How polycystic ovary syndrome affect fertility

Polycystic ovary syndrome (PCOS) is a common condition affecting around 6 – 10% of the female population.

Polycystic ovary syndrome (PCOS) is a common condition affecting around 6 – 10% of the female population.


How do you know if you have it?

Symptoms of PCOS include;

  • irregular periods or no periods at all
  • difficulty getting pregnant (because of irregular ovulation or failure to ovulate)
  • excessive hair growth on the body (hirsutism)
  • weight gain
  • thinning hair and hair loss from the head 
  • oily skin or acne

Whilst that doesn’t paint the nicest of pictures, it is important to note that women with PCOS get symptoms in varying degrees, from very mild, to far more problematic.

To reach a diagnosis two out of the following three need to be documented;

  • Polycystic ovaries, this is an abundance of the fluid-filled follicles which typically release an egg each cycle
  • Ovulatory dysfunction i.e. irregular or absent menstrual cycles
  • Hyperandrogenism, which is the presence of high levels of typically male hormones such as testosterone


What does it mean to have PCOS?

Whilst PCOS is commonly thought of as being a reproductive issue, it is also one closely related to other conditions including obesity, insulin resistance, high levels of insulin in the blood, type 2 diabetes, cardiovascular disease, some cancers, and psychological disorders such as anxiety and depression. 

However, its effect on fertility is particularly devastating with as many as 20% of fertility problems being linked to PCOS. It is often called the most common cause of anovulatory infertility in women, which is when an egg is not released during a menstrual cycle. 

Whilst we do not know how to prevent PCOS, there is hope in an emerging body of research exploring ways in which we can control the symptoms.


What is this research telling us?

It is estimated that in PCOS ovulation only happens in ⅓ of menstrual cycles. Ovulation is the part of the cycle where an egg is released from an ovary, and sent down the fallopian tube to be fertilised.

No ovulation, means no egg, and so nothing for the sperm to fertilise.

The key scientists are discovering is that by controlling blood sugar, and weight, it can balance the sufferers hormones which manage ovulation, thus increasing the chance of regular and healthy egg release.

So if you suspect, or know, PCOS is impacting on your ability to conceive, here are 5 methods to help balance your hormones.


1. Low GI foods

One of the toughest things about Polycystic Ovary Syndrome is staying at a healthy weight. The effect PCOS has on insulin, and bodily hormones, means that if you have this condition your body is more adept at putting on weight.

It is thought that this is why the PCOS gene has been so prevalent, particularly in developing countries. During times of famine, women with PCOS would have been able to eat less but still stay at a healthy weight, making them more desirable to reproduce with.

Now however, in a world where most countries have abundance, this is leading to higher rates of obesity.

This definitely does not mean starving yourself if you have PCOS. In fact, this could potentially work against you as your body tries to grab hold of every calorie you consume.

Instead working on keeping your blood sugars balanced, will help maintain insulin and hormone levels in your body.

The best way to do this is by following a low Glycemic Index (GI) diet. What this means is high fiber, minimally processed foods, and lots of healthy fats.


2. Exercise

If you have PCOS make exercise your best friend. Exercise has been shown to aid in regular ovulation in 50% of fertility patients with PCOS. This is really quite incredible.

Again, just like with diet, the aim is not to go crazy. It isn’t about training for a marathon tomorrow. It is about keeping yourself active regularly.

This means getting out and exercising 4 – 6 times per week, at a moderate level. A good rule of thumb, is to exercise at a level where you can hold a short conversation of 1 – 2 sentences.

Great types of exercise include;

  • Brisk walking
  • Light jogging
  • Yoga
  • Pilates
  • Weights / strength exercises
  • Circuit classes
  • Dance


3. Decrease mental stress

Stress causes all sorts of havoc on our energy levels, weight, and hormones. However stressing-less is often easier said than done.

Those whole ‘just relax and it will happen’ comments are just massively unhelpful!

So how do you ‘just relax’, especially if you keep seeing those negative pregnancy tests cycle after cycle?

Thing is, our brain is quite an interesting organ. Its key programming is to keep you alive. This will override anything else. If something shouts loudly enough at our brain, it sees that thing as a threat to our lives, and will do everything to make us focus on panicking about that one thing.

In today’s world we don’t have many lions out to get us. Instead we are surrounded by a lot of busy-ness. Things compete for our time, they need to ‘talk’ louder and louder to get us to pay attention. This triggers our lion response. It makes our brain believe that these harmless events are actually out to get us. Afterall, our brain is screaming to get our attention.

We get the same stress response as if that lion was really chasing us. Now the problem our body has is that when we had our lion stress response, it was momentary. Once the lion was gone, we relaxed and all was fine.

Today, we constantly have lions coming and going every day. So to de-stress we need to do a one-two punch.

The first is to recognise why our brain is responding this way, and showing it compassion. It is simply doing what it was designed to do.

The second, is to find ways to distract or calm our brain so that it has time to think rationally about the perceived stress, and heal from the inflammation stress causes.

Here are some ways to signal our brain that we are okay;

  • Watch something funny. A comedy, a stand up comedian, cat videos, don’t care just laugh.
  • Stretch or take a nice walk in nature.
  • Go for coffee with a friend. Better yet, take a nice walk along a beach, river, hiking trail, or lake with a friend. 
  • Log everything in a journal each night. Writing is a great way to take thoughts out of your head and put them on paper. It stops them needing to scream so loudly to be heard, and it also gives us a different perspective when we can see them written down.
  • Practice mindfulness or relaxation meditation.
  • Before you go to bed, say or write down 3 things you are grateful for. This is way more effective than you’ll ever imagine.
4. Vitamin D

New research is suggesting that Vitamin D may support hormone regulation in PCOS. It has been found that between 67 and 85% of women with PCOS also have a Vitamin D deficiency. In the research supplementing with Vitamin D holds potential in restoring ovulation and menstrual cycle regularity.


5. Sleep

Those of us in the wellness sector shudder as we think about the 90s and the early 2000s when there was an explosion of books around the concept of living on less sleep and just taking ‘micronaps’. Eeek!

Why was this so terrible? Multiple large studies, and many smaller ones too, have found that a lack of sleep – 6 hours or less per night – significantly impacts our metabolism.

There are two hormones responsible for this. Leptin is released by fat cells to tell our brain that we have had enough to eat, and in doing so suppresses our appetite. This happens despite test subjects receiving the same amount of calories as well rested peers, suggesting that leptin is signalling a state of famine, even when food is plentiful.

The second hormone, Ghrelin, is secreted by the stomach, and this hormone stimulates hunger. Ghrelin is increased when we enter sleep deprivation. Interestingly it also provides a drive for high carbohydrate foods, those with greater simple sugar content. As we only just learnt, this is not great news for people with PCOS.

The combination of increased caloric intake from too little leptin to tell us we’re full, and too much ghrelin telling us to eat, and the drive to eat sugary foods, spells big trouble for PCOS sufferers.

Thus sleep might be one of the most important factors in controlling weight, and hormones, for women with PCOS.


So what is the takeaway from all of this?

Polycystic Ovary Syndrome is not the depressing diagnosis it was once thought. There are plenty of simple, universally healthy, steps you can take to reduce the impact of this condition.

Learning to manage your stress, eating plenty of fresh fruit, vegetables, wholegrains, plant based proteins, and fish, getting a good night’s sleep, topping up on Vitamin D, plus getting some exercise in, will make a bit difference in your journey to conceiving a baby.

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