PCOS | What You Need to Know
PCOS is one of the most common endocrine disorders in reproductive age women and is unquestionably on the rise in the Western world.
This is also one of the conditions I see women feel most confused about managing on their own, likely because it can impact multiple different body systems and keeping track of all the moving pieces to this condition can be absolutely exhausting.
Signs & symptoms of PCOS:
Irregular periods (usually >28 days)
Anovulatory periods (no signs of ovulation)
Stubborn weight gain (despite eating well & exercising)
Acne (especially around jawline)
Coarse hair growth (especially on chin, upper lip, inner thighs)
Fertility challenges (TTC x 6 months or more)
Known history of cysts on ovaries (usually diagnosed on ultrasound)
Hair loss
Recurrent miscarriage(s)
PMS
Excess estrogen symptoms
What is really happening in PCOS?
As PCOS is a syndrome, there needs to be a few symptoms that present as criteria for diagnosis. This means there may be some symptoms that most women have, but there is usually a lot of variation as to what symptoms each person experiences.
Most often, blood sugar dysregulation, insulin imbalance and inflammation are big root cause factors when it comes to PCOS.
Insulin dysregulation changes how hormones are metabolized (yes, our metabolism + our hormones are connected). This can increase androgenic metabolites (testosterone, 5a DHT and/or 5a-androstendiol) and lead to androgenic symptoms (acne, hair loss, hair growth) often associated with PCOS.
From there, the elevated androgens can disrupt ovulation, leading to irregular cycles, possibly anovulation, cyst development, fluctuating hormone symptoms and more.
But remember, not everyone with PCOS has all the androgenic symptoms. Can you relate to this?
When androgenic symptoms are not present, there can still be hormone imbalance at the root of the issue. Essentially, insulin dysregulation, inflammation, pill-induced PCOS or adrenal dysregulation PCOS are the 4 main types. Some women fit into multiple categories, some just one.
And figuring out the root cause of imbalances helps guide support, so much.
Fertility + PCOS:
If you’re TTC & have any of the symptoms listed above, it's possible PCOS is a factor to consider. If you already know you have PCOS and are wanting to grow a family, this is an especially important time to balance hormones and nourish your body toward healing.
PCOS can impact fertility. Dysregulation of hormones necessary for ovulation and egg development is a very common issue when trying to conceive.
However, having PCOS is not a prognosis for infertility. There are many ways to support hormone balance, blood sugar, inflammation and deep healing to balance hormones + get pregnant!
The pill for PCOS?
A common medical treatment for PCOS is taking the hormonal birth control pill. This likely comes from the view that if cycles are irregular, using the pill to ‘regulate cycles’ can help with symptoms.
However, specifically when fertility is the goal, using hormonal birth control has not shown beneficial outcomes to improving menstrual cycles, ovulation, metabolic function or overall health.
Research has also shown that OCP use in women with PCOS did NOT have a beneficial impact on symptoms and potentially increased risk of additional health complications later in life, such as cardiovascular or metabolic complications.
Even more research specifically found lifestyle modifications to have a greater impact in preconception outcomes that hormonal birth control use leading up to conception efforts.
Both research and in my clinical experience I see nutrition, lifestyle and treating the root cause of PCOS restore so many women’s ovulation, support pregnancy and decrease risk factors. Here are some ways to get started with support.
Nutrition tips:
Eat fat, fiber & protein at every meal + snack to support blood sugar balance.
Eat the rainbow: get diverse fruits + vegetables in your diet to optimize nutrient status.
Focus on healthy protein options: grass-fed meats, eggs, fish.
Eat more whole grains (less processed grains like pasta, bread, white rice) but moderated carbohydrate intake in general.
Avoid processed high sugar foods like ice cream, soda, candy.
Eat nourishing foods, don’t skip meals! **eat breakfast!
Other ways to support healing:
Adrenal health. This one is really important.
Go to bed + wake up around the same time every day.
Practice stress resilience with deep breathing, moderate exercise, journaling, meditation, time for self care, etc.
Moderate exercise to help with hormone balance, metabolic function and circulation. Consider weight bearing exercise to help with metabolic function.
Balance blood sugar (see nutrition tips above).
Get my functional testing list as part of the Fertility Checklist here!
Nutrients that can support PCOS:
(Always check with your healthcare provider before starting something new)
Myo-inositol - helps regulate insulin + supports ovulation
Melatonin - helps lower androgens + improves egg quality
Fish oil - helps lower inflammation + improves pregnancy outcomes
Vitex (Chaste Tree Berry) - supports ovulation + progesterone
Saw Palmetto, Nettles, Pygeum - supports androgen metabolism
Green Tea - supports androgen metabolism + egg quality (antioxidant)
Magnesium - supports adrenal regulation, sleep and nutrient status
NAC - antioxidant support + balances testosteroneThe takeaway!
Get access to my PCOS supplement recommendations at 15% off!
What to do next?
Keep your head up! Our bodies are resilient and are constantly seeking balance. Gather information about how best you can support your hormones + health, tune into your body, what it needs and stay the course. Healing is not linear, but progress is essential.
If you’re looking for a comprehensive and functional approach to your hormones + fertility, you’re in the right place.
Uncovering the root cause of hormone imbalances + optimizing fertility health is the core of my work. If you’re ready for clarity about how best to balance your hormones and prepare for a pregnancy, learn more about my approach + highly successful strategy.