I went through a lot of doctors, sometimes it was because I moved, other times it was because I was getting nowhere. If I had donated all the blood I gave for the initial blood test every time I changed doctors I could have saved a lot of lives. I was getting really frustrated and was on the verge of giving up. The first doctor I went to, when I stopped getting my periods, said there is nothing wrong with me, that I was just over eating. At that time, I was not aware of any of the symptoms of polycystic ovarian syndrome. I just thought I was “born” with unwanted hair, skin tags, dark neck, etc. So it never occurred to me to question why I was having all these things and if they are even remotely connected. I just kept reducing my portions and started going to Curves. 3 months, 6 months, 1 year… nothing happened. I was just the same. Luckily I had good insurance, so I decided to go to a different doctor – an ob/gyn. She gave me birth control pills and a cream for my hirsutism. Ok, I got my periods but also the horrible side effects from the birth control pills. She changed my birth control pills thrice to find one that didn’t make me throw up every single morning. And the cream did nothing. But I was getting my periods so I was happy, until the weight gain started bothering me so much I couldn’t even walk up a flight of stairs without needing to rest. So I changed doctors again. This time I was lucky, she suspected PCOS right away, and ordered all the tests. The tests came back with all my wacky hormones, insulin resistance and everything. But I had to move again. And start all over again. It was not until a year ago that someone officially diagnosed my Polycystic ovarian syndrome. Enough of my rant, now to the real substance.
If you suspect you have PCOS, the first question you might have is what kind of doctor you should go to. Most of us start with our primary care physician (PCP) or the general practitioner (GP) when we start feeling something is wrong with our body. But there are different kinds of doctors, specializing in different things. So you need to evaluate what you would like to do at this point, short term and long term, and choose based on your needs.
Primary Care Physician (PCP) or General Practitioner (GP)
Our everyday care family doctor. PCPs might have a general idea about PCOS, but they will most probably refer you to an Ob/Gyn or an endocrinologist. Based on your insurance (HMO) you might have to go to your PCP anyway before you think about going to the other specialists, as you will need a referral.
Main women’s doctor. They usually treat most of the common gynecological issues. They will be able to order all the required tests (hormone panel, ultra sound, insulin resistance and other blood tests) to diagnose PCOS. Primary care physicians and Ob/Gyns can rule out other hormonal disorders like thyroid which has similar symptoms but needs a different treatment. They can also assist with some level of infertility, like prescribing Clomid or Provera to force you to ovulate. If you are not trying to get pregnant, more often than not, they prescribe a birth control pill along with Metformin. For some, this Metformin treatment is very effective, but for others it is not. If Metformin doesn’t seem to make any difference after taking it for 6 months – 1 year you might want to ask your doctor about other options. They might refer you to an endocrinologist.
Endocrinologists are trained to diagnose and treat hormone imbalances and problems by helping to restore the normal balance of hormones in your system. They might be the best for long term PCOS management. If you are not trying to get pregnant but want to take control of your PCOS, an endocrinologist might be able to help you. PCOS women are at high risk for diabetes (due to insulin resistance), lipid/cholesterol disorders and other issues. So it might be beneficial to meet with an endocrinologist and talk about your options. If you are trying to get pregnant you might need an endocrinologist who specialized in reproductive endocrinology.
Reproductive Endocrinologist (RE)
A Reproductive Endocrinologist is a physician who helps patients with infertility and reproductive problems. Reproductive Endocrinology is a specialty of endocrinology. An RE also treats menopause, endometriosis, impotence and other related reproductive disorders. They won’t help much with the long term management of PCOS, their job is to identify factors involved in your infertility and appropriate methods with which to treat these factors (IVF, IUF). An Ob/Gyn who specialized in infertility might also be able to offer these treatments.
Clinical Nutritionist (CN) / Registered Dietician (RD)
Nutritionist and Dietician are not the same. Though the work is similar, the credentials required are different. Dieticians are regulated by American Dietetic Association. A nutritionist could belong to National Association of Nutrition Professionals or The International & American Associations of Clinical Nutritionists (IAACN). Some people might say they are a “nutritionist” without any credentials, it is ALWAYS good to check credentials and licensing. I have a great nutritionist, she was recommended by my doctor. I am a vegetarian so a lot of general diets won’t fit me. I needed a tailor made plan for me. Whoever you choose, make sure they understand PCOS and create a diet that fits your needs. They should create a plan that will help you maintain a healthy lifestyle and keep your PCOS symptoms under control.
Alternative medicine. Homeopathic treatments that use a combination of natural supplements, diet and alternative treatments. Currently I am taking a naturopathic treatment and it is working for me so far.
Word of mouth is the best way to choose a doctor, especially from a fellow PCOS’er. Depending on what stage of life you are in, you can choose a doctor that fits your needs. Try to find a doctor who has listed PCOS as one of his/her specialties. Make sure to ask questions. Listen. Finding a good doctor is the most crucial step for managing PCOS. If you have to make several visits to find a good doctor who will listen to you, so be it. It is better that way than just waiting for the weight to somehow miraculously melt away!