Take Control of PCOS Today
A 2021 NIH panel proposed that the name of PCOS be changed to ‘metabolic reproductive syndrome’. This is due to the fact that it’s NOT just about your ovaries but every cell in your body and how you take care of it. It’s linked to the tiny organelles within your cells (mitochondria) that are either working well and you can get pregnant easily or they are dysfunctional and will prevent pregnancy. I write a lot about mitochondrial functioning and red light therapy.
PCOS rates in China increased by approximately 65% in the last 10 years - what is going on?
PCOS is a metabolic disorder that you have a LOT of control over. It can feel like you were just dealt a bad hand when the universe was handing out the keys to fertility but as I’ve mentioned earlier there is no incentive for the US medical system to cure you - but to keep you as an unwitting, medication ‘subscriber’ for life.
The Downstream Effects of Poor Metabolic Health - for You and Your Baby
Without addressing the core issues of metabolic dysfunction too many women will continue to have declining health that could have been addressed 10 years before other symptoms started to show up such as type 2 Diabetes, mental health issues, cardiac health and even alzheimers. You’ll also pass your dysfunctional mitochondria (power centers of our cells) to your baby…you are more likely to develop Gestational Diabetes (another metabolic disorder) which means you’re more likely to be induced, have a c-section, women who have had PCOS before pregnancy are likely to have delayed milk production so are less likely to breastfeed. Breastfeeding is associated with positive metabolic health for you AND your baby but if we don’t address this at a cellular level the cycle of poor health will continue and your lifespan is reduced…and your baby is primed to a life of metabolic disorders. So one customer has now become 2 lifelong customers for the US healthcare industry. Most Doctors are not incentivized to help you get well with lifestyle changes - it’s the opposite.
The CDC estimates that half of women with PCOS may eventually develop type 2 Diabetes by the time they reach 40.
A key driver of PCOS is high insulin. Insulin tells your ovarian theca cells to make more testosterone and disrupts your cycles. We have to stop the high insulin production and that starts with nutrition and exercise.
Lifestyle changes can reap big rewards when it comes to PCOS and help you get pregnant more quickly and live a longer healthier life with your children and grandchildren.
In 2021 a group of researchers found a significant reduction in testosterone and triglycerides in a group of women who participated in a 6 week Mind/Body intervention (I-BMS). Significant improvements were also found in anxiety, depression and quality of life.
A Ketogenic diet improves cellular metabolism. Consider all of these lifestyle recommendations for your partner too. It’s estimated that about 93% of US adults have at least one metabolic disorder.
What Foods to Avoid with PCOS?
If you’ve been diagnosed with PCOS cravings for sugary foods are likely to be on your mind. As I mentioned earlier high insulin caused by high sugar intake is a key driver. (I know, I know I’m probably preaching to the choir here - you’re probably well aware of this).
Eliminating sugar intake is a great step towards improving your chances of conceiving. But that doesn’t mean you have to go cold turkey and cut out all sugar today (how miserable would that be!). There’s always a middle way to approach dietary and lifestyle changes that make it easier to incorporate into your normal everyday life so you can still enjoy life (infertility has already done enough damage in that respect). A high carb diet goes hand in hand with developing a high BMI and that’s one more barrier to getting pregnant fast. Throw those seed oils out (you know them as vegetable oils but they are highly processed toxins that have no nutritional value and add to inflammation).
What You Can Do To Reduce PCOS Symptoms
If you don’t already have some blood work to reference these are some routine blood tests to check: HOMA-IR (insulin resistance, HB A1C glucose average over 90 days and triglycerides.
Two big things to eliminate - sugar and seed oils (aka vegetable oils). Both are associated with poor metabolism. Just 12 weeks of a low-glycemic diet can improve all key biomarkers of PCOS. Focus on more healthy fats and kick highly processed foods to the curb. Grab a copy of Lily Nichols’ book - Real Food For Fertility for an indepth look at nutrition recommendations for metabolic health.
Consider intermittent fasting to support metabolic health.
A ketogenic diet for 12 weeks is associated with significantly improved symptoms for women with PCOS - see results below.
Red Light Therapy quickly improves mitochondrial functioning and can be done affordably at home.
Adequate sleep (lack of sleep plays havoc with your hormones - see below).
Start a mindfulness practice - stress releases glucose into the bloodstream contributing to poor metabolism. The FertileMind app can support ongoing stress management.
Start an exercise program, move more throughout the day - at minimum take short walks after meals to reduce insulin levels.
Medication/Supplements such as Metformin and Inositol supplementation
Results from a 12 week change to a ketogenic diet.
Some of these are easier to change than others - and if you’re already feeling low with depression related to this uncontrollable ride called infertility then try not to give yourself a hard time. Start with red light, sleep and your mindfulness practices as they’ll have a significant knock on effect on your mood and motivation for the nutritional changes. Starting here allows you to build a foundation of other healthy habits. Experimental studies suggest that women with PCOS have an extra sensitive stress response so relaxation techniques can be difficult for some but mindfulness practices in my FertileMind app can be so helpful.
If you’re struggling with weight (yes it’s metabolism again) it’s likely that your gut flora and vaginal flora may not be in the optimal state for a healthy pregnancy so mindful eating can be a brilliant strategy for you - get some prebiotics and probiotics in your diet too - I’m not a big fan of sauerkraut and most fermented foods but it’s good for my metabolism.
Getting Pregnant with PCOS by Optimizing Sleep
I’m starting with sleep because it’s one of the most important aspects that you need to get figured out. Why? Well if you are sleep deprived making any other lifestyle changes is a lot harder. You’ll have more cravings and won’t want to exercise and your patterns of thought will be more negative. In one study, sleep deprivation for just 2 nights resulted in enhanced appetite and increased caloric ingestion, with a preference for sweet and fatty foods (anyone who works nights will struggle with cravings). Use the Sleep collection in the app to help turn down a racing mind at the end of the day and help you sleep longer. 7-8 hrs is recommended in the most current research. So make those Zzzs a priority.
PCOS & Stress Management
When we’re stressed the body is sending glucose/sugar into the blood stream as long as that stressor lasts…AND anytime we think about that stressor. So you can see why relaxation techniques can be helpful but don’t help manage our mind which is where the stress is ultimately coming from.
Once you’re sleeping better you’ll have more mental resources to engage in activities that will further improve your health and reduce the symptoms of PCOS. Mindfulness helps us to notice thoughts/emotions/behaviors that can sabotage health promoting activities. So it makes sense that your mindfulness practice will influence diet, exercise, mood (and sleep too). Mindfulness research demonstrates significant reductions in stress and increases quality of life whether you have PCOS or not. That sugar monster often shows up when when we’re not paying attention to our emotional state. How often do you find yourself reaching for a treat or standing in front of the fridge when you’re stressed, upset or just bored. As you become more aware of how you’re feeling and the thoughts that are leading you to the fridge you have an opportunity to check in with what’s really happening in this moment - are you really hungry or is there something else driving this craving. Awareness means you eat mindlessly a lot less (and without feeling deprived). As your mindfulness practice changes your relationship with stress it will have a knock on effect on diet, exercise, sleep, wellness and general quality of life.
In 2021 the results of a Texan research project published some promising results on mindfulness and teens with PCOS. The PCOS ‘Kind Mind Program’ improved self-efficacy in the key areas of nutrition and physical activity and increased physical activity strategies in adolescents and young people with PCOS.
Let’s Talk About Sugar
In my recent posts about carbs and blood sugars during pregnancy I mentioned how recent research suggests that how you eat, when you eat - not just what you eat or how much you eat can impact your blood glucose levels and insulin sensitivity. Protein and vegetables before carbs lowers blood sugar readings so it might take a bit of experimenting to see what works best for your metabolism. One pilot study on Type 2 diabetics on Metformin demonstrated that by eating protein and vegetables 15 minutes before carbs, post meal glucose levels were decreased by 28.6%. Postprandial insulin levels were also reduced. Full disclosure - I’m a midwife, I am not a nutritionist or dietician so do talk to your provider about your specific circumstances. Starting off a pregnancy in metabolic distress (high blood sugars) even if you don’t develop Gestational Diabetes isn’t the best start for your pregnancy or your baby. Even moderately raised blood glucose is associated with more miscarriages and serious complications. Your baby inherits your mitochondria (not your partners) and of course you want to give your baby the best start possible.
Polycystic Ovary Syndrome and Exercise
Exercise has an impact on all metabolic issues. A 2020 RCT of women who have been living with PCOS for several years and who attended mindful yoga classes showed a significant decrease in testosterone levels and reduced anxiety and depression. So if you’re trying to establish a new habit and want to ease yourself into it, try yoga (you can practice at home or online, but there is an increase in the sense of community when women attend yoga classes in person). 30-60 minutes a day is recommended; if you over-exercise, you can create more problems.
Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11137171/ (2024) Mindfulness and PCOS
C. Stefanaki, F. Bacopoulou, S. Livadas, A. Kandaraki, A. Karachalios, G.P. Chrousos, et al. Impact of a Mindfulness Stress Management Program on Stress, Anxiety, Depression and Quality of Life in Women with Polycystic Ovary Syndrome: a Randomized Controlled Trial Stress (2014), pp. 1-34
Nazia Raja-Khan, Katrina Agito, Julie Shah, Christy M. Stetter, Theresa S. Gustafson, Holly Socolow, Allen R. Kunselman, Diane K. Reibel, Richard S. Legro, Mindfulness-based stress reduction for overweight/obese women with and without polycystic ovary syndrome: Design and methods of a pilot randomized controlled trial, Contemporary Clinical Trials, Volume 41, 2015, Pages 287-297.
Tapper K. (2017). Can mindfulness influence weight management related eating behaviors? If so, how?. Clinical psychology review, 53, 122–134. https://doi.org/10.1016/j.cpr.2017.03.003
Patel, Vishesha, Menezes, Heather, Menezes, Christian, Bouwer, Stephanie, Bostick-Smith, Chevelta A. and Speelman, Diana L.. "Regular Mindful Yoga Practice as a Method to Improve Androgen Levels in Women With Polycystic Ovary Syndrome: A Randomized, Controlled Trial" Journal of Osteopathic Medicine, vol. 120, no. 5, 2020, pp. 323-335. https://doi.org/10.7556/jaoa.2020.050
Yin Margaret X. C., Du L. B., Zou X. N., Fung Y. L., Sun Y. Y., Chan Celia H. Y., Chan Cecilia L. W (2021). Can Psychosocial Intervention Suppress Testosterone and Triglycerides Among Women With Polycystic Ovary Syndrome? A Feasibility Trial. Frontiers in Psychology, Vol 12.
