PCOS Explained: How to Identify and Diagnose

Summary

In this podcast episode, Dr. Brendan McCarthy, Chief Medical Officer at Proa Medical Center, discusses polycystic ovary syndrome (PCOS). He explains the normal menstrual cycle, the role of hormones like estrogen and progesterone, and how they can go awry in PCOS. Dr. McCarthy emphasizes the importance of understanding why women with PCOS aren't ovulating, highlighting factors like high prolactin levels, stress, and insulin resistance. He stresses the need for a comprehensive approach to treatment beyond just managing symptoms.

Takeaways

• 🎙️ Dr. Brendan McCarthy is the chief medical officer of Protoa Medical Center and discusses his practice's mission to provide rewarding patient care.
• 💊 He emphasizes that medicine should be about service and joy, not just a business to make money.
• 🌱 He recounts his initial inspiration to practice medicine came from witnessing the positive impact of progesterone on a patient.
• 📈 The podcast discusses polycystic ovary syndrome (PCOS), emphasizing the importance of understanding the condition's complexity.
• 🔄 Dr. McCarthy explains the normal menstrual cycle and how hormonal fluctuations, such as estrogen and progesterone, play a critical role.
• 🚫 In PCOS, the issue arises from a lack of ovulation, leading to consistently high estrogen levels without the balancing effects of progesterone.
• 🧪 He stresses the importance of investigating why ovulation isn't occurring, which can involve issues with luteinizing hormone (LH) or prolactin levels.
• 📉 High prolactin levels can inhibit ovulation and might be caused by stress, certain medications, or even a pituitary tumor.
• 🌐 The podcast also touches on the impact of diet, specifically gluten, on prolactin levels and suggests it as a potential factor in PCOS.
• 📚 Dr. McCarthy plans to delve deeper into the biochemistry of PCOS in future episodes to help listeners better understand the therapies and treatments.

Q & A

What is the role of Dr. Brendan McCarthy in ProTa Medical Center?

Dr. Brendan McCarthy is the Chief Medical Officer of ProTa Medical Center in Tempe, Arizona.

Why is Dr. McCarthy moving to a new office?

The script does not provide specific reasons for the move, but it is implied that it could be for expansion or improvement of the practice.

What is Dr. McCarthy's view on medicine as a business?

Dr. McCarthy finds the idea of pursuing medicine purely as a business and for making money off-putting. He emphasizes that his practice is focused on providing rewarding care to patients.

How did progesterone's impact on a woman influence Dr. McCarthy's career?

Witnessing the positive impact of progesterone on a woman with chronic anxiety and a life out of control inspired Dr. McCarthy to focus his practice on providing such rewarding medical services.

What does Dr. McCarthy believe brings joy in life?

Dr. McCarthy believes that acts of service, like engaging with patients and providing helpful care, bring joy rather than money.

What is the main focus of Dr. McCarthy's practice growth?

The growth of Dr. McCarthy's practice is focused on meeting and working with like-minded doctors and people who share his philosophy of being helpful to every patient.

What is the significance of the normal menstrual cycle in understanding PCOS according to Dr. McCarthy?

Understanding the normal menstrual cycle is crucial for comprehending PCOS because it highlights how hormonal imbalances can disrupt the cycle and lead to conditions like PCOS.

What is the role of estrogen in the menstrual cycle as explained by Dr. McCarthy?

Estrogen plays a significant role in the menstrual cycle by stimulating various fertility-associated tissues and preparing the body for potential pregnancy.

Why does Dr. McCarthy emphasize the importance of understanding the role of progesterone in PCOS?

Progesterone is essential for maturing the uterine lining and balancing estrogen's effects. In PCOS, the lack of progesterone due to anovulation can lead to various symptoms and complications.

What is the connection between high prolactin levels and PCOS discussed by Dr. McCarthy?

High prolactin levels can inhibit ovulation, which is a characteristic of PCOS. Dr. McCarthy suggests that even micro-elevations in prolactin can impact ovulation and should be considered in PCOS diagnosis and treatment.

How does Dr. McCarthy approach the treatment of PCOS?

Dr. McCarthy emphasizes understanding the underlying causes of PCOS, such as hormonal imbalances and prolactin levels, rather than just suppressing symptoms with medication, to provide effective treatment.