Conceiving Easily with PCOS
Polycystic Ovary Syndrome (PCOS) is one of the most common gynecological and metabolic disorders that has an impact on fertility. It is characterized by long, irregular cycles, insulin resistance, cysts/immature follicles on the ovaries, and/or high androgen levels.
The first step is to determine which type of PCOS you have. There are four different types of PCOS:
Insulin resistance PCOS. This is the classic and most common type of PCOS characterized by elevated insulin, blood glucose, and androgens. They tend to struggle with weight loss and hirsutism (excess hair growth). For this type of PCOS, diet and exercise to balance blood sugar are the most important factors.
Inflammatory PCOS. Inflammatory PCOS comes from chronic immune system activation due to nervous system dysregulation, environmental toxins, gut dysbiosis, or an inflammatory diet. This inflammation is enough to impede ovulation, disrupt hormone receptors, and stimulate the adrenals to produce excess androgens.
Post Pill PCOS. Hormonal birth control suppresses ovulation by cutting off the communication from your brain to your ovaries. For most, ovulation rebounds as soon as the pill is discontinued. However for some, this ovulation suppression can last for months or even years. This irregular ovulation with post pill surge in androgens often qualifies for a diagnosis of PCOS, however is temporary and not true PCOS.
Adrenal PCOS. Adrenal PCOS means your androgen excess is coming from your adrenals in the form of high DHEA-S (dehydroepiandrosterone sulfate). This is a less common form of PCOS and typically requires more work with the nervous system.
Each type of PCOS has its own targeted treatment plan, but there are some main components that benefit everyone with PCOS.
Supplements. The number one supplement I recommend for all types of PCOS is myo-inositol powder. Myo-inositol is a b-vitamin like substance that helps glucose enter your body’s cells in response to insulin. It has been shown to improve ovulation rates, live birth rates, fasting insulin, insulin resistance, serum testosterone, and BMI. Inositol has also been shown to outperform metformin in studies. A meta analysis with 935 patients with PCOS going through IVF found that inositol powder reduced the dosage of stimming medication by 14%, increased grade 1 embryos by 8%, decreased the miscarriage rate by 66%, and increased the clinical pregnancy rate by 21%. Another study found that myo-inositol can be considered a first-line treatment in the regulation of menstrual cycles. Other supplements will depend on your health goals and presentation of PCOS. For example, NAC and magnesium can be wonderful for regulating insulin and encouraging ovulation. CoQ10 and omega 3 fatty acids can help boost egg quality and reduce inflammation. And adaptogens like ashwagandha are great for adrenal PCOS. It can be hugely beneficial to work with a healthcare professional to create a supplement regimen personalized according to your own individual needs.
Diet. A healthy, whole-foods, anti-inflammatory diet is important for everyone trying to conceive. However, those with PCOS may need to make specific dietary modifications to support metabolic and hormone health. I usually encourage my patients to do a gentle intermittent fast, eat plenty of protein with each meal (30g), and adequate levels of healthy fats and complex carbohydrates.
Lifestyle. Regular exercise plays a vital role in maintaining healthy glucose levels, which, in turn, aids in balancing excess androgens in the body. Of all exercise types, strength training is particularly beneficial as it promotes muscle development, fat burning, and stabilizes blood sugar levels. For women with PCOS, dysregulated cortisol (stress hormone) is a significant obstacle. Elevated cortisol levels resulting from imbalanced blood sugar, intense exercise, insufficient sleep, or emotional stress can lead to an overabundance of androgens, irregular ovulation, and hirsutism. To counteract this, incorporating regular mindfulness techniques can prove highly beneficial. By achieving a balance in stress levels through sufficient sleep, stress-reducing practices like meditation, and the right amount and type of exercise, one can significantly improve fertility and overall well-being while dealing with PCOS.
Acupuncture and Chinese herbs. And lastly, acupuncture and traditional Chinese medicine is a great modality to add to your fertility treatment plan. Acupuncture is great for increasing insulin sensitivity which means more regular ovulation and better egg quality, regulates ovulation and menstruation, reduces androgens, improves pregnancy rates, and improves testosterone levels and LH/FSH ratios.
While PCOS can present unique challenges to conception, taking proactive steps to improve your overall health and fertility can make a substantial impact on your journey to becoming a parent. Remember to work closely with your healthcare provider, maintain a healthy lifestyle, and seek emotional support throughout the process. With determination and perseverance, achieving a successful pregnancy with PCOS is entirely possible.
In healing,
Allison Locke, R.TCM.P FABORM OBAAM IHP