PCOS and Fertility: How to Approach Treatment

PCOS is treatable! Here’s how to start:

Personal Baseline:

What do your labs say? What symptoms are you dealing with? Have you had any imaging done? These are all the first things to start looking at when it comes to PCOS.

It’s important to note that while Caitlin and Sophia love working with women with PCOS, and we have many years of experience, we are dietitians, not doctors. We don’t diagnose!

So what to do with nutrition:

1. Balance blood sugar
2. 1. Make sure that there is a higher quality and quantity of protein at each meal and snack
   2. 1. “Quality” means it’s not inflammatory and provides more protein than it does any other macronutrient.
      2. Examples: meat, cheese, nuts, and seeds
      1. Most women with PCOS tolerate high protein dairy products like greek yogurt, cottage cheese, and cheese!
      2. SOME women do have fewer symptoms when they eliminate gluten and dairy, but it’s not the magic answer to PCOS management that it’s often believed to be
   3. Not everyone needs to be dairy free!
   1. Veggies, fruits, nuts, and seeds are your best sources of fiber!
   2. 1. Pro tip: artichoke hearts have a ton of fiber!
   3. Fiber is great at filling your plate and filling your belly! You’ll find that you get to eat a lot of food while managing your PCOS
   4. Eating real food, vs. a protein bar or shake will keep you full for longer. It will help you slow down and feel full, versus slamming down a protein bar in under a minute
   5. To succeed, you have to eat enough to feel full! Fiber and protein are keys in making that happen
3. FIBER!
   1. Starting your day with nutrients and blood sugar balancing protein!
   2. Even though it might seem like a lot of calories to have 3 egg scrambled with spinach and feta, a slice of toast with nut butter, and with a cup of coffee; you will feel full for so long and it will keep your blood sugar steady for hours!
   3. Swapping sweet for savory when possible. Eating sweet makes you crave sweet! It’s not your fault, its PCOS! Eating the right fuel first thing in the morning will keep your cravings at bay.
4. Breakfast
   1. Try cronometer.com! Plug in what you’re eating and let’s look at your vitamin/mineral/fiber intake in a day! Sometimes you can be eating “healthy” but missing key pieces for PCOS fertility
   2. Take a peek at your protein/carb ratio! Typical American diets can have way more carb to protein than is helpful for PCOS fertility
5. Check out your current nutrition status
   1. Keto, Atkins, and other super restrictive diets are not needed to boost fertility with PCOS
   2. Food is slow medicine; sometimes it takes several months of eating right to balance your cycles and get pregnant! You need to do something that can be sustained long term, not another crash-diet plan.
6. Sustainability
7. Supplements

Remember to check with your doc!! Some of these supplements can interact with medications or are contraindicated for certain medical issues.

1. 1. Is there insulin resistance present? How about high testosterone? Or high stress? How’s the thyroid? That’s where we start to dig into what supplements can help.
      1. We recommend myo-inositol and not d-chiro. PCOS ovaries can make too much d-chiro, so we are careful not to exacerbate that
   2. Inositols
      1. Helps improve insulin sensitivity and can boost egg quality, plus helps you make great cervical mucus
   3. NAC
      1. Another powerful blood-sugar/insulin supportive supplement
   4. Berberine
      1. Wherever you live in the world, most of us are vitamin D deficient. As levels of vitamin D rise, insulin resistance lowers! It’s also important for maintaining a healthy pregnancy!
   5. Vitamin D
      1. Support egg quality and improve insulin resistance
   6. Zinc
      1. Common mineral of deficiency in PCOS, helps with gut health, insulin resistance, and ovulation
   7. Magnesium
      1. You don’t want to wait until you’re pregnant! Start on a quality prenatal ASAP! (And stay tuned for our episode on prenatals dropping soon!)
   8. Prenatal
      1. We’re here for the omega-3’s! Omega-3’s are essential fatty acids that are vital for reducing inflammation and supports your body in building new tissues. Eggs, endometrial lining, and babies are all new tissues your body grows!
      2. DHA/EPA are the omegas you want! Don’t be seduced by algae oils! They don’t have the same DHA/EPA ratios as fish-based supplements
   9. Fish oil
2. Movement and Exercise
   1. Sleeping 6-7 hours vs. 4-5 hours is a game changer for PCOS
      1. Blackout curtains or a sleep mask can help you stay asleep longer. Here is a link to Sophia’s fave sleep mask
      2. Meditation apps and sleep stories can help you quiet your thoughts and get into a deeper sleep
      3. Blue-light blocking glasses can help if you’re using screens prior to bedtime
   2. Sleep environment is key
3. Sleep and stress management
   1. Many times women with PCOS have been told to lose weight in order to get pregnant, that they’re total exercise junkies! All that effort can be misplaced when it’s cranking up your stress hormones and stressing your immune system
      1. If you’re dreading your workout and coming up with every excuse not to go, find something else!
      2. Keep your own body in mind – if you’re 280 pounds, putting weights on your back and trying to squat is only going to put more strain on your body. Bodyweight exercises can be a lot more helpful!
      3. Cardio isn’t always the answer. Strength training and resistance workouts can do wonders for building muscles and changing insulin
   2. Find something that you like
      1. Stretching and breathing can lower your stress and help your body relax. Quality ovulation is dependent on your body feeling safe enough to become pregnant. Lowering stress hormones can be a big key in this
   3. Yoga
4. Exercise

Check out Caitlin’s program: Find Fertility with the PCOS+ Method.