Podcast: From PCOS to Menopause: Balancing Hormones Through Food with Dr. Basma Faris

Introduction

Dive into the world of women's health with Dr. Basma Faris, a board-certified OBGYN and culinary medicine specialist. In this eye-opening conversation, Dr. Faris shares her journey from dietitian to OBGYN and how she's revolutionizing care for women with PCOS and those navigating menopause.

🔍 Discover:
- The truth about PCOS and why it's often misdiagnosed
- How nutrition can be a game-changer in managing hormonal health
- Myth-busting insights on fruit consumption and protein intake
- Personal stories of resilience and adaptation through menopause

Whether you're dealing with PCOS, approaching menopause, or simply interested in optimizing your health, this episode is packed with practical advice and empowering insights. Don't miss Dr. Faris's compassionate approach to women's wellness that goes beyond numbers on a scale.

Listen now and take the first step towards a healthier, more vibrant you! 💪🍎 

Connect with Dr Basma Farms

IG: https://www.instagram.com/drbasmafaris/

PolyPrepMD.com: https://www.pollyprepmd.com/

Transcription of Podcast

Dr Orlena: Hello, hello, hello. Welcome to Fit and Fabulous with me, Dr. Orlena. We have an amazing guest today. Please welcome Dr. Basma Faris. Basma, welcome, welcome.

Dr Basma: Thank you so much. So happy to be here. Thanks for inviting me.

Dr Orlena: My absolute pleasure. Should we dive right in? Do you want to tell people a little bit about you and your amazing history and what you're doing?

Dr Orlena: Sure. So

Dr Basma: let's go back. I started my career Over 20 years ago was a registered dietitian and I currently am a board certified OBGYN and culinary medicine specialist. So I worked for several years as a registered dietitian. I had studied nutrition as an undergrad and got my master's degree and then at some point decided I wanted to be able to, you know, expand and do more with my patients.

Dr Basma: And so I made the leap to go to medical school with the intention of. Becoming either an endocrinologist or a gastroenterologist, because that was sort of what I knew and what I thought would align with my nutrition background the most. But then I ended up as, as one does in medical school, exploring all the different specialties and falling in love with OBGYN and that's what I became.

Dr Basma: And so I've been working ever since to try to join both, you know, nutrition and women's health together. And I do so in a few different ways which I think we're going to talk about today.

Dr Orlena: Fabulous. Fabulous. And an amazing history. So I know that a lot of medical schools don't cover nutrition.

Dr Orlena: They really didn't cover nutrition for us. I'm just going to whisper a side note for our non American listeners that OBGYN is what we call in the UK obs and gynae or obstetrics and gynecology. At least I think it is, isn't it? So, I'm really curious how you now use your culinary qualifications, or do you?

Dr Orlena: Tell me.

Dr Basma: I do. So I became certified in culinary medicine in 2020. So it's been a few years now which really for me served as a refresher of nutrition to bring me up to date and to connect me with other people that were doing similar things or other people in the field. And there are a few different places where I find it really serves me very well.

Dr Basma: Certainly in caring for pregnant people so nutrition is an important part of having a healthy pregnancy. So that's one area in which I use it. But the, where I spend. A good portion of my efforts is in helping people with polycystic ovarian syndrome. I sort of noticed even from the very beginning of my career as an OBGYN that people with PCOS really were not getting any nutrition education or counseling or help in that matter.

Dr Basma: And for, you know, not really even realizing that it was part of, you know, The care. And so just seeing that that was sort of a big area of need. I started a company focusing on that. So I have a telemedicine practice and education company focused on polycystic polycystic. Caring for people with polycystic ovarian syndrome, and then you know, really looking forward towards women going through the menopausal transition.

Dr Basma: I'm co hosting a retreat this fall with another OB GYN colleague in Morocco, where we're going to delve into nutrition for that transition and for women. Sort of the next phase of our lives. So I really like to use nutrition sort of wherever I can, across the, the lifespan but really focusing primarily on women and those are the different ways that I do that.

Dr Basma: Fabulous.

Dr Orlena: Fabulous. And that retreat sounds absolutely amazing and not too far from us in Spain. But, so we've got PCOS and we've, Mm-Hmm. , menopause and Menopause. Let's spend a few minutes talking about PCOS 'cause I know that well, first of all, if you could explain what it is, because not everybody knows what it is, but also I know that a lot of people don't realize they have it for a long period of time.

Dr Orlena: So perhaps you could talk a little bit about that and how. nutrition helps people.

Dr Basma: Please. Of course. I it's unfortunate that there is sort of this mystery around what PCOS is. And, and even though there are pretty clear diagnostic criteria and you know, you said it correctly, people often wait for several years before they get a proper diagnosis.

Dr Basma: Which can be very frustrating for people who are struggling, but poly PCOS stands for polycystic ovarian syndrome, which is actually a pretty lousy name for what the condition is, but it was named for the appearance of the ovaries on ultrasound in people that have PCOS and PCOS is a condition in which there is dysfunction of ovulation.

Dr Basma: And so that can result in irregular or absent periods. And fertility problems, because if you're not ovulating, then you can't conceive. And then in addition, elevated androgen. So that may be symptoms of having elevated androgens, like facial hair, cystic acne. And then you know, those are sort of the hallmarks of it.

Dr Basma: And when You have an ultrasound and people who have PCOS, oftentimes the ovaries are filled with these small follicles and follicles are the normal cysts that our ovaries produce that house our eggs. But when you have lots of unrealized or unruptured follicles, the ovary just gets really chock full of these little cysts and that's why they call it polycystic ovarian syndrome.

Dr Basma: Now, to make the diagnosis of PCOS, you need to, we use what's called the Rotterdam criteria. There've been many different criteria over the years, but pretty much universally this has been agreed upon as the standard in which you need two out of the three criteria. And the first criteria is to have That ovulation dysfunction.

Dr Basma: So the failure to ovulate or a delayed ovulation. And so that can be documented either by having longer menstrual cycles, absent menstrual cycles, or there are some, you know, biochemical tests that can be done to confirm that. So that's one criteria. The second criteria would be to have signs or symptoms of having elevated androgens.

Dr Basma: So androgens, people think of androgens as the male hormones, but we know that we women make androgens as well. Just in a different balance from men and in people, women and people with ovaries, if they have higher androgens that can result in either blood tests that show the abnormality or the symptoms of having facial hair or balding or cystic acne or hair on the chest.

Dr Basma: So places that you would think are more male patterns of hair growth. So that's the second criteria. And the third criteria is having that polycystic ovarian appearance on ultrasound. And just recently added to the diagnosis that if you don't have ultrasound readily available, you can do a blood test for a hormone called anti Mullerian hormone or AMH.

Dr Basma: And if that's elevated, that's a surrogate marker for that polycystic appearance on ultrasound. So those are the three criteria. And to make the diagnosis, you need to. Out of the three, at least. Some people have all three, but you just need two to make that diagnosis. And other conditions need to be excluded.

Dr Basma: So you need to exclude other hormonal disorders that may mimic PCOS. And so So

Dr Orlena: why do people with PCOS, why do they struggle with weight loss so much?

Dr Basma: So, that's the next part of it. And this is not part of the diagnostic criteria, but it's estimated 75 to 90 percent of people with polycystic ovarian syndrome also have insulin resistance and insulin resistance and the resultant high insulin that can go along with it can make it difficult to lose weight or can make weight gain easier that and having elevated androgens, which predisposes people to a more what we call Android distribution of fat, which would be the fat, the central.

Dr Basma: You know, exactly of adipose tissue of fat tissue around the, so sometimes you'll see classically people with PCOS, whether they are overweight or obese, they may have those real thin legs and more of a bigger, you know, abdomen. Do they know what drives the insulin resistance? No. And so it's not completely understood.

Dr Basma: There are some candidate genes, so in some people it may be, you know, strictly genetic. It's often probably epigenetic. So some, you know, changes to the, to the genes. To the genes for the non, non medical people out there. That means if your genes can be altered by molecules that attach to it, that turn those genes on or off.

Dr Basma: And that can be due to exposures that you experienced either while you were in utero in your mom's, you know, while your mom was pregnant or even in early childhood, it can be a result of there's all these different endocrine disruptors in the environment. So BPA has been implicated. And then certainly dietary factors that we know can contribute to insulin resistance.

Dr Basma: So it's probably a combination in most people. And even though there may be one starting point in an individual, it's usually multifactorial.

Dr Orlena: Perfect. And so how does, how do you help people with your nutrition? How do you help them improve their PCOS and presumably help them lose weight.

Dr Basma: So sometimes it's, I mean, I like to take the approach that let's try to fix the underlying metabolic issues as best as possible versus using a weight first approach because A, not everybody who has PCOS needs or wants to lose weight.

Dr Basma: But oftentimes it's those underlying the insulin resistance or the elevated androgens that are the driver of you know, the whole, the whole syndrome and then the third driver so it's funny to use that word cause that's the word that I use as well is would be chronic inflammation. And so if there's another disease process that's going on or another exposure that's causing someone to have low grade chronic inflammation and they all sort of feed off of each other.

Dr Basma: So the, you know, sort of the biggest lever I would say from the nutrition standpoint would be to help to manage the insulin resistance. And then also, it also, you can help to reduce chronic inflammation through dietary changes. The elevated androgen part of it is less resistant directly to nutritional changes, but indirectly by modifying the other two levers, we can do that.

Dr Basma: So if we're going to talk about insulin resistance first, there's many different ways that we can. approach insulin resistance from that standpoint, right? I would say the most obvious and sort of first step is to make sure we're reducing someone's intake of refined carbohydrates, sugars you know starches that have had the fiber removed,

Dr Orlena: refined carbohydrates.

Dr Orlena: I like everyone always talks about like, I'm going low carbon. I'm like, You don't mean that. You mean you're going low, white, refined carbohydrate.

Dr Basma: Correct. Cause people think they have to go low carb and there's so much nonsense out there. On the internet and all these different influencers that want people to go completely low carb or to eliminate.

Dr Basma: dairy and gluten. And, and really there's not any scientific basis for that, but yes, to reduce the amount of white of white, you know, starches and carbohydrates, because you you're trying to not to overstimulate the pancreas. So, and then all the different other strategies around portion control and making sure there's adequate fiber and making sure that meals are balanced so that there is.

Dr Basma: protein in the meal, which helps with satiety, that there's fiber in the meal that helps with bulk and helps to slow down digestion and helps the gut microbiome to make sure there's a little bit of fat in the meal to decrease, you know, to slow down gastric emptying. So there's all these different strategies that with adequate, you know, with, with good meal timing and sort of making sure that the meals are planned out that they satisfy all of those you know, hit all of those different nutrients, you can really go a long way to reduce the insulin resistance by not overstressing the pancreas.

Dr Orlena: And I just want to put you there and say, I know that we're talking specifically about PCOS and insulin resistance, but all of that advice you have just given has been fabulous advice for everybody. You don't have to have these illnesses to be eating like that. So just that's, in a nutshell, healthy eating.

Dr Orlena: Now, a question for you. Yes. Which is another of these controversial things. I was recently talking to somebody and they said to me, Oh, I've given up fruit because it's not good for my sugar levels. And I went, oh my goodness, please don't tell me that. So what's your take on fruit?

Dr Basma: I love fruit and I love fruit for everybody because A, we talk, you know, the other thing that we haven't really talked about yet is the chronic inflammation, right?

Dr Basma: So fruit contains naturally all the incredible. Both nutrients and phytonutrients, so all of our antioxidant vitamins, minerals, and all of the different phytonutrients that are also anti-inflammatory that you really get from fruit. Also fruit generally has enough fiber to slow down that digestion and minimize.

Dr Basma: Big rises in blood glucose. Everybody talks about spikes, you know I tell people if they really are very concerned and have their fruit after a meal or make sure they're pairing their fruit with something else that has some protein or a little bit of fat in it so that, you know, having their fruit with some nuts, having your fruit with some yogurt.

Dr Basma: Or if you're very concerned or somebody really is in the, you know, the place where they have you know, early stage diabetes or, or even you know, pre diabetes if they want to for a short period of time. And I'll do this with some of my patients who use a continuous glucose monitor. Just to learn what portion sizes are appropriate for a given person for a certain food, not to use them forever and ever, but to just learn for themselves what is the right amount for them and how much can their body tolerate.

Dr Basma: So just sort of as a learning tool. So that's what I say about fruit, but yes, I hear that all the time where people will say they can only have berries.

Dr Orlena: I'm so gassed. And it drives me,

Dr Basma: oh, it drives me bananas. Which I love, I love bananas. And so, and so important for the gut microbiome, we know people with PCOS have dysbiosis.

Dr Basma: They've been shown people with PCOS compared to people without have fewer and more varied gut bacteria. And so providing all the different prebiotic fibers is very important in improving the gut dysbiosis, which I think is sort of underappreciated.

Dr Orlena: Perfect. Perfect. Yes, totally. Now, let's just change tracks slightly, and I suspect you're going to give us a very similar message, but that's fine.

Dr Orlena: Let's just talk a little bit about menopause and perimenopause. And I believe that you have a personal story about menopause. Would you be happy to share that?

Dr Basma: Yeah, I, you know, unfortunately, I myself struggled with pretty severe endometriosis. And I had to have, I've had two surgeries to to treat my endometriosis and in the process did lose some portion of ovarian tissue.

Dr Basma: And then, you know, fast forward 10 years later when I wanted to get pregnant I knew I would have difficulty and I did I did ultimately conceive by IVF, but my reproductive endocrinologist at the time warned me that my ovaries were small and that I would likely experience menopause sort of earlier than expected.

Dr Basma: And then so it, and so it happened. And somewhere in, you know, in my, A few years ago in my mid forties, sort of mid pandemic also. So all these things happen at once. This sort of real, you know, dramatic shift occurred. Which I feel like I've now sort of come out on the on the other side of sort of re like sort of learning what my new normal is.

Dr Basma: But it certainly was a struggle. Cause it was a struggle just in terms of a huge change in, in lifestyle. You know, I was here in New York practicing in New York and we really were hard hit. In the early days of the pandemic. So huge changes to lifestyle, stop going to the, the gym got a spin bike as everybody else did to try to keep fit but not really in, in such a good way.

Dr Basma: Wasn't really doing any strength training. And as a result, I think lost a good amount of weight. Lean mass. I always have, was a very sort of strong person, always into lifting and, and also maintaining muscle fitness as a result. I have had some hip injuries and knee injuries. So just as injury prevention and then unfortunately with the pandemic, you know, a lot of that went Sort of went awry.

Dr Basma: And then that led to, as one might expect, injury. And then injury leads to, you know, deconditioning and all of the, those things. So I would say it's a few year process.

Dr Orlena: When you have that One thing goes wrong and then another thing goes wrong and it just feels like there's this negative plug hole and it pulls you in and it pulls you in and things just get worse and worse and it feels such a difficult place to be able to reverse it and start building up again.

Dr Basma: I think it's so underappreciated, right, that this happens anytime somebody has a injury and sort of the deconditioning happens so quickly.

Dr Orlena: Yeah.

Dr Basma: And as we age, getting back to that same level of. Lean mass is very challenging. It was a lot easier when I was younger, right? You get injured, you'd rehab and a few weeks later you're back to, but it's a much longer journey.

Dr Basma: And so you know, I experienced that a little bit when I was sort of postpartum and I, you know, I had my twins as a resident don't recommend. Definitely recommend that. And I was already, you know, in my, in my mid thirties. And so there was certainly, there was that, I think I sort of took a hit and then sort of came back after that you know, got fit again.

Dr Basma: And then, and then the pandemic and the, and menopause, like superimposed on each other really challenged me. And so you know, I was just talking, I have a personal training there and, and I was just talking to her Like last week and I was like, I'm not back to myself because I can't say that because I'm, I'm a different person.

Dr Basma: And I certainly feel different, but I was like, I'm back, you know? And she like, it was just that feeling. I was like, I'm back. I feel good. I feel strong. I don't, I'm not afraid. I don't feel like I'm going to hurt myself. And that's really most important. I'm lifting, I'm lifting heavier, I am, and I'm feeling confident.

Dr Basma: And so that has really been a challenge. The challenge in also in doing that, and this is, you know, unfortunately, as we, something that we have to think about, and you were going to ask what my nutrition recommendations are. And so these are them. As we're trying to, it depends sort of where you are.

Dr Basma: If you've been fortunate to maintain your strength, then you just need to maintain it, right? But if you're trying to build back or you know, you never were somebody that really had a you know, you weren't strong, you sort of always prioritized maybe thinness over, over strength.

Dr Basma: Have, you know, sort of live their life that way. It's hard and you do need to increase your protein intake. And that has been somewhat challenging for me because sometimes I find it

Dr Orlena: protein, my survey on protein. Cause I know that protein is a controversial area. And I think it's really interesting that I asked different experts and they all come up with different.

Dr Orlena: Recommendations, which makes me think you're not an expert. How on earth are you supposed to know? So what protein do you, what protein level do you recommend for people?

Dr Basma: Somewhere in the, if we're talking about grams per kilogram, some, and it depends on where you are, right? If you're talking about somebody like myself, who's trying to increase.

Dr Basma: My, you know, your lean body mass somewhere in the 1.2 to 1.5 grams per kilogram. If you are maintaining, you may not need that much. I know there are some people out there, some experts that are promoting a one gram per pound, right? Which is 2.2 grams per kilogram, which is a lot of protein. And I, and I think that is un unless you're somebody that is bodybuilding.

Dr Basma: Yeah. I don't think that's good advice for the general public but somewhere in that, you know, if you're trying to make a change where you're trying to increase your proportion of lean mass somewhere in that 1. 2 to 1. 5 You know, I know some people will say 0. 8 is all you need and it really depends.

Dr Basma: It depends on the type of protein You're eating if you're getting your you know If you're getting more plant protein that number may need to be at the higher end of that range if you're eating more animal protein You can probably be at the lower end of that range that I referenced. And so, because there's, you know, availability that you have to think about as well, and it's going to be individual.

Dr Basma: If you notice you're not really making any gains then you may need to increase it. Or if, you know, you're finding that, you know, you are, and you feel like, but you're eating too much and it's unpleasant, then maybe you're overdoing it. So

Dr Orlena: you, and you were going to talk about. How you found it difficult to eat proteins.

Dr Orlena: Would you like to talk about that? Yeah, I'm just not

Dr Basma: a huge, I'm not, I'm an omnivore, but I'm just not a huge meat eater, right? I'm just not a huge meat eater. And I eat lots and lots of a lot of high, a very high fiber diet. So A lot of vegetables, lots of whole grains, but as we, as we increase the proportion of our diet, that is coming from protein, our protein foods come with other things, right?

Dr Basma: They come with energy. They do provide us with calories and depending if it's a plant protein, it's going to come with fiber and some carbohydrates, and if it's an animal protein, generally it's going to come with some fat, right? And so you have to. Then if you're going to increase the amount of protein that you're eating, you have to cut back on the other someplace else, right?

Dr Basma: Because you're going to need a higher proportion coming from protein, but you don't want to, if in the pursuit of doing that, eat more calories. Then you need because then you end up increasing your your adipose tissue, right? So you end up gaining weight I don't like to talk about weight gain or loss because we have to be specific, right?

Dr Basma: So you're gonna end up gaining, you know, I'm just gonna whisper Adipose

Dr Orlena: tissue is fat

Dr Basma: just in case people don't know. Exactly. That's what I was gonna say. So fat stores if you consume more energy than you need and so sort of you have to you have to figure out where you're going to You know, cut

Dr Orlena: and unfortunately, when you try to increase your protein, you found that difficult.

Dr Orlena: Did you?

Dr Basma: Yeah, I found increasing my protein intake. Initially, I was increasing my overall caloric intake. And so so that can be, that can be challenging. Yeah.

Dr Orlena: Yeah, perfect. So what's your big advice to women who are perimenopausal, menopausal? What, in a nutshell, what, in a nutshell, what nutritional advice would you give them?

Dr Orlena: I love nuts.

Dr Basma: Me too, I am nuts for nuts. That's probably where I, I have, I'm, I'm nuts, I'm, I'm nuts for nuts. I, I, I do love them. But I, I can't have too many of them around. My advice is So I'm going to go ahead and start thinking about your body in terms of right. What do you want your, what do you want the rest of your life to look like?

Dr Basma: So take stock, take stock. What is your family history? Right. If you're, if everybody in your family. has diabetes, then you need to be approaching your nutrition in a way that's going to minimize your risk of diabetes, right? But if somebody like in, and so that may be you're having, you know, fewer carbohydrates and you're having a higher protein you know, diet, if everybody in your family had dies from colon cancer, well, then you're Thing, you know, things are going to look a little bit different for you.

Dr Basma: If everybody in your family has osteoporosis, that's something that you need to focus on. So let's take stock and think about a prevention, right? So prevention based on family history and then prevent, what do you, what else are you also trying to prevent, right? Let's prioritize. Strength, balance, fitness, and not, and not an aesthetic, like be at peace with your body, but don't try to pursue something that is just really somebody else's.

Dr Basma: expectation, right? We're, we're old enough at this point that you don't need to put up with that BS anymore. So love yourself, be at peace with your body. Your body has done amazing things, but really think about what you want to be doing as you look forward, instead of trying to fit into a mold of, Of what you were.

Dr Basma: People want to go back, right? People want to, Oh, I want to wear, I want to fit into that thing that I wore 20 years ago. It doesn't, it's not even in style anymore. Who cares? Like buy something new and buy something that makes you feel good and look good. And that fits you properly. Right? Like, what is this chasing these old, these old goals?

Dr Basma: So that's really, and I think once you can do that and have a little bit more of peace with yourself and really just look forward to what's the life that you want to have instead of looking backwards. I think it's much easier to realize your goals.

Dr Orlena: Perfect. What I call a vibrant rest of life. I want people to lead a vibrant rest of life.

Dr Orlena: Well, thank you so much Basma for coming and chatting to us. What do you say to those people who are struggling and they think, Oh my goodness, I'm in that place where you were playing that negative plug hole where everything is just collapsed around them and they feel. It's hopeless. I can't do anything.

Dr Orlena: I want all of this stuff, but it just feels unattainable. What do you say to those people?

Dr Basma: Take a, take a pause, take a breath and figure out what it's going to take you to get where you need to go and have some patience. For me, I had to stop and say, you know what I've, I have to, first I have to heal, right?

Dr Basma: I have to heal my hip. I have to, you know, I had pericarditis in there. There was like a whole bunch of stuff happening. So I have to first heal because I can't do anything if I'm in pain. Right. Then, you know, then get a, get, get a team around you who's, you know, they're, they're experts that are people that are experts in all of these things.

Dr Basma: And it doesn't have to cost you a fortune, right? There are many lower cost resources but you know, find, find people that can give you the information advice that you need to help support you on this next phase. So, and then, and take it slow. I had to realize number one was healing from injury. Number two was.

Dr Basma: strength. And then after that, once I get to that place, then I can focus on, you know, fat loss and, and, and, and these other things. So even if you are a trainer, right? I think of like athletes and how do they do it, right? These bodybuilders and whatnot, they do They have a bulk phase, right? First they bulk and then they cut.

Dr Basma: And these are sort of the two phases that they do. It's really hard to do them both at the same time. So, you know, increase that strength, get yourself to the place where you're strong and injury free and, and as you know, Little pain is possible. I can't, I don't know if it's possible to be pain free, but you know, to the point that you feel comfortable because you shouldn't be suffering and then after that you can, you can reach your fitness goals.

Dr Orlena: Perfect. Perfect. And if people are interested in either your PCOS services or joining you in Morocco, where can they find out more about those two services? Yes.

Dr Basma: So if you are on Instagram, you can follow me at Dr. Basma Faris. So D R B A S M A F A R I S where I talk about all of the things PCOS Pregnancy and menopause and my retreat that's coming up in Morocco in September.

Dr Basma: And also you can find me at my website, which is best with ferris. com or poly prep. com, which is P O L L Y P R E P. com. And that's the PCOS focused business and, and links to the practice. I will leave

Dr Orlena: the links in the show notes as well. So thank you. Thank you so much for spending some time with us.

Dr Orlena: It's been an absolute pleasure having you.

Dr Basma: Thanks for having me.