Dr. Jessica Shepherd
speaker
254 appearances
1 recordings
1 series
first heard May 2025
last heard May 2025
Dr. Jessica Shepherd’s voice in public audio — every appearance, attributed to the second.
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is that if it's shifting in that normal range to too high or too low, but it's not quite disease state yet, that we know that, right? And so that, again, is the preventative portion of why we need to take care of our bodies before we hit that wall and now we're in disease.
PCOS is one of those. I wish it were termed differently. It stands for polycystic ovarian syndrome. So when we use the word syndrome in medicine, it means it has a variety of different things that contribute to the disorder. Okay. So it's not just one specific thing. So the reason why it's a syndrome is because it relates to the amount of follicles in your ovaries may be increased, right?
So your body is supposed to be doing a certain thing. So I'll give you an example. If it's supposed to say, I'm using arbitrary numbers here. If you're going to have five follicles in your ovary, And that's what it does every month. And now someone has 20. That's different. It should do, right? So you're going to have kind of these fluctuations of hormones.
So now we're back to the hormone part of the syndrome, which is we usually see an increase in testosterone, right? So everything is supposed to be at the level it's supposed to be. So now if testosterone is a little bit higher, it's going to be sending messages not in the way or the amount or frequency that it should be. So there's another thing.
is how we have our cycles right so you start to see your cycles be more irregular i've had patients who have severe pcos and they won't have a period for like nine months or a year then they'll get one just randomly so you have all these changes that are ovarian in nature but the real heart of pcos is actually a metabolic disease so i'll go back to what metabolic means is really the function of how your body is doing internally usually from a glucose and insulin perspective
We spend so much time doubling down on the ovaries malfunctioning and it's an issue there. But really, a lot of it has to do with gut health, nutrition, and insulin and glucose.
I would say that's what we typically treat it with. Do I, am I a fan of what we typically treat it with? No, because then we're just focusing on the ovarian portion of it.
So many of my patients, I work with functional nutritionists, but I also use that timeframe to saying maybe, so for example, now put you on a GLP, which can then impact your insulin and glucose and then shift the body's ability to function the way it should.
Yeah.
Well, to balance the insulin and glucose and the metabolic health portion of PCOS. And a lot of times the diseases that we have are from a metabolic perspective. And so that's why when we look at the studies now with GLP-1s, yes, you get the benefit of weight loss or people are on it because they're diabetics.
So endometriosis, which is, I'm so glad I spent 10 years being a minimally invasive gynecologist because that's the patients we would see, mainly were endometriosis patients, is that it is when the lining, so when we have our uterus, we have that little kind of cavity within our uterus, which is where we shed endometrium and the lining and we get our period. Okay.
I love that you just put that perspective to it. But that's exactly what it is. And so when you shed the lining, that lining is only supposed to be there in that cavity. What happens is when that tissue may go somewhere else... It could go on the bowel. It could go on the uterus. It could go on the bladder.
So it kind of like trails and ends up in other places in the abdominal cavity.
Yeah, it can kind of travel in other places.
gets to those places, it causes pain. Most common symptom of endometriosis is pain and also infertility, right? Because it's impacting the other organs in the reproductive system. Now, we do know that it's an underdiagnosed disease. One in 10 women will have endometriosis. One in 10? One in 10. They may not experience it the same, but we are underdiagnosing it.
And the other thing is that there is somewhat of a genetic predisposition or a likelihood of getting endometriosis if you had your mother and or sister have endometriosis.
The best way to treat it is to look at it from the root cause, which is estrogen. So if we are able to say, how can we decrease the level of estrogen that's creating this inflammatory response? So there are many ways that we can do that. Some people are put on birth control. Remember we talked about suppressing.
We can also use medications that are specifically designed to decrease estrogen specifically for that reason, for endometriosis. And then some people need surgery. And the reason they need surgery is because it creates these kind of adhesions or these kind of scar tissue in the pelvis. And so that can cause the pain and or infertility.
And we can go in there as a minimally invasive surgeon and get those kind of nodules and adhesions out. And that's how the patient can feel better. So there's a lot of different ways that we can actually impact endometriosis, which is why we should be talking about it more.
I want to start with skin because we all know when we're in our younger years, ages that our skin is very kind of, it glows, it has this ability to not have wrinkles. And so as we start to age, which is a biological feature of what we're going to go through, decline in estrogen, can't then go to that part of our skin that impacts the collagen, which gives us our ability to be plump, to be firm.
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