PCOS is a condition that affects a woman’s health and her fertility and it is a condition that I have been fortunate enough to see quite frequently in practice as a naturopath. I must say I enjoy treating women with PCOS as I tend to find that this condition responds well to natural treatments. There are so many women I have seen who have been told that they will be unlikely to fall pregnant naturally, however, I find that once we can re-establish a more regular cycle and thus “restart” ovulation, many women go on to conceive naturally. There is certainly nothing more rewarding than helping a woman achieve her dream of having a healthy baby.
Initially naturopathic treatment focuses on re-establishing a regular menstrual cycle and although this can take a few months I have seen women conceive on that “first” cycle where ovulation has resumed. Whilst there is ongoing debate world-wide regarding the clinical diagnosis of this condition it is agreed that PCOS involves hormonal imbalances which are associated with a woman not ovulating regularly. If you don’t know when and if you are ovulating this can certainly make it more difficult to get pregnant. One of the important factors affecting the hormone balance in PCOS is blood sugar levels and what is often referred to as insulin resistance.
Weight management, sugar balance and exercise are key. And while all of those things can feel onerous, you might be surprised how effective small changes in these areas can be for your fertility.
How do blood sugar levels affect my fertility?
Up to 10% of women with PCOS have diabetes and those women with PCOS who are not diabetic have an increased risk of developing diabetes at some point in their lives. It is also thought that 50-70% of women with PCOS have what is known as “insulin resistance”, which refers to the body’s inability to respond properly to the hormone insulin. Insulin performs the essential role of helping to move glucose out of the blood and into the body’s cells where it can be utilised for energy. It can be very harmful to the body if too much glucose stays in the blood instead of being moved into the cells. In insulin resistance, the normal response to insulin is not occurring, and so as a result the pancreas (which produces insulin) pumps out more and more insulin, resulting in higher levels of insulin or what is commonly referred to as “hyperinsulinaemia”.
Hyperinsulinaemia has a direct effect on the ovaries causing them to produce more “androgens” (“male” hormones including testosterone) which may be associated with symptoms such as acne, excess hair growth (e.g. above the lip, jawline, chest or back) and irregular periods (due to irregular ovulation). However, I usually find that women do not often experience all of these symptoms, although the irregular periods and thus difficulty conceiving are very common.
In essence then, blood sugar levels are an important component of PCOS for many women and most importantly, can have a direct effect on hormonal balance and ovulation. Thus learning how to support a healthy blood sugar balance and improving your body’s ability to respond to insulin are important factors in trying to minimise the hormonal imbalances associated with PCOS. Supporting a healthy blood sugar balance may help improve your chances of ovulating more regularly and thus improve your chances of getting pregnant. I do see this time and time again in practice; simple dietary and lifestyle strategies combined with naturopathic support can help improve a woman’s blood sugar balance and improve her chances of ovulation and conception.
What can you do to support a healthy blood sugar balance?
1. Maintain a healthy weight and waist circumference measurement. If you are overweight your body tends to produce more hormones in its fat cells and this adds more of a burden on the already existing hormonal imbalance. It is also important that you are not underweight either as your body will “shut down” ovulation if it thinks it does not have enough fat stores to support a pregnancy. A healthy waist circumference is just as important. Use the guidelines below to see if you fall into the healthy or unhealthy range and if you do, make a time to talk to your naturopath about what positive changes you can make to help.
I have seen many women struggle with weight loss and despite trying many different “fad” diets, are unable to achieve weight loss that they can maintain long-term. Even a loss of 5% of your body weight can help improve your hormonal balance, restart ovulation and improve your chances of getting pregnant.
A. Healthy body weight = Body Mass Index (BMI) of 20-25.
You can calculate your BMI by dividing your weight (in kgs) by your height (in metres) squared.
For example: if your height is 165cm and your weight is 71kg your BMI would be: 26.1 i.e. overweight range.
There are a number of online calculators that will calculate this simply and easily by entering just your height and weight.
B. Healthy waist circumference: <80cm (women) and <94cm (men).
To check your waist circumference, take the measurement against your bare skin and approximately halfway between your lowest rib and the top of your hipbone. This may be in line with your belly button or it may not.
NB: Normal weight and thin women can also have PCOS and are just as likely to experience insulin resistance and while weight loss in these instances is not the goa,l blood sugar and ovulation regulation remain key factors. Every patient has different needs and weight is only one piece of the puzzle. Your naturopath can help you determine the right path for you.
2. Eat small meals more frequently
Try to eat something every 3-4 hours i.e. breakfast, midmorning snack, lunch, midafternoon snack and dinner. Although eating more often may seem odd, you are not actually increasing the total amount of food you are eating for the day; rather, you are eating the same quantity but just dividing it up into more meals throughout the day. However, the type of food you eat is very important.
3. Aim to avoid sugar as much as possible
Read labels and check ingredient lists; you will be surprised at how much sugar is in cereals, sauces, yoghurts, peanut butter and processed foods. Avoid snacking on dried fruit and choose protein-rich snacks such as raw nuts (e.g. walnuts, almonds) instead. If you feel like you are “addicted” to sugar and can’t imagine how you could cope without it, consider Sarah Wilson’s 8 week “I Quit Sugar” plan. I have seen many women find this approach inspiring, easy to follow, fun even and there are some great, yummy recipes in there to help keep you going!
4. Try to have some kind of protein at each snack/meal
Protein-rich foods include fish, chicken, tofu, meat, soy, dairy (e.g. milk, yoghurt, cheese), nuts, turkey and egg. Snacks may consist of a handful of almonds and pumpkin seeds OR some plain unsweetened yoghurt mixed with frozen berries/fresh fruit and ground nuts/seeds OR sliced apple with almond nut butter. Often making these changes involves working out a plan with your naturopath however, some of my favourite cookbooks which follow these principles are listed below.
Be inspired by:
1. Jennie Brand-Miller “The Low GI Guide to Managing PCOS”.
2. Dr Kate Marsh, Jennie Brand-Miller and Prof Robert Moses “Bump to Baby Diet”
3. Michael Moore “Blood Sugar” (this book if for the “foodies” and is written by a chef who has diabetes. Personally, I use this cookbook a lot as I find the flavours and combinations delicious and easy to prepare).
5. Exercise regularly
Ahhhh!!! We all know we should exercise regularly, right? But did you know that regular exercise can not only help reduce weight and relieve stress, but it can also have a positive effect on your blood sugar balance. Overweight women with PCOS generally need to exercise more and be more careful with their diet in order to lose weight, compared to women without PCOS. However,
Aim for at least 30 minutes a day and include some form of weight-bearing exercise (e.g. weights, walking, jogging, running, dancing etc) at least 3 times a week. Also increase your incidental exercise as much as possible – take the stairs, ride to the shops etc. Ask yourself “can I do this and move at the same time?”. Move whenever you can. Look for every opportunity to get on your feet and get moving!
Irregular periods may also be related to low body weight (or body fat content) as your body needs a certain amount of fat to produce hormones. Discuss your individual exercise requirements with your naturopath if your body weight is below normal.
6. Consider supportive treatments such as supplements and herbs
There are various nutrients (e.g. Chromium, B vitamins, Magnesium) that are required for blood sugar metabolism and may be useful to help assist in supporting healthy blood sugar control. Speak to your naturopath about your individual requirements to help tailor a treatment plan for you. Well prescribed individualised herbal medicine approaches are also very effective. Of course Acupuncture is a great support in regulating cycles, managing stress and increasing energy.
As you can see there are a lot of steps you can take to help in the management of PCOS. I have seen many women conceive naturally when they are well supported with this information including a return of regular periods. A check-up with your naturopath can help you to identify the most important factors for you to focus on and the good news is that a lot of these guidelines are great for your general health as well. Start making positive changes for your health today!
Tina Jenkins, FGHG Naturopath.
Tina Jenkins has always had a special interest in helping couples with fertility problems and has particular success in treating women with PCOS, irregular and/or absent periods as well as problems with ovulation. Tina has also assisted numerous parents regarding children’s health care problems and as a mother herself, has experienced firsthand the many benefits natural health care can bring to young children.
For more information about Tina check out her profile. To make an appointment with Tina or any of our naturopaths to discuss what more can be done to support your fertility issues, please telephone 9419 9988.
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