The Women's Journal

“But, you don’t look like you have PCOS . . .”

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By Brian J. Shiple, D.O. & Kelly P. Shiple, PA-C

Polycystic ovarian syndrome (PCOS) is the leading endocrine disorder in reproductive aged women. While there are numerous theories as to the cause of this condition, one cause being genetics, the etiology still remains unknown. Because of this, there is no definitive cure. As with most conditions that are not fully understood, there are also various, conflicting methods of diagnosing and treating PCOS.

Common symptoms associated with PCOS include irregular periods, polycystic ovaries, acne that is resistant to treatment, excess facial and body hair, difficult to treat depression and anxiety, severe PMS, difficulty losing weight, obesity, infertility, and frequent miscarriage. These symptoms are often extremely difficult to treat as they are fueled by insulin resistance. PCOS often coincides with hyperandrogenism, excess amounts of male hormones like testosterone and DHEA, hypothyroidism, or an underactive thyroid, and overactive adrenal glands due to chronic inflammation caused by insulin resistance. According to the NIH, 85-90% of women with irregular periods have PCOS. More than 80% of women with androgen excess symptoms have PCOS. Infertility affects 40% of women with PCOS. Lastly, 90-95% of women who struggle with infertility due to a lack of ovulation have PCOS.

Women with PCOS are at higher risk for developing diabetes, breast cancer, endometrial cancer, and heart disease at some point in their lifetime than women without PCOS. This makes early diagnosis and treatment very important. Several different classification systems are used to diagnose PCOS in the medical field currently. The Rotterdam criteria require patients to have two out of three of the following: polycystic ovaries, hyperandrogenism, irregular periods or no period at all. The Androgen Excess and PCOS Society includes clinical and/or biochemical hyperandrogenism and ovarian dysfunction or polycystic ovaries in their diagnostic criteria. Because of these strict, but widely used ways to diagnose PCOS, it is highly under and misdiagnosed, despite the alarmingly high statistical incidence.

In most cases if you have all of the above symptoms, it is likely safe to say you have PCOS. In our practice, the diagnosis of PCOS is as simple as a lab test. More difficult cases usually have maybe one, two, or none of the above symptoms and still have a positive lab test. Proper treatment often helps these complicated patients to feel better and function more optimally than they ever thought possible while helping to prevent long term disease processes.

Dr. Shiple did not truly learn about PCOS until one of his three daughters began having trouble with acne, irregular periods, and premenstrual dysphoric disorder (PMDD) as a teenager. A common treatment for PCOS is birth control. This seemed like the logical solution for all of these problems at the time. Numerous different brands of birth control pills were tried, but only seemed to make things worse. Soon the PMDD turned into persistent trouble with anxiety and depression. Several antidepressants and anxiolytics were tried at different times without any success. It was not until Dr. Shiple started taking the bioidentical hormone replacement therapy courses taught by our mentor, Neal Rouzier, MD, at WorldLink medical and learned more than medical school had taught him about PCOS, that he realized this had been the problem all along. As PCOS is often genetic and passed down from generation to generation, ultimately all three of Dr. Shiple’s daughters were eventually diagnosed with PCOS. Fortunately, after discovering the proper treatment for the condition all of their symptoms are currently well controlled.

We understand what you are going through and you do not have to go through it alone. If you are ready to take control of your PCOS and get your life back give the office a call to schedule your consultation today.


“After discovering my diagnosis of PCOS I felt hopeless and scared. I quickly jumped to thinking, ‘Would I ever be able to have children one day? Would my symptoms progressively worsen, as I get older?’ I felt like a prisoner in my own body. Thankfully, I had an incredible duo of providers, Dr. Brian Shiple and his physician assistant Kelly Shiple, who made me feel supported and hopeful, again. They thoroughly explained what PCOS was, how to treat it, and ways to prevent it from worsening. They prescribed me Metformin, properly treated my thyroid, and gave me dietary guidelines to follow. I wouldn’t be where I am today without Dr. Shiple and Kelly. My PCOS will be a continuous journey, but it will never define who I am.” C.D.

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