But when it comes to fertility, ovulation is the foundation.

PCOS, or polycystic ovarian syndrome, is a common reason for diagnosed “infertility,” which is rising faster than ever in the US. One of the hallmark signs of PCOS is ovulatory dysfunction, meaning that a woman has irregular periods or anovulatory cycles which are menstrual cycles in which ovulation does not take place. Ovulation is crucial for pregnancy because that is the process that actually releases the egg that will eventually become fertilized. If you’re wondering how to get pregnant naturally with PCOS, the first step is to make sure that you are actually ovulating.

Why PCOS Causes Infertility

With PCOS, ovulatory dysfunction makes trying to conceive (TTC) difficult because there are fewer eggs released in any given year. Rather than having a monthly period, many women with PCOS have cycles that stretch more than 35 days, sometimes twice that, and some women don’t have periods at all. PCOS can also get in the way of TTC efforts because it’s associated with insulin resistance, inflammation, and hormone imbalances that affect the quality of the uterine lining, damage the fragile embryos in their earliest stages, and increase the risk of miscarriage. These factors combined can add up to the 6 or 12 months of unsuccessful TTC efforts that lead women over, or under, age 35 (respectively) to be diagnosed with infertility and referred for IVF.

Assisted reproductive technology has been a wonderful gift to families who were otherwise unable to conceive without it. But what if there was a way to get pregnant naturally without having to rely on medications, invasive procedures, and tens of thousands of dollars’ worth of medical appointments

Guess what There is! Read on to find out.

How to Get Pregnant Naturally with PCOS

Getting pregnant naturally with PCOS means addressing the root cause of fertility problems in PCOS. These main issues include: irregular ovulation, inflammation, and problems with egg quality.

Improving Ovulation in PCOS

The first key step in improving ovulation rates in PCOS is figuring out if and when you are ovulating. You can do this in two ways:

1. Blood Tests: In most ovulatory cycles, progesterone levels are highest on day 21. This is because ovulation usually takes place around 2 weeks before a period starts, and in a “normal” monthly cycle, ovulation would take place somewhere around day 13-16. After ovulation, the ovary starts producing progesterone, but does not do this if it doesn’t release an egg. So, to confirm if a woman is “ovulating on time,” we can run a blood test to measure the progesterone levels in her blood and if they’re in the correct range, we know she ovulated “on time.” If a woman has long but regular cycles, meaning they come after the same number of days, we would run this test one week before her expected period.
2. Tracking BBT: If a woman has irregular cycles, it is difficult to predict when to test “day 21 progesterone” or to complete that progesterone test at the correct time. Plus, the progesterone test doesn’t tell us when she ovulated necessarily, only if she ovulated and when, within a general range, that may have taken place. Instead, a woman can track her period using fluctuations in body temperature that give very specific information about the timing of ovulation. Learn how to do this here: Basal Body Temperature 101

Once you know if and when you’re ovulating, it’s time to take steps to make it more regular! Here are a few key ways to do this:

1. Reduce Stress: Stress is a major driver of adrenal dysfunction, which drives androgen production and worsens the hormone imbalances associated with PCOS. Stress also messes with blood sugar and lowers progesterone levels which can make the uterine environment unfavorable for pregnancy.
2. Consider Androgen Blockers: In the traditional medical model, spironolactone and the birth control pill are prescribed to reduce androgens because these hormones are responsible for many of the problems seen with PCOS. However, spironolactone isn’t safe when TTC, the birth control pill defeats the whole purpose, and neither allows our bodies to naturally get back into balance. Instead, natural herbs like red reishi, Chinese peony, green tea extract and black cohosh reduce androgens and improve ovulation rates. Be careful though; many of these herbs are not safe to take during pregnancy and you can be pregnant for up to a week before a pregnancy test shows positive. I recommend working with a functional medicine doctor if you’re using herbal medicines for this reason.
3. Take Melatonin: Disruptions in the circadian rhythm lead to cortisol and DHEA imbalances, which circle back to point #1 in terms of their hormone-disrupting effect. Short-term melatonin use helps regulate the stress cycle, but has also been shown to improve ovulation rates in PCOS and reduce inflammation.

Reduce Inflammation

Inflammation is caused when the immune system gets triggered by foreign invaders or toxic chemicals. Some of these toxic chemicals come from the body’s own metabolic processes (i.e. “waste products”) but others are caused by lifestyle factors. Here’s how you can lower your own inflammatory load:

1. Take Melatonin: It made it to this list too! Melatonin is just that powerful. If you look back up at point #3 above, you can see that melatonin reduces inflammation in PCOS sufferers in addition to increasing likelihood of ovulation.
2. Eat an Antioxidant-Rich Diet: The more colorful the food, the better! That doesn’t mean that white foods aren’t allowed, it just means that you can amp up your antioxidant load without needing to rely on more supplements. My favorite ways to get antioxidants every day is by eating organic beets, blueberries, arugula and raw walnuts. Better yet, I combine all of these into a salad, topped generously with extra virgin olive oil and balsamic vinegar.
3. Consider Curcumin and Vitex: Similar to melatonin, curcumin and vitex reduce inflammation and improve ovulatory outcomes. I usually have my patients take all three when they are TTC.

Work on Your Egg Quality

From a nutritional perspective, it’s pretty simple: eating eggs improves egg quality! Go figure, right That’s because eggs are an excellent source of zinc, B vitamins and choline, all of which are essential for egg quality and developing of a growing baby. Here’s an easy, non-supplement way to improve your own egg quality: eat two eggs per day! The additional protein is also valuable for keeping blood sugar balanced and reducing inflammation from insulin.

1. Eat 2 Eggs Per Day: see above for details!
2. Check out my blog post all about Fertility Supplements for Egg Quality

In closing…

If you have been told that IVF is your only option, remember that there may be meaningful steps you can take first to support your body naturally. Learning how to get pregnant naturally with PCOS starts with restoring ovulation, lowering inflammation, and improving egg quality, which are the true foundations of fertility. While assisted reproductive technology has helped countless families, it is not the only path for every woman. By identifying whether you are ovulating, addressing stress and blood sugar balance, reducing inflammation, and nourishing your body with targeted nutrition and supportive therapies, you may be able to create a healthier environment for conception. With the right testing, guidance, and a root-cause approach, many women with PCOS can optimize their fertility and move toward pregnancy with greater confidence and clarity.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Get Pregnant Naturally with PCOS appeared first on Dr. Alexandra MacKillop.

So, what does work, then?

As with anything in functional medicine, it starts with building a foundation. Nutrition, rest/exercise balance, stress management, and psycho-emotional health serve as the self-care building blocks of our health. Those elements need to be in place in order for us to function at all, much less start thinking about optimizing/maximizing our well-being. When those building blocks start to crumble, hormones are one of the first systems to fall out of balance.

I like to describe this foundation as the load-bearing walls of a house. Where roof shingles and a picture window, or nicely painted shutters are all important components of a building’s ability to appear visually balanced, none of that matters if the framework of the house isn’t structurally sound. Without four, solid, load-bearing walls, the roof, windows and shutters are all falling to the ground.

Symptoms of Hormonal Imbalances

The hormones of the human body are so diverse and dynamic, that it’s pretty much impossible to zero in on a specific hormone imbalances without getting into the nitty-gritty details of the patient’s lifestyle, labwork, and physical exam findings. (This is why any prepackaged program is pretty much guaranteed to lack the necessary nuance and individualization required to be effective.) Of course nutrition, exercise, and supplements can play important roles in restoring hormone balance, but you can’t diagnose HPTAG axis dysfunction through a web page or subscription box. #sorrynotsorry

In general, imbalances in the delicate relationships of our hypothalamic-pituitary-thyroid-adrenal-gonadal axis start with a few generalized symptoms. If one of my patients came into my office complaining of a group of the following, and their history supported the pattern of these symptoms, I’d immediately start thinking about the endocrine system:

• Fatigue
• Weight gain or loss
• Changes in hair thickness or texture
• Irregular, absent, or other changes in periods
• Sleep disturbances
• Blood sugar regulation problems

In order to confirm a hormonal imbalance, we would need to run a series of blood tests, including a thyroid panel and sex hormone panel. Keep in mind that those symptoms can correspond to lots of different life circumstances and/or pathologies, so it’s important not to self-diagnose or jump to conclusions without looking at the big picture of health. (That means taking personal history, physical exam, and lab work into account in addition to presenting symptoms.)

What to Do About a Hormone Imbalance

The #1 thing that you can do for your health whether you suspect you’re suffering the effects of a hormone imbalance or not, is to make sure that the foundational building blocks of self-care are in place in your life. No cocktail of medications or supplements, and no juice cleanse or exercise regime can undo the continual damage of a poor self-care routine. In fact, those things often contribute to allostatic load, amplifying the stress response and making hormonal problems worse.

1. Manage Stress

Probably the most important thing you can do to support your hormones is take steps to manage your stress. Chronic stress profoundly affects our health and wreaks total havoc on our hormones. The longer we are suffering the effects of stress, the harder it is to interrupt (or reverse) the damage that is done. Stress comes in many forms, but we most typically think of psychological triggers like work deadlines and over-packed schedules.

To manage psychological stress, learn to start saying no. Take the time to self-reflect, and let go of the things that no longer serve you—whether they be extracurricular commitments, hobbies, toxic relationships, or involvement in activities that don’t align with your values. In certain cases, this might even mean finding a new job or moving to a new area. I am a huge proponent of therapy, and would recommend it to just about anyone who is looking to improve their psychological well-being through stress management.

2. Sleep

Sleep is probably the most underrated aspect of modern life. Most people get far fewer than the recommended 8+ hours of sleep per night. (Some sources suggest that women need even more, perhaps up to 9 or 10 hours.) When we aren’t sleeping enough, cortisol, adrenaline and other adrenal hormones go into overdrive. We also suffer pretty dramatic cognitive effects from sleep deprivation even after just one night—things like memory problems, mood changes, and even personality fluctuations.

Not getting enough sleep also has been proven to contribute to insulin resistance, metabolic syndrome, elevated cholesterol, and increased risk of cardiovascular disease. Yikes! (If you are dealing with PCOS, these effects are even more profound.)

3. Eat enough

Most of the women I talk to vastly underestimate the amount of food they need. The diet industry has convinced us that we need about as much food as toddlers, which is so sad. Not only does under-eating amplify the stress response in our bodies, but it’s psychologically, emotionally, and spiritually toxic.

Not getting enough calories, enough fats, enough carbs, or enough proteins very quickly leads to hormonal disruption. Micronutrient deficiencies (vitamins and minerals) take a little longer to manifest, but they interrupt hormonal signals, too. Eating balanced meals is essential for hormone health, and that includes eating early, eating often, and eating enough.

4. Balance Exercise and Rest

Just like many of us vastly underestimate the amount of food we need, we also tend to overestimate the amount of exercise we need. Both too much and too little exercise can lead to hormonal disruption, so it’s important to figure out the right amount of exercise for your body, and find movements you enjoy so you can stay consistent.

5. Cultivate a Support Network

As with anything, it takes a village. No matter how much sleep you get, or how balanced your approach to exercise and nutrition is, life happens. The difference between people whose health deteriorates under stress and those who are able to endure actually has far less to do with the people themselves, and far more to do with their support networks. We were never meant to live this life alone.

The influence of relational and spiritual support on health and well-being should never be ignored. To build your social support network, make time to regularly meet up with friends and family, plug in to a local church, and join community groups centered around common interests, like baking, biking, beekeeping or whatever floats your boat.

To balance and beyond…

If your self-care routine is well-established and firmly in place, yet you’re still experiencing symptoms, it’s time to schedule an appointment with your healthcare provider. A functional medicine doctor can take a closer look at your health history, run some lab tests, and help you get to the bottom of your struggles once and for all. But even if and when you identify what’s going on, don’t neglect your self-care. There’s no better medicine than a healthy self-care routine in terms of exercise, nutrition, sleep, social support, and stress management.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

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Sign Me Up!

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Want more Grab a copy of my new book, The Postpartum Check-In !

Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post 5 Ways to Balance Your Hormones, Naturally appeared first on Dr. Alexandra MacKillop.