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 Researchers found that women with polycystic ovary syndrome, or PCOS,
a common condition characterized by metabolic and fertility
problems, were more likely than others to distrust their primary
care physician's judgment and to feel that they weren't getting
enough social support from health care providers.
"I would hope that women with polycystic ovary syndrome will find it
encouraging that there's a growing acknowledgement that they are
dissatisfied with their medical experience," said study coauthor
Marla Lujan of Cornell University. "What hasn't been recognized is
how important a role social support plays. If you trust your health
care providers and enjoy your interactions with them, you're more
likely to go back."
Though it's estimated that anywhere from 7 to 20 percent of
reproductive age women suffer from PCOS, women often see many
doctors over many years before they get a diagnosis. Part of the
problem is that there isn't a single, simple test for PCOS.
That means the diagnosis is based on symptoms.
Women are diagnosed with the condition if they have two out of three
hallmark symptoms: irregular periods or no menses at all; clinical
evidence of high levels of male hormones, which can lead to
increased acne and hair growth in places such as the chin, upper lip
and sideburns; and a large number of follicles on the ovaries that
show up as small bumps on ultrasound.
Another contributor to delayed diagnoses may be primary care
physicians' lack of familiarity with the condition, not to mention
the latest information on it, said Dr. Andrea Dunaif, chief of
endocrinology, diabetes, and bone diseases for the Mount Sinai
Health System and the Icahn School of Medicine in New York City.
The name, which is really a misnomer, doesn't help, Dunaif said. The
bumps on the ovaries aren't cysts and the condition has symptoms
that go far beyond the reproductive system, she explained.
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PCOS has also been linked to increased risks for diabetes, obesity
and heart disease.
As reported in the Journal of the Endocrine Society, Lujan's team
surveyed 322 U.S., 134 diagnosed with PCOS and 198 without the
condition. While women with PCOS believed their primary care
physician was well qualified to treat general health issues, they
had less confidence in their doctor's knowledge of PCOS.
Women with PCOS also reported having arguments with their primary
care physicians and feeling an overall lack of emotional support and
empathy.
That doesn't surprise Dunaif. "When they go to their primary care
physicians, particularly if it's not a gynecologist, the physician
often isn't going to be educated about what they have," Dunaif said.
"And so, the physician is going to think the patient's complaints
about irregular periods and difficulties losing weight don't make
sense."
That leads to the women's complaints being discounted, Dunaif said.
"And they're not getting the answers they need," she added.
"Typically the patient I see has become very frustrated."
The internet has been a boon to patients with PCOS, Dunaif said.
"They get online and figure it out and then tell their physicians,"
she said. "When they say they argue with their physicians, I think
the arguments are based on the fact that they have become more
knowledgeable than their physicians in this area."
Dunaif has a piece of advice for primary care physicians. "Menses
are a vital sign," she said. "You should be asking women what their
menstrual history is. It can be a sign that there is an endocrine
disorder that needs to be diagnosed."
SOURCE: http://bit.ly/2n843w7 Journal of the Endocrine Society,
online August 1, 2018.
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