Swaying with PCOS – Part 1

Updated 10-6-22

PCOS, or Polycystic Ovarian Syndrome, is a very common condition believed to be suffered by 1 out of 10-15 women (and this number may actually be higher because many people have some symptoms of PCOS without having the condition full-blown). It occurs when hormones get out of balance in a woman’s body and can affect fertility negatively.

This hormonal imbalance can create challenges for swaying both pink and blue – for pink, PCOS not only makes it harder to conceive, but actually causes your hormones to shift in a way that favors boy conceptions, while at the same time making it more difficult to follow all three of the TTC girl diets. For blue, PCOS can make it tougher to conceive and the medications often prescribed for PCOS can make you more likely to conceive a baby girl. Plus, gaining weight on a blue-friendly diet may aggravate PCOS, unless great care is taken to gain muscle rather than fat. But don’t despair, there are ways that we can tweak the sways for both genders to help you stay healthy and conceive the baby you’ve been dreaming of.

What is PCOS?

PCOS (polycystic ovarian syndrome) occurs after the body develops a condition called insulin resistance. Normally, after you eat a meal, some of your food is converted by your liver into glucose, a very basic, chemically uncomplicated sugar that provides easy to use energy to the cells. This causes the amount of glucose in your bloodstream to skyrocket. But your body doesn’t use glucose well alone; it needs a second chemical, the hormone insulin, to be able to metabolize the glucose. Insulin helps glucose make it into your cells where it then can be used as energy. In addition, insulin bundles up extra glucose into a form called glycogen, which it then stores for later use. This process keeps your blood sugar from getting too high.

Unfortunately, after a lifetime of eating foods that provide the body with massive doses of glucose (refined carbs and sugar, eating excessive calories) our cells start to get a little bit “deaf” to the effects of insulin. They don’t respond to it at regular levels any more and your body must begin to produce more and more insulin to compensate for that. Lifestyle factors such as being overweight, constant snacking, and lack of exercise exacerbate this problem.

Over time, the pancreas, the organ that produces insulin, gets tired. It just can’t make enough insulin to cope with this situation and extra glucose builds up. Your blood sugar stays high all the time, makes it extra hard for your body to lose fat, makes it easier for your body to store fat, and this road eventually leads to Type 2 diabetes, heart disease, blindness, nerve damage, and kidney disease.

In terms of fertility, the excess glucose triggers an odd chain of events. High insulin levels stimulate the ovaries to make extra testosterone. This excess testosterone causes the signs and symptoms related to PCOS (see below), can stop you from ovulating, and can make the eggs you do ovulate, lower in quality and less likely to produce a viable pregnancy.

Why do we get PCOS, anyway??

Well, that’s a pretty stupid design, isn’t it?? The very thing we need to provide energy to our cells, can actually go haywire and render us infertile, even eventually KILL us!

PCOS, like Type 2 diabetes, is considered a “disease of civilization” meaning that humans in their native environment, probably didn’t get it (we’ll talk more about this below). PCOS was not even described by the medical establishment until 1935 and at that time it was a rare disorder. Yet it is currently so widespread that many doctors no longer refer to it as a disease and consider it more of a genetic variation. In fact, it is believed that 75-100% of all women would eventually develop PCOS if their diet and lifestyle promoted it strongly enough. PCOS is not unlike being overweight – for some of us, it happens more easily than for others, but it would probably happen to everyone eventually if our lifestyle encouraged it. Some women seem to develop PCOS more easily than others – certain ethnic groups and the women in some families are much more likely to develop PCOS than the general population. Some evidence indicates that the youngest woman in a family of mostly brothers may be more likely to develop PCOS than others are, but this is very far from set in stone.

Evolutionarily speaking, then, is there any POINT to PCOS?

Medical research is beginning to conclude that when a condition is widespread throughout the general population, that usually means that condition carries with it some sort of survival benefit that in humanity’s native environment; aided in survival and/or passing down genes to future generations.

PCOS is no exception – if food was scarce and you frequently went for days or even weeks without a good meal, the person whose body was the best at keeping blood sugar elevated for longer after eating and hanging onto every calorie it could in the form of fat, had a distinct advantage over the skinny mini’s who immediately burn off every scrap they put into their mouths.

Even higher testosterone itself carries with it survival benefits – a person who may need to struggle for survival, and even fight over scarce resources, NEEDS to be able to make testosterone. Testosterone in small amounts is imperative for building and maintaining muscle mass, and testosterone in women has been linked to higher sex drive as well. So if one person’s body was a little better at keeping T levels adequate even in times of scarcity, that person would have an advantage for competition for mates and resources, and may be interested in mating when others with lower T levels are not.

Beyond that, some genes are more functional in males vs. females but both genders still carry the genetic blueprints even if they are less important for one gender. An example would be nipples in men – they don’t strictly need them, of course, but since women DO need them, both sexes still develop them, just in different forms. PCOS may be a vestigial form of some metabolic process that is highly important to male survival, but in women serves either no purpose or one that is much less important.

One other side effect of PCOS that is important to us here is ~warning~ nothing other than my own speculation. It occurs to me that in a time of famine, if very little meat was available and people were subsisting largely on pure carbohydrates, the tendency according to most theories of gender swaying, would be for many more girls than boys to be born…maybe even exclusively girls if things got bad enough. If a culture turned its back on meat all together by choice or circumstance, and went entirely vegetarian, over time this could lead to drastic imbalances in the gender ratio. In this scenario, it would then be a “genetically smart” strategy to be able to produce an excess of sons in the face of a carb-heavy diet. So if one woman’s body takes a sudden excess of carbs and exchanges them into testosterone and then has 2 sons instead of 4 daughters, those lads may then have a very large genetic advantage – even IF due to PCOS, the woman was only able to achieve half the number of pregnancies! PCOS may be one mechanism by which Mother Nature balances gender ratio and part of the reason why gender ratio hovers at 50-50 regardless of a culture’s diet.

How do I know if I have PCOS??

The symptoms of PCOS include acne, weight gain (particularly, but not exclusively, the “apple” shape), trouble losing weight that may get worse when you eat a lot of carbs, hair growth on places like the face, chest, and neck, thinning hair on the top of the head, irregular, infrequent periods, bleeding between menstrual cycles, repeated ovarian cysts with pelvic pain (your doctor will see these cysts on ultrasound), and frequent positive OPK even when you’re not ovulating. MANY if not all women have some of these symptoms some of the time and do not have PCOS and others have no visible symptoms other than unexplained infertility but DO have PCOS.

For a real diagnosis, you must have your doctor run a series of blood tests that will measure your testosterone level, your blood sugar, your insulin levels, cholesterol, blood pressure, and also to rule out other things that can cause similar symptoms, like thyroid conditions. You will most likely also need a pelvic ultrasound to check for ovarian cysts (and just a warning to those who have never had this done, it is an internal exam and an ultrasound wand must actually be inserted into your vagina…this is a lot less scary than it sounds and the techs are very kind and sensitive to your feelings.)

It may be a good idea to have these tests run before you sway (especially if swaying for pink) if there is ANY doubt in your mind as to whether you have PCOS or even just mild insulin resistance, because the IGD, FGD, and “Crash and Burn” variation of LE Diet where people focus more on empty carbs, may aggravate PCOS and make it less likely to get your desired gender if you attempt to follow it. (The whole-grain, high-vegetable variation of the LE Diet is actually quite good for PCOS as is the HE Diet, with a couple of minor changes we will discuss below.)

If I DO have PCOS, what do I do?

First of all, don’t panic. I PROMISE that anyone can conceive a boy or a girl, even people with PCOS. Two of the most beautiful little girls I’ve ever seen belongs to a friend of mine with PCOS (and four handsome sons besides). Jon and Kate Plus Eight’s Kate Gosselin has 5 daughters and she has PCOS!! It may be a little more difficult for those with very severe PCOS to have daughters than it is for some others, and it may be a little more difficult to conceive sons while on meds for PCOS, but it is nothing that we can’t overcome.

Secondly, listen to your doctor. Most people are allowed and able to manage their PCOS thru diet and lifestyle changes and this is, of course, always the best option. However, if your hormone profile indicates medication, then don’t be afraid of taking it. For a pink swayer, it will help your sway. For a blue swayer, you will want to take the medications for a short period while you lose some weight and get your diet under control, and then see if you can wean off of them because these medications do tend to sway pink.

What are the prescription medications given to people with PCOS?

1)Metformin – This is a diabetes drug that will help lower your blood sugar, and in turn, your testosterone levels (sways pink)

2)Clomid/Femara – these drugs make you ovulate by temporarily lowering your estrogen levels and then your body raises them sharply to compensate. (sways pink and can only be used for 6 months in a row maximum.)

3)Birth Control pills – Often prescribed to regulate menstrual cycles in women with PCOS who are not currently TTC, and can help keep hormones working in a more normal fashion (sways pink)

4)Spirolactone – this medication lowers androgens, male hormones like testosterone and the precursor hormones to testosterone in your bloodstream (sways pink but unsafe during pregnancy and should be stopped at least a few weeks before you TTC.)

What if my doctor won’t give me medication for PCOS?

While we all want a quick and easy fix, PCOS responds very well for most people, to changes in diet and lifestyle (see below) that will only enhance your sway. Doctors only tend to prescribe medication for people whose PCOS is quite severe. If you’re not a person who requires medication, many herbs are used to help control PCOS (although I am not a super fan of the herbs – they have their own set of issues that make them a poor second choice to diet and exercises). If you are on medication, do not mix and match medication with herbs.

Please note – we have gotten poor results for conception with herbs. They have messed up the menstrual cycle badly, delaying or even stopping ovulation for a good many people who used them. Additionally, if a person assumes they have PCOS when they don’t, when their cycle is delayed due to other causes, taking herbs can exacerbate underlying problems. I no longer recommend taking herbs even with PCOS, and VASTLY prefer you guys control your PCO-tendencies via diet and exercise, or medication when needed. Still, I’m leaving this info here for those who want to read about it.

1)Vitex – a lot of women with PCOS have claimed great results with vitex. Others have reported that they believe it aggravated their PCOS (but that may be because their cycles were delayed for other reasons, reasons that Vitex can worsen). Since every woman’s body and hormone profile are unique, it’s likely that both are correct! If you are swaying pink and not on medication for your PCOS, taking 800-1200 mg vitex for a few months in the 2 W on (CD1-CD 13/14 EVEN if you do not ovulate on CD 13/14), rest of cycle off pattern, may help to make your cycles more regular. If you notice any negative changes, stop the vitex. (Vitex sways pink, but it is not terribly effective. For blue swayers, if it helps you get off the much stronger and more effective prescription meds, that is a good trade!!)

The exception to the 2W on, rest of cycle off pattern for vitex, is if you’re going to take Clomid. Since you cannot take both vitex and Clomid, you may wish to take vitex nonstop for 1-2 full months (while using reliable barrier birth control), then stop the vitex on CD 1 and start Clomid on CD 3. (Update – this has caused tons of trouble for people as they stopped ovulating on the vitex and then had to wait a long time to get their period so they could start their Clomid.)

2)Saw Palmetto – helps to reduce the levels of androgens in your body, that your body can turn into a form of testosterone it easily uses. Take 320 mg SP in the same 2 W on, rest of cycle off pattern and you can also use it nonstop for 1-2 months before starting Clomid as described in the Vitex section – but be aware it causes all the same trouble the vitex does. (sways pink, but is not very effective, and for blue swayers, if it helps you get off the much stronger and more effective prescription meds, that may be a good trade!!)

3)DIM – this is an enzyme found in cabbage, cauliflower, broccoli. It helps you metabolize estrogen, which is helpful for those with PCOS who often have too much estrogen in their bodies or develop excess estrogen when they work to lower testosterone. Lowering androgens like testosterone, sometimes has the side effect of raising estrogen. (It is not fully known how this supplement sways and I don’t recommend it for that reason.) The dose of DIM is 100 mg a day taken every day for at least 90 days before you want to TTC, then stop it once you wish to start TTC because your body needs estrogen to get pg.

4)DCI – this is a compound found in buckwheat that has been shown to lower insulin levels and testosterone, and improve ovulation in women with PCOS. 600 mg a day was the dosage used in the study that I read, but you may want to start at a lower dose and work up from there. (It is not known how this supplement sways, but lower testosterone indicates it would sway pink. I don’t recommend things I have not seen several people use, though, and I don’t recommend DCI.)

5)Chromium – a trace mineral that improves glucose and insulin levels. 200 mcg a day. (It is not fully known how this sways, thus I don’t recommend it.)

6)Cinnamon powder – ½ t per day thru diet (this is TEASPOON, a very small amount!) reduced blood sugar, triglyceride levels, LDL (bad ) cholesterol, and cholesterol overall. Lower blood sugar and cholesterol, indicates that cinnamon sways pink – but for blue swayers with PCOS, if cinnamon helps you get off the stronger prescription drugs, it’s a good trade. (Note – this sways pink but has lowered blood sugar so sharply that it made several people woozy and faint especially on the LE Diet. I only use it now in women with 50 lbs or more to spare.) In months you are planning on TTC, I would switch to 1/4 teaspoon at ovulation, and at positive pregnancy test, wean off the cinnamon completely by spacing doses further and further out till down to dietary amounts only.

7)NO LONGER RECOMMENDED L-Carnitine – Supposedly helps to get rid of glucose in the blood that your body isn’t metabolizing and also helps your body turn food into muscle, which will burn off more calories than body fat. (sways blue) NOTE – I no longer recommend this due to the fact that it raises T levels and may aggravate PCOS that way. Blue swayers, you will already have higher T levels and raising them more will not help your sway, it will only aggravate your PCO. If you have already bought some, you can give it to your husband if you’re swaying blue.

8)Magnesium – Magnesium may help preserve insulin sensitivity. 250 mg a day – no more! If that level gives you an upset stomach, go to 200 mg or even less. Some claim magnesium sways pink, but blue swayers, you should either get some mag in a prenatal vitamin or thru foods – trying to avoid magnesium is pointless because your body will simply rob your bones to get it and there will be absolutely NO change in the levels of magnesium in your bloodstream. If you’re taking a prenatal that will have enough magnesium in it, no need for more.

9)Fiber – People who eat high fiber and whole grains, have better insulin sensitivity than those who do not. Fiber also helps reduce estrogen and testosterone. Vegetarians have been shown to excrete more testosterone and estrogen in their feces than meat eaters because of increased fiber. Pink swayers should take extra fiber supps, while blue swayers, you should simply get ample dietary fiber thru foods – 9-11 servings of fruit/veg a day for blue is a great goal to aim at.

10)Vitamin X (exercise!!) – when you have PCOS you MUST exercise. Pink swayers, even if you cannot do the 60 min. a day, 6-7 days a week level of exercise, exercise is so good for lowering your blood sugar levels that you must include it even if it is moderate exercise. Blue swayers, moderate exercise and weight lifting will help control your PCOS and will also sway blue for you!

Pink swayers – I would feel ok about taking vitex, SP, DIM, DCI, magnesium, fiber, and cinnamon (please note, I don’t recommend any of these things any more except fiber and cinnamon for a small minority). And don’t forget Vitamin X!!

Blue swayers – I would feel good about taking Chromium, magnesium (via prenatal), and getting ample fiber thru foods. If I was trying to get off prescription medication for PCOS, I would consider the other supps, because they may still keep your PCOS under control but not as dramatically as the prescription drugs do (but it’s still best to control PCO with diet and exercise). And don’t forget Vitamin X!!

Drinking enough water can help both pink and blue swayers, because sometimes our bodies confuse thirst with hunger and we eat when we are actually just thirsty. You don’t have to drown yourself; you only need 8, 8 oz. glasses of water a day – about the size of a coffee mug.

ALL SWAYERS SHOULD TAKE FOLIC ACID OR FOLATE!!!!!

Things to avoid for everyone with PCOS…theoretically –

Caffeine (can spike blood sugar – green tea may be better than coffee/soda) PLEASE NOTE pink swayers – we have gotten great results with coffee for pink and it actually may improve insulin response over time. I now recommend continuing coffee for pink with PCOS provided you have made appropriate dietary changes and added exercise.

Conjugated Linoleic Acid (makes insulin resistance worse)

Vit. E (in supplement form, may make insulin resistance worse and also can inhibit cell division which is not good for fertility – both LE and HE Diets will provide ample Vit E thru diet anyway.)

Smoking (aggravates insulin resistance and lowers egg quality, contributes to miscarriage) NOTE to blue swayers – move heaven and earth to get your husband to quit smoking if you want a son!!! Smoking is terrible for sperm quality and it has been proven that men who smoke father more daughters.

Constant snacking (eating constantly keeps blood sugar elevated. Some people find that by eating less often, their insulin response improves because it’s as if they’ve given their insulin receptors a “rest”.) While you do need to eat regularly when swaying blue you should err on the side of having 3 meals a day and only one snack rather than 3.

Irregular meals when you NEED to eat (some people find that regular meals and snacks – not CONSTANT eating but every few hours – keeps their blood sugar levels stable and helps to avoid hunger and cravings for carbs.)

Eating refined carbs/sugars at all, and eating large amounts of even whole grains. (whole grains are ok in moderation because the fiber in whole grains helps rises and falls in blood sugar – but just watch your portions and limit yourself to 2-3 servings of whole grains a day)

Skim dairy…skim milk in particular. Milk (even non-skim) has a LOT of carbs in it in the form of lactose, which is a type of sugar that your body easily converts into glucose. Cheese, yogurt, and kefir are ok because the microorganisms that turn milk into cheese/yogurt/kefir also digest most if not all of the lactose. Cheese has NO carbs, while a cup of milk has 13 g carbs per cup…it’s easy to see how the high-milk intake of the IGD and FGD can really aggravate PCOS. Full fat dairy is better than skim. If you are sold on cal-mag and swaying pink, it’s best for you to get cal-mag via supps rather than drinking gobs of milk. This ONE THING – eliminating skim dairy – has made people who have never had a regular cycle in their lives see their cycle shorten and regulate.

Eating too many calories (pink swayers, you should be limiting calories to 1500-1800 (if you are very short or have a lot of weight to lose, you may drop down to 1200-1500, no lower) which will help your PCOS anyway. Blue swayers, you will have to aim for the lower end of the HE Diet guidelines. 2000 cals – this seems like a lot, but you should be exercising and even if you do not lose a pound, by virtue of adding exercise, you will be converting some body fat to muscle mass and improving your insulin resistance as you do. Blue swayers, if you have a LOT of weight to lose or your weight plateaus, you may even want to drop down to 1800 calories but no lower. It may even be best for you to take a year and lose weight safely and slowly at lower caloric intake, while adding muscle mass thru exercise, and then resume your sway at that point.)

Gaining weight (and in fact you should LOSE some if you can. Pink swayers, you should be losing a bit of weight anyway. Blue swayers, if you are lifting weights and eating enough protein, gradually reduce your weight by 5-10% of your body mass – you don’t need to waste away to nothing. Remember, you are trying to get off of medications that are swaying pink for you and a little weight loss may be just what the doctor ordered.)

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