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Conception Oct 28, 2018
10 Minutes

Are you affected? The often hidden barrier to conception: PCOS

We take a look at one of the most common causes of infertility: Polycystic Ovarian Syndrome (PCOS). The reality is that a lot of us are affected by this condition, however as many as 50% of sufferers do not know they have it as the symptoms can be variable, with some people experiencing many symptoms and others experiencing very few. In this article we take a look at some of the basics and then most importantly some science-backed ways you can reduce its impact on your life:

‘PCOS is becoming a more prevalent disorder among women of reproductive age’ (1)

PCOS is a tricky one. It’s tricky to diagnose, has many symptoms (which can be caused by other things) and conditions that come alongside it (blood sugar issues being just one). As with many things in life, we still aren’t entirely sure what causes it, although the suggestion currently is that, once again, it is a combination of genetic and environmental/lifestyle factors.

Once again: hormones (and hormonal imbalance) seem to be at the root and many women do not realise they have it until they have issues with getting pregnant. It is the ‘most common cause of menstrual irregularity that lead to infertility’ and it is the cause of 30% of infertility in couples seeking treatment (2)

So, how do you know if you are affected?

Well, it is quite tricky as many of the symptoms (especially if they’re mild) may be blamed on other things or go unnoticed – which is exactly what happened to me. It was only when I tried to get pregnant that I was actually diagnosed by my gynaecologist.

The most common symptom is cycle irregularity and lack of ovulation. I for one had very long cycles –  often around 36 days – and during times of stress no periods at all (which I just put down to being ‘one of those things’ or down to weight loss which came with stress).

Other common symptoms: (and you can experience some, all or even none!)

  • Unwanted hair growth

  • Ovarian cysts (although not everyone gets these despite the name) – this is essentially as the follicles (immature eggs) within the ovaries stop growing at a certain point which can lead to:

  • Lack of ovulation

  • Issues with weight gain: particularly visceral areas (think lower belly)

  • Thinning hair

  • Fatigue/low energy

  • Skin conditions and acne

  • Mood issues: anxiety, mood swings and feeling depressed

  • Headaches

  • Sleep problems (there are links to sleep apnea)

  • Painful periods

I personally experienced sleep issues, anxiety and irregular periods which I chalked up to my high pressured job and general pressure that I put on myself – turns out that it wasn’t just that – but explains how it can be easily missed….

The trouble with this condition is that it can (depending on the severity) come hand in hand with a whole host of other issues (we aren’t quite sure yet on which causes which) but it has been linked to metabolic issues, obesity (affecting 30% of PCOS patients), insulin resistance, cardiovascular risk and mental health issues.

Sounds uplifting (not!) – so what can you do about it?

Well first and foremost diet, lifestyle and exercise has been shown to be effective at managing and improving the symptoms. I managed to eliminate all of the cysts on my ovaries and the symptoms via this method. I also have a baby boy now so just goes to show it doesn’t have to always mean infertility.

Here are some ways to improve the situation:

One of the very first things to take a look at is your sugar consumption. There is a strong correlation between PCOS and blood sugar and insulin issues with as many as 70% of those suffering from PCOS having some form of insulin resistance.

What is insulin resistance? 

In a nutshell this is where the cells of the body don’t respond to insulin which is the hormone that helps control blood sugar (allowing it in) to a cell for use to create energy. When you have higher insulin levels, it can impact the ovaries causing imbalances in testosterone and SHBG (which guides testosterone to where it needs to be). This can cause many of the symptoms of PCOS.

What can you do to help this?

The first and easiest thing to do is to cut back on refined sugar, processed foods, sweeteners and instead go for low glycemic index (GI) whole foods and grains instead. Helping regulate your own blood sugar is a no brainer – for PCOS management – and for your health overall. I personally found a huge benefit in my period regularity and symptoms by cutting out refined sugar from my diet and focusing more on low GI foods.

Where can you find these/what to avoid?

Refined sugar or food that the body breaks down easily to give a sugar spike (high Glycemic Index Carbohydrates) aggravates insulin resistance so a smart first step is to avoid the following:

  • White/processed bread, pasta, white potato/parsnips, rice

  • Cakes and biscuits

  • Sweeteners, sweets, chocolate and jams

  • Dried fruits and fruit with high sugar content: banana, mango, pineapple, orange, watermelon and grapes in particular.

  • Processed soups and pasta sauces (which often have a lot of hidden sugar).

  • Energy drinks and replacement non-dairy milks with hidden sugar ie. rice milk or almond milk that has sugar/sweetener added.

  • Fruit juice.

  • ‘Low-fat’ products (as they often have hidden sugar)

That is not to say to avoid all carbohydrates – instead – focus on carbohydrates that break down slowly in the body – these are known as low glycemic index and will not give you the sugar spike that causes too much insulin in the blood. The key is not to feel deprived, or to avoid food groups altogether it is just to swap certain choices for others that will not cause such a spike in sugar (and more insulin).

  • Quinoa

  • Rye bread or whole grain bread

  • Sweet potato

  • Legumes ie. lentils

  • Rolled Oats (whole/unprocessed)

  • Berries (blueberries, blackberries, raspberries)

  • High coco content dark chocolate: ie. +70%

  • Peanut butter (no added sugar)

  • Non starchy vegetables

  • Green/vegetables juices instead of fruit juices.

  • Nuts and chia seeds

  • Green tea

  • Cinnamon

Eating whole foods that have anti-inflammatory properties are the second step: Why?

‘Inflammation is found in PCOS patients who are obese as well as non-obese. Women with PCOS of normal weight have a higher buildup of fat in the visceral area compared to other parts of the body. This distribution of visceral adiposity in non-obese women has been shown to be correlated with increased insulin resistance and is probably a causative factor of low-grade inflammation in these patients. These data suggest that obesity does not need to be present in a PCOS patient to experience low-grade inflammation’.

Translation: inflammation will only make this situation worse. (Click here for a reminder why inflammation is not something good and what to do about it).

Foods to avoid that inflame:

  • Refined Carbohydrates: think white bread, cakes, biscuits.

  • Fried Foods

  • Fizzy drinks

  • Red Meat

  • Margarine

  • Processed meats and foods

Foods that fight inflammation that you should eat more of:

  • Green leafy vegetables (containing Polyphenols)

  • Nuts

  • Olive Oil

  • Tomatoes

  • Dark berries: strawberries, blueberries, raspberries

  • Fatty fish: sardines, mackerel, tuna and salmon: click here for much more on the science.

Avoiding other elements that can knock your hormones further off balance: is the other way to go. We know that PCOS relates in part to hormonal imbalance and we also know that these days processed food does not help with that. We also know that it is best to avoid meat that is not organic (as it can be full of artificial hormones and steroids) and similarly dairy that could have been treated with hormones. Avoiding Endocrine Disrupting Chemicals (EDCs) and pesticides are the other no-brainer here. That includes plastics. Drink water from a glass container and avoid storing food in plastics or eating from cans that are coated in plastic. Whole fresh food and filtered water stored in glass are two simple ways to achieve this. Click here for more easy and practical ways you can approach this.

We also know that balancing your hormones is important in relation to exercise – particularly when it comes to balancing glucose levels in the blood and insulin. You want a good balance of cardio (getting your heart rate up and using up some of the glucose stored and in your blood) and strength training (which builds muscle and builds up your resting metabolism). However, one thing to be mindful of is that too much HIIT will increase the level of cortisol in the blood (click here to be reminded why this is the enemy of conception). That being said, being overweight is not helpful either with insulin resistance and obesity strongly linked to PCOS so being physically active is important. Avoid a sedentary lifestyle – even if it is just walking more. Click here for much more of the science around how exercise can benefit.

Can Caffeine help?! every day it seems there is a different report saying coffee is good for you/its bad for you etc. However, when it comes to PCOS there is research to suggest that a moderate amount of caffeine (ie. 2 cups) either in the form of coffee or green tea (avoid energy drinks/colas etc) can have a benefit, particularly controlling the impact of testosterone going to places in the body that it shouldn’t. Click here for the science.

There has been a strong link between Vitamin D deficiency and PCOS. Vitamin D plays a role in reproduction and glucose metabolism (two things that are common issues for people with PCOS) low vitamin D levels are also associated with increased levels of inflammation and oxidative load both things we know are not good (click here for more on both). Studies have suggested that approximately 67%–85% women with PCOS have Vitamin D deficiency (3). Ask your doctor to do a simple blood test to check your levels.

So supplements are the way forward?

Well – the current research using Vitamin D supplements for PCOS have not yet yielded conclusive results, we are not quite sure what is the cause and if low vitamin D causes PCOS or PCOS causes low vitamin D. However, what is for sure that being deficient isn’t helpful for PCOS or anything else for that matter. As with all supplements however it is best to speak to your doctor and get your levels checked before you make any changes. Click here for more.

What about other supplements?

Inositol: This is actually naturally occurring, a vitamin-like compound that belongs to the vitamin-B complex. There are as many as nine different types found in: the body (which produced its own), nuts, whole grains, beans. Research does however suggest that can be specifically used to treat symptoms of PCOS such as elevated serum testosterone and lack of ovulation. One Italian research group found that after six months of myo-inositol supplementation both excess hair and acne were ‘significantly’ reduced and this happened because there was a reduction in the blood plasma of LH, testosterone and insulin. The other important part is that people with PCOS can have lower levels of SHBG (which helps testosterone get to the right places) and research has shown that myoinositol can help increase SHBG in the body. Click here for much more.

An additional helping hand?

Personally I found that both Ashwagandha and Maca really helped reduce my symptoms and rebalance my hormones. The science say they both work too – click on each to find out more. I also used Acupuncture which has been shown to have significant benefits for PCOS and hormonal imbalance. Click here for more of the science behind how Acupuncture works.

If all else fails – do not lose hope. Diet and exercise have to be the first port of call when it comes to tackling your PCOS – however, if you are still facing issues getting pregnant despite this, your doctor may prescribe you Clomid. Clomid has had very good results when it comes to conception for people suffering from PCOS. In fact; ‘clomiphene citrate…has been shown to result in pregnancy 50% of the time after three cycles of treatment, and 75% of the time after nine cycles.’ (5)

The good news: I am a PCOS sufferer but I now have a son and my doctor told me at my last appointment that I am officially cyst free and my periods are now normal so I can tell you honestly and first hand, it is possible if you control your diet, lifestyle and exercise to make a big difference. Click here for some things that worked for me. Give it a try – if nothing else you’ll feel more energy and certainly healthier. Win Win.

  1. BARTHELMESS EK, NAZ RK: Polycystic ovary Syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). 2014: 6: 104-119

  2. BARTHELMESS EK, NAZ RK: Polycystic ovary Syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). 2014: 6: 104-119

  3. Zhoumeng Lin CH, EZEAMAMA A: Serum Vitamin D Levels and Polycystic Ovary syndrome: A systematic Review and Meta-Analysis: Nutrients. 2015 Jun: 7(6) 4555-4577

  4. KULIE T, GROFF A, REDMER J, HOUNSHELL J, SCHRAGER S: Vitamin D: An Evidence-Based Review: Journal of the American Board of Family Medicine.

  5. BARTHELMESS EK, NAZ RK: Polycystic ovary Syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). 2014: 6: 104-119


This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.

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