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More Than Just Weight Loss: Letisha's PCOS Management and Holistic Approach
This is not intended to provide medical advice. The interview has been edited for clarity and length. Please consult your doctor for any health-related concerns.
Letisha's polycystic ovary syndrome or PCOS journey began like many others - with irregular periods, weight struggles, and acne.
“At the time I was really struggling with not having a menstrual cycle,” says Letisha. “That is something that I struggled with my entire life. And I also have always struggled with my weight, even though I grew up as an athlete. I had a history of disordered eating. I have always presented in a larger body, and I would also experience cystic acne, especially on my jawline.”
As far back as I can remember my weight was an issue. I started dieting somewhere between the ages of 8 to 12 years old.
When she saw a gynecologist at 23 years old and shared a list of her symptoms, Letisha finally received a PCOS diagnosis. “She happened to sit down and just listen to me explain everything from the time that my menses started up to that point,” Letisha explains. “And she said, ‘you have something called polycystic ovary syndrome or PCOS.’”
Building on her personal experiences, Letisha has transformed her journey into a career dedicated to helping others. She is a licensed nurse, an award-winning PCOS coach, and a personal trainer, currently on her way to becoming a registered dietitian. With a B.S. in Nutrition & Food Science and over 5 years of experience, Letisha has guided many individuals with PCOS towards becoming their healthiest and happiest selves, combining her professional expertise with a deep personal understanding of the condition.
PCOS Symptoms: More Than Just Irregular Periods
While irregular periods, acne and weight struggles were Letisha's primary symptoms, PCOS can manifest in various ways. Letisha emphasizes that PCOS is more than just a reproductive issue: "I didn't know that it was a condition that needed my attention. I didn't know it was something that I needed to manage, had no clue that it was more than my weight and my periods at the time."
As Letisha delved deeper into understanding her condition, she discovered the multifaceted nature of PCOS. Symptoms can include:
Irregular or absent periods
Weight gain and difficulty losing weight
Acne, particularly cystic acne
Excess hair growth (hirsutism)
Hair loss or thinning
Fertility challenges
Insulin resistance
Mood changes and mental health issues.
PCOS and Mental Health: The Emotional Toll
The impact of PCOS can extend beyond physical symptoms too, often taking a significant toll on mental and emotional wellbeing. Letisha's journey includes struggles with disordered eating and body image issues, which she traces back to her childhood experiences.
"As far back as I can remember my weight was an issue,” says Letisha. I started dieting somewhere between the ages of 8 to 12 years old. I remember being treated differently by my family members and nurses and people at the doctor's office. In my mind, I thought if I just lost weight, it would fix everything. Everybody would be happy. People wouldn't be upset with me anymore.”
Weight Management with PCOS: A Complex Challenge
One challenging aspect of PCOS for many people can be weight management. Letisha shares, "I arrived at a place where I told myself, ‘You know what, you have this thing that's going to impact your weight. You just need to find something that's going to be long term, like stop doing the quick fixes, stop doing the fad, the gimmicks.’"
Letisha's weight loss journey led her to lose 100 pounds over a couple of years, even venturing into bodybuilding.
However, this extreme approach ultimately led to health issues. "I got to my lowest weight and probably my most fit physique and was trying to adjust to eating normally again and my body, for lack of better words, just fell apart. My hair started falling out and my whole body was inflamed. And it was sore, and I was puffy and swollen," she recalls.
Additionally, her digestive system started to disrupt her daily life, “I was having to use enemas just to go to the bathroom,” she says. “I felt like everything I ate was giving me an allergic reaction. I lost all of my strength. I went from this really strong, confident woman in the gym to not being able to go to the gym anymore because I felt so weak.”
To get help with her new symptoms, Letisha went back to her doctor. “And she just said, you're doing great. Keep dieting and exercising,” recalls Letisha. “You have a history of PCOS. You probably still have it. She patted me on the back and walked out. I was a little stunned. And I was also enraged. I just cried in my car.”
It was at that moment that Letisha decided to turn her pain into a mission to help others. She began networking with PCOS advocates and began her journey to become a registered dietician.
I really like to try to take away that food fear as much as possible
She explains, "PCOS brought me to this career change. I came into this knowing that I wanted to run a private practice because of my own experience of having PCOS. I live in a really rural area. There are not a lot of healthcare professionals with PCOS as their expertise."
Her goal is to fill the gaps in PCOS care, offering virtual telehealth services and collaborating with other healthcare professionals to provide comprehensive support for those with PCOS.
Nutrition for PCOS: Beyond Restrictive Diets
Letisha's approach to nutrition for PCOS has evolved through her personal experiences and education. She emphasizes the importance of nourishment over restriction: "I really like to try to take away that food fear as much as possible and be like, okay, like if you need convenient foods, let's do it this way and make sure that you get a bunch of nutrients and your protein and your fats."
Her advice includes practical tips like using a crockpot for meal preparation and finding ways to incorporate nutrient-dense foods without excessive restriction.
Lifestyle Changes for PCOS: A Holistic Approach
Letisha advocates for a holistic approach to managing PCOS, which includes more than just diet and exercise. She highlights the importance of stress management, sleep, and addressing past traumas.
"Managing my stress and really changing a lot of the ways that my lifestyle helped me get into a better place with my gut health," she shares, emphasizing the interconnectedness of various lifestyle factors in managing PCOS.
PCOS Treatment Options: A Personal Journey
Letisha's journey with PCOS treatment has been one of exploration and personalization. She shares, "I've definitely tried a few things. I have worked in conventional medicine and I've also worked for a functional health coaching company. My personal values and the way I approach health is I like to be somewhere in the middle."
Some of the treatments Letisha has explored include:
Metformin: An insulin-sensitizing drug commonly prescribed for PCOS.
Birth control: To regulate menstrual cycles, though Letisha found it challenging to stay consistent with this option.
Spironolactone (Aldactone): An anti-androgen medication to help reduce excess androgens which can reduce acne and excessive hair growth.
Supplements: Letisha regularly takes vitamin D, Omega-3s and fish oil supplements.
GLP-1 medications including Wegovy: A newer class of drugs that can help with insulin resistance and weight management. The GLP-1 that the most people are familiar with is Ozempic, a semaglutide that heps lower blood sugar levels in people with type 2 diabetes. Wegovy has a larger dose of semaglutide than Ozempic.
Letisha's experience with PCOS treatments, particularly GLP-1 medications, has been complex. “I have kind of mixed personal testimony on those so far,” says Letisha. “My biggest thing was that I drastically underate. And yeah, I lost weight but it was because I was under-eating calories. I did notice that my insulin response was better than it has ever been. I felt guilty for the first time because I could eat pretty much any meal and not have this rebound effect.”
Although the GLP-1 medication did have a somewhat positive effect, including a more regular menstrual cycle, Letisha had to weigh the financial aspect of being on the drug long term. “So I couldn’t keep it up forever,” says Letisha. “Obviously the weight came back on again.”
PCOS and Wegovy
While Letisha considered what to do next, she found out her insurance would cover Wegovy, a glucagon-like peptide-1 (GLP-1) receptor agonist. Currently, the Wegovy is not specifically FDA-approved for PCOS but is approved for weight management in adults who are overweight or have obesity. Not totally convinced of its efficacy, Letisha weighed the pros and cons of Wegovy with her doctor before starting the medication.
Because Letisha was in the midst of long study sessions, parenting two little kids, and commuting to school for her dietician degree, her lifestyle was more sedentary than she would have liked. Her doctor agreed that some additional health support was needed and prescribed Wegovy.
“I had a really, really hard time, with nausea and vomiting,” she says. “I definitely noticed a delay in gastric emptying and experienced extra fullness. I wasn't able to eat. I could go really long periods without eating”
There were also the mental health considerations, “I have ADHD, too, and that was really hard for me,” says Letisha. “I knew intellectually it's not good for me to go long periods without eating.”
To combat the lack of appetite, Letisha would eat a hearty breakfast but still felt undernourished. After a few weeks, some of her PCOS symptoms seem to be more under control. Her hair stopped falling out and she began having more regular periods but her feelings about the medications remain mixed.
“I think that [GLP-1s medications] have the potential to be so helpful, especially for the PCOS community,” says Letisha. “But I do worry that people are going to go for long periods of time being undernourished. I do worry that people are not going to get their abs done.There is some concern that it could exacerbate eating disorders. And while we don't have research on that now, I do think in the future we will.”
Instead of focusing solely on weight loss as a solution to her PCOS symptoms, Letisha adopts a holistic approach for herself and her clients. "I approach nutrition without food fear," she says. "If you need convenience foods, we'll ensure they provide essential nutrients, protein, and fats. My goal is to support your PCOS while keeping you informed and prevents you from being stressed al the time."
PCOS Throughout Life Stages
Letisha points out an important but often overlooked aspect of PCOS: "PCOS is lifelong. So we will have it even after menopause. There are so many aspects to PCOS that what you're focusing on now with your PCOS may look different in five years or the next year or whatever."
Insulin resistance is a key component of PCOS for many women. Letisha explains her experience with medications like metformin: "I understand a lot of people with PCOS struggle with insulin resistance where they may not be diabetic yet, there is an increased risk of that, but improving your insulin levels can help lower your testosterone, that impacts your ovulation."
Self-Advocacy for PCOS Patients
Throughout her journey, Letisha has learned the importance of self-advocacy. She encourages others with PCOS to speak up for themselves and seek the care they need. "You are your best advocate,” she says. “Do your best to understand, learn, speak up, and ask for things that you need.”
Letisha's work in PCOS advocacy extends to education and raising awareness. She offers free resources on her website Endocrine Collective, including a research database, to help others understand and manage their PCOS better. "I just randomly am adding new studies in there all the time. I thought there needed to be one place that had research articles organized and that people can access and start using that to help advocate for themselves," she explains.
A Message of Hope and Empowerment
Letisha's journey with PCOS is one of perseverance, learning, and empowerment. "Regardless of what you're going through, you're not alone,” she says. “However you feel is valid. You're going through some really hard things and you're doing the best that you can to manage a condition that even the leading experts in this world haven't figured out yet."
