Q&A with louise chang, md

Louise Chang, MD, founder of HealthySmartsMD, is committed to health advocacy and patient education. She champions the efforts of people with chronic conditions to live better and avoid the impact of future health complications. Dr. Chang is an adjunct assistant professor of medicine at Emory University and physician at Grady Memorial Hospital in Atlanta, GA. She was previously the Senior Medical Editor of WebMD and WebMD Magazine. She has been recognized for award-winning health content including medical news, videos, and special projects. Dr. Chang has collaborated with CBS news and has been interviewed by television and news radio programs, magazines, and newspapers. In 2012, Dr. Chang served as a panelist on the White House Seniors’ Health Town Hall. Dr. Chang is a graduate of Stanford University and New York Medical College. She completed her residency and chief residency at Saint Vincent’s Hospital Manhattan. Board certified in internal medicine, she is a member of the American College of Physicians and Society of General Internal Medicine. Her academic research has been published and presented at regional and national conferences.

What is PCOS in respect to your area of expertise?

As an internal medicine physician, I have met many women with medical histories or symptoms that have warranted evaluation for PCOS. During my time as medical editor at WebMD, I had the opportunity to see the knowledge gap that exists regarding PCOS among the general public as well as health providers. I’ve had the privilege to speak to many women across the US about their PCOS experiences. Each woman’s story is unique, but I’ve found overlapping themes of frustration related to having the PCOS diagnosis, symptoms, medical care, and treatments. It’s from the input of the many women who have generously shared their stories with me that I have developed a tool which I hope will help ease the burden that many have and empower women to become experts of their PCOS.

What are the PCOS symptoms?

Symptoms of PCOS may begin shortly after puberty, but can also develop during the later teen years and early adulthood. Because symptoms may be attributed to other causes or go unnoticed, PCOS may go undiagnosed for some time. Women with PCOS typically have irregular or missed periods as a result of not ovulating. Although some women may develop cysts on their ovaries, many women do not.

Other symptoms include:

  • Weight gain. About half of women with PCOS will have weight gain and obesity that is difficult to manage.
  • Fatigue. Many women with PCOS report increased fatigue and low energy. Related issues such as poor sleep may contribute to the feeling of fatigue.
  • Unwanted hair growth (also known as hirsutism). Areas affected by excess hair growth may include the face, arms, back, chest, thumbs, toes, and abdomen. Hirsutism  related to PCOS is due to hormonal changes in androgens.
  • Thinning hair on the head. Hair loss related to PCOS may increase in middle age.
  • Infertility. PCOS is a leading cause of female infertility. However, not every woman with PCOS is the same. Although some women may need the assistance of fertility treatments, others are able to conceive naturally.
  • Acne. Hormonal changes related to androgens can lead to acne problems. Other skin changes such as the development of skin tags and darkened patches of skin are also related to PCOS.
  • Mood changes. Having PCOS can increase the likelihood of mood swings, depression, and anxiety.
  • Pelvic pain. Pelvic pain may occur with periods, along with heavy bleeding. It may also occur when a woman isn’t bleeding.
  • Headaches. Hormonal changes prompt headaches.
  • Sleep problems. Women with PCOS often report problems such as insomnia or poor sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea.  With sleep apnea, a person will stop breathing for short periods of time during sleep.

What are you currently doing for PCOS?

In the fall of 2013, I launched a PCOS website that is freely available to people seeking information about PCOS. The website provides content in various forms (guest expert Q&A, research news, feature articles, reference, recipes, FAQ) as well as a PCOS symptom tracking tool to help women learn more about how PCOS affects them and become the experts of their own PCOS.

What are 5 key facts about PCOS that you would like the public to know?

PCOS affects about 7 million women in the US. That’s more than the number of people diagnosed with breast cancer, rheumatoid arthritis, multiple sclerosis (MS), and lupus combined. PCOS is not one-size fits all. Having PCOS doesn’t mean you can never have children. Lifestyle measures can make a big impact. You are not alone.

What do you want to get out of helping women with PCOS?

I want to enable women to feel empowered and in control of their PCOS. For example, many women “experiment” in different ways (such as following special diets and taking supplements) in an effort to help, but they are not sure if there is a benefit. I’d like to help bring together women’s efforts in a collective way to be able to share back real world evidence from users about what really seems to work and what doesn’t.

Does your business/practice have an online presence on social websites?




What interests you about serving on the PCOSAA Advisory Committee?

The level of public awareness about PCOS is disproportionately small compared to the numbers of people affected by PCOS. More women in the US are affected by PCOS than the number of people diagnosed with breast cancer, rheumatoid arthritis, multiple sclerosis (MS), and lupus combined, but there is far more awareness and resources dedicated to these conditions. Raising the level of awareness to help with earlier diagnosis is important, but so is awareness of new research findings, medical updates, appropriate treatment options, and inappropriate gimmicks.  

What can PCOSAA do, as an organization, to bring more awareness and to get more doctors to test women for PCOS?

PCOSAA can help bridge the communication and information gap between patients and health providers. Symptoms of PCOS can be vague and non-specific, so it is easy to attribute them to other causes or brush them off as insignificant. Awareness means bringing it into the conversation and having it on your radar so you are prepared to be able to rule in or rule out the diagnosis.