An Integrated Approach to PCOS with Dr. Jennifer Roelands

Hi, I'm Dr. Tabitha, the gutsy gynecologist. I'm a triple board certified, OB GYN and Functional Medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey. And I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyne health and your overall health. And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more band aid medicine, ladies. We're talking root cause resolution on this show. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome. Welcome back, ladies. Okay, I keep getting requests to do more episodes about pcos. I think there's still some confusion around what it is, what it isn't. And women are, you know, going to their gynecologist or the primary care doctors and you are just given the standard treatment. The birth control pill is told to be a treatment, Metformin, inspironalactone. And that really is not the treatment. You guys, those are symptom managers. They are band aiding the issue. It's not actually fixing what's driving this pcos. And so I found someone who has been through this journey and she's actually another ob gyn. She's had PCOS and she is an integrative doctor. And so she has the awesome perspective of also treating it conventionally and now treating it integratively with all of the tools of nutrition and lifestyle changes and everything that actually gets you back to wellness and not just managing this disease. So I hope that you'll stick around for this episode. Or if you know any woman who is struggling with things like chronic acne, irregular periods, you know, chin hair growth, or thinning of hair on the head, those are really common symptoms of pcos. So it might be worth passing this episode along. A lot of you probably have daughters who potentially are dealing with this situation. And here's another issue that goes along with it is at the first sign of these imbalances, it's really common to get put on a birth control pill because gynecologists are just trained that that's the answer to everything. And so you may have PCOS or your daughter might have pcos, but it's being masked the birth control pill is actually masking the problem. And so women are walking around thinking they're having periods every month, when really it's just a withdrawal bleed that is created by those synthetic hormones in the birth control pill. So you don't have regular cycles. Your endocrine system is not actually functioning and working. The birth control pill is giving you this false security, this false sense that everything is okay when it in fact is not. And there is now evidence that birth control pill usage can also cause pcos. So it's very complicated and conventional medicine does not understand it. Honestly, PCOS is, you know, my guest is going to talk about this today, but it's a syndrome. It means that we don't have any other explanation for what's going on. You have this constellation of symptoms and you have some kind of underlying metabolic and endocrine dysfunction. And so take a birth control pill. And honestly, the birth control pill, it's just shutting down your own hormone production. It stops the conversation that your brain and your ovaries are continually having all day, every day, where your brain makes hormones, talks to the ovaries, the ovaries make hormones and talk to the brain. And the birth control pill stops that conversation, stops your hormone production. And you are taking synthetic hormones to grow the lining in your uterus every month and therefore having a period. But you are not cycling your hormones. It does not regulate your hormones. It does not balance your hormones. It stops your hormones. And I mean, the most notable thing about that is the birth control pill stops testosterone production in your ovaries. And so that is why, as a band aid, it helps PCOS because it stops the production of testosterone, which is one of the main symptoms of pcos. But it doesn't actually stop the driving process that's causing the elevated testosterone in the first place. So I hope that makes sense to you. And most likely, if you're listening to this, you've been given the birth control pill and realized it doesn't really fix your problem because every time you try to come off of it, you either go back to having super irregular periods or no periods and all the symptoms come back. So my guest today is going to talk about how to heal pcos. What are the root causes, why is this happening, and how does she address them as a physician and what it looks like to work with her. If you are looking for someone to help guide you down this journey. And so this is a great episode. Let me just sing her praises really quick. Dr. Jennifer Rowlands. She calls herself the CEO of, well, Women MD instead of the CEO. It's a virtual women's health clinic founded on the passion for reimagining, a more holistic approach to women's health care. She specializes in pcos, hormones and gut health. So obviously we got along really great. She partners with women to find out the root cause of their symptoms so they can have energy and predictability in their periods, their weight, their fertility and feel like themselves again. She's an integrative medicine trained obgyn, very much like me. She's a speaker, a podcaster, and mother of four as a former PCOS sufferer and she also has Hashimoto's. She's been on that hormone roller coaster even as a doctor. She was blown off by other doctors and told her labs were normal. That sent her on a quest and she discovered the root cause of her symptoms and she was finally able to lose weight, clear up her skin, wake up feeling rested and having energy, and then she ultimately got pregnant. So she has a podcast that's called Ignite Her Power and it aims to educate, support and give real solutions to women's health issues. So listen to this all the way through. If you need to pause it and come back, that's the beauty of the podcast. Or rewind it and listen to something again, go. Oh my gosh, yes. And please click the show notes because she has a quiz, a root cause people PCOS quiz that you can take the link to, have a discovery call with her. There's a 20 minute free call where you can figure out like, is this my issue? Can you help me? The links are all in the show notes for that. So she's a wealth of knowledge and a great resource. So I hope that you get so much value out of this. Here we go. Well, welcome, Dr. Jen, to the Gutsy Gynecologist show.

Thank you so much. I'm excited to be here.

I am too. We need to have this discussion because I am seeing so many women misdiagnosed with PCOS or not getting the diagnosis when they need it. Are you seeing the same thing over on the West Coast?

I am. I'm seeing patients who or taking a very long time to get a diagnosis. They're kind of in this limbo land of what's going on. Why are all these things happening to me? And taking years and multiple doctors to get the diagnosis. Yeah.

And I just remember practicing conventional gynecology and there was always those obvious patients, Right? You're overweight, you have chin hair, a lot of acne, you haven't had Period in six or eight months, it's really easy. Like, oh, yeah, you have pcos. Let's get you on metformin, let's get you losing some weight and see how it goes. And it wasn't until I really started studying functional medicine that I started thinking about those patients and what a disservice I had done to them. And like, oh, she was at my appointment drinking her Mountain Dew and she was a third shift worker and like all these things that we didn't address or talk about. And so I would love for you to just debunk a lot of stuff, help women really understand what the heck PCOS is, because everybody's confused. I get DMs like, oh, I have cysts on my ovaries, I must have pcos. Or I'm thin, so my doctor says I don't have it. So let's just break it all down from the beginning, since this is your jam. Like, what is PCOS and what is it not?

Yeah, so pcos, Polycystic Ovarian syndrome. And it's a syndrome that's probably one of the biggest myths here that we should probably talk about first, is it's called a syndrome because you really have to rule out everything else first. You have to make sure that someone doesn't have a thyroid problem or hypothalamic amenorrhea. Really big word. Like you need to make sure that you've ruled out the other things. And so then, you know, it becomes a syndrome because you've now have these constellation of symptoms or constellation of signs that then say she, she meets the criteria for pcos. And those two really big ones are hyper. Androgen. Hyperandrogens or high male hormones, people typically refer to them. Although we have testosterone in our body, so it's kind of a little bit of a misnome. And then anovulation, or you're just not having regular cycles. So you really need those two really key components of, to make the diagnosis. And in the past, we used to use a criteria where we would include seeing cyst on the ovary, but it's not. They're not cysts. They're actually follicles that are inside of the ovary and they kind of make this appearance that looks like a string of pearls. But nowadays I think more people are accepting the fact that this is not required for a diagnosis. In fact, there are, I think it's like 10% of women that will have PCOS appearing overs that don't truly have pcos.

Right.

So you can't use it as a criteria anymore. If you happen to get it, great. If you don't, it's okay. It doesn't mean that you don't have pcos. So really, the two big components here are irregular cycles or an ovulatory cycles, and high androgens.

And what's driving these high androgen levels? Like, why are women getting elevated testosterone and DHEA levels?

This is a little bit controversial because people think this chicken and egg philosophy, right? Is it the high androgens that then cause insulin resistance issues that cause inflammation issues, or is this insulin resistance issues that then ultimately lead to high androgens and inflammation? Like, where's the start of kind of this idea as to why someone is destined to have high androgens? And there's even some. I've seen some work by, you know, Dr. Felice Gersh is someone who does a lot of this PCOS work, and she's looked a little bit into also that genetically, you know, we're starting to find more and more information about SNPs and someone's genetic potential and, and maybe they actually have this sort of. I don't like the word dysfunction, but this sort of turning on of a gene where the ovary is just not as capable of getting that ratio of estrogen to testosterone correct. And so the more and more I think we find about genetics and these SNPs and what they mean, I think we're going to find there's sort of these women that are destined to have pcos, and then certain things, it could be environment, it could be that insulin resistance turns these genes on and they ultimately sort of become PCOS patients. Okay.

I love that simple explanation of like, you're not having periods and your androgens are too high. That makes it so clear because I had a patient just last week who has a period on her own every single month, yet her OB just told her she has PCOS because her testosterone was two points above the range on the lab result. And so I, I never want to, you know, go against another doctor or badmouth another physician. But I had to explain to her why I just don't think that was a correct diagnosis and why we're barking up the wrong tree, essentially. Wouldn't you agree?

Yeah, I mean, I think someone like that, that's very gray zone too. I mean, I would be. Two points isn't very much. Right? You see PCOS patients and their Testosterone is like 80. Yeah. I mean, it's high and they have signs of high androgens. They may have really bad acne or they have chin hair, or they just kind of have these appearance hair along the midline. They kind of have those symptoms and signs that kind of go together. So rarely if someone is, is in that scenario, often I'm like, well, you know, it's not, it won't harm anything to repeat these. And also making sure your insulin resistance isn't high. Right. Like, could there be another reason why your testosterone is a little bit up that we may need to sort of just deep dive into? And then once that's corrected, maybe you truly don't have pcos.

Right. That was the other issue is her fasting. Insulin was 3. I was like, your, your insulin works just fine. Your blood sugar is great. Your A1C, I think, was 5.1 or something like that. So I, I think it's super important to look at all of the pieces of the puzzle and really get the full. So say someone has been diagnosed with pcos, they get put on metformin, they realize it's not really working. You know, maybe it's causing loose stools, stomach cramps, hasn't really regulated their periods, and they go searching, you know, what are you bringing to the table that is going to be such a game changer for them? You know, we're both conventionally trained doctors. And so what I found is that these women who have been left for dead, essentially by conventional medicine or told the wrong things or just blown off, they don't necessarily want to hear from us as physicians, even though we have gone on to see the light and understand integrative and functional medicine, because of what they've gone through. And so they're more apt to look to a health coach or just another woman who has gone through their scenario. And so I would love for you to explain to women, like, what is your process for really getting them to get back to wellness? And how is that different than what you did 15 years ago?

Yeah, so the beauty of PCOS is, is that not every woman is the same pcos. Women are very uniquely different. I mean, you can use the word types of pcos. You can use the word phenotypes in medicine. Like, you can use different, because I know this comes in the naturopathic world. They talk about PCOS types. It doesn't really matter. You don't want to box someone into those types anyway, because it changes throughout their lifetime. But everyone is different. And so when I work with patients, what I used to do is say, okay, do you want to have a period or not? Here's a birth. I mean, do you want to get pregnant or not? If you don't, well, birth control is your best option if you're having weight issues. And I'll add metformin. If you're having acne, I'll add spironolactone. That used to be sort of the cocktail for everybody. Right. Like, it's just, you want a lemon drop martini? It's consistently a lemon drop martini, but it's not. But for pcos, it's a very, you know, they're. While most women have insulin resistance, I mean, I think they quote up to 80% have insulin resistance. There are a few that don't. But it's not just that driver. I really sort of look at it as saying, what are the drivers behind someone's symptoms? So is it insulin resistance? Is it inflammation? Is it gut health? So I use those three drivers to sort of determine, do I need to do blood work to try to determine any of those three drivers? And then how can I uniquely go through that process with that patient to then help them reverse those symptoms? And also the other important part that we don't do in conventional is that we don't really ask, what is someone's goal? We always assume that someone wants to lose weight.

Right.

Like you have pcos, I'm sure you want to lose weight and get pregnant. It's like. But did we ever actually ask them what their goal is? Yeah, because sometimes I ask patients like, well, what, you know, what do you want help with from me? Like, how can I help you? And they're like, well, I actually just want to fix my hair. My hair is really thin. It bothers me. Or I, you know, my skin, I really want to fix my skin. And those are not the goals in my mind. I'm thinking the patient wants to address. And so some of those things, I think the most important thing is find out what are their goals that they want to address. What is it that's bothering them? Which PCOS symptoms, because there's so many.

Yeah.

Is actually bothering them. What are the drivers of their PCOS symptoms? Let's figure out which category that they're in and then focus on those categories with nutrition, with lifestyle changes, smart supplements, sometimes conventional medications. But it needs to be geared first on what is the actual cause of what's going on. And I'm a big proponent of, like, I'm an anti diet person, because it doesn't. I, I've been practicing for 15 years. I have not found the one woman who's like, like, yes. Dieting is like, awesome.

Exactly.

The best thing ever. Like, it just doesn't work. It's about trying to figure out what foods work for you and what foods you can add into your, your normal, you know, daily diet and how you can actually tailor it to you to. So it's sustainable. If I know what foods work for me, I can just kind of make up what I want to eat versus, like telling me a thousand calories, 40 grams of carbs, no chocolate, like, it's, that's everything I'm going to want. All the things you told me that I can't have. So I feel like it's about trying to find those sustainable actions as opposed to just putting everybody in. Like, here's the prescription, you know, do this, do this, do this. So it's very unique, I think, because PCOS patients are very unique. Someone who has lean PCOS is very different than the person who is very close to diabetes. Like, they're usually very different types of patients. And so we just want to make sure that we're being personalized in our approach to how we treat them.

Yeah, I think that's key, is every woman is so unique in how their physiology is functioning and what their nutrient depletion level is and their inflammation and all of these things you talked about in their gut health. I mean, I see that every day. Like, I have a program that helps a lot of women, but inside the program, the gut healing regimen is completely personalized. Right. Like, it's never a one size fits all approach. So I would love for you to just explain to my listeners what are some basic markers that you're looking in blood work that your conventional doctor may not be checking? You know, you mentioned inflammation. I think that's a really big helpful one. I get women all the time who've never had their testosterone and DHEA checked. You know, it's like, oh, my gosh.

Yeah. And, and I, I even, I think I've done a post on this before, too. It's like, once you get diagnosed with pcos, you should be asking for routine labs every year. You should be saying to your doctor, I realize I'm 30, but I'm at high risk for cardiometabolic problem long term. So I want a CRP level done every year for inflammation. I want my testosterone and DHEA levels checked. I want my fasting insulin to be checked, you know, for insulin resistance issues. Hemoglobin A1C, while it's a good marker, is not great for sort of those pre diabetic people, because by the time you have glycosylated glucose, you're sort of already pretty down the pipe, far down the path when you could have picked it up much earlier. So I'm a big proponent of using fasting insulin. I mean, you could do an oral glucose tolerance test, but most people don't want to sit around the lab for two hours and drink the glucose test and then get their blood drawn.

Nasty.

Oh, my God. Yeah. I mean, yeah, we've had kids. You're probably a little traumatized from your glucose test. So I'm a big fan of getting, you know, fasting insulin. If you want to get hemoglobin A1C with it, totally fine. It's going to. Both are kind of going to give a reflection of what your insulin resistance is. And then I also, you know, focus on too, like, is there nutrient issues we need to worry about from what they're eating? So do they need to have like a folate level or homocysteine level, or do they need to have, you know, certain nutrients that may be a factor based upon what they tell you they eat and what they may or may not be getting in their diet? So I always, you know, once I work with a patient, I'm like, tell your doctor you want these labs every single year so that you can stay on top of your health and you can start recognizing if something becomes off, which path you want to go down. Because once you've learned, like, for me, about your body and kind of ways to reverse these symptoms, then you should be able to sort of recognize, oh, okay, here I see that my fasting insulin is now 6. I need to focus on this, maybe add intermittent fasting, continuous glucose monitor, you know, try to sort of go down those paths and figure out how to do that. And I do that too. And I have a six week, like a DIY course that people can, you know, heal your pcos that they can actually go through and sort of do this on their own and teach themselves what they need to ask their physician for. And I think it's really, really important that people do because so if you leave it up to the physician, they're typically going to say they don't do blood work until what, 40? Then we start kind of looking at some of, you know, your cholesterol. We don't do a lot of those things. Oh, thyroid. I should say the other one, last one is thyroid.

Yeah.

Because you are at higher chance of having a thyroid problem if you have pcos and oftentimes Those symptoms so much are exactly the same, right? Fatigue, joint pain, hair loss, weight gain, can't sleep, all of those can be completely thyroid problems or pcos. So it's really important every year to sort of stay on top of getting a screen for your thyroids because you never know if you've actually developed a thyroid problem as well.

Yeah, I think that's great. I think it's so important. And, you know, you mentioned those symptoms are overlapping. Like, half of those symptoms go with low estrogen and low progesterone. Like, you really do need to look at the full picture so that you can figure out which, you know, system is dysfunctional or are they all, at this point, do they all need to be worked on? And a lot of times it's all of them.

Right. I think the more that you. The more a patient understands their physiology, the more they'll pick it up faster and go, oh, yeah, like, this is probably inflammation out of control because this is what happened last time when I did this. Or, you know, you can recognize those and then now go, these are the tools that work for me. Let's do this and really kind of have self advocate for your health.

Yeah, I love that. That's so important. Okay, so you also mentioned gut health, which is my favorite topic. So tell me, why do we need to evaluate the gut if you have pcos?

Well, we know PCOS patients have different type of bacteria in their gut microbiome. So their little. Their little environment, the little, you know, zoo of lots of different things that are in there that are in your gut that actually you need to and nourish. So we know from studies that they do have different types of bacteria. And so we know that they have problems with sort of the normal. Could be just digestion, it could be bloating issues, it could be constipation issues. Like, they typically have some underlying dysfunction. And so. And we also know that estrogen metabolism relies on the gut. So if you already have. You're already prone to this happening to you, and it's really critical that you have good estrogen metabolism, because we know that, you know, hallmarks of PCOS is that their estrogen progesterone ratios are off and their testosterone. Right. And so if you can't really get rid of the hormones that are not serving you and your gut is really not absorbing nutrients that you need to make those hormones, the whole system has kind of got errors as you go through, like, little problems. You're not making appropriate hormones, you're not getting rid of those Hormones. So really, really I haven't. I mean, honestly, a lot of people don't, A lot of patients don't recognize the gut has anything to do with their pcos. And frequently on my one on ones or with my group coaching program, they'll be like, oh, is that, that bloating I have all the time is related or I don't. I have constipation. I just thought I had constipation. It's like, well, no, actually the, the type of bacteria in your gut are not serving you and you're not absorbing good nutrients and you're also not having regular bowel movements to get rid of estrogen. So you really need to sort of focus on what are better foods that you can introduce into your diet to then change those type of bacteria. Right. I mean, the back there's, as you know, because you do this and this is your jam is, you know, if you eat, if you eat pizza, then the pizza bacteria like to hang out and stain your gut. You need to sort of conform those to be ones that are going to be more helpful for you long term for, for really sort of supporting your, your hormones. Much better.

Yeah, without a doubt. And, and I find it so sad because usually women, if they do get a diagnosis of pcos, they have these GI complaints. We're sending them to the gastroenterologist and they're getting these invasive procedures like colonoscopies and EGTs. And it's all so unnecessary and it gives this false sense of, well, my colonoscopy was normal, so I'm fine, my gut is fine. And it really just can confuses the patient even more. They just keep getting told, oh, that's normal, you're fine. You know, same thing with imaging. They're getting CT scans for their belly pains and ultrasounds. Well, the doctor says everything is fine. And I have to go back and say, like, all of those things are for anatomy issues. Those are like not what we're looking for. We're looking at the cellular level microscopically, where we can't see, see it on the image, we can't see it in a scope. And so that's, I think, part of the reason it takes women so long to find doctors like you and I, because they keep getting reinforced this idea that everything's been checked and it's normal. And that's like the most frustrating thing any women could hear, right?

Yeah. And, or they're given the ibs, Right. Everybody gets ibs. Everybody has ibs. They're, they're told it's normally, it's ibs. Just take this IBS drug. And I think patients, I know patients don't understand that these drugs, all they're meant to do is make you have a bowel movement or slow your bowels down, right? If you have IBS diarrhea, slow it down. If you have ibs, constipation, speed it up. But they don't do anything to fix the problem. There's absolutely no. Like, they don't fix anything. It's just. You now have IBS at 26 years old. You should take a medicine to go to the bathroom for the next 70 years. Like, it makes no sense to me. Like, it's. It's one of. That IBS thing is one of the more frustrating things that I think that medicine really just does not address. It's like, well, why do they have ibs? Why do they have this issue? How do we reverse this ibs? Because IBS is not a long term diagnosis. You don't. It doesn't have to be a long term diagnosis. The people just sort of just like, heartburn, right? Heartburn's the same thing. They're like prosec forever for your whole life. It's like, actually heartburn is not a long term diagnosis. Like, you can actually reverse that. Like, what part of what. When in medicine do we stop trying to reverse stuff? We just. It's. It's kind of crazy. The IBS and reflux thing makes me crazy. I'm like, it's about trying to figure out why you have it, right?

You know, and they're not diagnoses, they're symptoms Again. I mean, IBS is the same as pcos. It's a syndrome that we, we haven't been able to figure out why these symptoms are happening, so we just give it a name. Like, I literally was in medical school when IBS came out as a diagnosis, and I remember thinking, that's a bunch of crap. Like, that doesn't even make sense. That's not a thing. That's just a bunch of symptoms. And yet we all jump on the bandwagon. Here you go. Here's your medicine to speed it up or slow it down. You're exactly right. And so we're just. We're not taught to look for the root cause of why something's happening. It's all just band aid medicine. And so I love that you're essentially ripping off the band aid, right?

You're.

You're saying, like, let's look at the symptoms, stop covering them up and look at them so that we can actually figure out where they're coming from.

Yeah. And sometimes it's as simple. Someone has an IBS diagnosis, as simple as just trying to give them good nutritional advice about, you know, half your plate of vegetables. I mean, it doesn't even have to do necessarily with food sensitivities, which is a whole other topic. But it can be just as simple as, like, let's talk about what you eat. Like, when you eat, do you have carbs, fat and protein? Do you have good vegetables? And then just cleaning up someone's what they eat. It does wonders for people with ibs and it's. They had no idea that the ratios they were eating and the way they were eating was really causing all these symptoms. Oh, yeah.

For my daughter had severe constipation from the time that she, you know, started eating human food, weaned off breast milk and started eating, you know, probably at the age of 111 1/2 more of the processed breads, pastas, all the crap that we feed them. And she became so constipated. It was like life interfering, accidents, trauma, you know, very. And it went on for six years. And the pediatrician, all she had to offer was Miralax, which is awful and toxic, and all it did was make things swing from really bad and backed up to really loose mess, horrible trauma. And I finally, when I went through functional medicine training, I figured out that it was dairy. As soon as I removed dairy from her diet, she could poop. That was devastating to me as a mother and a physician that it was so simple and yet no doctor had the answer and I didn't have the answer. And I let her go through that for six years unnecessarily, because we don't look at food and how it affects our body when it's really. It's driving all of this, wouldn't you say?

Yeah, yeah. I mean, I think nowadays, yeah, it's rare that I have not talked to someone about something related to food in any. Anything. It could be menopause, thyroid, pcos, any of these things. It's so much about, you know, food is truly medicine, and it can be the answer to a lot of treatment for what we do. And yeah, it can be a huge game changer for people that. That just change what they're eating, figure out what foods work for them, and then they're just, you know, off of all these medications. I had a patient who had so many medications for anxiety and depression, ptsd, like she was on a PCOS patient was on A ton of medications. And she ultimately had a dairy and a gluten allergy. And so we cleaned that up. She had regular periods, regular bowel movements, got off of all of her anxiety, depression meds, was using lavender magnesium for her, you know, her generalized anxiety. And she's. It was, it was, it was awesome. It was such a great feeling for this lady who was a police officer. And she just had a very stressful job. And she had just been adding and adding and adding and adding more anxiety medications. And, you know, that's the sort of way conventional approach is, if this doesn't work, add another one. If this doesn't work, add another one. And ultimately it was really just related to her food. I mean, no one had asked her, like, do you have regular bowel movements? Like, do you have bloating issues? Do you. No one had asked her any of these questions. And when I started asking this question, she's like, actually, yeah, it's pretty hard to go to the bathroom. Like, it shouldn't be this hard to go bathroom. That should actually be fairly easy in life, the bathroom part. So it's amazing how many times it goes back to the gut, right? How all these things kind of go back to the gut, which is related to what you're eating, really.

Oh, my gosh. So important you guys, like, if you didn't get anything else from that, what you're putting in is what you're going to get out. And that is, that can be the game changer. I mean, tell me, is there one certain way a woman with PCOS should eat or is it really individualized?

Yeah, I sort of have like a PCOS plate method where, you know, in general, if you, if you guess that 80% of women have insulin resistance, lean or not. Right. 80% of PCOS patients have insulin resistance. You're not going to go wrong by using principles that help with insulin resistance. Because even if someone doesn't have it in their 30s, as they get older, 40s, as we know, perimenopause and menopause, certainly insulin resistance pretty much hits everybody, right? And so I always sort of look at the plate and say, okay, I want half of your plate to be non starchy vegetables, a quarter of your plate to be protein, whatever it is. It could be vegetables or it could be animal proteins. It depends on what you prefer. And then the other quarter can be starchy vegetables, and then you want healthy oils on top of that. Healthy oils. Healthy oils are there to make the vegetables taste good. Right? Like it's for you to be able to eat the half of the plate vegetables in my mind, like, that's really sort of to. To make them taste good. And so if you try to use sort of like a, just a basic plate method, as opposed to I have to get 55 grams of carbs or 22 grams of protein or just simplify it to look at every single meal and go, oh, how can I make sure that I'm sort of getting this basic plate model then? It just makes it easier. As someone who may have kids they have to feed or a job that's stressful, they can just kind of say, okay, how can I make this a little bit more workable for me? And then you can completely personalize it from there, right? You can certainly say no data based upon like a continuous glucose monitor and say, okay, sweet potatoes don't work for me. Or, you know, asparagus is great. Or you can kind of personalize it from that basic model. I also sort of have the follow that same rule with PCOS patients of no naked carbs. So carbs have to be combined with protein and fat. I have seen it myself with a continuous glucose monitor. I've seen, I have a little. I have pcos. I'm not sure if we talked about this either. PCOS and Hashimoto's. And I've seen like, I love waffles. They're like my favorite thing. Like, I have four children and so waffles on Saturday is like the thing. And I've personally seen how just sort of eating the waffle with butter or eating that waffle and putting chia seeds and peanut butter on it has made a drastic difference in watching those glucose levels. So it, it truly is important to make sure that your carbs are always paired with a fat and protein at that time because it will help you absorb them and be more slow absorbing carbs as opposed to those fast, simple sugars that will spike your glucose and then spike your insulin ultimately. So sort of that no naked carb rule. I always talk to patients about trying to just sort of have this basic plate and the no naked carbs.

Oh, I think that's so important that that's definitely something you guys could start doing right now is just always make sure you're not eating carbs by itself. And there's not a lot of situations where I would ever advocate that. I can't even think like someone eating a bagel for breakfast. Like, literally that's how I used to function as an ob. I would eat a lot of naked carbs. All day long, from dusk till dawn, in the middle of the night waiting for babies. I'm sure you did the same thing reaching for the M M's or the licorice or whatever's at the nurse's station. And I can't even imagine what my CGM would have looked like back in the day. Like, holy cow. But we have to get off that roller coaster and realize like that is driving these disease processes, right?

Yeah. Yeah. And again, that's sort of like the basic level of sort of everybody with pcos. And then you really personalize if someone has really bad insulin resistance. You talk to them about techniques of, you know, 12 hour eating window and intermittent fasting and some really, you know, broader ideas for insulin resistance or gut health issues addressing maybe more of like a little elimination diet to figure out what's causing their problems or inflammation. Like, is it something you're putting on your body, like, so you can customize those nutrition plans based upon what's going on with someone. But I think the basic sort of lifestyle ideas to really make sure that you're getting that kind of plate that, that serves you well, you know? Yeah.

So we do the basic stuff, we dial in the food and the lifestyle. Are you doing functional stool testing with patients? Are you looking at the microbiome, biome?

You know, I still, I'm integrated medicine trained, so I, I just, I haven't found, I don't always do it, the stool sample. I know there's people who do it for everybody. I, I kind of feel like there's so much you can do before you end up needing to do a stool sample. This is my personal opinion. I know there are people who love the stool GI map and they use it for everybody. But for me, I found like a lot of times just talking to patients, you find those, the. They give you the answer. Right. They tell you, oh yeah. You know, I notice every time I have pizza, I bloat or every time I have too much ice cream at night, I have acne. Or they kind of give you a lot of those hints that make you think maybe we should try to sort of clean this up a little bit or maybe eliminate certain foods so I don't automatically go to that. I do if I feel like it's. We're kind of not really figuring out the answer and really want to sort of take a deeper dive into maybe some other things that might be going on. Because there are some advantages to sort of the stool test and figuring out what, like fungus issues and just some other Kind of outside the box stuff. But I typically don't just because I haven't really found. When I looked at the research, I really haven't found anything that said, oh yeah, this is really like, this is for this type of person, it's still kind of an evolving science. We don't even really know how much these samples are really getting of our total microbiome. Like how much is this representing our microbiome. So I think as the science evolves, I, I may change my position. But right now a lot of times I just, just sort of do it based upon what the patient is telling you.

Awesome. So it sounds like there's a lot of different ways women can work with you. You mentioned your do it yourself course, your health coaching. What does that look like? If someone does, you know, they're listening, they're like, oh my gosh, yes, this is what's going on with me. I need to work with Dr. Jen.

Yeah. So I see patients because I have a telemedicine clinic. I'm licensed in Missouri, Montana and California and I'm working on my Arkansas license right now. And so I see patients, they can book a 20 minute call for free. Where we're just talking about what is it that you're looking for to make sure that we're the right fit for each other so we can see each other in one on one option. Or I do have the course that if you have PCOS or menopause, I have two different courses. You can actually sort of walk yourself through the method that I use with patients, one on one or I do group coaching twice a year for PCOS. So it's a group of like 10 to 12 patients and myself and the nutritionist. And we really kind of walk you through that six week course, but we're helping to support you each week with certain, like we'll pull some of the information out and talk about that specific topic and kind of really get, dive deep into those questions you may have about that topic. And it's really been great because patients will not only they're getting support, but they can literally say, okay, what about this for me, like, how does this work? You know, how, how would you add omega 3s or hey, I don't like, you know, flaxseed or you know, I don't like this, so what would you add instead? So it's really a great way to have a one on one approach. But, but you know, not sometimes these things can be more expensive one on one. So it's nice to sort of do it in that group. Coaching model. Yeah.

Awesome. Okay. So where can women find you so well?

Woman MD so W E L L W O M A N M D that's my website. And Instagram and TikTok, it's all the same. YouTube. Everything is all the same. And I have a podcast called ignite your pal her. So all those things. I pretty much have the same handle for most things. They can find me on any of those platforms.

Awesome. I'll have all those links in the show notes so people can reach out to you if you feel like you have people PCOS. Dr. Jen is your lady. So thank you so much for being here. This has been awesome.

Thank you so much. I appreciate it.

Oh, my gosh. I know you got something out of that episode. If nothing else, you're just being reminded that food is medicine. Food absolutely affects your physiology. It affects how your blood sugar and your insulin are working, how your thyroid is working, how your adrenals and how your gut is working. It really does impact you. So I want you to consider evaluating what you're putting in your body when you're putting in, how much all of that matters. So I hope you got so much value out of that. And connect with Dr. Jen if you feel like some this is something you need, especially if you're in California and you just need women's health. Like, she also does bioidentical hormone replacement and generalized women's health. She's so much like me, so reach out to her. The links are in the show notes. I do want to mention an awesome review that I got. It was so sweet and I love her name. I don't know what you call those handles or whatever. It's Hottie 95503. She says so informative. Five stars. I absolutely love listening to your inspirational podcast each week. I have been able to gain so much knowledge and takeaways from each episode. I'm grateful to have someone like you trying to stay on top of the functional medicine recommendation for us women at all stages of our life. So that was so sweet. I love that. Thank you so much. I'm glad that you're finding value in this. And back to the PCOS. I did a podcast episode, episode 130, how to reverse PCOS. And that can be a really good starting point for you. If you're like, I think I have this going on. What should I do? I have some basic supplement recommendations that you need to get you started. Because at the core of it, we need to support our nutrition. We need to support our vitamin and mineral status, everything that's going on at the cellular level. So there are basic supplements that will really get you shifting, get things moving. So check out episode 130 if you're like, yeah, I need to start doing some PCOS work. That's the simplest way to start. So go out, have an amazing week.

Week.

I'm so honored that you shared this time with me. And go lift up another sister. Either share this episode with her or just send her a text, like, telling her why she's so awesome. I think if we made an effort to do that once a day to one woman that we know, we could have this major ripple effect because they would probably go, go, oh my gosh, that felt really good. I'm going to either say that back to her or I'm going to go and do that and send it to another friend and imagine all the beautiful positive energy that we could create if we just started lifting each other up out loud as sisters. So go do something amazing this week, ladies.