QC: Facts Of PCOS with Dr. Sadikah Behbehani

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Confused about PCOS and endometriosis? You’re not alone—and you might’ve been misdiagnosed. In this essential episode, Dr. Sadikah Behbehani, a double-fellowship trained reproductive endocrinologist and minimally invasive surgeon, sets the record straight.

She breaks down the real differences between Polycystic Ovary Syndrome (PCOS) and endometriosis, explains how they can coexist without causing each other, and outlines the actual diagnostic criteria for PCOS. This conversation is critical for teens, adults, and parents trying to make sense of irregular periods, hormonal changes, or conflicting diagnoses.

What you’ll learn:
 • Why PCOS and endometriosis are often confused but are very different
 • How misdiagnosis happens—and how to avoid it
 • What the Rotterdam criteria are, and why they matter
• Why polycystic-appearing ovaries alone are not enough for a PCOS diagnosis
• The truth about irregular cycles in teens and when to be concerned
• When PCOS should be diagnosed—and when it shouldn’t
• How endometriosis and PCOS can impact fertility and treatment

Whether you're newly diagnosed or searching for answers after years of symptoms, this episode will give you science-backed clarity and validation.

Listen now to get empowered with accurate information and practical next steps.

Have a question for a future episode? Submit it through the link in the description, email [e-mail], or visit www.endobattery.com/contact.

#PCOS #Endometriosis #HormonalHealth #PCOSAwareness #EndometriosisAwareness #Misdiagnosis #RotterdamCriteria #WomenHealthPodcast #ChronicIllness #PelvicPain #PCOSInTeens #DrBehbehani #EndoBatteryPodcast

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Episode Transcript

Speaker 1 (00:03):
Life moves fast and so should the answers to your
biggest questions.
Welcome to EndoBattery's QuickConnect, your direct line to
expert insights Short, powerfuland right to the point.
You send in the questions, Ibring in the experts and in just
five minutes you get theknowledge you need.
No long episodes, no extra timeneeded, and just remember

(00:24):
expert opinions shared here arefor general information and not
for personalized medical advice.
Always consult your providerfor your case-specific guidance.
Got a question?
Send it in and let's quicklyget you the answers.
I'm your host, alana, and it'stime to connect time to connect.

(00:51):
Today I'm excited to have DrSadiqa Bebehani, a double
fellowship-trained OBGYNspecializing in reproductive
endocrinology and infertility,as well as minimally invasive
gynecological surgery.
Dr Bebehani completed a secondfellowship at the prestigious
Mayo Clinic, where she masteredcomplex pelvic surgery using
both laparoscopy and robotics.
As an associate professor atthe University of California
Riverside School of Medicine,she is also deeply involved in

(01:14):
medical research andpublications.
With her rare combination oftraining in surgery and
infertility, dr Babiani isuniquely equipped to treat
complex gynecologic conditionssuch as endometriosis and
fibroids that affect fertility.
Let's jump in and be empoweredwith knowledge.
There tends to be a lot ofcrossover between endometriosis

(01:34):
and PCOS.
Can you tell us a little bitmore about the PCOS piece of it
and what it is, how it kind ofresponds in the body, and just
give us that overview?

Speaker 2 (01:46):
Yes, I'm glad that you bring this up because this
is a question we get asked oftenin clinical practice is how are
endometriosis and PCOS related?
We have to remember thatendometriosis occurs in about
15% of the population.
So, not looking at pelvic painor fertility patients, just in
the general population, about15% of women will have

(02:06):
endometriosis and 5% to 15% ofthe population will have PCOS.
So they may not necessarily becaused by the same cause, like
in utero, or the samemanifestation that created the
disease.
But because they are bothprevalent and common, it is
definitely possible for women tohave both endometriosis and

(02:29):
PCOS.
So I often get asked is theendo causing PCOS?
Is the PCOS causing endo?
No, there are no studies toshow that one causes the other.
It's just because they're bothprevalent.
It is absolutely possible forboth diseases to co-occur in
someone.
Now, what is PCOS?
You asked me what PCOS was.
Pcos, for those of you whodon't know, stands for

(02:49):
polycystic ovarian syndrome andit is often misdiagnosed.
So a large proportion of womenwill come see me and say oh well
, my doctor diagnosed me withPCOS 5, 10, 15 years ago.
The first question I ask themis how was the diagnosis
established?
And most of the time they'renot able to provide the evidence
or the results that led to thediagnosis of PCOS.

(03:12):
So PCOS is often misdiagnosedand sometimes is overdiagnosed.
But when we are correctlydiagnosing PCOS we diagnose it
based on a criteria called theRotterdam criteria.
So that's the scientific way ofdiagnosing PCOS.
What the Rotterdam criterialooks at is to see if women have

(03:33):
irregular periods or no periods.
So that's one of the criteria.
Number two is elevatedmale-type hormones called
androgens testosterone, dhea,17-hydroxyprogesterone.
Those fall in the category ofandrogens or clinical findings
of elevated androgens, likehaving increased facial hair,
acne, sometimes male patternbaldness.

(03:55):
Those are all called clinicalfindings of elevated androgens
or elevated male-type hormones.
And then number three is theappearance of polycystic ovaries
on ultrasound.
So you need two out of thosethree things to be diagnosed
with PCOS, and the reason whythis is important is because
many women will have anultrasound to show multiple

(04:16):
follicles or cysts on theirovaries and be automatically
told that they have PCOS.
You cannot diagnose PCOS basedon just one of the three things.
You cannot just have polycysticappearing ovaries and have PCOS
.
You need to have polycysticappearing ovaries plus one of
the other two things on thecriteria, which are either

(04:36):
irregular periods or absentperiods or clinical or lab
findings of elevated androgens.
So you need two out of three todiagnose PCOS.
And then you can't be reallyyoung and diagnose PCOS.
You need to wait a certainnumber of years after you start
your period.
So you can't have a 15-year-oldwho started her periods two
years ago, see a GYN and be toldshe has PCOS.

(04:59):
She's too young to be diagnosedwith PCOS.
You need at least six to eightyears of regular menstrual cycle
.
So from the start of the firstperiod we wait six to eight
years before you re-evaluate thesituation to see if they have
PCOS or not, because it takesthis long for the brain to
stimulate the ovaries to producehormones on a regular basis.

(05:22):
So it's very common for girlsin the first six to eight years
of starting a period to haveirregular periods, elevated
androgens and polycysticappearing ovaries on ultrasound.
But they will not have PCOS ifyou just give them time to
regulate their own hormones.
So that's another importantthing to remember is you need to
give your body time to adjustto having periods before you're

(05:43):
able to diagnose PCOS.

Speaker 1 (05:46):
To hear more about the connection of endometriosis
and PCOS from Dr Bebehani, checkout episode 91.
That's a wrap for this QuickConnect.
I hope today's insights helpedyou move forward with more
clarity and confidence.
Do you have more questions?
Keep them coming.
Send them in and I'll bring youthe expert answers.
You can send them in by usingthe link in the top of the

(06:07):
description of this podcastepisode or by emailing contact
at endobatterycom or visitingthe endobatterycom contact page.
Until next time, keep feelingempowered through knowledge.