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Book review--Living With PCOS by Angela Boss and Evelina Sterling

I just received a review copy of Living With PCOS by Angela Boss and Evelina Sterling. I actually sold the original edition of this book in my bookstore for a time, so I was interested to see the new version.

Before I review, I want to qualify, I went into reviewing this book a little differently than many readers would. I am a dietitian who believes in the power of nutrition to help women with PCOS. In the process of building the inCYST network, I've also had the honor and pleasure of meeting and working with colleagues who use many different (and evidence-based) approaches to PCOS management that expand past what a medical doctor might offer. So I am most likely to connect with experts on the topic with a similar perspective.

What this book is very good at:
--putting the readers in the frustrated and invalidated shoes of a woman with this diagnosis, and advocating for better identification and syndrome management.
--providing a laundry list of qualities to look for in a primary care physician.
--summarizing lab values typically used to develop a woman's treatment plan.
--explaining medications typically prescribed for PCOS management.
--including an entire chapter on depression, an aspect of PCOS that medical professionals seem to not want to acknowledge, but which is very, very prevalent.

What this book could have been better at:
--advocating for as much discretion when choosing a nutrition professional as choosing a physician. Many dietitians say they treat PCOS when they haven't even pursued specialized training for the diagnosis.
--advocating for as much discretion when choosing an alternative care provider as choosing a physician. Again, there are many people who view women with this diagnosis as a revenue stream, not women who deserve evidence-based, ethical treatment.
--explaining why breastfeeding can be problematic in PCOS.
--describing and evaluating alternative therapies, supplements, and herbs. A very high percentage of women with PCOS are so desperate for help they are doing a lot of self-treating and self-medicating, which can be helpful…or very dangerous.
--broaching the topic of emotional eating, binge eating, and eating disorders. It's rampant in this population, it needs to be validated, explained, and destigmatized, as much as the rest of the symptoms do.

I was not entirely comfortable with the section on low carbohydrate diets. Even though it acknowledged that these diets are restrictive and difficult to maintain, it went on to make some general recommendations about how to pursue one. One of the most common problems we encounter at inCYST in our individual counseling, is a blanket carbohydrate restriction that eventually ends up with a binge. It's a noble goal, to reduce carbohydrates, but there are ways to do it that do not promote disordered eating. Perhaps including a dietitian in a future version of this book could help promote healthier eating patterns that are evidence-based.

Because I've been working with Dr. Van Dyke to better understand laser treatment for hirsutism, I was interested on the section regarding laser hair removal. There were some important facts about this treatment that were not included.

In general, for someone who is new to the diagnosis, it's a helpful rundown of what to expect when working with a medical doctor, but the slant is toward that relationship. If you have chosen, in your own personal situation, to prioritize medical treatment without using nutrition, naturopathy, acupuncture, or other complementary treatments, it is a good resource. However, if your treatment team includes other approachess, you will not find information in this book to enlighten you or guide you with regard to those issues.

Click here for more information on the book.

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Book review--Living With PCOS by Angela Boss and Evelina Sterling + supplements