Are you affected? The often hidden barrier to conception: PCOS

A lot of us are affected by this, numbers seem to be rising, but it is also not necessarily obvious if you have it. It is also the number one cause of infertility in couples seeking treatment. Time to get educated:

Polycystic Ovarian Syndrome or PCOS:

‘PCOS is becoming a more prevalent disorder among women of reproductive age’ (1)

It is one of the most common causes of infertility yet it is estimated that as many as 50% of sufferers don't realise they have it.

Despite being super health conscious myself: I was one of them….

PCOS is a tricky one. It's tricky to diagnose, has many symptoms (which can be caused by other things) and conditions that come alongside it (blood sugar issues being just one). We still aren’t entirely sure what causes it, although the suggestion currently is that, once again, it is a combination of genetic and environmental factors.

PCOS is once again a condition where your hormones are out of balance - a common issue in today’s world (Click here to find out more)

I know first hand all about this as I suffer from it myself, and it wasn’t until my early thirties that I was diagnosed. It is also the ‘most common cause of menstrual irregularity that lead to infertility’ and it is the cause of 30% of infertility in couples seeking treatment (2)

So, how do you know if you are affected?

Well, it is quite tricky as many of the symptoms (especially if they’re mild) may be blamed on other things or go unnoticed - which is exactly what happened to me. It was only when I tried to get pregnant that I was actually diagnosed by my gynaecologist.

The most common symptom is cycle irregularity or missed periods (which happen when you don't ovulate). I for one had very long cycles -  often around 36 days - and during times of stress no periods at all (which I just put down to being ‘one of those things’ or down to weight loss which came with stress).

Other common symptoms: (and you can experience some, all or even none!)

  • Unwanted hair growth

  • Ovarian cysts (although not everyone gets these despite the name)

  • Issues with weight gain: particularly visceral areas (think lower belly)

  • Thinning hair

  • Fatigue/low energy

  • Skin conditions and acne

  • Mood issues: anxiety, mood swings and feeling depressed

  • Headaches

  • Sleep problems (there are links to sleep apnea)

  • Painful periods

I personally experienced sleep issues, anxiety and irregular periods which I chalked up to my high pressured job and general pressure that I put on myself - turns out that it wasn’t just that - but explains how it can be easily missed….

The trouble with this condition is that it can (depending on the severity) come hand in hand with a whole host of other issues (we aren’t quite sure yet on which causes which) but it has been linked to metabolic issues, obesity (affecting 30% of PCOS patients), insulin resistance, cardiovascular risk and mental health issues.

Sounds uplifting (not!) - so what can you do about it?

Well first and foremost diet and exercise has been shown to be effective at managing and improving the symptoms. I managed to eliminate all of the cysts on my ovaries and the symptoms via this method. I also have a baby boy now so just goes to show it doesn’t have to always mean infertility.

Here are some ways to improve the situation:

One of the very first things to take a look at is your sugar consumption. There is a strong correlation between PCOS and blood sugar and insulin issues. Meaning that often you have too much sugar in your blood, too much insulin produced and therefore over time a reduced sensitivity to it. 101 has to be to cut back on refined sugar, processed foods, sweeteners and instead go for low glycemic index (GI) whole foods and grains instead. Helping regulate your own blood sugar is a no brainer - for PCOS management - and for your health overall. I personally found a huge benefit in my period regularity and symptoms by cutting out refined sugar from my diet and focusing more on low GI foods.

Eating whole foods that have anti-inflammatory properties are the second step:

‘Inflammation is found in PCOS patients who are obese as well as non-obese. Women with PCOS of normal weight have a higher buildup of fat in the visceral area compared to other parts of the body. This distribution of visceral adiposity in non-obese women has been shown to be correlated with increased insulin resistance and is probably a causative factor of low-grade inflammation in these patients. These data suggest that obesity does not need to be present in a PCOS patient to experience low-grade inflammation’.

Translation: inflammation will only make this situation worse. (Click here for a reminder why inflammation is not something good and what to do about it).

Foods to avoid that inflame:

  • Refined Carbohydrates: think white bread, cakes, biscuits.

  • Fried Foods

  • Fizzy drinks

  • Red Meat

  • Margarine

  • Processed meats and foods

Foods that fight inflammation that you should eat more of:

  • Green leafy vegetables (containing Polyphenols)

  • Nuts

  • Olive Oil

  • Tomatoes

  • Dark berries: strawberries, blueberries, raspberries

  • Fatty fish: sardines, mackerel, tuna and salmon

Balancing your hormones with your diet is the other way to go. We know that PCOS relates in part to hormonal imbalance and we also know that these days processed food does not help with that. We also know that it is best to avoid meat that is not organic (as it can be full of artificial hormones and steroids) and similarly dairy that could have been treated with hormones. Avoiding Endocrine Disrupting Chemicals (EDCs) and pesticides are the other no-brainer here. That includes plastics. Drink water from a glass container and avoid storing food in plastics or eating from cans that are coated in plastic. Whole fresh food and filtered water stored in glass are two simple ways to achieve this. Read a lot more about this in the hormone section of this site.

We also know that balancing your hormones is important in relation to exercise - particularly when it comes to balancing glucose levels in the blood and insulin. You want a good balance of cardio (getting your heart rate up and using up some of the glucose stored and in your blood) and strength training (which builds muscle and builds up your resting metabolism). However, one thing to be mindful of is that too much HIIT will increase the level of cortisol in the blood (click here to be reminded why this is the enemy of conception). That being said, being overweight is not helpful either with insulin resistance and obesity strongly linked to PCOS so being physically active is important. Avoid a sedentary lifestyle - even if it is just walking more.

There has been a strong link between Vitamin D deficiency and PCOS. Vitamin D plays a role in reproduction and glucose metabolism (two things that are common issues for people with PCOS) low vitamin D levels are also associated with increased levels of inflammation and oxidative load both things we know are not good (click here for more on both). Studies have suggested that approximately 67%–85% women with PCOS have Vitamin D deficiency (3)

So supplements are the way forward?

Well - the current research using Vitamin D supplements for PCOS have not yet yielded conclusive results, we are not quite sure what is the cause and if low vitamin D causes PCOS or PCOS causes low vitamin D. However, what is for sure that being deficient isn't helpful for PCOS or anything else for that matter.

How do you boost your Vitamin D levels?

Well - if you’re like me, you’ve stopped the sun worshipping of days gone by and slather on the factor 50 in favour of better skin (and obviously because you don’t fancy skin cancer) you’re probably going to be deficient. Similarly, if you live in the Northern Hemisphere and work in an office you probably have low levels anyway. We know for many health issues it is better to have more rather than less Vitamin D - here are some things you can do:

It is worth knowing that there are two types: D2 (ergocalciferol) and D3 (cholecalciferol) which is usually manufactured using fish oil. Worth noting that D3 is usually absorbed more easily by the body when taken in supplement form.  

  • According to a report in the Journal of the American Board of Family Medicine exposure of arms and legs for 5 to 30 minutes between the hours of 10 AM and 3 PM twice a week can be adequate to prevent vitamin D deficiency. 4 It is worth noting that the vitamin D that is produced by your skin from sun exposure is D3.

  • However, if you’re not comfortable with sun exposure - natural dietary sources of vitamin D include salmon, sardines, mackerel, tuna, cod liver oil, shiitake mushrooms, and egg yolk (as a reminder watch going too high up the food chain too often with fish consumption given mercury).

  • Over-the-counter multivitamin supplements frequently contain 400 IU of vitamins D1, D2, or D3. Alternatively, over-the-counter vitamin D3 supplements can be found in 400, 800, 1000, and 2000 IU strengths. For better absorption it is recommended to take D3 in some form of oil (see more as to why below).

  • To prevent vitamin D deficiency in healthy patients, the 1997 Institute of Medicine recommendations suggested a daily vitamin D intake of 200 IU for children and adults up to 50 years of age; 400 IU for adults 51 to 70 years of age; and 600 IU for adults 71 years or older.  The upper limit recommended was 2000 IU daily. However, some experts consider this to be too low and recommend that children and adults without adequate sun exposure consume 800 to 1000 IU daily to achieve adequate serum vitamin D levels.

Vitamin D is fat soluble - which means it dissolves in fat rather than water so - it is best absorbed by the body when it is taken with an oil which is often the case so best to go with a supplement which is in some form of oil.

An additional helping hand?

Personally I found that both Ashwagandha and Maca really helped reduce my symptoms and rebalance my hormones. The science say they both work too - click on each to find out more. I also used Acupuncture which has been shown to have significant benefits for PCOS and hormonal imbalance.

If all else fails - do not lose hope. Diet and exercise have to be the first port of call when it comes to tackling your PCOS - however, if you are still facing issues getting pregnant despite this, your doctor may prescribe you Clomid. Clomid has had very good results when it comes to conception for people suffering from PCOS. In fact; ‘clomiphene citrate...has been shown to result in pregnancy 50% of the time after three cycles of treatment, and 75% of the time after nine cycles.’ (5)

The good news: I am a PCOS sufferer but I now have a son and my doctor told me at my last appointment that I am officially cyst free and my periods are now normal so I can tell you honestly and first hand, it is possible if you control your diet, lifestyle and exercise to make a big difference. Click here for some things that worked for me. Give it a try - if nothing else you’ll feel more energy and certainly healthier. Win Win.

  1. BARTHELMESS EK, NAZ RK: Polycystic ovary Syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). 2014: 6: 104-119

  2. BARTHELMESS EK, NAZ RK: Polycystic ovary Syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). 2014: 6: 104-119

  3. Zhoumeng Lin CH, EZEAMAMA A: Serum Vitamin D Levels and Polycystic Ovary syndrome: A systematic Review and Meta-Analysis: Nutrients. 2015 Jun: 7(6) 4555-4577

  4. KULIE T, GROFF A, REDMER J, HOUNSHELL J, SCHRAGER S: Vitamin D: An Evidence-Based Review: Journal of the American Board of Family Medicine.

  5. BARTHELMESS EK, NAZ RK: Polycystic ovary Syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). 2014: 6: 104-119


This article is for informational purposes only. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The information on this website has been developed following years of personal research and from referenced and sourced medical research. Before making any changes we strongly recommend you consult a healthcare professional before you begin.

Sarah Heywood