PCOS with Dr. Felice Gersh
Thank you for making your way here. If you don’t know me, I’m Dr. Aimee — a fertility expert in the San Francisco Bay. I’m pleased to have Dr. Felice Gersh joining me from Irvine, CA for a discussion about PCOS.
The topic of tonight’s show is PCOS. Lucky for us, Dr. Gersh is a world expert on the subject. I’m pleased to share a recap of our discussion here.
Dr. Gersh, can you tell us about your most recent book?
Yes, the book, PCOS SOS is based on many years of experience and hours digging through the world’s literature on PCOS and related subjects. It’s a seven-step program designed to help every woman with PCOS optimize her health so that she can lead the life she’s meant to live.
It starts out with a deep dive into the science of PCOS. Answering questions like, What it is? Why do women have it? How did they develop it? What are the symptoms, signs, and manifestations of the disease? Then the book focuses on what you can do — practical ways to really turn things around.
Women with PCOS really have some of the most challenging issues in health to overcome.
Dr. Gersh, you are way ahead of your time in the way you’ve set up your practice. You’re a board-certified OB-GYN as well as an integrative medicine practitioner. Can you tell me more about how those things come together for your patients?
Women with PCOS have so many health challenges. I say it really takes a village to help them. I’m the captain of the ship in terms of their healthcare, but I can’t be everywhere and everyone to them.
So I’ve created a program that incorporates many other healthcare providers. I have in my office a marvelous naturopathic doctor. She specializes in helping with nutrition and gut healing which is hugely problematic for women with PCOS. She also specializes in acne and hair loss. We offer platelet-rich plasma for both skin and hair as well as high-end peels. This is for women with active acne or scarring from acne. We have a PA and a nurse practitioner to help women that deal with stress. We incorporate meditation, breathwork, essential oils, aromatherapy, and guided imagery.
All of these help with stress and sleep problems. We also have a fitness specialist who deals with body composition issues, offers fitness assessments and then prescribes exercise. Cardiovascular issues are a big concern for PCOS women so we incorporate vascular scanning to see how their hearts and arteries are doing. We also have a massage therapist that does body massages, cranial massage and cranial facial release.
Needless to say, we cover the whole gamut of issues so we can optimize their health and quality of life.
What you’re describing are so many cutting edge treatments. I don’t know if there’s any other clinic in the world that offers these types of treatments to their patients. If someone can’t visit your clinic, can they learn about these approaches from your book?
Yes, I’d love for everyone to be able to see me, but that’s not possible. It’s a global epidemic. There’s not one country in the world that doesn’t have a growing significant incidence of PCOS.
I want women with PCOS to have access to information regardless of where they live. It’s so hard to get information and tools. Sadly so many well-intentioned doctors keep doing the same thing over and over again and it doesn’t work. That’s the definition of insanity. They don’t have any other tools. That’s why I went into integrative medicine so that I could offer more options for patients. We want to address the fundamental issues that PCOS women are dealing with inside their bodies. Not the hammer and nail approach.
Is this passion to educate women all over the world about PCOS personal for you?
Well yes, it is. While in my twenties and in medical school, I went two whole years of not getting my period. I also had acne. It was very distressing. I went to a top highly respected OB-GYN at my medical school and he brushed me off.
He suggested I go onto birth control pills. I pleaded with him that I wanted to have a baby. His response was to advise me to go on fertility pills. I’m not against fertility pills, but even if you use them you want to be healthy before you start that process. The health of the uterus sets the foundation for the future life of the baby. It’s why a mother’s health is imperative before she even gets pregnant!
Yes — I call that trimester zero! That’s one of the most important trimesters and we don’t talk about it enough.
You’ve just had a book launch, PCOS Fertility Fast Track on Kindle. The print version will be coming out soon. Congratulations.
Yes, I am going to have a series of fertility fast track books. This is a 12-week plan. It tells you week by week for 12 weeks of exactly what to do if you’re in a rush to get pregnant.
Fertility is a vital sign of health. We want every woman to be fertile because that’s a sign of health. When you want to have a baby it’s certainly essential.
Women with PCOS have among the highest rates of pregnancy complications. Miscarriages, gestational diabetes, preterm labor, and preeclampsia are all complications that are more likely in women with PCOS. By optimizing health, these (and all) women have a better chance of a healthy pregnancy and baby.
While we have you, I want to switch gears a bit and also tap into your expertise in integrative medicine. I was reading that you are also a specialist in CBD and CBD oils. Can you tell me a bit more about that?
This is a very new thing and way of looking at the human body. Before 1990 we didn’t even know about the receptors in the body that react to cannabis. We have this amazingly complex system in the body called the endocannabinoid system.
It’s sort of a case of reverse engineering because we discovered the potential benefit of the plant cannabis thousands of years ago. Then we discovered humans have receptors that can interact with components with the plants. So they named our system based on the plants. Endo (within us) Cannabinoid (based on cannabis). Well, it turns out that this system is very interlinked with fertility.
Everything about reproduction is linked to the endocannabinoid system. How the egg develops, the health of the egg, ovulation. How the egg gets transported down the fallopian tubes, enters the uterine cavity, implants into the uterine wall — everything in pregnancy. This includes going into labor and delivery. It’s all related to the female hormones and endocannabinoid system.
In many women, there’s a poor function of the endocannabinoid system. This can create all sorts of metabolic havoc for women. These magical components in the plant cannabis can help balance irregularity or deficiency in the endocannabinoid system.
Most of what I deal with is the hemp-based cannabis as there’s a whole array of plant compounds that magnifies the benefit exponentially. There’s research coming out that shows PCOS is actually manifesting a dysregulation of the endocannabinoid system.
I’m getting good results in some women using CBD products, not when trying to get pregnant — but at other times, to deal with PMS, mood disorders, cramps, etc. I think there’s a potential for insulin regulation and fatty liver. There’s literature that it may help reverse fatty liver, which is an epidemic -especially for women with PCOS.
I’m also looking at these products for vaginal help. The vagina is not just a tube for babies coming out and men coming in. It has its own unique microbiome. We’ve done a lot inadvertently to harm the vagina. I’m hoping by using CBD and hemp-based derivatives that we can help restore the microbiome of the vagina.
For women that have dysmenorrhea and pelvic pain — which is so epidemic, or interstitial cystitis, chronic pelvic pain, and endometriosis —using hemp suppositories can lessen their pain and systems. I’m getting really excellent results and more literature and data will be forthcoming.
I’m really excited about this new horizon and potential for women to have helpful solutions to problems that up to this point have not had many.
We now know that endometriosis (a problem for 10% of women) it’s actually a problem of progesterone resistance which is related to high exposure to pesticides — dioxin. By trying to override resistance we give cannabis products to calm down cells that create an inflammatory cascade that happens with women with endometriosis.
I have to imagine that you’re a leader and everyone else just follows. I say that as I’m just listening to you speak and feel your energy and feel so stupid honestly, as you’re opening my eyes to so many things I’ve never thought of for my patients. Certainly, we don’t recommend CBD for fertility patients, and there’s much more work to be done there. However, for my patients that deal with endometriosis and PCOS, I’ll be asking that they get in touch with you via telemedicine consults to figure out the dosages and oils that you recommend for them.
I want to talk to you more about fasting. What do you think about this fasting trend?
Well, it’s a new trend that’s really an old trend. When you go back into the history of humanity we evolved during times of feast and famine. We evolved to live in that state — where we sometimes don’t have food. So our bodies have developed incredible mechanisms for that.
If you fast for one day then your body burns calories. After three days the body indicates to you that you need food and sheds off crappy cells. The good cells recycle their internal components and spew out amino acids and fatty acids and reconstruct these cells. Those cells will then live longer. One of the things that define our potential for longevity is how many replications of cells we can have. That’s why a dog isn’t going to be 50 years old. No matter what we do humans won’t be 200 years old.
Certain cells in the body reach a certain number of replications and then they can’t replace themselves. So if you can get cells in the body to live longer and better it opens the potential for a longer healthspan. You have revamped your body. You have healthier cells. You’ve gotten rid of the junky cells. You can burn liver fat, and you reduce inflammation and when this happens you normalize your insulin levels and so on. Everything gets better. People can lose weight. It increases brain growth factors. People feel calmer, happier, and smarter.
I think there’s a definite place, in most people’s lives to consider prolonged fasting. There are a few exceptions. Elderly or women pregnant or nursing. The vast majority of the population under 65 are great candidates for fasting. I use the fasting-mimicking diet as it’s hard to get compliance from people to stop eating for 4 days in a row.
At USC they developed the fasting-mimicking diet which is really brilliant. They’ve designed a food protocol that for five days flies under the nutrient sensors in the brain. I call it cell food. You get to eat it, but your cells don’t see it. This is because it doesn’t include enough protein for cells to register. The body doesn’t realize you’re eating. It’s enough food for getting through five days. It really helps people with metabolic issues and I’ve been using it with PCOS patients and getting excellent results.
Then there’s also intermittent fasting where you would stop eating all together except for water or under 300 calories and do that for two days a week. People lose weight. Very few people can sustain this on a repeated basis.
Doing a fasting-mimicking diet 3–4 times a day is more manageable for people.
Time-restricted eating is another form. It’s so important. We are time creatures based on our circadian rhythms. We are designed to be day creatures. It turns out our insulin function is better in the earlier part of the day — the first part of the day. When we eat in the morning our bodies deal with the food much better.
In our society, many people are night eaters. In spite of all the data people fast from early evening to early afternoon. You’re doing it at the wrong time. What you should do is get a 13 hour fast and then return. From dinner, which should end by 8 PM (7 PM is better) and then wait 13 hours and then eat again. Eat within a couple of hours of waking up. Have a good sized-breakfast, then have a medium lunch or a medium dinner. Or if you’re more advanced have a bigger lunch and a smaller dinner. Try to aim for more eating in the morning vs. evening. The other thing is to stop snacking. You can’t set the beat for your clock genes if you keep snacking.
I had so much fun talking with you, I’d love to invite you back. There is so much more we can talk about — sleep, circadian rhythm, etc. I’d love to do a part two of this show.
We are so lucky to have Dr. Gersh as a resource for women. She’s amazing and elevating the level of care women receive.
If you’re reading this and you can’t see Dr. Gersh I’d encourage you to seek out an OB-GYN or Naturopath that can take care of you in the same holistic way.
As always, please comment below or send me a note if you have any questions about this show or if you have a suggested topic for a future show.
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