Elise Rouvrais est naturopathe à Montpellier, spécialisée dans la santé féminine et les pathologies hormonales. DR
Naturopath in Montpellier, Elise Rouvrais retrained in this field a few years ago. Also trained in functional health and micronutrition, she specializes in women's health and hormonal pathologies, including polycystic ovary syndrome (PCOS), a complex endocrine condition of ovarian and pituitary origin.
PCOS is often discussed in terms of infertility, however the symptoms that result from it are multiple. What are they? ?
There may be signs of hyperandrogenism (acne, hairiness, hair loss) that are very disabling and complicated to manage. This can lead to certain anxiety-depressive states. We know that in patients with PCOS, there is more anxiety, depression. Then, if there is excess weight associated with PCOS, we will generally find insulin resistance. This is both a cause and a consequence. In any case, excess weight and insulin resistance will aggravate the symptoms of PCOS, or even reveal it. If we let them settle in, we can move towards prediabetes or diabetes and cardiovascular diseases. On the other hand, some women may have ovulation disorders that cause infertility. We don't talk about sterility, because if they ovulate from time to time, they can get pregnant but they will statistically have less chance of doing so.
In the context of diagnosing PCOS, the Rotterdam criteria are generally mentioned. What are they ?
The thing to understand is that the diagnosis of PCOS is above all a diagnosis of exclusion, it is done in two stages. First, you have to check that there are no other pathologies or diseases that could explain certain symptoms. Only after, we check the Rotterdam criteria. You have to have two out of three for a specialist, therefore a doctor, gynecologist or endocrinologist to make the diagnosis of PCOS. He checks for the existence of biological and/or physical hyperandrogenism, therefore the fact that there are too many androgens in the blood or hyperpilosity, acne, hair loss… Then, he will check if there are any cycle disorders. Finally, he looks at the appearance of the ovaries to see if they are rich in follicles.
200% Deposit Bonus up to €3,000 180% First Deposit Bonus up to $20,000According to Elise Rouvrais,“PCOS is called “polycystic ovaries” but we say that because at the time we lacked precision in medical imaging. “At the time when “this was discovered, we thought they were cysts. Today we know that they are not cysts but simply follicles. This is the raw material in women to have children, so it is not something pathological. Generally the word cyst can be scary, we can think that it is something abnormal when in fact it is simply women who have more follicles than others at a given moment.”
PCOS affects 1 in 7 women, yet the WHO estimates that 70% of those affected are not diagnosed worldwide. Why ?
I think it is linked to the training of health professionals, who are perhaps not all aware of the subject yet, even if there has been a lot of progress. Consultations are sometimes there but the diagnosis is not made. I also think that PCOS is quite taboo, because the symptoms can be demeaning for women or in any case, it is difficult to talk about it. This inevitably leads to a lack of visibility.
Have you ever met people who were convinced they had PCOS or who were given a diagnosis that turned out to be incorrect??
Yes, very often. It's a bit of a two-speed world where we meet women who were diagnosed very early, and finally as they grow up, the majority of the symptoms calm down or disappear. At the time of puberty, it's quite normal to have acne or menstrual disorders. We generally wait eight years after the first period to make a diagnosis. There are also women who have multifollicular ovaries or symptoms that are found in PCOS and who will be wrongly diagnosed. In these cases, I refer to health professionals because my job is not diagnosis.
As a naturopath, what levers do you recommend putting in place in parallel with medical monitoring for a person with PCOS ?
The levers are totally different depending on the person and their PCOS, because each one has their own hormonal background. For women who have metabolic syndrome, insulin resistance, it will be necessary to work on this to reach a healthy weight. Lifestyle, therefore a varied and balanced diet, regular physical activity and sleep and stress management are three pillars that already make it possible to regulate a hormone secreted in the brain called LH, which controls ovarian activity and testosterone secretions. By working on this, we will have an impact on hyperandrogenism and cycle disorders. Today there is no curative treatment to treat PCOS, there are suspensive treatments like the pill, but when you stop, the symptoms return. So it is good to have other avenues of action. Women can be actors in their health at their level. Whatever symptoms you experience due to PCOS, there are solutions and you should not despair, it can get better.
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