Getting pregnant with PCOS can be stressful. I'm here to tell you it is possible! I got pregnant on my first try after being diagnosed with PCOS.
Have you been diagnosed with PCOS? Are you worried about being able to conceive naturally? Have you been trying trying for a while and looking for hope to help you get there? This post outlines everything I did to get my body ready to conceive when my husband and I wanted to start trying for kids.
My PCOS Story:
When I was diagnosed with PCOS in the summer of 2018, my very first thought was, will I ever be able to have children? I'd heard enough about PCOS to know that it can impact fertility. I was having very irregular periods, which makes it really tricky to know when you're ovulating.
I was prescribed metformin and hormonal birth control to manage my PCOS symptoms, but I knew the minute I went off BC I'd be back in the same spot and struggling with the symptoms and not ovulating. I decided to regulate my cycle naturally and reverse my PCOS symptoms so we could conceive. The first step was identifying if I was ovulating or not.
According to The Period Repair Manual, "When it comes to hormonal health, it's all about ovulation." Ovulation is how our bodies progress through all the menstrual cycle phases.
After doing everything outlined here, my husband and I conceived on our first try and we're expecting our first baby in November 2019.
How do I know if and when I'm ovulating?
Signs of possible ovulation include: fertile mucus and regular cycles. Signs of definite ovulation include: rise in basal body temperature after ovulation and an increase in progesterone in the middle of the luteal phase (through blood work). It's important to note, just because you are having a period doesn't always mean ovulation because it's possible to have an annovulatory cycle.
Obviously, we all want to ovulate when we're trying to conceive. You can't conceive without ovulating. So here are some things you can do at home to figure out if you're ovulating.
What can I do to tell if I'm ovulating?
- Start tracking your cycle. Use an app to start tracking when your period starts and all of the symptoms that happen throughout your cycle including body temperature, fertile mucus and more. Flo Living and CLUE are my favorite apps. This will help you pinpoint symptoms happening in a cyclical manner throughout your cycles. This will also help you determine when you ovulate just by what your body is telling you. I started tracking my cycle over 6 months before we started trying.
- Track ovulation with strips. I started doing this 3 months before we were ready to conceive. My cycles were starting to get regular (thanks to everything I did below!), so I started using a digital ovulation test to know when my fertile window was. I bought the expensive digital ones to cut out any guesswork. I know if you aren't having regular cycles it can be really expensive to take a test every day. Below I'm sharing all the tips I did to regulate my cycle and get my body to ovulate regularly.
- When I started taking the tests, although my cycles were always 28 days, my fertile window changed from month-to-month. One month the window was days 12-15 and the next month the window was days 16-19. So even though you may have regular cycles, the fertile window could change.
Okay, so what if you're doing these things and you haven't got a positive ovulation test and you're cycles aren't regular? This means less than 21 days or more than 35 days. This is the case with most women with PCOS. PCOS is essentially a problem with ovulation, which results in an overproduction of androgens. Here are 10 steps to help you ovulate and regulate your cycle.
Getting Pregnant with PCOS: 10 Steps to Ovulate and Boost Fertility
This is a list of 10 things I did prior to trying to conceive to set my body up for success. You can absolutely start doing these things at any point during your journey to conceive. Although these are great for women with PCOS, they're all really beneficial for anyone hoping to conceive in the future.
- Quit hormonal birth control. Although you'll start having regular periods while you're on it, they aren't real periods. Your body is being regulated by synthetic hormones and the moment you come off, you're going to be back where you started. There's even a thing called post birth control syndrome and can make PCOS worse. I highly recommend the book Beyond The Pill if you're debating whether or not to come off. Take a look at this article form Dr. Brighten as well. Please don't freak out if you are on it, just read up on the impacts and make the best decision for you.
- Eat an anti-inflammatory diet. I wanted to minimize the inflammation in my body because inflammation disrupts hormonal communication. Food is the #1 way to heal what's going on inside your body. Read more about this way of eating here. Essentially, you eat real, whole foods and avoid gluten, dairy, added sugar, alcohol and unhealthy oils. Most of the recipes on my site follow an anti-inflammatory diet!
- Work to heal your gut. This one goes hand in hand with eating a good diet. According to Dr. Brighten, " a lot of times hormonal imbalances start in the gut." The gut hormone connection is real, especially the gut thyroid connection. And guess what? Birth control disrupts your gut. If you've been on it for a long time and have been eating inflammatory foods there's a good chance you could do some gut healing. Here are a few ways to heal your gut:
- Eat a gut-healing diet with a lot of fermented foods
- Take a probiotic
- Quit hormonal birth control
- Take a food sensitivity test (get 20% off!) and cut out your high reactive foods for a couple months
- Manage your blood sugar. A lot of women with PCOS struggle with a blood sugar imbalance. And mismanaged blood sugar is actually a form of stress in our body. It's usually why you see so many women going low carb with PCOS. After reading The Period Repair Manual and meeting with my functional CNP, I learned that carbs are actually essential for ovulation. This is why I don't eat a low carb diet. However, I do manage my blood sugar by being mindful of what I'm putting into my body and when. Here are some simple blood sugar balancing tips:
- Eat real, whole foods (hellooo anti-inflammatory diet)
- Cut out added sugar
- Eat regular meals (skipping meals and blood sugar dropping isn't ideal for hormones either!)
- Eat protein and healthy fats at every meal, especially breakfast
- Get a workout in
- Reduce stress. This is easier said than done! But managing your stress plays a huge role in balancing hormones for fertility. There's a little something called the progesterone steal. Your body will either make cortisol or progesterone. When you're in a constant fight or flight mode your body will prioritize making cortisol instead of progesterone. Another result of increased stress is a short luteal phase, which means your body is making less than optimal amounts of progesterone.And we all know progesterone is critical for fertility. Our bodies know when we're in a constant state of stress and our bodies will prioritize survival over pro-creation. Unfortunately, constant state of stress these days can mean work, family, traffic, bills etc. and not so much being chased by a lion (when we probably wouldn't want to be procreating!). Here are a few ways to manage stress:
- Develop a night-time routine and get enough sleep
- Start saying no to things to give yourself free space
- Download a meditation app like Headspace
- Re-evaluate your workout routine—even working out really hard can be a form of stress
- Practice self care (baths, yoga, getting your nails done, going for a walk, date night)
- Try cutting out coffee to see how it affects your adrenals —maybe switch to an iced matcha latte or collagen matcha latte .
- Find a functional doctor and get custom hormone labs. This one was a game changer for me. I saw a functional CNP, Julie Grafmeyer, and she helped me so much. I got my blood work done and learned what it means for PCOS. It's so important to know exactly what is going on in your specific body and start to take measures to heal. It helps you form a plan for supplements, stress management, blood sugar management and more. Here's an at-home panel you can do for hormones.
- Balance your thyroid. I really believe balancing my thyroid was one of the main reasons we were able to conceive and I was able stay pregnant. In one of Dr. Brighten's most recent emails she says that a mismanaged thyroid is one of the leading causes of miscarriage and it often goes undiagnosed. Not only that, but it's also a cause of infertility. My TSH was very high and I was considered to have hypothyroidism. This one is something you might have to really push your doctor on. A lot of times they'll only do a panel for your TSH but they should really be doing a comprehensive thyroid panel. You can do an at-home panel of all hormones here if your current doctor isn't willing to do this.
- Enhance diet with supplements. These may vary based on your specific blood work, but overall here are PCOS supplements that work. We can get a lot of vitamins and minerals from the foods we eat, but these supplements help us get things that may be missing or lacking in our diet. They also include things that help heal the gut.
- Cut out environmental toxins. Over the years companies have started putting toxic ingredients in the products we use everyday including our cleaning products and makeup. These toxins are endocrine disruptors. Here's a great article on how endocrine disrupting chemicals cause hormonal imbalance. Check out the Think Dirty App to learn what products to avoid. A good place to start is your skincare routine, makeup routine and cleaning products. Don't feel overwhelmed and go out and spend a fortune on all new products. You can slowly swap non-toxic products in as you run out of others.
- Exercise is medicine. Exercise sensitizes your muscle to insulin. Choose an exercise you enjoy and can stick to. But also be careful of over-exercising. This was the case for me. I was doing Orange Theory several times a week and it was putting my body under stress. I switched to yoga, walking, weight training and short interval training and saw a huge difference.
BONUS: Try seed cycling. Seed cycling is the practice of eating specific seeds at certain points in your menstrual cycle to help promote the healthy balance of estrogen and progesterone to regulate cycles, increase fertility, and ease PMS symptoms and other symptoms as a result of hormonal imbalances. Read this seed cycling for fertility post for a in-depth guide on how to get started. We conceived the first month I tried seed cycling.
Hidden drivers of PCOS:
Lastly, here are a few hidden drivers of PCOS. The best thing about identifying if you have one of these is that once you correct it, your symptoms should improve pretty quickly. You'll definitely want to make sure you check into these things on top of following everything above.
- Thyroid disease: as I mentioned earlier, this is something that can go hand in hand with PCOS. Hypothyroidism impedes ovulation and worsens insulin. Make sure you get a full thyroid panel!
- Vitamin D deficiency: your ovaries need vitamin D. Here in Ohio it's easy to not get enough. My vitamin D was very low after getting my blood work back.
- Zinc deficiency: your ovaries need zinc.
- Iodine deficiency: your ovaries need iodine.
- Elevated prolactin: this increases DHEA.
- Too little food or too few carbs: you need carbs to ovulate. Just make sure you're eating the appropriate amount and balancing your blood sugar.
Do I have to do all of these things right now?
This isn't meant to overwhelm you, but instead, it's meant to arm with you the information you need to take control of your fertility and feel empowered that YOU CAN DO THIS. Don't let a doctor or anyone tell you "this is just how you are" or that you have to do fertility meds or IVF if you don't want to. You have options.
I'm living proof that these things work. I started with my diet and slowly changed my lifestyle to boost fertility. Don't feel like you have to do everything at once. Start with one step and once you've integrated it into your life and it's become a habit, move on to the next thing.
I wrote these steps in order of how I did them. Start from the top and go down the list. You can absolutely start trying to conceive before you've mastered everything here. This is just a comprehensive list of what worked for me!
After making adjustments, give your body time to regulate:
It takes 100 days for your follicles to mature from their dormant state all the way through ovulation. If your follicles were unhealthy for any part of the process, the result could be period problems months later. The issues you're experiencing now could be a result of something that was going on in your body months ago.
So give yourself at least 100 days from when you make changes to start seeing any type of result. Stick with it, I promise it's worth it!
Please follow me on Instagram and reach out via direct messages or via email if you have any questions at all.
More PCOS posts:
- The best PCOS resources for healing naturally
- Seed Cycling for hormones and fertility
- My all-natural skincare routine
- PCOS supplements
- My anti-inflammatory diet
- My blood work and what it means for PCOS