I first decided to become a nutritionist because of my own struggle with a very common gynecological condition which affects many women in the developed world- PCOS.
PCOS or polycystic ovary syndrome affects approximately 6-12% of women and is characterized by small cysts which form on the ovaries, usually accompanied by lack of ovulation or inconsistent ovulation, irregular periods, excess testosterone, and weight gain or adrenal issues.
There are several different kinds of PCOS and we don’t fully understand the many ways this condition can manifest. In fact, PCOS is often used as a basket diagnoses for women with annovulatory conditions who don’t easily fit into categories. There are women with PCOS who are overweight or obese, where most of the research has been done, and there are women with PCOS who are normal weight. In fact, about 40% of women affected by PCOS are normal weight.
Here’s what we do know: PCOS almost always has an insulin component. Most women with PCOS, even normal weight women have something called hyperinsulinemia. This can be genetic or it can be environmental, but what it means is that normal eating produces a much larger than normal insulin response in these women, which surges various hormones and causes an imbalance.
We also know that many women with PCOS are over-stressed and deal with cortisol and adrenal issues. Whether these are cause or effect, or even both, really depend on the woman, but addressing them is part of the process. Chronic inflammation and estrogen dominance are also commonly associated conditions. Metabolic syndrome is common as well, even in the normal weight group.
In my experience as a nutritionist, women with PCOS often struggle with gut issues and food sensitivities– these issues can and do often affect hormonal health through a cascade of other events. If the gut is not healthy, the body is not healthy and an unhealthy struggles to be fertile.
While there is still so much we don’t know, we do have some great evidence for what kinds of nutritional approaches can help PCOS women to recover some of their fertility and improve their odds of success in becoming pregnant through natural or assisted reproductive methods.
As a nutritionist, I firmly believe that the food we eat is the absolute basis of our health and with a condition like PCOS, that means addressing insulin and nutrient issues from the get-go.
Each woman with PCOS is different and the recommendations I make are strongly connected to what I know of her as an individual. However, the typical PCOS woman needs a diet focused on eliminating inflammatory foods and lowering blood sugar. This doesn’t mean a keto diet, though sometimes it can be helpful in certain cases, but typically, increasing fertility is all about increasing nutrient density- something that keto doesn’t always do well.
An anti-inflammatory paleo diet with a reduction of higher glycemic fruits and starches is a great place to start for many women with PCOS, including those who are normal weight. However, when cortisol and gut issues are in the picture, sometimes this becomes more complex.
I typically recommend regular and steady meals for women with PCOS when first addressing the condition, rather than fasting, because fasting is a stressor on the body which can increase cortisol and adrenal issues. However, after some time on a healthy diet, fasting can often be incorporated and helpful in improving blood sugar status with PCOS.
I also think several functional tests can be very illuminating in these cases. First, a food sensitivity test is often recommended to help illuminate certain immune issues at play as well as general gut health. In some cases a stool analysis, genetic testing, and micronutrient testing can all be beneficial sources of information that give us more details about the unique situations at play with each woman.
Supplemental protocols for PCOS vary woman to woman but many supplements help support health with PCOS. Women with PCOS often struggle to methylate so a good B-vitamin supplement is always helpful. I like this one which pairs some liver detoxification. A good DIM supplement (like this one) helps remove excess estrogen and by extension testosterone and supports healthy estrogen metabolism. Because gut issues and food sensitivity are so important, a gut protocol with a good probiotic or sporebiotic and something for the gut lining are helpful. Additionally, Ubiquinol (like this) can be very helpful for increasing egg quality in women and is a good supplement to take when working with assisted reproduction techniques like Clomid, Femara, IUI, or IVF. Addressing cortisol issues has to be done woman to woman and I don’t feel it’s ethically correct to recommend adrenal supplementation without knowing a woman’s unique chemistry, though this is often part of the process.
Keep in mind that the best quality supplements are not available to the public at large and are difficult to find on websites, even something like Amazon. Above I provided links to brands I trust more than others, but the best quality supplements must be purchased directly from certified nutritionists or doctors offices. I can ship certain supplements to those who would benefit from them, just contact me here. My clients have access to these supplements in my office as well.
Because I specialize in PCOS and nutritional approaches to support women who struggle with it, I see many clients with the condition and am uniquely qualified to address its many iterations. I can understand and empathize with the emotional struggles this condition presents as well.
Functional nutrition is all about addressing the root causes of illness and PCOS is no exception. Functional nutrition can help discern what some of the deep underlying issues are for your unique fertility and can help create a unique plan and approach for you condition. The best part about functional nutrition is that no two people are the same and your nutrition recommendations and customized plans will be unique to you, rather than something basic you can find online.
It is my passion to help women with PCOS regain some control over their fertility and I’d love to help you. Please contact me here or click this link to book a free first consultation with me.