Dear Readers,
We’re trying something a little new here at MedShadow. It’s important to us that you understand not just why we do what we do, but how we do it. Every now and then, one of our staff members will write the introduction to the newsletter and walk you through a recent project. I’m Emma, your senior health writer at MedShadow, and in June, we published a major piece on PCOS (polycystic ovary syndrome), a condition with a wide range of symptoms caused by several hormonal imbalances in the body.
Browse This Article
The PCOS Article: How I Wrote It
PCOS was an especially important topic for me because, like around 10% of women in the world, I have the condition. Researchers have learned a lot about PCOS over the last decade, but many doctors (including some of my own) still treat it as if the only symptom is difficulty conceiving children.
I’ve been told “here’s some birth control, come back when you want to get pregnant and we’ll deal with your condition then.” In fact, PCOS can cause myriad other symptoms. For example, it causes insulin resistance. More than half of women with PCOS will be diagnosed with diabetes before they’re 40 years old. Luckily, if we are aware of the risk, some of us will be able to stave off diabetes—and the need for medications with potentially dangerous side effects we may need to treat it—with lifestyle changes such as eating a Mediterranean diet that is high in fiber and healthy fats, and low in refined carbohydrates.
Evaluating Patients, Doctors, and Conflicts of Interest
As I’m sure you’ve noticed, I often speak to expert health care providers and patients themselves. Before speaking to a healthcare provider, I’ll ask them about any conflicts of interest, such as working as a paid consultant for a pharmaceutical company. I’ll double check what they tell me using a database called CMS Open Payments, which tracks payments doctors receive from pharmaceutical companies. If there is a conflict, I typically won’t use that doctor as a source. Occasionally, the doctor may still be the best expert on a particular medication or side effect. If this is the case, I’ll disclose the conflict of interest when I introduce the doctor in the article.
When I speak to patients, I share their experiences with different side effects. I always check if the side effects they mention are documented in the literature. If they’re not, I’ll usually still share the person’s experience, but if they are documented, I’ll also describe the evidence we have for why this might happen.
Finding Big Picture PCOS Research
Although PCOS has been recognized for many years, researchers are still only scratching the surface of how the imbalances in hormones affect us. Because of that, this was a particularly challenging article to research. I started my research review, as I often do, by searching the Cochrane Library. Cochrane conducts systematic reviews of research related to health. A single study can only tell us so much. Cochrane brings together many studies on the same topic, comparing the quality of their research methods, the number of participants scientists recruited, and of course, the results of each study.
The organization then produces summaries of the existing research about a particular condition or treatment, which include not only the findings of the studies, but how confident we can be in their results. For example, you’ll see Cochrane Reviews linked in the section of the article titled Lifestyle Interventions and Weight Loss for PCOS. Those reviews provided solid evidence that for women with PCOS who are able to, losing weight and maintaining healthy diets can help to manage many symptoms of PCOS, including those that aren’t directly related to weight or insulin, such as facial hair and acne. There’s a similar organization, Examine.com, which has a special emphasis on supplements and nutrition, that you’ll also see linked throughout the article.
Smaller Studies Fill in Some Blanks
My next step is to look for individual studies on specific topics. An individual study usually won’t be as powerful as a review, but if it’s well-designed and includes a large number of participants, it can provide a strong suggestion that a specific intervention can help, or even that particular drug might be the cause of an unwanted side effect.
For example, in the section on vitamins and supplements for PCOS, you’ll see a link to a study showing that patients who took metformin, a medication commonly prescribed to women with PCOS, tend to absorb less vitamin B12 from their diets, putting them at risk for a vitamin deficiency. I always look for the highest quality, most recent studies I can find,
If the best I can find is a very small study, I often still include it in the article, but I’ll add the warning that the study was small, meaning its findings are not as reliable as larger studies or reviews. In the PCOS article, I included several smaller studies, because so much of the research is preliminary, and many of these studies give us hints at different interventions we can try before we need to turn to medications.
You’ll see these alternatives to meds ideas mentioned in the section on exercise and the section on spearmint tea, for example. Interventions like walking for 30 minutes or drinking spearmint tea are unlikely to hurt you and are potentially healthy habits even if you don’t have PCOS, which is why I’ll usually include those studies even if they’re small.
I hope this is a helpful introduction into how I think and approach our articles here at MedShadow. If you ever have questions or want to reach me, my inbox is always open. You can email me at [email protected]. In the meantime, stay healthy out there!
Sincerely,
Emma Yasinski
