At the 2023 ACOG Annual Clinical & Scientific Meeting, the impact of social media on polycystic ovary syndrome diagnosis and treatment was discussed.
Social media has a significant impact on polycystic ovary syndrome (PCOS) diagnosis and management, according to a presentation by Swetha Naroji, MD, MB; and Lauren Wozniak, MD, MPH, at the 2023 American Academy of Obstetricians and Gynecologists Annual Clinical & Scientific Meeting.
The “Fourth Estate” refers to the power of the press and media for advocacy and the capability of framing political issues. In recent years, social media has shown the capacity to change the views of patients and impact decision making, making it a Fourth Estate.
In a recent survey, it was found that the United States has the greatest proportion of individuals turning to social media for health advice. About 1 in 5 US individuals trust health influencers above medical experts.
PCOS is a condition of menstrual dysfunction and androgen excess. There is significant phenotype variability, with potential, acne, infertility issues, cancer risk, and other outcomes. Social media posts on PCOS received 3.5 billion views in 2021, rising to 5.3 billion in 2023.
Content producers for PCOS are unverified individuals with elements of advertising personal products on their social media pages. Of the top 100 PCOS TikTok profiles, only 2% were verified.
When searching for a diagnosis, patients may search “#pcosdiagnosis” on social media. However, these videos may display information that misleads individuals on what to expect in a clinical setting. The National Institutes of Health 1990 criteria, Rotterdam 2003, and Androgen Excess Society 2006 may be used to diagnose PCOS, but there are many more clinical guidelines available.
To determine PCOS, the American College of Obstetricians and Gynecologists analyzes ultrasound, ovarian volume, and endometrial abnormalities. In comparison, the American Academy of Pediatrics focuses on physical exams and does not recommend pelvic ultrasound. This shows visible variation in methods of diagnosing PCOS among clinicians.
As clinicians and children may be confused over the variation in PCOS diagnosis, patients, especially teenagers, may be vulnerable to receiving improper expectations from social media posts. Treatment is also affected, as clinicians prioritize prevention and symptom reduction. However, social media posts may prioritize symptoms such as acne.
PCOS management focuses on metabolic conditions, cancer prevention, fertility, and acne. A 5% to 10% reduction in weight loss through diet and exercise helps manage these factors. Patients who turn to social media may find methods of weight loss not recommended by clinicians.
A 2015 study found significant weight loss after 6 months in patients with an energy restricted diet when compared to patients with no restriction. This shows efficacy from a calorie restricted diet.
Another study examined changes in body mass index and insulin resistance in patients with a low carbohydrate diet, finding improved outcomes in all factors. Data has also indicated potential improvement from dietary approaches to stop hypertension. This shows significant variation in results of various diets on PCOS, with no clear “best” method.
Experts currently recommend physical activity and healthy eating to promote weight loss, with no specific diet recommended. Researchers have also found a 5% to 10% reduction in weight loss is not feasible in real life situations. Patients should focus on building healthy habits, finding an activity they enjoy, and starting an all foods fit diet.
PCOS is managed medically through a variety of factors, such as metformin, spironolactone, and lifestyle modification. Birth control is often recommended to reduce hyperandrogenism symptoms, reduce endometrial cancer risk, and provide contraception.
Patients may not understand the purpose of birth control for PCOS, and some social media influencers may exaggerate the recommendations of clinicians to only include birth control. There are also future therapies such as GLP-1 being advocated on social media, but experts have not reached a consensus on the efficacy of these methods.
Many patients also seek supplementation for PCOS. Currently, clinicians do not have conclusive data on the efficacy of these supplements. This may lead patients to seek social media posts advocating for products such as vitamin D, calcium, magnesium, zinc, biotin, and others.
Overall, there is conflicting recommendations from clinicians and social media influencers. Social media posts leave a significant impact on patient decisions related to PCOS, making it vital for clinicians to counter misinformation.
Naroji S & Wozniak L. The unintentional influence of social media on PCOS diagnosis and management. Presented at: 2023 Annual Clinical & Scientific Meeting. May 19-21. Baltimore, Maryland.