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This is the first instalment of a Global News series called Unheard. Unserved. Maritime Women\u2019s Health In Crisis. In our first story, we introduce you to a New Brunswick woman who struggled for more than two years to get a diagnosis for PCOS.\u00a0<\/strong><\/p>\n Brooke Sears is no stranger to having her concerns go unheard.<\/p>\n Over the years, she has had to act as her own doctor, nurse and health advocate \u2014 something that became necessary when fighting for a diagnosis for her polycystic ovarian syndrome, otherwise known as PCOS.<\/p>\n PCOS can present differently across patients, but for Sears, it meant acne, irregular periods, hirsutism and extreme difficulty losing weight.<\/p>\n \u201cI just was not understanding why I was failing at this,\u201d Sears says. \u201cLike, just felt like a failure all the time.\u201d<\/p>\n As a teenager growing up in New Brunswick, Sears was bullied for her weight and was repeatedly put-off by health-care professionals.<\/p>\n \u201cIt\u2019s been pretty aggravating,\u201d Sears says. \u201cIt\u2019s a lot of extended wait times for things, a lot pushing things to the side, and just sort of, \u2018Oh, we\u2019ll tackle that later, we\u2019ll talk about that later.’\u201d<\/p>\n As a member of the Glooscap First Nation, she often felt like she needed to hide her biracial identity from doctors for her symptoms to be taken seriously.<\/p>\n \u201cIndigenous women are especially not considered in the health-care system, but at the same time where I am, you know, a little bit more white presenting, as much as I hate to admit that that is a bit of a privilege, it is,\u201d she says.\u00a0 \u201cBut I strongly feel like if it had to come up, it probably would have resulted in problems.\u201d<\/p>\n The battle begins<\/strong><\/p>\n It wouldn\u2019t be until Sears\u2019 early 20s when she was referred for PCOS testing in Nova Scotia, that she got a glimmer of hope.<\/p>\n But she says her experience with an OBGYN in Cumberland County was far from encouraging.<\/p>\n \u201cI believe she saw that I was overweight, and she tunnel visioned on that,\u201d Sears says. \u201cI told her, I said, doctor, I eat 800 calories a day and I do intense cardio for an hour a day, five days a week. And \u2026 I might lose a pound a week at best.\u201d<\/p>\n But, Sears says, her doctor wasn\u2019t convinced.<\/p>\n \u201cShe looked at me and said, \u2018Hmm, surely you must be doing something wrong.’\u201d<\/p>\n At that appointment, Sears was also informed they had lost her blood panel results, necessary for indicating hormonal imbalances critical for diagnosing PCOS.<\/p>\n When she offered to re-do the test, she was told it would cost the hospital too much money.<\/p>\n \u201cI\u2019m just basically being dismissed as not being important enough to consider these things,\u201d Sears explains.<\/p>\n Sears says she was handed a low-carb bread recipe and sent on her way.<\/p>\n \u201cI was devastated and shocked. I didn\u2019t know how to respond. I kind of just took her piece of paper she gave me, and I was like, \u2018What\u2019s happening?\u201d Sears recalls.<\/p>\n But experts say when women tell their medical providers they are trying to lose weight, and nothing is working \u2014 they really need to listen.<\/p>\n \u201cA lot of these PCOS patients \u2026 without treatment, they end up with type 2 diabetes \u2014 all kinds of other issues, (like) fatty liver disease, things like that,\u201d warns Julie Kane, a nurse practitioner and owner of Bird Island Wellness in Newfoundland.<\/p>\n \u201cThis is not something where it\u2019s just a diet or just exercise. A lot of PCOS patients need medical management.\u201d<\/p>\n Treatment options<\/strong><\/p>\n According to Kane, the first line of defense when tackling the hormonal side of PCOS is progesterone.<\/p>\n \u201cProgesterone is a hormone that is produced in our ovaries,\u201d Kane says. \u201cIt is our reproductive hormone. Progesterone is also our feel-good hormone, our sleep hormone, and it is very beneficial.\u201d<\/p>\n Low progesterone levels in women have been normalized by the health-care system. But Kane says less of the hormone can result in the mood imbalances and fertility issues commonly associated with PCOS.<\/p>\n \u201cSo, progesterone actually is taken at night, prescribed as a capsule,\u201d Kane says. \u201cThere\u2019s different doses in terms of treatment. I start patients at a low dose, and we titrate up depending on how the patient feels.\u201d<\/p>\n Kane says she\u2019s seen patients feel better within days, but a lot of medical providers aren\u2019t aware progesterone is an option.<\/p>\n \u201cThe progesterone that I prescribe is bioidentical, meaning when you take it, your levels increase,\u201d Kane explains. \u201cYour levels of progesterone actually increase on your lab work.\u00a0 With birth control and IUDs, I don\u2019t see a change. So, you\u2019re not really getting that benefit.\u201d<\/p>\n Birth control methods do not directly address the root cause due to their synthetic nature, Kane says, despite doctors prescribing them as a \u2018catch-all\u2019 treatment for various conditions involving women\u2019s reproductive health.<\/p>\n Something, Tanya Zboril, a nurse practitioner who owns both TBT clinic locations in Ontario and Nova Scotia, wants health-care workers to be wary of.<\/p>\n \u201cThey are commonly prescribed because they are effective at stopping the reproductive cycle and improving symptoms. For instance, they remove the amount of free testosterone that can be circulating in the body, which can cause the scalp balding, the dark facial hair, the acne.\u201d Zboril explains. \u201cBut they\u2019re not always well-tolerated, and they come with a risk of blood clots. Which can lead to heart attack and stroke.\u201d<\/p>\n PCOS is not just a hormonal condition, but a metabolic one as well \u2014 hence patients\u2019 difficulty gaining and losing weight.<\/p>\n \u201cIt\u2019s similar to diabetes in that there are fluctuations in a person\u2019s blood sugar levels. And this is very hard to diagnose with labs,\u201d Kane explains.<\/p>\n When it comes to treating the metabolic side of PCOS, birth control methods aren\u2019t effective.<\/p>\n Zboril says there needs to be a comprehensive approach.<\/p>\n \u201cRight now, Metformin, which is a medication you might have heard associated with diabetes, is considered gold standard as an insulin sensitizer, but results are not always consistent. So, you can look at using GLP (-1s) as well.\u201d<\/p>\n She says there\u2019s also a diuretic called spironolactone that can help block some of that free testosterone and has been known to be an effective treatment to reduce inflammation.<\/p>\n \u201cAnd almost the most important one \u2014 natural thyroid medication should be given because there\u2019s evidence to support the fact that PCOS may be also an autoimmune issue,\u201d Zboril says. \u201cThere\u2019s plenty of women that have PCOS that also have Hashimoto\u2019s (disease), which is an autoimmune thyroid disorder.\u201d<\/p>\n Zboril and Kane both say there is no one-size-fits-all solution for PCOS, meaning practitioners have to have a deep understanding of their patients\u2019 symptoms in order to properly treat it.<\/p>\n An unsophisticated health-care system<\/strong><\/p>\n Two years following her appointment at the Cumberland County Regional Hospital, Sears\u2019 family practitioner officially diagnosed her with PCOS.<\/p>\n But she says Maritime doctors\u2019 hyperfixation on her weight contributed to disordered eating habits that were challenging to shake.<\/p>\n Researchers estimate about 1 in ten women have PCOS, says Zboril. But that number could be much higher as many women go undiagnosed.<\/p>\n