PCOS & Fertility

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that affects approximately 1 in 10 women of childbearing age.

It is also one of the leading causes and these number are big for a condition that has such a profound impact on a woman’s fertility; and yet, the support for it is lacking.

The symptoms of PCOS can impact a woman’s life and can include the prevalence of acne, irregular cycles, , mood swings, weight gain, and excess hair growth, to name a few. Having difficulties becoming pregnant is often what prompts an investigation leading to a PCOS diagnosis.

Receiving a PCOS diagnosis can be a lot to take in, and research has shown that many women with PCOS may suffer from anxiety and depression, on top of other health concerns. While there is currently no cure for PCOS, there are several options to help manage the symptoms of this condition, including nutrition and exercise.

So, what exactly is PCOS?

PCOS is a disorder of the endocrine system. Your endocrine system is like your internal communication network. It is composed of organs that produce hormones (called glands) that help regulate things like metabolism, reproduction, sleep, mental state, and growth. Your ovaries are glands that produce estrogen and progesterone, and these hormones play an important role in your menstrual cycle, fertility, and ability to support a pregnancy.

Common Impacts of PCOS

High androgen levels

A blood test to check androgen levels, or the levels of male sex hormones, can help diagnose PCOS. Women with PCOS tend to have higher levels of testosterone, and this can profoundly impact ovulation and menstruation.

Normally, each month a woman’s body matures one egg during ovulation. A follicle is then prompted to grow and mature with the help of follicle-stimulating hormone (FSH).  Then, luteinizing hormone (LH) surges, and the mature follicle ovulates. If you are tracking ovulation at home with a kit, the test strips you are using are testing for an LH surge. This surge occurs just prior to ovulation.

It is often found that women with PCOS have multiple follicles (fluid-filled sacs, which are the “cysts” in polycystic ovaries). These follicles do not mature enough to be released. The lack of ovulation has a cascade effect, with estrogen, progesterone, LH, and FSH levels all impacted. The female sex hormones–estrogen and progesterone–are depressed, while the male androgens–which include testosterone–become elevated.

Insulin Resistance

In some women, PCOS is suspected if insulin levels are elevated. If this is the case, you require higher levels of insulin to keep your blood sugar levels normal. However, high levels of insulin are one of the drivers of ovulation disturbances, causing the ovaries to produce more testosterone, as described above. Insulin resistance and higher levels of body fat can contribute to worsening insulin resistance and additional PCOS symptoms.

Many of the additional health concerns linked to PCOS are, in fact, linked to insulin resistance, including Type 2 Diabetes, Heart Disease, Metabolic Syndrome, and even certain types of Cancer.

Step 1: Let’s Look at Nutrition

Nutrition and lifestyle changes can greatly help to improve insulin resistance, high androgen levels, mental outlook, and body composition, all of which can help reduce the severity of PCOS symptoms.

Foods that have a low glycemic index (GI) are beneficial for those with PCOS. These foods help control insulin levels, as they are digested more slowly. This helps to reduce insulin spikes, which can happen with high GI foods.

Inflammation is also associated with PCOS, so consuming items with anti-inflammatory properties, such as dark, leafy greens, blackberries, blueberries, and “good fats” like avocado and olive oil can be hugely beneficial.

Step 2: Let’s Get Moving

Regular, moderate exercise is great for everyone. But it is particularly helpful for PCOS patients in supporting a healthy body composition. Many women with PCOS find their weight to be a huge struggle. Trying to find ways to fit in a little bit of extra exercise can go a long way to helping manage weight and the related PCOS symptoms associated with it.

Exercise guidelines tell you to aim for 150 minutes a week. If you aren’t working out at all that can seem incredibly daunting. Even adding in a few 10-minute workouts a week to start can have an amazing impact, not only on your physical health but also on your mental health. From there, you could aim to increase that 10 minutes to 15 minutes and go from two times a week to three times a week. Keep adding on a little at a time. And if you miss a workout, do not let that derail you. Just pick back up the next time you have a spare 10-15 minutes!

Try to find a balance between some cardio cardiovascular activities (like running, brisk walking, biking, and aerobics classes) and exercise in general can help reduce insulin resistance and cardiovascular health, improve mood, achieve a healthy body composition, and support overall fertility health and ART (Assisted Reproductive Technology) success rates. Resistance training benefits can help reduce insulin resistance, increase metabolic rate, support a healthy body composition, reduce injury rates, and prepare your body for a more comfortable pregnancy (if that is your goal).

PCOS sucks. There, we said it.

We know your diagnosis may feel overwhelming; therefore, start with a few small lifestyle changes at first. Get used to them, and then try adding another one in. You’ve got this!