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Do you experience more acne than most women your age, extra weight in your belly, unwanted hair growth or irregular periods? If so, you may be suffering from a condition called Polycystic Ovarian Syndrome (PCOS).


PCOS is a gynecological issue that affects one in 10 women. Symptoms include unwanted excess hair growth, weight gain, painful acne, and metabolic problems. Women with PCOS often have longer cycles than average (35 days or more) due to delayed ovulation. Sometimes, women with PCOS do not ovulate at all for many months. Others may have regular bleeding but no actual ovulation (anovulatory cycles). Women with PCOS often have difficulty getting pregnant, and have more pregnancy complications such as miscarriage and gestational diabetes. They are also at higher risk to develop diabetes and heart disease later in life.


The symptoms of PCOS are commonly treated with combined hormonal pills (birth control pills). This may improve symptoms like acne and hair growth, but because the pills block ovulation, women taking them may have no idea what is going on with their underlying conditions. Ultimately, hormonal pills cannot cure the problem, and they do not reduce the risk of chronic diseases in pregnancy and later in life.


At Reply, we take a different approach. Our primary goal is to help women optimize their health as much as possible. For example, even a small weight loss (10-15 pounds) can significantly improve hormone balance in some women with PCOS. Rather than prescribe hormonal pills as the first line of treatment for PCOS, we recommend treatments that promote underlying health and fertility. This might include medical treatments and/or working on lifestyle factors like diet and exercise.


As part of our care, we work to understand each patient as an individual. PCOS manifests differently in different women. This is important as every woman has a unique body and a unique cycle. Often, we target treatments to certain days during a patient’s cycle. In order to do so, the patient must be tracking her cycle. At Reply we teach fertility awareness tracking to patients who are not already able to do this. This way, women are partners with their providers in their care, and are equipped with a health tool that can serve them in many ways throughout their lifetime.


If you’ve ever struggled with irregular periods or bothersome symptoms, or been prescribed the pill for management of PCOS without being able to understand your underlying health, you may be interested in the Reply approach. We are always happy to review your symptoms, cycle history, and any hormonal tests to help customize an approach that is best for you.

To schedule an appointment at Reply, call us at 919.230.2100
or visit our Become a Patient page.

July 3, 2024
“After over a year of trying and a miscarriage, it just felt like there was no hope and no way out of this situation. It seemed like there was no solution, that I would always be sick, and that we would never get to hold any of our children in this life.”
By Deborah Colloton April 30, 2024
Two things struck me during reflections surrounding 2024 “National Infertility Awareness Week”:
August 24, 2023
Why don’t more couples know about restorative reproductive medicine? By Amanda Naramore, APRN Most women have never heard the words Restorative Reproductive Medicine but many of the 13% of women struggling with infertility(1) do often ask themselves very important questions: Why hasn’t my doctor offered natural way to achieve pregnancy that cooperates with my reproductive system? or Why aren't my doctors working to explain my "unexplained infertility?" These are appropriate questions, but unfortunately they are not answered because most medical providers have never heard of RRM or fertility awareness charting.(2) Restorative reproductive medicine is a growing practice that has helped countless women restore their reproductive health. The International Institute of Reproductive Medicine defines RRM as a “medical discipline that identifies and treats the root cause of reproductive problems, aiming to treat, optimize and restore the patient’s health"(4). Most medical schools offering OBGYN residency programs do not teach students about RRM or even introduce them to the possibility of its existence (2). As a graduate of a women’s health nurse practitioner program, I was never exposed to the notion of health restoration. The curriculum identified the female medical abnormalities and went directly to treatment with birth control or in the case of infertility, referral to artificial reproductive technology (ART). There were no natural alternatives to treatment discussed or suggested. In fact, infertility is often referred to as a disease state instead of a symptom of a bigger problem. The lack of exposure a medical student or OB/GYN resident receives to RRM and fertility awareness charting will directly affect their ability to offer a positive alternative to ART. Providers simply do not know there is an entire medical community devoted to a unique fertility restoration approach. This knowledge deficit leaves many women frustrated with their options to improve their fertility and even suspicious of the medical community. Medical providers can also become discouraged. It seems like such a glaring inadequacy in medicine, yet the answer has been available for over 20 years. Here at Reply, we utilize RRM not only to repair the couple’s overall health and optimize their fertility but also to teach them about the female’s reproductive system by utilizing fertility awareness charting. This practice is backed by years of medical research and evidence-based medicine. RRM has excellent success rates in achieving pregnancy, especially in cases where IVF has failed, and women were of advanced reproductive age.(3) Another reassuring fact is that the RRM success rates for pregnancy are comparable to ART, excluding the use of donor eggs.(4) Our Reply team is working to educate couples about a healthier and more natural alternative to ART. We feel this approach respects the couple, as it helps them optimize their health while trying to conceive a healthy pregnancy.
By Samantha Ratcliffe, CNM, WHNP-BC February 22, 2022
”Not until I found Reply, did I feel confident that I would ever have a child of my own.” Watch to learn how the Reply Fertility “Finding and Fixing” Program helped Pamela to address her PCOS, to conceive, and to have a happy and healthy pregnancy.
By Samantha Ratcliffe, CNM October 21, 2020
In the case of breast cancer, there are some risk factors that cannot be changed such as your first period occurring before age 11, menopause arriving late, or the presence of particular genetic mutations. However, there are a number of breast cancer risk factors that you can control, many of which can be discussed at your preventative annual well-woman visit!
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For women who experience chronic or acute migraine, changes associated with pregnancy and postpartum can present new challenges to a difficult diagnosis. Variations in sleep, infant behavior such as crying or feeding schedules, and maternal hormone fluctuations can feel like unavoidable migraine triggers. For migraineurs, facing the thought of migraine headache without a plan can be scary. Let’s parse through fact and fiction about migraines and childbearing to determine how to prepare well for conception, pregnancy, and postpartum in a healthy and confident way.
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