Ana had been trying to get pregnant for months when she finally received a diagnosis of Polycystic Ovarian Syndrome (PCOS). Finally, she had an answer about why it was taking so long – but she wasn’t really sure what her diagnosis meant. When she came to see me, her first question was “Will I ever be able to get pregnant with PCOS?”
She’s not the first woman to ask this question after learning they have PCOS. These women sound fearful as they ask, and I’m happy to be able to relieve that fear when I tell them the answer is usually YES! It isn’t easy, and sometimes medical interventions are necessary. But there is certainly hope for women who have PCOS and are yearning to have a child.
Even more encouraging is the fact that often, all that’s needed is an easy intervention. I have seen many women with this form of hormonal imbalance improve their fertility and go on to experience a healthy pregnancy!
Let’s take a brief look at what PCOS is, then I’ll answer some of the most common questions and concerns I hear about the effects of PCOS on fertility. I’ll help you discover how a more natural approach like mine can help in your PCOS and fertility journey.
What is PCOS?
PCOS is the most common type of female endocrine (hormone) disorder and one of the leading causes of female infertility. It affects nearly 10% of women worldwide, and occurs prior to menopause. Women of any age can have PCOS.
Diagnosis can be difficult since the symptoms of PCOS – including irregular periods, depression, unexplained weight gain, acne, and facial hair can also be signs of many other women’s health issues.
One thing that women may not know is that PCOS isn’t a disease – and it doesn’t necessarily last forever. In fact, PCOS is often a temporary condition, more likely to develop around puberty and perimenopause, or as a result of hormonal imbalance, especially insulin resistance .
But what exactly does it mean to have PCOS? Every month, your ovaries produce follicles, which are actually cysts themselves, filled with benign fluid and hormones, estrogen in particular. With PCOS your ovaries produce a high number of these follicles, and too many “male” hormones. This prevents any follicles from becoming strong enough to prompt ovulation.
Typically, one or two of the follicles produced each month become dominant and produce an egg. During ovulation, that egg flows into the fallopian tube headed towards the uterus. This causes hormone secretion, including progesterone, which prepare the uterus to support pregnancy in the event that the egg is fertilized, and a normal monthly period when it is not. But with PCOS this process is disrupted.
How Does PCOS Influence My Fertility?
When you have PCOS, it changes the hormonal pathways in your body that produce eggs and prepare the uterus for pregnancy. The three most important reasons why becoming pregnant, or staying pregnant may be more challenging for women with PCOS are:
- Women with PCOS often do not ovulate.
- Women with PCOS tend to have irregular periods rather than “normal” predictable monthly cycles.
- When and if an egg is released, the endometrium (lining of the uterus) may not be sufficiently prepared to sustain pregnancy.
You can learn more about what’s behind PCOS in my articles about the causes and symptoms of PCOS. There is good news though— those complicated hormonal imbalances can often be changed to increase your chances of conception.
How do I know if I have PCOS?
PCOS certainly isn’t the only cause of infertility, so if you’re struggling with being able to conceive, you can’t assume that PCOS is the problem. But if you have specific symptoms that indicate an abundance of androgens, it’s worth checking out.
Often, these high levels of testosterone and DHEA cause irregular periods and can even cause menstruation to cease. Women with PCOS often develop body hair patterns similar to male hair growth, including thinning hair on the scalp. Weight gain and extreme difficulty losing weight is another indication that you might be dealing with PCOS.
There isn’t a signal medical test to diagnose PCOS, but a doctor can make a diagnosis through a physical exam, ultrasound, and/or blood tests.
If I Have PCOS, How Can I Increase My Chances of Getting Pregnant Naturally?
This is the most important question with PCOS often have. These women, like Ana, need good information on the treatment options. Many treatments are available, including conventional and natural approaches, to help balance hormones and increase chances of a healthy pregnancy.
As with any health condition, I prefer to take a natural approach first. Even if conventional methods such as medications become necessary, nutritional and lifestyle changes are almost universally necessary for women with PCOS. My approach includes the following natural measures:
Follow a low-glycemic load diet
As I said before, insulin resistance is often a factor in the development of PCOS. My decades of experience have taught me that reducing the glycemic load is essential in combating insulin resistance, balancing sex hormones, and increasing fertility.
What does a “low-glycemic load” mean? It’s all about limiting carbohydrate intake. For most women, this means 16 grams of carbs per meal, and 7 grams per snack. Women who are more active may need to adjust to a slightly higher carb intake.
To keep the glycemic load down, carbohydrates should be eaten with fiber, protein and/or healthy fats rather than eating carbs alone.
I recommend eliminating all high-fructose syrups, sugar, white flour, white rice, white potatoes, and other highly processed, refined sugars and starches. Carefully limiting refined carbohydrates is crucial to fertility because it reduces your insulin resistance, decreases androgens, and results in more regular ovulation and menses.
The drug metformin is often used for infertility issues and will accomplish the same thing as the recommended eating plan. The difference is that my approach does it naturally, so won’t produce negative side effects.
This step is so effective that I often see patients come back after following this protocol who are having regular cycles for the first time in their lives. For more information, read my article, “Understanding Carbohydrates – Let’s Take Away The Confusion.”
Maintain a healthy weight and stay physically active
I know that losing weight isn’t easy – especially for women with PCOS. Obesity is a significant problem for between 35-60% of women dealing with PCOS. A high waist-to-hip ratio is linked to the characteristic high levels of insulan, androgen and estrogen levels that disrupt normal ovulation and fertility. Being overweight can cause other fertility issues as well, so it’s important to do anything you can to reach and maintain a healthy weight. Losing just 5% of your body weight can lead to more regular menstrual cycles and ovulation.
In addition to the low-glycemic diet discussed above, I recommend women with PCOS also limit gluten, dairy, alcohol and caffeine, all of which can be at the root of hormonal imbalances. An elimination diet can help you discover any hidden sensitivities to gluten and dairy, among other common allergens.
It’s important not to restrict yourself too much. Going to extremes can increase stress on the body, making weight loss even more difficult. Fad diets aren’t sustainable, and any weight lost is typically regained quickly. The quality of your food matters far more than the number of calories you consume.
Other factors to focus on when trying to lose weight with PCOS include sleep, gut balance, adrenal and thyroid function, and exercise. Regular exercise can not only aid in weight loss by helping to reduce insulin resistance but carries numerous other health benefits. Regular exercise can create a domino effect reaction of positive influences on your mood, sleep, and stress levels.
Restore balance with nutritional and herbal support
Because nutrition is so important to hormonal balance, it’s crucial that you are getting all the nutrients your body needs to function properly. In our modern world, it’s difficult to do that through food alone. I recommend that all women take a pharmaceutical-grade multivitamin with a mineral balance also high in antioxidants. This is even more important for women dealing with PCOS.
Other micronutrients that help to offset insulin resistance include the B vitamins, such as B3 (niacin), B6, B9 (folic acid), B12, C, D and E; and the minerals vanadium, chromium, magnesium, and manganese. Taking a daily omega-3 supplement will help you counterbalance the systemic inflammation that almost always goes along with insulin resistance. For more specific hormonal and endocrine support, herbs such as chasteberry, raspberry leaf, kudzu, red clover, and milk thistle, as well as traditional adaptogens such as ashwagandha, astragalus and maca can be extremely helpful.
In addition to my MultiEssentails, I offer numerous high-quality, pharmaceutical grade supplements to enhance your health in my online shop at www.marcellepick.com. Click here to learn more.
Reduce stress and create a balanced life
Many practitioners often overlook the fact that women with PCOS describe their lives as being riddled with anxiety more often than others in the general population. Women who experience difficulty conceiving also report higher rates of depression. Finding support to reduce your stress levels, either online or with individual therapy/coaching has been shown to be helpful.
While there are techniques like yoga and meditation that most people can benefit from, reducing your stress and balancing your life is unique to you. You have to find what works for you, whether that’s a new hobby that brings you joy, decreasing physical stress on your body, or finding the ability to say “No” when you don’t truly want to do something that someone has requested of you.
Your body’s natural ability to rid itself of toxins is compromised you’re your body is under stress. Following my Nutritional and Lifestyle Guidelines closely not only helps with insulin regulation, but also promotes optimal metabolism (detoxification) of sex hormones. Check your environment for endocrine disruptors as well. For example, the ovaries have been shown to be very sensitive to bisphenol A (BPA), a widespread industrial chemical found in polycarbonate plastics. A simple solution is to stop using plastic containers for your food and beverage containers, and start using ceramic, glass or stainless steel. Paying close attention to what is in your cleaning products, beauty products, and detergents can also be helpful in lowering your body’s toxic load.
For more information, read my articles on detoxification.
Seek out other resources, like websites specialized in treating PCOS
PCOS Diva, PCOS Challenge, and the PCOS Awareness Association are some great options that offer information, support, recommendations, and tips for women with PCOS, whether you’re trying to conceive or not.
Yes, you can heal your PCOS!
Of all of the suggestions above, dietary changes are the most important. For most of the women I see at the Women to Women clinic, eating low carb is the single most helpful part of the plan. I’ve had amazing success in helping women improve their chances of getting pregnant just by using these simple steps.
Remember Ana? She changed her diet drastically and followed some of my other suggestions. And a few months after she first came to see me, she arrived with great news – she was pregnant! She had a healthy, happy pregnancy and is now reveling in the joys of motherhood.
There have been many advances made in reproductive technology in recent years for women with PCOS. You can discuss your fertility treatment options with your practitioner or a qualified fertility specialist. In over three decades of experience, I have found that a woman’s fertility treatment outcome is brightest when she first makes the above-recommended changes to restore her hormonal balance. I recommend you try these changes for at least 6 months before medical interventions. You can address next steps your cycles become more regular.
And perhaps most importantly, don’t give up hope! A positive outlook and willingness to make the necessary changes is so important in gaining control of your health – and your life!
Reviewed by Dr. Mark Menolascino, MD