrogen, it puts out the signal called luteinizing hormone via the pituitary gland, which triggers the ovary to make the precursor to estradiol, testosterone. So now you're making all this lH luteinizing hormone goes really high, and now you're making all this testosterone, but you have this block so you can't go down the assembly line smoothly to turn it into extra dial. So the brain keeps saying more estrogen, so that makes more Lh that makes more more testosterone. Yeah, I know. So you have like, it's like they know it's like, like a comedy only without the fun part, you know, like you have this like assembly line. And you know, you just can't get from this step to this step properly. So you get a backup of all of this, this is our testosterone save all this testosterone. Well, it turns out that when you have high levels of testosterone, it alters the gut microbiome that even promotes more testosterone. And then to boot to make things like, you know, insult to injury, we now know that we consume in the United States and across the world, what has been labeled the Western diet, or the sad diet, standard American diet, which is full of crap. So that creates a lot of gut dysbiosis and leaky gut.
And it turns out that women would piece us this, the first study came out of China, that they have impaired gut barrier assumption, they have leaky gut, they have dysbiosis, they have the wrong gut microbiome, which then creates more inflammation, and their immune cells. This came out in 1998, the immune cells, the innate immune cells, like mast cells, and neutrophils and macrophages that create all the inflammatory response, you know, that is designed to kill pathogens invading via bacteria and viruses and parasites, that those cells which line the gut and there's tremendous numbers of them lining the gut, that they have a lower threshold to be triggered to create the inflammatory response. So now, on top of everything else, you have all these toxins, these endotoxins coming out of the gut to the leaky gut, passing between the gaps in the lining cells into the area inside the body where all these immune cells are living. And they're like exploding with their inflammatory cytokines creating this inflammatory response in response to the toxic stuff coming in, because the immune cells are designed to respond to pathogens and damage.
So this is like damaged stuff. So you have the pathogens of bacteria from the gut coming in the damage coming in. So they go, they become like explosive, and then you create this chronic state of inflammation. So and that drives more insulin resistance. So inflammation drives insulin resistance. And then on top of everything else, when you have high levels of insulin and glucose, which then promotes even more inflammation that promotes the production of higher levels of another hormone, insulin like growth factor, one IGF one, which has receptors in the ovary, which in turn triggers even more testosterone production is vicious, vicious, vicious,
Dr. Stephanie Gray 22:38
assembly line analogy. I think that's great for listeners.
Dr. Felice Gersh 22:41
But all of these problems are modern problems. That's why pcls is escalating in its prevalence, because in ancient times, we didn't eat crap, because there was, I mean, they might have eaten tainted food. And that's why we have all those immune cells lining the gut in case of food poisoning, but it was different problem, but they weren't eating processed food. They weren't eating glyphosate and emulsifiers, and pesticides and all this weird stuff that somehow is now part of our food supply. And they obviously didn't have all these endocrine disruptors, it was no plastic, there were no flame retardants, and all of that sort of thing.
So women in ancient times did have PCs, because it's genetically in them to have this very mild defect in converting testosterone to estradiol, but it was very mild and it wasn't a handicap, it turned out it was actually a bonus, because they had just slightly reduced fertility. Just a little bit extra testosterone, not enough to create a beard and acne and all these problems, but just enough to make them more dynamic, more outgoing, more. The leaders, you know, because they've actually done studies of women who were Olympic gold medalists, and they found that they had this like really mild, more will say normal version of PCs, they have a little bit higher levels of testosterone. Yeah, you know, as a bonus, right. In fact, we know that women who are like triple X chromosome, they don't make hardly any testosterone. It's just a genetic, you know, abnormality. They're like trisomy for three exes.
And they are much shyer, they're less outgoing, they're more timid. And with a little bit of testosterone, it's like, okay, nobody's gonna push me around, you know, so like the women with a little testosterone, they're a little bit more out there, you know, they're just gonna be more adventurous and so on. So it was really a plus to have the genetic pcs of many millennia ago. But now fast forward to today's toxic world toxic food, toxic environment with all these chemical endocrine disruptors, we've taken what was an advantage and turned it on its head into a huge
Dr. Stephanie Gray 24:51
Dr. Felice Gersh 24:54
A burden like on the healthcare system on the women on their lives, and that they Is that recognizing that there are innate benefits of being PCs, and that if we can take our bodies and the women's bodies with PCs back to their origins, you know, back to their original healthy state without all the chemicals without this crazy toxic food, that we can recreate the health and vibrant life of a woman with PCs without all the negative stuff?
Dr. Stephanie Gray 25:26
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Dr. Felice Gersh 26:58
Well, there's reproductive issues. And in the reproductive world, it's the number one cause of infertility. I mean, it's really huge. And unfortunately, it's also a problem with for women who end up going for advanced reproductive technologies like IVF, they have actually very high failure rates. And the reason is because they have so much inflammation in their bodies, that they have inflammation even in their ovaries, and their egg quality is reduced. They actually had one study where they pulled some fluid out from the ovary around a follicle, you know, the little fluid and they found it was filled with inflammatory cells. So that means it's inflamed, so you don't you're not going to have healthy eggs in an inflamed environment.
So that's so you know, you can you can put an egg and a sperm together but if the egg is you know, junky, the same thing for the sperm By the way, you know, there's a lot of men that are having a lot of sperm quality to problems, but so basically, it's a big problem for women. You know, you can trick them into ovulating but if the egg is crappy material, it's nothing to do with it. And then they have high rates of miscarriage, you know, so it only takes for a little while doesn't work, right? So they have high rates of infertility. They have high rates of miscarriage and when it does work and they get pregnant. They have very high rates of pregnancy complications, gestational diabetes, Pregnancy induced hypertension, preeclampsia, preterm labor, abruption, and their babies can be either growth restricted, they're too small, or they can be macrosomic. They're too big. Because if the placenta is malfunctioning, and it doesn't deliver the nutrients and the oxygen adequately, you get a like a small, undersized baby that's malnourished, right?
And so that's bad that that baby is going to be metabolically challenged. But if the placenta is doing okay, but you have all this insulin resistance, which pregnancy magnifies, so pregnancy is innately an insulin resistance state, it's when you tip over the edge that you become gestational diabetes, which is so prevalent in women with PCs, then they have too much blood sugar, well, that's going to all go to the baby because that blood sugar plant passes right through the placenta. So you're that baby's being pumped up with glucose. So you get this like really jumbo Baby, you know, 1011 pound babies, and they have their own metabolic problems, too. So the each end of the spectrum leads to a baby that's going to be a child and a person that is going to be already handicapped with metabolic issues from the day that they're born even before, you know, because they're programmed and it changes who have their genes are manifesting, they call it an epigenetic modification. So the bottom line is many, many pregnancy related complications. Then, if you think about all the things that can go wrong in pregnancy, like hypertension and diabetes, well, those can manifest without pregnancy to women who are just pcls. They are more prone to diabetes by age 40.
Women with PCs have a seven times higher chance of becoming diabetes by age. Toni than the average woman. It's huge, they're more prone to hypertension. And then the arteries themselves, they're more prone to not they don't make nitric oxide, a gas that keeps the arteries dilated and keeps the lining the intima, the lining of the arteries healthy. So they don't have the healthy arteries that other women could have. It's like premature aging of the vascular system because of estrogen deficiency. So and then, of course, inflammation surplus, what a great combination, you know, too much inflammation and not enough estrogen. And of course, they go together, because estrogen is very key to regulating inflammation and the immune system and so on. That's why there's estrogen receptors on all immune cells, because it's part of that whole process. So you end up with all of these manifestations, and then it gets worse, because you get Don't
Dr. Stephanie Gray 30:51
Dr. Felice Gersh 30:53
know that women. They have a much higher rates of anxiety, depression, I mentioned sleep, so they have problems with insomnia, they have more sleep disordered grieving, which includes sleep apnea. And then they have more autoimmune conditions. So they're more prone to hashimotos thyroiditis than the average woman. But they're also more prone to other autoimmune diseases as well, like lupus and women with PCs, this is not often recognized. They also have higher rates of other reproductive problems of females, like uterine fibroids and endometriosis share more common in women with ACLs than the average woman. It's not like you're only allowed one reproductive problem, I wish but it No, it doesn't work that way.
You could have fibroids and endometriosis and yeah, so it's like, oh, no, but it but it is true. And they're more prone to like, having aches and pains like in their joints were osteoarthritis and more gut problems, like irritable bowel syndrome, or acid reflux, and weight problems, like 80% have a weight problem. And even the ones who and it's very hard to lose weight, because as I mentioned, they have insulin resistance, which means their insulin levels are too high. And insulin, which is a vital hormone for survival, also has as its one of its main missions is to promote and store fat. So that's the problem, it's impossible to lose weight when your insulin levels are high all the time. And because that's just the opposite of what insulin allows. So you've got to get those insulin levels down in order to lose weight. And the mitochondria are not good at burning fat, the skill set in order to burn fat is just not there. So women with PCs live in a sea of energy, because they have all this fat, all this stored energy, but they can't harness it into creating energy so that they often are very tired. And they're, you know, they it's just a very bad thing. They, they, they they're cold, they don't feel good, because they can't create the energy yet they're living in a body filled with energy. And even the thin women, they call them lean PCs, they do not have normal body compositions, if you actually tested them, they may look okay on a scale, or if you look at them, but when you look at their body composition, they have higher amounts of visceral or belly fat and organ fat.
And even the thin ones are more prone to fatty liver, which is very prevalent among women with PCs, which then adds fire fuel to the fire because once you have a fatty liver, non alcoholic fatty liver disease, your liver is inflamed. And it goes into a dysregulated state where if the liver produces cholesterol and triglycerides, and glucose converts it from its storage form, which is glycogen. So the liver then spews out into the bloodstream, excessive amounts of cholesterol triglycerides, which are the fats and glucose. So you have this uncontrolled production of all this stuff coming out of the liver, that's not in relationship to what the body needs, which then of course, creates even more metabolic dysfunction. So these are some of the problems that PCs can face. Now, not every woman has every one of these problems, thank goodness. And it's a spectrum. So some have a little some have a lot but these are all within the sphere of issues that women with PCs face
Dr. Stephanie Gray 34:20
and I'm glad you're mentioning all of these because I can I can tell you right now a lot of listeners who are listening want to be listening to this episode because they have PCs have probably never heard 90% of what you just shared right there just told Oh yeah, PCs, you know, take birth control or payment for whatnot. And they're never, you know, never given any of this information. And so this is going to be just an amazing episode. So
Dr. Felice Gersh 34:43
why haven't we got one thing, but one thing into the midst because you brought up birth control pills, which is the ubiquitous treatment like everyday poor women, the pieces that go in the first thing they're told this will regulate your cycles? No, there's no regulating cycles with birth control pills. They take down the ovarian function altogether. And they can give in some PCs, women some symptom improvement because they take the ovaries offline. So now the ovaries aren't making so much testosterone and they're you know, and it changes the liver function. So you make more binding hormone to a binds up sex hormone binding globulin, which binds up some of the excessive testosterone that circulating, so you can actually improve some of the symptoms, I cannot deny that. But birth control pills are metabolically bad for women. And everyone knows that, that it's in the books, right that birth control pills can increase blood clots. So what's that all about? Is that an isolated event? No, it's the blood clotting increase is part of the inflammatory response.
That's part of the life saving inflammatory response that people have when, for example, you're attacked by an animal and you or you have an accident, you get a big gash in your arm, that's going to create an inflammatory response that the immune cells rushed to the scene. And they're going to create all those enzymes to try to kill the bacteria that creates that redness in the skin, that's not infection, that's inflammation, so that you're trying to kill invading bacteria that could come in, and then you're bleeding, right? So you're going to activate your platelets so that you'll clot so you don't bleed to death. And then platelets are also about healing. So then you're going to activate the healing properties of platelets, which are all this stuff is related to estrogen if that skin even makes estrogen because it's so important for these functions. Well, part of this whole inflammatory response, which includes the the instigation of inflammation, and ultimately, the resolution of inflammation, so it's a process, but the institution of the process of, of inflammation includes activating platelets to create blood clotting, so you don't bleed to death if you get a big gash in your arm. birth control pills activate that, right birth control pills create a chronic state of inflammation, that promotes increased blood clotting. So that is a bad thing.
Because we do not want to have chronic states of inflammation. That's what birth control pills can cause more high blood pressure in people. That's why we don't give them to smokers. We don't give them to old people, we wouldn't give them to a woman who just had a heart attack. I mean, that's ridiculous, right? Because we know that these are not good for your metabolic functioning. Well, women with pcus have underlying issues, they produce metabolic dysfunction and risk, you know, of all the things that we just talked about. So and women with PCs, because they are chronically in a state of inflammation, like because their immune cells are lower to trigger inflammation response, they have this high levels of glucose, insulin resistance, and and they have all that they tend not to be as good as detoxifying, when they've done studies of women with pcusa have higher levels of environmental toxins in them, not necessarily because you're exposed to more but because they're just genetically not as good as getting rid of it from their bodies. So that creates a state of inflammation that occurs in women's bodies with PCs.
Why would I give them a drug that further exacerbates that condition. And there's now been published studies that show that women with PCs who innately have increased risk of blood clots, when they add birth control pills into the mix in further increases their risk of having blood clot, it works, it takes a bad situation and makes it worse. So that is illogical. There are published papers now showing that young women on birth control pills have increased risk of cardiovascular events later in life. Why one Earth worldwide want to give those drugs to women who already have these risks inherently within them, and have all these additional potential for cardiovascular risk as they get older as well. So it doesn't make sense to give birth control pills, we have to have better ways to deal with both contraception and the all the manifestations of pcls. Well said.
Dr. Stephanie Gray 39:03
As you can tell Dr. Gersh is more than an expert on pcls. She's literally a prolific lecture on this content and there is more to come. So be sure to check out next week's episode, which is part two of our conversation on PCs, where we get to the hope as far as how you can swing odds in your favor and heal from PCs. Stay tuned. Be sure to check out my book your longevity blueprint. And if you aren't much of a reader, you're in luck. You can now take my course online where I walk you through each chapter in the book plus for a limited time the course is 50% off. Check this offer out at your longevity blueprint calm and click the course tab. One of the biggest things you can do to support the show and help us reach more listeners is to subscribe to the show. And leave us a rating and review on Apple podcasts or wherever you listen. I read all of the reviews and would truly love to hear your suggestions for show topics, guests or how you're applying what you've learned on the show to create your own longevity blueprint. A podcast is produced by the team at counterweight creative As always, thanks so much for listening and remember, wellness is waiting.
The information provided in this podcast is educational. No information provided should be considered to be or used as a substitute for medical advice, diagnosis or treatment. Always consult with your personal medical authority.
Transcribed by https://otter.ai
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