PCOS and Fertility

While being diagnosed with polycystic ovary syndrome (PCOS) MAY impact your fertility - the underlying hormonal imbalances are mostly manageable. While PCOS is ASSOCIATED with infertility - that doesn’t mean it will be your experience, especially if you work on improving the underlying hormonal imbalances.

I recently attended a seminar where the Professor who is involved in PCOS research described the possible issues with fertiity as a ‘road block’ or the process getting stuck at one point in the chain of events. Meaning your body is capable of fertility, it may just need a bit of help to get there!

While medications such as Metformin and Hormonal birth control may help manage symptoms and synthetically alter hormone levels - they are not resolving the issue - just masking it. This is why working with a qualified Naturopath can help you balance your hormones naturally and in a more lasting way - by resolving the root causes and therefore improving symptoms for the long term.

Balancing your hormones through natural methods such as specific quality supplements, dietary and lifestyle changes can improve symptoms, promote monthly ovulation and enhance fertility. Working on resolving these hormonal imbalances before you conceive is important, as they can impact the health of your child along with increasing the risk of pregnancy and birth complications.

The main driver of PCOS is insulin resistance which in many cases is a direct result of dietary and lifestyle factors such as food choices, stress, sedentary lifestyle and exposure to endocrine disrupting chemicals found in plastics, pesticides and fragrances. Therefore you have a huge impact on improving insulin resistance by working on these daily habits and exposures. You can read more here on food choices and improving insulin resistance.

Insulin resistance also contributes to the increased androgen/testosterone level seen in PCOS women (and subsequent hair growth), as well as increasing your risk of diabetes, obesity, cardiovascular disease, pregnancy complications (gestational diabetes, preeclampsia, preterm birth) and impaired fetal development. Your child would also have a higher risk of developing diabetes and obesity during their lifetime.

This is why preconception care for any couple for at least 3-6 months is a great idea! The healthier the egg and sperm at conception the healthier your child - not just at birth but also throughout their lifetime!

As you can see we have a huge impact on the balance of our hormones and there’s much we can do to restore balance, enhance fertility and optimise the health of future generations.

If you are concerned about fertility in regards to PCOS or other hormonal imbalances, I’d love to help you.

Marion McConnell is a degree qualified Naturopath who helps women with stress, hormone imbalances, anxiety and fatigue.  The clinic is located in New Farm Brisbane, and consultations are also available via Skype.  You can contact Marion here.

Hormones and Weight

Do you struggle to lose or maintain your ideal weight? Your hormones may be sabotaging your weight loss efforts!

Hormones are messengers throughout your body - instructing your cells and organs - and help regulate many body processes such as metabolism and weight.

Many women have underlying hormone imbalances that cause much frustration in regards to regulating weight.

The most common hormone imbalances that may be influencing your weight include -

THYROID FUNCTION

Many women have under-active thyroid function and lower than ideal thyroid hormone levels (T4 and T3) which regulate our weight and metabolism, along with many other influences particularly on our energy and mood. If you have been told your thyroid is ‘fine’ after a blood test, you may still have an under-active thyroid and can read more here.

INSULIN RESISTANCE

Insulin helps to regulate blood sugar levels and keep them within an ideal range. When the demand for insulin is excessive - primarily from consuming too much sugar, sweet foods/drinks and refined grains - you can become insulin resistant, meaning you need more and more insulin to have the same effect.

This imbalance is mostly associated with diabetes, but is becoming more common, occuring at younger ages and contributes to the development of many chronic health issues. Insulin resistance is also a major factor in polycystic ovary syndrome (PCOS). You can read more about insulin resistance and how to improve it here.

CORTISOL

Many women live in a constant stressed state which results in increased cortisol and adrenaline. Cortisol is protective and energising in acute bursts but our bodies are not designed to handle ongoing stress and will eventually reach burn out. Along the way our ability to regulate weight will be impacted in a number of ways.

Cortisol slows metabolism by impairing thyroid function, may lead to comfort eating or poorer food choices, contributes to other hormone imbalances, impacts gut bacteria balance, and increased cortisol levels are linked to increased abdominal fat cells. Stress impacts every area of our body and managing stress is key to keeping your hormones and weight in a happy balance!

SEX HORMONES

The most common imbalance for women is higher estrogens in relation to progesterone. This estrogenic environment encourages weight to be stored around the hips and thighs, and you may experience other symptoms such as PMS, fluid retention, sore breasts, painful or heavy periods, fibroids and endometriosis.

Many factors can encourage this imbalance especially ongoing stress, use of the Pill and exposure to estrogenic chemicals (skin care, make up, fragrances, cleaning products, plastics and pesticides). Especially as women we can be applying and exposing ourselves to a huge amount of these chemicals everyday!

Estrogen plays a significant role in the regulation of adipose tissue or fat cells, and these cells can also contribute to the production of more estrogen. Optimal liver and digestive function is important in helping your body to remove these excess estrogens.

Hormone imbalances have numerous impacts on weight regulation, and while supplements can help restore hormone balance there are also steps you can take in your daily life to support happy hormones and improve weight regulation.

Here’s my top 5 tips -

• Stress Management to help reduce cortisol. Lack of sleep, caffeine and alcohol can all increase cortisol, while gentle to moderate exercise can help to reduce cortisol. Here are some other cortisol lowering tips.

• Follow a low sugar lifestyle to regulate blood sugar and insulin - you can read more here.

• Include a variety of vegetables and fibre to support digestive health and removal of excess hormones and chemicals.

• Make sleep a priority as this influences other hormone levels and weight regulation.

• Switch to non-toxic products, use glass/ceramic/stainless steel over plastics and choose spray free or organic produce whenever possible.

If you need help assessing your hormones and restoring hormone balance I’d love to help you.

Marion McConnell is a degree qualified Naturopath who helps women with stress, hormone imbalances, anxiety and fatigue.  The clinic is located in New Farm Brisbane, and consultations are also available via Skype.  You can contact Marion here.

PCOS Diet Guidelines

Most women with PCOS have insulin resistance - which means you are more sensitive to the effects of sugar and your body is less able to deal with it (remove it from your blood stream). This is why one of the most effective ways to improve your experience of PCOS and reduce associated symptoms and health risks is to choose a low sugar lifestyle.

When you ingest sugary foods or drinks your blood sugar increases. Insulin helps to reduce your blood sugar back to ideal levels - your body likes to keep many things within a certain range for optimal health such as your blood sugar and blood pressure. Over time a sugary diet will require more and more insulin to keep your blood sugar in check - and you can become insulin resistant when insulin loses its power - you need more and more to have the same effect.

Uncontrolled blood sugar can have many damaging impacts on health and has been associated with an increased risk of infertility, weight gain, gestational diabetes, miscarriage and pregnancy complications. Even if you are not planning on having children, insulin resistance puts you at an increased risk of obesity, diabetes and heart disease.

However insulin resistance is something you have a huge influence over through the food and drink choices you make.

While official health guidelines recommend 6 teaspoons of sugar per day - I’d say the less you can have the better especially if you are trying to improve insulin and blood sugar imbalances. If you focus on including quality protein, fat and a variety of vegetables - what our bodies are designed to thrive on - you will feel satisfied and find it easier to reduce sugar.

Many women may not be aware just how much sugar they are consuming as it can be hidden in many products - especially those that are marketed as being ‘healthy’. This is why it’s imperative to read nutrition labels, as the wording on packaged foods can be very misleading.

A simple way to check sugar content is to know that 1 teaspoon of sugar is about 4g sugar.

Check the nutrition label under ‘sugar’ to see how many grams are in a ‘serve’ or ‘per 100g’ - then you can work out how much you will be consuming. So if a product has 12g sugar per serve (and the serve is what you would actually eat - sometimes you’d eat more than 1 serve - you need to check how big the serving size is!) then you’d be consuming 3 teaspoons sugar from that product (12g divided by 4g per teaspoon = 3 teaspoons)

Here’s some examples -

Generally if sugar per 100g is under 5g it is a low sugar product. Dairy such as milk and yoghurt naturally contain lactose, so allow around 4g or 1 teaspoon of lactose per 100g/100ml. Also check ingredients to see if they have added other sugars. I don’t advise drinking a lot of milk to my clients (and if you like milk I recommend A2 milk from guernsey and jersey cows as this can be less inflammatory and easier to digest, also look for brands that are less processed), however fermented dairy such as yoghurt and quality cheese are generally ok depending on your tolerance. Hard cheese, butter and ghee have minimal lactose. As with any group of food look for quality over quantity and work out what suits YOU best.

Ingredients are listed in descending order - so the first ingredient makes up the bulk of the product. If sugar is one of the first ingredients - that’s not a great sign.

Also look for foods that contain real ingredients - if you can’t understand the ingredients and there’s lots of numbers and additives - then it’s not good enough for you.

Sugar can appear in many forms including glucose, fructose (other words ending in ‘ose’), syrups, agave, honey and fruits.

Avoid low-fat and diet products with artificial sweeteners - these are chemicals which have been linked to an increase in weight and appetite! Some people prefer stevia and xylitol (from birch) and these can have less impact on your blood sugar, however I prefer to use unprocessed local honey if I need a little sweetener.

‘Natural’ sugars such as honey, maple syrup, dried fruits and coconut nectar are still sugar to your body - so just because it’s ‘natural’ doesn’t mean you can eat a heap of it. Sugars are also found in products such as sauces, dressings and other savoury products where you might assume there would be none.

Here’s another example of nutritional labels on breakfast foods.

If you feel like you can’t live without sugar maybe there are other underlying hormonal imbalances, nutritional deficiencies, poor meal choices, low fat or low calorie diet, or emotional reasons you’re reaching for the sweet stuff? Making sure to include some protein and fat at each meal to help keep you full for longer and help reduce sugar cravings. Deficiencies in iron, B12, vitamin D and an under-active thyroid are common in women and cause fatigue - which is why many women reach for sugar as a quick energy boost.

Supplements such as magnesium, B vitamins and chromium can also help reduce cravings. Some women find going cold turkey is the best way to break their addiction, while others just gradually crowd out the sugary options with more savoury foods. I recommend checking out Sarah Wilson’s books if you need help quitting sugar.

Including fibre from a variety of vegetables will also help regulate blood sugar, as will including some fermented vegetables such as sauerkraut (if tolerated) to support your gut bacteria, which has also been associated with improvements in insulin sensitivity. Cinnamon has also been shown to help regulate blood sugar - you can add this to smoothies, porridge and on top of sweet potato.

Including 1-2 pieces of fresh fruit per day is ok but you may be advised to avoid initially until your insulin resistance improves. Some fruits are lower in sugars such as berries, fresh figs, grapefruit, guava and papaya, while dried fruits are more concentrated and higher in sugars.

Below are some low sugar meal and snack ideas:

• Eggs (fried, poached, boiled, scrambled) with butter and pan fried vegetables. Or an omelette with vegetables and feta or goats cheese.

• Avocado and eggs on 1 piece of sourdough or sprouted bread - with 1-2 forkfuls of sauerkraut.

• Smoothie with berries, avocado, 100% whey or pea protein, hemp/chia seeds on unsweetened milk of choice.

• Overnight oats with berries, nuts/seeds and unsweetened full fat yoghurt.

• Slow cooker meals with meat on the bone and vegetables.

• Roast or steamed vegetables with pesto and protein of choice.

• Hearty salads, Buddha or Nourish bowls with protein and fats/dressings.

• Handful tamari almonds or nuts/seeds.

• Olives and cheese

• Apple slices with tahini or nut butter.

• Boiled egg with sugar free, whole egg mayo (avoid vegetable oils when possible, though this can be hard when buying packaged products).

• Vegetables or nut/seed crackers with hummus or cashew cheese.

• Berries with unsweetened full fat dairy or coconut yoghurt.

NOTE - Look for pasture raised meat/poultry/eggs/dairy products and wild, local fish when possible.

Other lifestyle factors that can improve insulin include

• reducing/managing stress and cortisol,

• getting enough sleep (lack of sleep can increase cortisol),

• movement or exercise, and

• avoiding sugary alcoholic drinks.

If you would like more individualised help treating PCOS, Hormone Imbalances or improving your Nutrition, I’d love to help you.

If you’d like to work with me, you can find out more HERE

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Fibre And Hormones

While fibre is most commonly associated with symptoms such as constipation, it can also have a huge impact on your hormones!  If you have a hormonal imbalance such as Endometriosis, PCOS (polycystic ovary syndrome), heavy or painful periods, fibroids, fluid retention, sore breasts or a family history of breast or other hormonal cancer - fibre can help!

Most of these symptoms and conditions involve excess estrogens (PCOS is different - usually androgens/testosterone is high) which can accumulate in your body and fat cells from dietary and environmental sources.  These include pesticides on food, hormones in farmed animals, use of the oral contraceptive pill, fragrances and other chemicals in body/beauty products and plastics.  Many of these act as xeno-estrogens, meaning they can bind to estrogen receptors throughout the body and mimic the effects of estrogen.

An increased level of estrogens is associate with an increased risk of hormonal cancers such as breast, ovarian, cervical and endometrial.

Fibre is your friend in helping to reduce excess levels of hormones and to help keep them in balance.  While there are other factors involved in treating hormonal imbalances, this is one thing you can easily improve and utilise in your daily life to support happy hormones and reduce your risk of disease.

Fibre works its magic by binding toxins/chemicals and excess hormones and removing them through your colon.  If you are not consuming enough fibre, hormones can be reabsorbed back into your body, instead of being eliminated!  Fibre reduces the activity of the enzyme (B-glucuronidase) that allows this reabsorption. 

Your gut bacteria and gut health are also reliant on adequate fibre, and also help regulate estrogen removal and reabsorption.  Your gut health is also a huge part of your immune system, and poor gut health including leaky gut (intestinal permeability) underlies auto-immune conditions.  There is research suggesting an auto-immune component to Endometriosis and even PCOS, due to the underlying changes throughout the body and the similarities to other auto-immune conditions. 

PCOS commonly involves issues with insulin and this can also be improved by consuming enough fibre and following a low sugar diet.  Insulin regulation is also impacted by estrogen levels - so you can see how hormones influence each other and that supporting the balance of all hormones is beneficial to your overall health. 

My favourite fibre family is cruciferous vegetables!  These include broccoli, cauliflower, cabbage, brussel sprouts, radish and other leafy greens such as rocket, bok choy, kale and collard greens. While these vegetables provide fibre they also contain a sulphur compound (as does onion, garlic and leeks) which helps to support liver detox enzymes which help our body to remove chemicals and excess hormones.  These compounds have also been shown to improve estrogen metabolite ratio (the ratio between 2/4/16-hydroxyestrone metabolites, a higher level of 4 and 16 metabolites are associated with increased risk of hormonal cancers) and have many protective effects in the body against disease. 

Aspragus is another great vegetable which has a prebiotic action to feed your gut bacteria.  Aim to get most of your fibre from a variety of fresh, seasonal, local and spray free (whenever possible) vegetables. You can also include 1-2 pieces fruit (berries, kiwi, papaya, passionfruit, pear, apple), along with legumes and whole grains (oats, rice, quinoa, buckwheat) depending on your tolerance to these foods.  Soaked and sprouted grains/legumes/nuts/seeds are easier to digest.

Sauerkraut and Kim Chi are another great addition as these fermented vegetables have the benefits of fibre as well as containing beneficial bacteria.  Introduce slowly - start with a forkful per day and build up if you feel good on this.  If you have issues with fermented foods you may have a significant gut imbalance which needs correcting first.

The more fibre you get through whole foods the better, but if you need a fibre supplement please speak to your Naturopath, Nutritionist or health food shop.  Many popular fibre supplements use less nutritious fibre and can contain added nasties such as chemical sweeteners, colours and sugars.  Slippery elm powder and chia seeds are great natural fibre supplements.  With any fibre supplement it's best to start slow and build up, along with keeping up adequate water intake. 

A qualified Naturopath or Nutritionist can help you assess your hormone levels and estrogen metabolite ratio.  If you have hormonal symptoms or a family history of hormonal disease, this can be a great way to check your risk level and work on balancing hormones and preventing disease in the future. 

Marion McConnell is a degree qualified Naturopath who helps women with stress, hormone imbalances, anxiety and fatigue.  The clinic is located in New Farm Brisbane, and consultations are also available via Skype.  You can contact Marion here.

PCOS Treatment

If you are one of the many women diagnosed with PCOS (Polycystic Ovary Syndrome) you may have been prescribed the Pill and Metformin.  Unfortunately these medications will not resolve the underlying hormonal imbalances, even if they do help mask some of your symptoms.  

PCOS is commonly associated with increased testosterone and insulin resistance.  These imbalances contribute to acne, male pattern hair growth, weight gain, irregular menstrual cycles, reduced or no ovulation and infertility. The symptoms experienced can differ between women.

Fortunately there are other effective treatment options that will help support healthy hormone balance, resolve symptoms and support optimal ovulation and fertility.  

• Herbs including Paeonia, Licorice, Cinnamon and the herbal compound Berberine can help support hormone balance, ovarian function and improve insulin sensitivity.

• Inositol may help reduce elevated testosterone and acne.

• Zinc is vital for healthy ovulation and hormone balance and also helps to reduce acne and heal skin. Facial hair growth may be related to the conversion of excess testosterone to dihydrotestosterone - and zinc helps to reduce this conversion.

• Magnesium deficiency has been associated with insulin resistance and studies show that supplementing with magnesium can improve insulin sensitivity. There are also added benefits from taking magnesium such as calming your nervous system, improving sleep and reducing cramps and headaches.

• Reducing sugar consumption is imperative - focus on eating a variety of vegetables with adequate protein and healthy fats. What you eat everyday will have the biggest impact on your blood sugar, insulin levels and hormone health.

• Liver support is also important when correcting hormonal imbalances as it plays a large role in hormone metabolism. Herbs such as St Mary's Thistle are great for this, and you can also include cruciferous vegetables, turmeric, ginger, rosemary, onions and garlic in your diet to support liver function.

• Chemicals in pesticides, plastics, body care products and cleaning products also disrupt hormones so avoiding these as much as possible is a great idea for hormone and overall health! There are many natural alternatives available so it can be as simple as switching products next time you need to replace something.

• Lastly working on stress management and supporting healthy gut function will also support healthy hormone balance and allow your body to clear excess hormones.

While these are the most common imbalances and treatment of PCOS, every woman is different and may have different contributing factors or influences.  Saliva testing is a great way to assess hormone levels and help determine the best treatment for you.

If you would like more personalised support in restoring hormone balance I'd love to help you.

Marion McConnell is a degree qualified Naturopath who helps women with stress, hormone imbalances, anxiety and fatigue.  The clinic is located in New Farm Brisbane, and consultations are also available via Skype.  You can contact Marion here.