Genetic testing often enters the fertility conversation through IVF, when embryo testing before transfer identifies certain chromosomal and inherited risks. Many couples appreciate this information, though there are potential moral concerns regarding what to do with carriers. Embryos aside, however, gene testing before pregnancy can also offer insight into a mother (or father’s) health as it applies to successful conception, miscarriage prevention, and reducing risks for the baby both before and after being born. Moreover, valuable genetic insight does not require IVF. This is great news, as most couples actively seek ways to conceive naturally and avoid invasive reproductive technology. Gene testing before pregnancy delivers similar information through the lens of functional medicine while still supporting informed and proactive choices.

Why Complete Gene Testing Before Pregnancy?

When mothers and couples have access to their genetic information, they gain clarity. This clarity pertains not just to potential diagnoses, but about long-standing health patterns and inherited vulnerabilities that may otherwise go unnoticed. Gene testing before pregnancy allows care to shift from reactive to truly preventive. Rather than waiting for complications to surface during pregnancy or delivery, couples have the opportunity to intervene early with lifestyle strategies to support their genetic, and epigenetic health.

This kind of foresight is foundational in functional medicine. Strategies like nutrient repletion, supporting detoxification pathways, reducing inflammation, and optimizing hormone balance are far more effective when they’re guided by genetics instead of reactions or guesswork. After all, you can’t correct, prevent, or support a risk you don’t yet know exists.

Who Should Consider Gene Testing Before Pregnancy?

Genetics are part of everyone’s health story. Our genes carry disease risk, but our environment and exposures throughout life, both positive and negative, influence whether those genes are expressed. High-quality nutrition, for example, can help quiet genes associated with cancer risk as well as fertility-related conditions like PCOS, endometriosis, and autoimmune disease. On the other hand, environmental toxins, chronic stress, and repeated or high-dose antibiotic use can switch these same genes on. When that happens, health can suffer in ways that directly and sometimes dramatically affect fertility.

Because of this, it’s reasonable to argue that nearly everyone can benefit from understanding their genetic health, and many may want to consider gene testing before pregnancy as part of a proactive approach to family planning.

Age adds an important layer of urgency to this conversation. After age 35, egg quality naturally declines, and genetic vulnerabilities tend to exert a stronger influence. Issues like chromosomal instability, impaired methylation, oxidative stress, and clotting tendencies can impact fertility and pregnancy outcomes more significantly. This is not just a maternal issue. Paternal genetics matter as well, since a healthy pregnancy and child require both a healthy egg and a healthy sperm.

In this post, we’ll explore five ways prospective mothers and fathers can use gene testing before pregnancy to optimize their own health and support the long-term health of their future children.

1. MTHFR (Methylenetetrahydrofolate Reductase)

One of the most commonly discussed genetic findings in preconception care involves the MTHFR gene. Variants in MTHFR can affect folate metabolism, methylation efficiency, and the body’s ability to detoxify effectively. Impaired methylation has been linked to miscarriage, preeclampsia, placental dysfunction, and neural tube defects.

Gene testing before pregnancy gives prospective parents the opportunity to identify these risks early and support detoxification and DNA synthesis before those demands increase during pregnancy. Testing for MTHFR typically identifies variants such as C677T or A1298C through saliva or blood samples. An individual may carry one copy (heterozygous) or two copies (homozygous) of a given variant, which can influence how significantly methylation pathways are affected. Insurance coverage varies and is often dependent on a history of pregnancy loss or clotting disorders.

From a functional medicine perspective, these findings guide targeted interventions, including the use of methylated folate and other B vitamins, limiting exposure to synthetic folic acid, and reducing environmental toxin burden. This becomes especially important when evaluating standard prenatal vitamins, many of which may not be appropriate for individuals with certain MTHFR variants.

2. Factor V. Leiden

Clotting genetics are another critical piece of the preconception puzzle. Inflammation and abnormal clot formation pose serious risks during pregnancy and can contribute to pregnancy loss at any stage. One of the most well-known examples is Factor V Leiden, a genetic variant that increases the tendency toward excessive clotting and can interfere with normal placental blood flow. This disruption raises the risk for miscarriage, stillbirth, fetal growth restriction, and preeclampsia.

Gene testing before pregnancy can identify whether an individual carries one copy (heterozygous) or two copies (homozygous) of this variant through blood or saliva testing. Insurance coverage often depends on family history or a record of prior pregnancy complications. When clotting risk is identified early, care can focus on reducing inflammation, supporting healthy circulation, and coordinating obstetric management, including anticoagulation when clinically appropriate.

• Treatment: Strategies usually include blood thinners (anticoagulants) such as low molecular-weight heparin (LMWH) and sometimes, aspirin. Functional medicine also offers natural benefit from higher dose fish oil. Talk to your doctor about your options for Factor V as well as mutations in Prothrombin G20210A (below).

3. Prothrombin G20210A

Another important clotting-related gene to consider is the Prothrombin G20210A mutation. This variant also increases the risk of abnormal clot formation and can compromise placental circulation. Pregnancy places significant demand on vascular health, and genetic interference in these pathways raises the risk for both maternal and fetal complications.

Gene testing before pregnancy can identify this mutation through standard laboratory testing, with insurance coverage typically following the same criteria used for Factor V Leiden. From a functional medicine perspective, this knowledge allows care to focus on prevention rather than crisis management. Targeted nutrient support, inflammation control, and proactive monitoring can be put in place early, empowering mothers to pursue appropriate maternal care long before a pregnancy complication ever occurs. As a functional medicine doctor, my #1 treatment is a whole foods, ancestral diet that includes organ meats, fish and healthy animal fats.

4. COMT (Catechol-O-Methyltransferase)

Genetics related to hormone metabolism also play an important role in fertility and overall pregnancy experience. Variants in the COMT gene influence how the body clears estrogen, regulates neurotransmitters, and responds to stress. Slower estrogen metabolism can contribute to hormone dominance, implantation difficulties, and more pronounced pregnancy symptoms. Increased stress sensitivity disrupts cortisol balance, which in turn affects immune tolerance and hormonal signaling throughout pregnancy. COMT variations may also influence how an individual responds to certain antidepressant medications, a consideration that is especially relevant given how many women are using these medications prior to conception or during pregnancy.

Gene testing before pregnancy often evaluates COMT through saliva-based genetic panels. Insurance coverage is uncommon, and self-pay rates vary depending on which other markers are involved on the genetic panels. (I’ve seen anywhere from $100 to $350). In functional medicine, these results guide strategies such as supporting estrogen detoxification pathways, improving stress resilience, and providing targeted micronutrient support. Because stress and impaired hormone metabolism can significantly challenge both conception and pregnancy, addressing these risks proactively allows many of these obstacles to be prevented rather than managed after the fact.

5. CFTR (Cystic Fibrosis Transmembrane Conductance Regulator)

Carrier screening plays a crucial role in responsible family planning. CFTR gene testing identifies carrier status for cystic fibrosis and sheds light on certain male fertility issues. An estimated 1 in 25 people is a carrier of CFTR mutations, so couples benefit from knowing this about themselves before conception. Gene testing before pregnancy uses blood or saliva samples to determine carrier status rather than disease presence. Insurance frequently covers this screening during pregnancy planning or when family history exists. Genetic counseling supports informed decisions when both partners carry variants.

Taken together, these tests form a powerful foundation for prevention, but modern prenatal care rarely encourages couples to complete this testing outside of IVF offices. However, all couples deserve to know the truth about their health so they can hopefully avoid the pain and devastation of fertility and pregnancy challenges. Gene testing before pregnancy replaces uncertainty with strategy. Each result informs nutrition, supplementation, and lifestyle choices for maximally effective preventative medical care.

Functional medicine is founded on this level of personalization. Work with a functional medicine doctor to unlock your own genetic potential to maximize your health, fertility, longevity and more.

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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The post Gene Testing Before Pregnancy: Why and How to Harness the Power of Your DNA appeared first on Dr. Alexandra MacKillop.

If you’re wondering how to naturally increase fertility, the most important thing you should know is that fertility isn’t just about the reproductive organs—it’s a whole-body indicator of health. As a functional medicine doctor, I’ve helped countless patients learn how to naturally increase fertility by addressing imbalances across all systems of the body. If you’re trying to conceive without resorting to pharmaceuticals or IVF, this guide will give you the strategic, root-cause roadmap to reclaim your fertility naturally.

Why Increase Fertility Naturally?

Natural fertility optimization isn’t just about conception—it’s about creating the healthiest possible environment for you and your future child. Couples choose to increase fertility naturally because they want to avoid synthetic hormones, invasive procedures, or expensive treatments that ignore the real cause of the issue. They want to heal, not override, their bodies. IUI, IVF and other fertility treatments can alo be extremely costly, which is another important reason to consider learning how to naturally increase fertility. However, even when pursuing fertility treatments, or perhaps undergoing a process of egg retrieval for egg freezing or a sperm harvesting for sperm freezing, it’s still a good idea to take all possible measures to increase fertility naturally so that the eggs have the best possible chance of success.

Conventional medicine often reduces fertility to a hormone problem. But infertility is a signal—your body is telling you something is off. When we listen, investigate, and treat the underlying dysfunction, the result isn’t just fertility—it’s vitality, balance, and lasting health.

Lifestyle Practices That Harm Fertility

Before we can build fertility, we need to stop destroying it. The modern lifestyle is fertility-toxic. Here’s how:

• Chronic Stress: Activates the HPA axis and shuts down reproductive hormones. Cortisol hijacks your cycle, suppressing ovulation and libido. It also significantly suppresses testosterone production and sperm quality in men.
• Poor Sleep: Disrupts circadian rhythms and hormone production—especially melatonin and progesterone, as well as testosterone in men.
• Toxin Exposure: Pesticides, BPA, phthalates, and heavy metals mimic hormones and disrupt endocrine balance. There is also data out there that exposure to plastics in clothing also act as fertility disruptors, creating changes in electrical and magnetic signaling that negatively impact ovarian function and sperm quality. Look for clothing that is free of plastics, PUFAs, and other synthetics.
• Nutrient-Deficient Diets: Low-fat, high-sugar, or overly restrictive diets destroy hormone production and egg quality. Our ultra-processed modern diet is void of nutrients despite being rich in processed carbohydrates and seed oils. In fact, both simple carbs and seed oils have been proven to negatively impact fertility. Aim to include high-quality animal proteins and fats as well as organic, darkly colored fruits and vegetables like berries and leafy greens. I also recommend a daily carrot salad for hormone balance.
• Overtraining/Under-Eating: Particularly common in driven, Type A women, this leads to hypothalamic amenorrhea, where the brain shuts down ovulation entirely.
• Alcohol, Caffeine, and Smoking: All three impair egg quality, sperm health, and hormone balance. I recommend avoiding all three if you’re TTC.

A note about these lifestyle factors: These foundational elements are pretty universal amongst articles describing methods for how to naturally increase fertility. Because they’re so ubiquitous, it may seem tempting to overlook them in search of something more direct, more exclusive, or more granular. While I do offer such recommendations below, I want you to know that lifestyle is the single most important factor in fertility as well as in health as a whole. It will do you no good to look to supplements or anything else for how to naturally increase fertility while overlooking the lifestyle. There is no supplements, and honestly no drug, that can undo the effects of poor sleep, high stress, toxin exposure, calorie deficits, substance abuse, and a poor diet.

How to Naturally Increase Fertility by Identifying the Root Cause of Fertility Disorders

To truly increase fertility naturally, you must identify why your body isn’t conceiving. Here are the most common root-cause conditions that sabotage fertility:

1. Thyroid Disorders

Low thyroid function (hypothyroidism) decreases progesterone, disrupts ovulation, and increases miscarriage risk. If your TSH is “normal” but you’re still tired, cold, or constipated—get a full thyroid panel. Subclinical hypothyroidism often flies under the radar. Hyperthyroidism, such as seen in Graves’ disease, also negatively impacts fertility. If you’re wondering how to increase fertility naturally, you should start by getting your thyroid thoroughly checked out.

2. PCOS (Polycystic Ovary Syndrome)

PCOS is an insulin-resistance and androgen-dominance issue. It impairs ovulation, leads to cystic ovaries, and causes irregular cycles. You must correct blood sugar dysregulation, reduce inflammation, and support hormone detoxification to restore ovulation.

3. Endometriosis

This inflammatory, estrogen-driven condition causes pelvic pain and infertility by distorting reproductive anatomy and disrupting implantation. Gut health, immune balance, and estrogen metabolism must be addressed aggressively.

4. Hypothalamic Amenorrhea

This is the brain pulling the emergency brake on fertility due to perceived stress or lack of energy availability. It’s common in athletes, perfectionists, and under-eaters. Recovery requires restoring adequate caloric intake, body fat, and nervous system calm.

5. HPA Axis Dysfunction (Adrenal Fatigue)

The hypothalamic-pituitary-adrenal axis controls the stress response. When it’s dysregulated, it suppresses reproductive hormones. You must rewire the stress response through nervous system regulation, sleep, and adrenal support to restore fertility.

How to Naturally Increase Fertility with Supplements

Certain nutrients powerfully support reproductive function. Many of these are key players in my practice for optimizing fertility:

• Myo-Inositol: Improves insulin sensitivity and ovulatory function—especially critical for PCOS.
• CoQ10 (Ubiquinol): Enhances mitochondrial function in eggs and sperm, improving quality and developmental potential.
• Omega-3 Fatty Acids: Reduce inflammation and support hormone production.
• Methylated B Vitamins (especially B9/Folate): Crucial for methylation, egg health, and preventing neural tube defects.
• Magnesium: Calms the nervous system, supports adrenal function, and improves sleep—all essential for fertility.
• Vitamin D3: Regulates hormone production and immune balance. Low levels are directly linked to infertility and miscarriage.

How to Naturally Increase Fertility by Looking at the Whole Body

Your uterus does not operate in a vacuum. Fertility is the result of systemic harmony, not isolated hormonal tweaks. Here’s how the entire body affects your ability to conceive:

Brain & Nervous System

The hypothalamus and pituitary gland orchestrate your reproductive cycle. Chronic stress rewires your brain to shut down reproduction. Nervous system regulation—via breathwork, somatic practices, and trauma healing—is fertility medicine.

Gut Health

The gut regulates nutrient absorption, immune response, and estrogen metabolism. Dysbiosis, leaky gut, or SIBO drive inflammation and hormone imbalance. Heal the gut, and you lay the groundwork for conception.

Liver Function

The liver detoxifies excess estrogen and metabolizes hormones. A sluggish liver leads to estrogen dominance, PMS, and ovulatory issues. Support with cruciferous vegetables, dandelion root, NAC, and targeted herbs.

Blood Flow

Pelvic blood flow is essential for ovarian and uterine health. Sedentary lifestyle, poor circulation, and inflammation impair oxygen and nutrient delivery to reproductive organs. Movement, dry brushing, acupuncture, and castor oil packs all enhance circulation.

Musculoskeletal System

Tension in the pelvis, scar tissue, or misalignment in the spine can block blood flow and nerve signaling. Bodywork (chiropractic, craniosacral therapy, pelvic floor therapy) helps clear the path for conception.

Lymphatic System

The lymphatic system clears cellular waste and toxins. A stagnant lymph system clogs hormone pathways and raises inflammation. Rebounding, sauna, hydration, and manual lymph drainage support this overlooked detox pathway.

Final Thoughts: Fertility Is a Barometer of Health

To naturally increase fertility, you must stop chasing hormones and start chasing health. When your body feels safe, nourished, and in balance—it will create life. This isn’t theory. I’ve seen it happen over and over with patients who were told their only option was IVF.

Natural fertility is not luck. It’s the result of uncovering root causes, supporting the body as a whole, and restoring biological wisdom. Your body is not broken. It’s communicating.

You just need to learn how to listen—and how to heal.

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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The post How to Naturally Increase Fertility appeared first on Dr. Alexandra MacKillop.

Polycystic ovarian syndrome (PCOS) affects millions of women worldwide, presenting a variety of symptoms, including irregular menstrual cycles, acne, weight gain, and infertility. Traditional approaches often focus on symptom management, but functional medicine offers a deeper, more sustainable solution by targeting the root causes of PCOS. Rather than simply masking symptoms, functional medicine works to restore balance within the body through personalized, holistic interventions. Here’s how functional medicine addresses PCOS from every angle to promote lasting health.

Functional medicine goes beyond treating symptoms—it strives to correct the underlying factors that drive disease. With PCOS, this means addressing not only hormonal imbalances but also lifestyle factors that exacerbate the condition. These factors include sleep hygiene, nutrition, exercise, stress, and toxin exposure.

For effective treatment, patients must embrace behavioral changes. Functional medicine emphasizes:

• Improved Sleep Hygiene: Consistent, restful sleep is crucial for regulating hormones and blood sugar.
• Nutritional Adjustments: A balanced diet that supports stable blood sugar and reduces inflammation can help correct insulin resistance, a key factor in PCOS.
• Exercise Patterns: A tailored exercise regimen can regulate hormones and boost metabolism.
• Stress Management: Chronic stress elevates cortisol, which worsens insulin resistance and hormonal imbalances.
• Reduction of Toxic Exposures: Avoiding endocrine-disrupting chemicals, such as those found in plastics and personal care products, helps restore hormonal balance.

By focusing on these lifestyle changes, functional medicine doesn’t just alleviate symptoms but rewires the body’s health from the inside out.

Sleep as a Treatment for Polycystic Ovarian Syndrome

Sleep plays a pivotal role in functional medicine, particularly in its relationship to cortisol and blood sugar regulation. Poor sleep disrupts hormonal balance, elevating cortisol levels. This, in turn, increases insulin resistance—something that directly affects around 70% of women with PCOS.

Lack of sleep leads to:

• Higher cortisol levels, contributing to increased blood sugar and insulin resistance.
• Disruption of the body’s natural circadian rhythm, affecting the timing of hormone production.
• Increased cravings for high-sugar and high-fat foods, which worsens blood sugar management.

4 Strategies for Better Sleep Quality:

1. Consistent Sleep Schedule: Go to bed and wake up at the same time every day, even on weekends, to regulate your circadian rhythm.
2. Limit Blue Light Exposure: Avoid screens (phones, computers, etc.) at least an hour before bedtime. Blue light interferes with melatonin production.
3. Create a Sleep-Inducing Environment: Ensure your bedroom is cool, dark, and quiet. Consider using earplugs or a white noise machine to block disruptive sounds.
4. Relaxation Techniques: Engage in deep breathing, progressive muscle relaxation, or meditation before bed to activate the parasympathetic nervous system, signaling the body to wind down.

Nutrition as a Treatment for Polycystic Ovarian Syndrome

Managing blood sugar is central to PCOS treatment. Women with PCOS often struggle with insulin resistance, making blood sugar control a crucial factor. Functional medicine promotes a low-carb, blood sugar-controlled diet that focuses on whole, nutrient-dense foods.

Key Strategies:

• Low-Carb, High-Protein Diet: Emphasizing lean proteins, healthy fats, and low-glycemic vegetables supports stable blood sugar levels.
• Continuous Glucose Monitoring: Using a continuous glucose monitor (CGM) allows you to track postprandial glucose levels. The goal is to keep glucose levels under 110 mg/dL, which prevents insulin spikes and the inflammatory response that worsens PCOS.
• Protein and Fiber: Protein stabilizes blood sugar by slowing digestion, while fiber slows the absorption of sugar, preventing blood sugar spikes. Including protein at every meal—especially lean meats, fish, eggs, and plant-based proteins—is crucial for blood sugar regulation. Likewise, fiber-rich foods such as leafy greens, avocados, and legumes help maintain glucose balance.
• Ketones: Among low-carb diets, keto is one of the most effective for reversing insulin resistance. But it’s also the most intense. If a keto diet is not sustainable or realistic for you in the context of your health, there’s good news. Research shows that supplementing with exogenous ketones in the form of beta-hydroxybutyrate reduces both androgens and blood glucose in women affected by PCOS.

Exercise as a Treatment for Polycystic Ovarian Syndrome

Exercise is vital for hormone balance and glucose management. While all forms of exercise benefit metabolism, weight lifting stands out as the most effective for improving insulin sensitivity.

Why Weight Lifting Works Best for PCOS:

• Muscle Mass and Insulin Sensitivity: Strength training builds lean muscle mass, which helps the body use insulin more effectively, lowering blood sugar.
• Increased Resting Metabolic Rate: Muscle tissue burns more calories at rest than fat tissue, enhancing fat loss and supporting hormone regulation.
• Cardio versus Weight Lifting: The research here is mixed. Many sources claim that resistance training is more effective than cardio for controlling PCOS, but other quality, high-power studies also show that the reverse is true. As a functional medicine doctor, I simply recommend that my patients pick a type of exercise that they enjoy and then do it regularly. If 30-50 minutes of exercise, 5-days per week doesn’t alone improve insulin resistance, then the problem isn’t exercise and we need to look more broadly at overall health and lifestyle.
• Yoga: Yoga, while not as effective as resistance training for glucose control, still offers benefits by reducing stress and improving hormonal balance. A review study published in Evidence-Based Complementary and Alternative Medicine found yoga to improve menstrual regularity and reduce symptoms of PCOS.

Environmental Toxins: A Hidden Factor in Polycystic Ovarian Syndrome

Endocrine-disrupting chemicals (EDCs), found in plastics, personal care products, and household cleaners, are major contributors to hormonal imbalances in women with PCOS. These chemicals mimic estrogen in the body, exacerbating symptoms such as weight gain, acne, and irregular periods.

To minimize toxin exposure:

• Switch to BPA-Free Products: Avoid plastic containers and opt for glass, stainless steel, or BPA-free plastic.
• Use Natural Personal Care Products: Choose cosmetics and toiletries free of parabens, phthalates, and other chemicals that disrupt hormonal balance. Screen the safety of personal care products using databases such as the Environmental Working Group or Yukka.
• Air Purification: Invest in a high-quality air purifier to reduce indoor pollutants and environmental toxins.

Stress Managementas a Treatment for Polycystic Ovarian Syndrome

Stress drives androgen production from the adrenal glands, worsening symptoms like acne, excess facial hair, and hair thinning in PCOS. High cortisol levels also impair insulin sensitivity, further compounding metabolic issues.

3 Strategies for Stress Management:

1. Mindfulness Meditation: Daily mindfulness practice reduces cortisol levels and improves emotional well-being.
2. Breathwork: Controlled breathing exercises activate the parasympathetic nervous system, helping to manage stress and reduce its impact on hormone production.
3. Regular Physical Activity: Engaging in activities like yoga, walking, or swimming helps balance stress hormones and improves mental clarity.

Supplementation as a Treatment for Polycystic Ovarian Syndrome

In my practice, supplements play a huge role in managing patient health, particularly with PCOS. Here are some of the most common supplements I use to treat PCOS, and the research that backs them up:

• Inositol: This supplement, specifically in the form of myo-inositol and D-chiro inositol, has been shown to improve insulin sensitivity and ovarian function. The research pretty much shows a consensus on the effectiveness of this supplement across subtypes of PCOS. (Here’s one example.)
• Licorice Root: Licorice has anti-androgenic properties that can reduce elevated testosterone levels, improving symptoms like acne and excess hair growth. Much of the research on licorice has been done on rats, but we also have strong data on its use traditionally in treating PCOS.
• Peony Root: Peony has been used in Traditional Chinese Medicine to regulate menstrual cycles and support ovarian health. This herb is particularly useful for adrenal-driven PCOS and improving fertility.

By incorporating these strategies into a personalized treatment plan, functional medicine addresses PCOS from all angles, targeting not only the symptoms but also the root causes of the condition. Whether through dietary changes, targeted supplements, or stress management techniques, functional medicine provides a comprehensive, sustainable solution to hormonal imbalance in PCOS. Polycystic Ovarian Syndrome is a complex and multifaceted condition, but with functional medicine’s holistic approach, women can find relief and restore hormonal balance. By addressing lifestyle factors like sleep, nutrition, exercise, and stress, and incorporating smart supplementation, functional medicine provides a path toward long-term wellness.

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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The post Treating Polycystic Ovarian Syndrome with Functional Medicine appeared first on Dr. Alexandra MacKillop.

In this post, we’ll explore the most important foods to avoid for each type of PCOS from a functional medicine perspective, while also offering evidence-based supplements and beneficial foods to help balance your hormones naturally.

Types of PCOS

1. Adrenal PCOS

Adrenal PCOS is driven by excess androgen production from the adrenal glands. This type of PCOS is typically associated with high stress levels, poor adrenal function, and imbalances in cortisol. Women with adrenal PCOS may experience symptoms such as excess body hair (hirsutism), scalp hair thinning, acne, and irregular periods.

Foods to Avoid for Adrenal PCOS

• Caffeine: Excessive caffeine can stimulate cortisol production, exacerbating adrenal stress. It’s best to avoid caffeinated beverages like coffee and energy drinks.
• Refined Sugars: Refined sugars and processed carbs cause blood sugar spikes and crashes, which can lead to further cortisol imbalances.
• Alcohol: Alcohol places additional stress on the liver, impairing its ability to detoxify and regulate hormones.
• Processed Foods: These often contain trans fats and additives that may disrupt hormone function and contribute to inflammation.

Beneficial Foods for Adrenal PCOS

• Adaptogenic Herbs: Foods like ashwagandha, maca root, and holy basil can help regulate cortisol levels and support adrenal health.
• Healthy Fats: Avocados, olive oil, and omega-3-rich foods (like salmon and flaxseeds) nourish the adrenals and promote hormone balance.
• Leafy Greens: Rich in magnesium, spinach, kale, and Swiss chard help calm the nervous system and reduce stress.

Supplements for Adrenal PCOS

• Ashwagandha: Known for its adaptogenic properties, ashwagandha can help lower cortisol and support adrenal function.
• Vitamin C: High-dose vitamin C can reduce cortisol levels and improve adrenal function.
• B Vitamins: B5 and B6 are especially helpful for adrenal support and stress management.

2. Post-Pill PCOS

Women with post-pill PCOS develop symptoms of PCOS after discontinuing birth control pills. The synthetic hormones in birth control pills can suppress natural hormone production, and once the pill is stopped, the body may take time to rebalance itself. Common symptoms include acne, hair thinning, and irregular cycles.

Foods to Avoid for Post-Pill PCOS

• Soy: While soy is a good source of plant-based protein, it can interfere with estrogen levels and disrupt hormonal balance, particularly in women who have just stopped taking the pill.
• Dairy: Some women find that dairy exacerbates acne and hormonal imbalance due to its potential to increase androgens.
• Refined Grains: White bread, pasta, and other refined grains can spike blood sugar, which in turn elevates insulin levels and can worsen hormonal imbalances.

Beneficial Foods for Post-Pill PCOS

• Cruciferous Vegetables: Broccoli, cauliflower, and Brussels sprouts help the body detox excess estrogen and promote hormone balance.
• Flaxseeds: Rich in lignans, flaxseeds help balance estrogen levels by supporting estrogen metabolism.
• High-Fiber Foods: Fiber-rich foods like oats, quinoa, and chia seeds can help regulate insulin levels and improve digestive health.

Supplements for Post-Pill PCOS

• Inositol: A combination of myo-inositol and D-chiro-inositol can help improve ovarian function and regulate insulin.
• Zinc: Zinc supports healthy skin and can reduce acne related to hormonal imbalances.
• DIM (Diindolylmethane): Found in cruciferous vegetables, DIM supports the body’s ability to detoxify estrogen and may help with hormonal acne.

3. Inflammatory PCOS

Inflammatory PCOS is marked by chronic low-grade inflammation throughout the body. This type of PCOS is often associated with symptoms like weight gain, acne, fatigue, and insulin resistance. Chronic inflammation can exacerbate the symptoms of PCOS and interfere with hormone regulation.

Foods to Avoid for Inflammatory PCOS

• Fried Foods: High in trans fats, fried foods can increase inflammation in the body and contribute to insulin resistance.
• Sugar-Sweetened Beverages: Sodas, energy drinks, and even sugary fruit juices can spike blood sugar and increase inflammation.
• Processed Meats: Bacon, sausages, and hot dogs are often high in inflammatory omega-6 fatty acids and preservatives.
• Artificial Sweeteners: These can disrupt gut microbiota and promote inflammation.

Beneficial Foods for Inflammatory PCOS

• Turmeric: Contains curcumin, a potent anti-inflammatory compound that can help reduce inflammation in the body.
• Berries: Blueberries, strawberries, and raspberries are packed with antioxidants that reduce oxidative stress and inflammation.
• Omega-3 Fatty Acids: Fatty fish like salmon, sardines, and mackerel are rich in omega-3s, which help reduce inflammation.

Supplements for Inflammatory PCOS

• Curcumin (Turmeric): An anti-inflammatory powerhouse that can help reduce systemic inflammation and improve ovarian function.
• Omega-3 Fatty Acids: Supplements like fish oil can significantly reduce inflammation and support overall hormone balance.
• Vitamin D: Low levels of vitamin D have been associated with inflammation and insulin resistance in PCOS.

4. Insulin-Resistant PCOS

Insulin resistance is one of the most common underlying factors in PCOS. When the body becomes resistant to insulin, it leads to higher levels of circulating insulin, which can worsen hormonal imbalances, increase androgen production, and contribute to weight gain, fatigue, and acne.

Foods to Avoid for Insulin-Resistant PCOS

• High Glycemic Index Foods: Foods that spike blood sugar, such as white bread, pastries, and sugary cereals, should be avoided.
• Trans Fats: Found in many packaged snacks and fried foods, trans fats can worsen insulin resistance and increase inflammation.
• Refined Grains: These foods cause rapid spikes in blood sugar and insulin levels, exacerbating insulin resistance.

Beneficial Foods for Insulin-Resistant PCOS

• Low-Glycemic Index Foods: Non-starchy vegetables, legumes, and whole grains help stabilize blood sugar levels and improve insulin sensitivity.
• Magnesium-Rich Foods: Spinach, pumpkin seeds, and almonds are great sources of magnesium, which can help improve insulin sensitivity.
• Cinnamon: Known for its ability to improve insulin sensitivity, cinnamon can be added to smoothies or oatmeal.

Supplements for Insulin-Resistant PCOS

• Berberine: An herbal supplement that has been shown to improve insulin sensitivity and regulate blood sugar.
• Magnesium: Magnesium supplementation can help improve insulin sensitivity and reduce the risk of developing type 2 diabetes.
• Alpha-Lipoic Acid: A potent antioxidant that can enhance insulin sensitivity and improve metabolic function.

Personalizing Your Diet for PCOS

Whether you have adrenal, post-pill, inflammatory, or insulin-resistant PCOS, a functional medicine approach focuses on addressing the root causes of your hormonal imbalance through diet, lifestyle, and targeted supplementation. By avoiding inflammatory foods, refined sugars, and processed carbs, and by incorporating hormone-balancing foods, you can help mitigate the symptoms of PCOS and support long-term health.

Remember that everyone’s experience with PCOS is unique, so it’s important to work with a functional medicine practitioner or healthcare provider to customize your diet and supplement plan for optimal results.

By understanding the type of PCOS you’re dealing with and adjusting your diet accordingly, you can reclaim your health, balance your hormones, and feel empowered to manage your symptoms effectively.

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 Use Supplements for PCOS appeared first on Dr. Alexandra MacKillop.

For women in particular, one of the biggest reasons for hair loss on the top of the head relates to hormonal imbalances attributed to a condition called PCOS, which has four different subtypes. When I am working with a woman in a clinical setting, PCOS hair loss is often one of the most frustrating symptoms that she wants addressed as quickly as possible.

In this article, we will be discussing reasons for hair loss, how I evaluate for the causes of hair loss in my functional medicine practice, and how I help my patients reverse PCOS hair loss with natural treatment. We will also cover additional topics, such as how long it takes to reverse PCOS hair loss and whether or not the condition is likely to come back.

Diagnosing PCOS Hair Loss

The condition of hair loss itself is not hard to diagnose. In fact, it’s usually one of the easiest things to identify when a woman is experiencing it because you can see the evidence of it stuck t oyour clothing, clogging your vacuum or your shower drain, and strewn around your house. However, PCOS hair loss can also be insidious because it doesn’t always appear like patchy clumps of hair falling out. In fact, patchy hair loss of that nature is less likely to be related to PCOS and more likely to be related to another condition, like autoimmunity, nutritional deficiencies, or toxin exposure. Instead, PCOS hair loss tends to look more like thinning along the hair line and increased shedding overall.

One of the biggest challenges in diagnosing PCOS hair loss is differentiating the hair loss as specifically PCOS hair los as opposed to hair loss from other conditions. Keep in mind that not all women who have PCOS experience hair loss as a symptom. At the same time, a woman may have PCOS and also be experiencing hair loss due to other factors. Finally, a woman experiencing hair loss (and her doctor) may have suspicions of PCOS because of the hair loss, even though she might not have PCOS at all.

Treating PCOS hair loss means that a couple of things need to first be true: for one, she needs to have diagnosed PCOS and two, the hair loss needs to be because of the PCOS and not the result of other factors. Therefore, it’s important to conduct a thorough workup to make sure that other health conditions are not also at play. If those other health conditions are missed, treating the hair loss through the PCOS paradigm will result in the patient not getting better and maybe even worsening because of delayed diagnosis.

Reasons for hair loss apart from PCOS hair loss:

Here are some other common reasons that I see hair loss in my practice. Please keep in mind that this is not an exhaustive list, and it’s possible for a person to have more than one condition:

1. Hypothyroidism: Hormonal reasons are a big driver of hair loss, but those reasons are not always exclusive to reproductive hormones, such as PCOS hair loss. In fact, when I see a patient experiencing hair loss, my first thought actually is not PCOS, but rather a thyroid conditions. Hypothyroidism is more common among women with PCOS that among thos without it, and the thyroid is actually a big reason that my PCOS patients experience “PCOS hair loss” even though it’s truly driven by the thyroid.
2. Hashimoto’s and other autoimmunity: Hashimoto’s is one type of autoimmune condition, which is commonly responsible for causing hypothyroidism. However, I include it separately on this list because not all cases of hypothyroidism are caused by Hashimoto’s, and not all cases of Hashimoto’s end in hypothyroidism. Because Hashimoto’s involves an autoimmunt inflammatory response agains the thyroid and resultant thyroid damage, many people do end up developing hypothyroidism as a result of Hashimoto’s. However, the inflammation and self-reactivity associated with Hashimoto’s can also result in hair loss, even with normal thyroid function. Other autoimmune diseases such as inflammatory bowel disease (IBD), lupus, Sjogren’s syndrome, rheumatoid arthritis and others can also cause hair loss. Grave’s disease, which is an autoimmune thyroid condition associated with hyperthyroidism can also cause hair loss, all of which should be differentiated from PCOS hair loss.
3. Low Estrogen: Hair follicles don’t last forever. Instead, they experience a growth phase that can last several years and then they transition to a state of dormancy called the telogen phase, which lasts a few months before the follicle atrophies, dies and the hair falls out. Periods of low estrogen in women, such as those seen with hypothalamic amenorrhea, menopause, breastfeeding, and other health conditions shortens the growth phase of the hair, moving it into the telogen stage more quickly. PCOS is classically associated with excess estrogen, particularly when testosterone levels are very high, but other women experience low estrogen for other reasons, despite PCOS. In this case, the PCOS hair loss would be due to low estrogen levels rather than the high androgen levels.
4. Perimenopause: PCOS hair loss is classically understood to be caused by elevated testosterone levels, which cause atrophy of the hair follicles and shorten the growth phase. However, transient elevations in testosterone can also be caused by the early stages of perimenopause. While the causitive factor in the hair loss is the same (testosterone), high androgens in perimenopause that cause hair loss are not the same thing as true PCOS hair loss.
5. Nutrient deficiencies and restrictive dieting: Nutrient deficiencies cause hair loss because multiple micronutrients, like B vitamins, zinc, iron, vitamin C and countless others are essential for creating new hair (along with skin, nails, and maintaining function of the body’s organ systems.) In cases of significant nutrient deprivation, such as extreme dieting or chronic illness, nutrient deficiencies can develop which result in hair loss. (The nutrient deficiencies can also cause other health problems, like hypothyroidism, which contribute to hair loss as well.) It is also not uncommon for the ketogenic diet, vegan diets, and use of semaglutides like Ozempic to cause hair loss.
6. Post-COVID: Severe illness such as that seen from extreme cases of COVID-19 can also contribute to hair loss. The inflammation associated with the inflammatory response, or use of steroids in treatment, contribute to a shortening of the growth phase and resultant hair loss.
7. Inflammation: Apart from COVID-19, infections may trigger widespread inflammatory responses in the body that bring about similar changes to the hair follicles. These too need to be differentiated from PCOS hair loss, though keep in mind that blood sugar disorders including the insulin resistance seen in PCOS also contribute to hair loss.
8. Heavy metals and other toxicity: Heavy metals like arsenic, thallium, cadmium and mercury all contribute to hair loss by interfering with the mechanisms of hair growth. This causes weakening of the hairs themselves, increased breakage and early shedding. Thallium exposure is the most common heavy metal implicated in hair loss. Thallium exposure most typically comes from coal smelters, which release this toxin into the air, and it also becomes deposited in the soil and water. For this reason, it is essential to wash fruits and vegetables and use a high-quality water filter to ensure that what you are drinking is safe.
9. Hormonal birth control: Hormonal birth control is made from artificial progesterone, which tricks the body into not ovulating. This means that the body then is unable to produce natural progesterone, and progesterone deficiency also contributes to hair loss through a similar mechanism to low estrogen. At the same time, some types of these artificial progesterones are derived from testosterone and share characteristics to the hormone testosterone. In PCOS hair loss, testosterone receptors in the hair follicles respond to signaling from testosterone and cause atrophy of the follicles and resultant hair shedding. The artifical progesterones, derived from testosterone in the hormonal ocntraceptives, have a similar effect when they bind to testosterone receptors, causing a similar mechanism of hair loss as seen in PCOS hair loss.
10. Stress: High stress increases adrenal responses, which affect blood flow to the hair follicles. They also result in increased production of androgenic stress hormones which affect hair follicles similarly to high testosterone levels in PCOS hair loss. High stress can also induce an adrenal form of PCOS and contribute to PCOS hair loss through that mechanism.
11. Certain medications: like chemotherapy drugs which notoriously cause hair loss, use of steroid medications, antidepressants such as fluoxetine (Prozac) and lithium, blood pressure medications like ACE inhibitors, blood thinners, seizure medications, and Accutane can cause hair loss on the top of hte head, which need to be distinguished from PCOS hair loss. Many women with PCOS are taking these medications and don’t realize that their hair loss results from the medications instead of being the specific symptom of PCOS hair loss.
12. Eczema, fungal infections and other skin disorders: Inflammatory and infectious skin conditions can create inflamation that is pervasive enough to reach the hair follicles themselves. This inflammation and reactivity damages hair follicles and can cause weakness, breakage, shedding and hair loss. PCOS and the accompanying blood sugar imbalances increase risk of developing fungal infections like candida, including infections on the scalp, which can contribute to hair loss but should be differentiated from true PCOS hair loss.
13. Childbirth: During pregnancy, the body lengthens the telogen stage of hairs. This means that hairs which would ordinarily reach the end of the growth and telogen stages and fall out instead do not. They remain in the telogen stage, not growing necessarily but not falling out either. Then, after the baby is born and the hormone and immune system shift, the hairs finally fall out, all at once. For some women, this effect is delayed until breastfeeding ceases, or until periods return. In women with PCOS, return to menstruation can take much longer and women may incorrectly believe the hair loss is due to PCOS hair loss because so much time has elapsed since childbirth. This is why accurate testing and clinical workup are important for making a diganosis.
14. Hair treatments: Use of hair dye, particularly hair treatments containing bleach, chemical straightening products, and heat treatments like hair dryers, flat irons, curling irons, and even washing hair in very hot water all cause dryness and damage to the hair itself. This weakens the hairs, increasing breakage and making it more difficult for hair to grow long. This can look like hair loss, especially when the breakage occurs close to the scalp. Hair breakage can also be increased with aggressive hair brushing techniques, tight ponytails and hair styles involving the hair pulled back, frequently wearing hats and barrets, sticky elastics or clips can also pull and snap hairs.

PCOS Hair Loss

The “true form” of PCOS hair loss results from elevated androgen levels. However, keep in mind that the condition of PCOS can also contribute to hair loss as mediated through inflammatory changes, blood sugar problems, and changes in other hormone levels. However, when we are talking about the effect of PCOS in causing hair loss, we are referring to the form of PCOS hair loss that is caused by elevated androgen levels.

As I touched on earlier, elevated androgen levels induce a process called “follicular miniaturization,” in which the high androgens bind to testosterone receptors in the hair follicles, causing them the atrophy and break down. The result is thinner hairs, weaker hairs, and eventual death of hte hair follicles. This leads to not only increased hair shedding but fewer healthy and functional hair follicles in general.

Treatment for PCOS Hair Loss

When the hair loss has been proven to be truly the result of high androgens in PCOS, treatment is necessary in order to slow the progression of the condition. Because of the mechanism of testosterone in PCOS hair loss, treatment necessitates strategies for reducing androgens, increasing blood flow to the scalp to restore follicle function, and providing increased nutrients to allow the hair follicles to remain healthy and grow health hair.

In my functional medicine practice, I treat the different types of PCOS differently. Understanding what is driving the high testosterone levels is imperative for lowering them. So, we always start there. However, there is good evidence that the following strategies are also implicated in reversing the testosterone-associated changes that take place in PCOS hair loss:

1. Spearmint Tea: In PCOS hair loss, testosterone converts into a highly androgenic hormone derivative called DHT. Spearmint tea, particularly when enough is consumed, reduces the conversion of testosterone into this highly androgenic form which damages hair follicles. The research shows that drinking at least two cups of tea daily is needed to see effects. I recommend always drinking organic, looseleaf tea to reduce exposure to toxins.
2. Zinc: Similar to spearmint, zinc has been shown to reduce converstion of testosterone to DHT. It also reduces the responsiveness of testosterone receptors in the hair follicles of themselves so that the androgens have less of an effect in causing PCOS hair loss. It’s important to note that the effects of zinc supplementation in PCOS hair loss are not simply the result of correcting zinc deficiency, though many people are unknowingly deficient in zinc. Instead, the supplementation improves PCOS hair loss regardless of deficiency. However, it is possible to overdose on zinc, so it is important not to exceed supplementation past 80 mg daily, and to be mindful of the fact that excess zinc supplementation can create copper deficiency, which may also cause hair loss. In my practice, I recommend starting with 30 mg of zinc bisglycinate or zinc picolinate which are superiorly absorbed compared to other forms.
3. Saw Palmetto: Like spearmint, saw palmetto reduces the conversion of testosterone into DHT via the enzyme 5-alpha reductase. For this reason, it’s not necessary to supplement with both of them in order to control hair loss. Instead, I usually start my patients on one or the other. However, different people respond differently to them, so sometimes we prefer to use multiple strategies on the front end and cut back. Because of the timeline required to control PCOS hair loss, this solution is appealing to some patients.
4. Green Tea: Whereas saw palmetto and spearmint reduce conversion of testosterone to DHT, green tea reduces androgen levels in general. This is important because hair follicles are not the only part of the body impacted by the high androgen levels. Green tea is therefore a good solution because of its ability to treat PCOS, instead of focusing primarily on PCOS hair loss.
5. Red Reishi: This adaptogen funcitons similarly to saw palmetto and spearmint in blocking the 5-alpha reductase enzyme. However, being an adaptogen, it also provides other benefits to the body, particularly in improving the stress response, supporting the immune system, and reducing inflammation. I am inclined to prescribe this to patients when they are dealing with an inflammatory or adrenal form of PCOS, or if they have co-occurring health conditions such as those listed earlier.
6. Topical Rosemary Oil: Rosemary oil has components that block DHT, like many of the herbs listed above. However, the difference is that rosemary oil is applied topically to the scalp and massaged in, instead of taken orally. This allows more direct access to the hair follicles. It also contains compounds that stimulate the hair follicles to increase growth, and antioxidants that reduce the effects of other factors on causing damage to the hair follicles, in addition to the androgens in PCOS hair loss. Finally, topicaly application and massage stimulate blood flow which brings nutrition and oxygen, supporting the health of the follicles. I recommend applying a small amount of rosemary oil directly to the scalp, massaging for about 15 minutes, resting for another 15 minutes to absorb and then washing out. Be mindful that oils such as these may cause the hair to appear greasy, so be mindful when washing.
7. Red Light Therapy: Near infrared and red light laser therapy have excellent research to back up use for promoting hair growtih and slowing hair loss, regardless of cause. This form of light stimulates cells called fibroblasts, which produce hair growth factors and increase blood flow. The result is thicker hairs that grow more quickly, and even reversal of some of the atrophy-related changes in PCOS hair loss. Red light therapy is a great option for PCOS hair loss because it doesn’t require you to take a pill, and the devices used to administer red light therapy can be used for other applications as well. I personally use the NovaaLab red light laser, and this is what I recommend as well. If you want to use the NovaaLab laser and save 10%, use the following code(s) to get started:
   • NovaaLab Red Light Laser for targeted laser spot treatment (more potent)
   • NovaaLab Deep Healing Pad which can more easily be used to apply red light treatment to the whole head at once

How long does it take to heal PCOS hair loss?

Because PCOS hair loss so profoundly affects a person’s quality of life, one of the most pressing quesitons my patients have is how long it will take to heal the condition. PCOS itself is complicated, but the nature of how hair grows and falls out in the first place is even more so. Recall from our discussion above that PCOS hair loss comes from the effects of androgens, which cause atrophy of hair follicles that weaken the strands and death of the follciles themselves. The hormons also shorten the growth phase, and send the hair follicles into the telogen phase more quickly. The telogen stage lasts several months (often around 3) before the hairs fall out.

Treating PCOS hair loss at the root cause itself takes several months. Lowering androgens and lowering production of DHT can take several months, sometimes up to 6, to even start to see changes. Then, once the androgen levels change, the hair follicles themselves take time to heal. Once that happens, there’s still then a delay because of the telogen stage, of around 3 months. After that, we then need even more time to start to see hair regrowth.

Because of these complexities, starting to see changes in PCOS hair loss sometimes take up to a year or more. This will happen more quickly if PCOS has not been a problem for as long, because the longer the hair follicles have been exposed to the testosterone, the more time they will need to heal. It’s also going to take longer if other problems are also at play, such as those seen in the first list, like nutrient deficiencies, toxin exposure, or inflammatory conditions.

Among all the treatments outlined above for PCOS hair loss, I want to share that red light laser therapy produces changes the fastest. This is because rather than waiting for hormone levels to drop, the high-intensity laser directly reverses the effects of testosterone at the level of the hair follicles. This leads to faster healing while the additional time is taken to address the hormonal imbalances that cause PCOS hair loss. Remember, however, that because of the telogen stage of hair, even with red light laser therapy, it will require a minimum of 3 months to start to see changes in hair loss. Hair loss you’re experiencing right now is the result of the chemical state of your body at least three months in the past.

Overall, PCOS hair loss treatment is challenging and takes a long time, but that doesn’t mean it’s impossible, and it doesn’t mean you should give up hope. The fastest and most effective way to help PCOS hair loss is to make sure that you have the right diagnosis (and aren’t missing anything), and to treat the underlying root cause of the PCOS hair loss (high androgens) so that it doesn’t return in the future.

Healing takes time, and there are no quick fixes. Because of the time requirements, remember that there are no drugs or medications that can produce changes faster, so natural treatment really is your best bet. Be patient, have grace on yourself, and do the next right thing!

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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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 Understanding and Reversing PCOS Hair Loss appeared first on Dr. Alexandra MacKillop.

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.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

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

But first as a woman, and second as a functional medicine doctor, I definitely do not see this as an acceptable standard for care, mostly because I know that there are other options that are not only more effective, but also much safer than the pill. Let’s dive in…

A few things to keep in mind as you read this post:

There are many reasons for abnormally painful periods and this post covers just three of them. But more importantly, if you’re struggling with painful periods, or any other symptom, it’s extremely important that you discuss your concerns with a licensed healthcare provider. There are many factors that could be at play, and you deserve to be heard and cared for in the very best possible way.

3 Reasons for Painful Periods

As I noted above, there are many women’s health diagnoses that have period pain as a symptom—things like endometriosis, fibroids, PCOS, and more. For this discussion, we will focus on reasons for period pain in women who don’t have a formal diagnosis. However, even if you do have an existing diagnosis, addressing some of these issues may actually help improve your symptoms.

1) Hormone Imbalances

The menstrual cycle can be divided into two main parts: the follicular phase (pre-ovulation) and the luteal phase (post-ovulation). We typically think of estrogen as the “main” hormone of the follicular phase, and progesterone as the “main” hormone of the luteal phase, but really Both are present and working all the time, just at different levels.

Sometimes, the relative proportion of estrogen and progesterone (in relation to each other) fall out of balance, and this can cause symptoms like cramps and other forms of menstrual pain. For example:

During the luteal phase (after ovulation), the menstrual lining starts to build up in case the egg is fertilized. Estrogen’s job is to build up the lining, directing blood flow and tissue growth in the uterus, whereas progesterone’s job is to keep things from getting out-of-control, so to speak. If estrogen levels are disproportionately high in relation to progesterone levels (i.e. estrogen dominance), the uterine lining will become more robust, often leading to a heavy period with clots, which may be painful to pass. Additionally, high estrogen levels lead to higher levels of prostaglandins in the uterus, which causes higher levels of inflammation and pain (see point #3).

Estrogen dominance and progesterone deficiency are just two examples of hormone imbalances that can cause period pain. Other hormones like cortisol and thyroid hormones (especially hypothyroidism) affect the menstrual cycle and can cause symptoms such as pain.

2) Feminine Protection Products

I would give a TMI warning but really I don’t think periods should be a taboo subject anymore. Frankly, ever person alive is here because of the functioning of a woman’s reproductive system, and I think we all could stand to understand it a little bit more. So, yes…we’re going there.

Tampons are convenient, but not if they’re causing painful cramps—and yes, tampons can cause or worsen cramps if they aren’t inserted correctly. Take a look at the graphic above. The tampon pictured is right up against the cervix. When the uterus contracts to expel blood, it will bump up against the tampon causing pain, kind of how punching a wall hurts a lot more than punching into the air.

Instead, angle the applicator downward. By pointing the applicator downward (and relaxing during insertion), the tampon will be able to reach an area of the vagina called the posterior fornix, which is behind the opening of the cervix. Then, instead of bumping into the tampon, which is held firmly in place by the muscles of the vagina, it will slide past the tampon, which is much more comfortable.

However, some women have cramps no matter where the tampon is located. Alternatively, you can use pads or a menstrual cup. The Diva Cup takes a little getting used to (you’ve gotta be up close and personal with your lady parts) but rather than stopping at the cervix, it encircles it, eliminating any possibility of bumping and pain. The plus side of a menstrual cup is that it only needs to be changed every 12 hours, rather than 4-6.

Another reason women tend to tolerate pads or menstrual cups better is because most brands of feminine hygiene products contain preservatives and bleaching chemicals that can irritate the vagina, increasing the local levels of inflammation and causing pain. (More on inflammation in point #3). For this reason, I typically recommend keeping foreign objects out of the vagina and instead using external protection (pads), a menstrual cup (made from silicone), or organic tampons such as seventh generation, Rael, Tampax pure, or OB Organic.

3) Inflammation

When you have cramps What do you do?

If you handle it the way I did for many years, you pop an Advil, take a nap, and pray that you feel better in an hour. And, if you’re like me, it works.

That’s because napping and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen both reduce inflammation in the body, and it’s inflammation that’s responsible for period pain.

The inflammation caused by a period comes from chemicals called prostaglandins, which are naturally produced in the lining of the uterus to trigger contractions during menstruation and labor. In addition the triggering muscle contractions, these prostaglandins also create low-grade inflammation , which is perceived as pain in the pelvic area (i.e. cramps).

Whenever we have a localized area of inflammation, we have pain. This pain can vary in intensity, but in general, the higher the level of inflammation, the worse the pain is. That’s why bumping your shin on the corner of the bed hurts, but not as badly as breaking your leg would. The injury is much worse in the latter case. However, bumping your shin on the bed hurts more when you already have a bruise from doing the exact same thing the day before, or if you have a sore leg from running a marathon, or if your whole body is sore because you have the flu. That’s because in each of those cases, there is pre-existing inflammation in the body and the higher the level of inflammation, the worse the pain is.

The same is true with the localized inflammation in the uterus during menstruation. The naturally produced (and very necessary) prostaglandins in the uterine lining cause some inflammation, enough to produce mild cramping during the first couple days of a period. However, if there’s already a heightened degree of inflammation in the whole body, be it from chronic stress, poor nutrition, crash dieting, over-exercising, illness, or otherwise, the total amount of inflammation in and around the pelvis is higher. The higher the level of inflammation, the worse the pain is.

No matter the reason for the period cramps, whether due to a hormone imbalance, endometriosis, fibroids, or anything else, reducing the total amount of inflammation in the body will decrease the level of pain.

How to Naturally Reduce Inflammation

1. Acupuncture: this is probably my #1 recommendation for co-management of care with women’s health concerns in practice. Traditional Chinese Medicine is incredibly powerful in terms of its ability to help balance hormones, reduce stress, and decrease the inflammatory response.
2. Nutrition: Not eating enough, or enough of the right nutrients, can create imbalances that lead to heightened inflammation. Some of the most common nutritional deficiencies that predispose women to painful periods include omega-3 fatty acids, magnesium, and vitamin D. Talk to your doctor about having your levels checked.
3. Musculoskeletal Problems: Tight muscles are painful muscles, and if you’re dealing with chronically tight and painful muscles, that probably means you’re also dealing with high levels of inflammation in your whole body. I’m always amazed by how much better I feel when I rub epsom salt lotion into sore shoulders, massage out the knots in my neck with my acucurve self-massager, or stretching out on my foam roller.
4. Sleep: Poor sleep causes all kinds of problems, not just in terms of periods. Not getting enough sleep is interpreted by the body as a chronic form of stress, and pretty much all other health efforts will be blunted if you’re not sleeping enough. Adults need 8-10 hours per night.

In general, it’s not normal to feel awful during your period. While I’m a firm believer that menstruation is a natural process (and therefore it’s normal to feel different at different times of the month), but if your period is getting in the way of your ability function, that’s not okay. You deserve to find out what’s going on so you can feel your best and live a fulfilling life.

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 3 Reasons for Painful Periods (and Natural Treatment) appeared first on Dr. Alexandra MacKillop.