Posted on January 24 2021
'My doctor asked me to get pregnant and my PCOS will go away after having a child. Is this true?'
PCOS/ PCOD is complicated. Unlike other metabolic diseases such as Thyroid and Diabetes, there is no one clear test to check if you have PCOS. There could be a huge spectrum of symptoms that fall under the hat of PCOS.
For a medical diagnosis though, you must have a minimum of two of the three symptoms as mentioned below:
- Oligo –and/or anovulation (not producing eggs on a regular basis)
- Hyperandrogenism (increased male hormones)
- Polycystic ovaries (>12 or more follicles measuring 2 –9mm in diameter and/or increased ovarian volume on pelvic ultrasound scan).
However women with a genetic mutation for PCOS may have multiple other symptoms including (but not limited to):
- Unexplained weight gain.
- Mood disorders and depression.
- Acanthosis Nigricans (darkened skin: behind the neck, underarms, groin).
- Rapid hair loss and male pattern baldness in women.
- Excess body and facial hair.
- Lack of energy and drowsiness.
Though the above symptoms are just manifestation of fluctuating hormones, it is often difficult to classify someone as having PCOS or not.
As much as 30% of women with PCOS often remains undiagnosed. Needless to say, because this condition is so vague, there are many myths surrounding it. Let us talk about a few here:
1) Women with PCOS cannot conceive naturally.
MYTH: To a large extent like any other metabolic condition, PCOS symptoms are manageable with lifestyle changes and a structured nutrition plan.
Having worked with hundred's of clients, I can almost certainly say that making lifestyle changes alone is enough to start seeing symptom reversal. Click on the link below to hear Alison's story to successful pregnancies with PCOS:
While anovulation (not releasing eggs from the ovaries) continue's to be a major problem for women with this condition, working on lifestyle changes and nutrition can aid in symptom management and even natural pregnancy.
That being said, there will still be some women who might need to seek a fertility expert and explore alternative options. This is not to say that they cannot conceive, but just that they may need expert intervention.
I suggest visiting an expert after making the right nutritional and lifestyle changes and trying for a period of six- months at least to conceive naturally. Read this article below to understand the important lifestyle changes for PCOS:
2) Smoking has been associated with PCOS.
TRUTH: Not only smoking but hooka's/ sheesha's and even passive smoking contributes to PCOS symptoms.
Cigarette smokes have something called glycotoxins. These toxins not only increase your risk of heart diseases but also certain types of cancer's and PCOS.
Smoking increases AGE level's in the body. AGE's or advanced glycation end- products (glycotoxins) increase oxidation and inflammation in the body. They also accelerate ageing.
Women with PCOS have twice the circulation of AGE's in the body and also more receptors for AGE's in the ovaries than others. Even smoking as little as a couple of cigarettes per week is proven to be harmful.
Alternatively, switching to a low AGE diet (high in legumes/ beans and fruits) is proven to be effective in reducing oxidative stress and boost insulin sensitivity.
3) Soy is bad for PCOS and must be avoided.
MYTH: Soy beans have been villanised by fake sponsored studies by the dairy industries and the media. When in fact, nations with the highest consumption of soy beans and it's by products have the least cases of PCOS.
One of the reasons soy beans get such a bad name is because of miscommunication of words really. Soy beans are said to be high in 'estrogen' and PCOS is linked with fluctuating estrogen level's. When in reality, soy beans have no estrogen or estrogen like hormones at all.
Instead, soy beans have something called PHYTOestrogen. While there are multiple types of phytoestrogen and each of them contribute to a number of health benefits, soy beans have a particular one called isoflavones.
Isoflavones protect against various age related diseases such as:
- Cardiovascular diseases.
- Breast Cancer.
- Loss of cognition.
More about soy here. The bottom line is that not only is soy safe, but also beneficial when it comes to PCOS symptom management.
Besides this, there are certain gut bacteria that convert the isoflavones in soy into a compound called equol. If isoflavones are super beneficial compounds, Equol are like super super beneficial compounds. They protect women against hot flushes, menstrual cramps and improve bone health.
4) PCOS is always associated with a drop in estrogen (female sex hormone).
MYTH: PCOS is a hormonal disorder and often associated with an increase in androgen activity (male sex hormone).
All of us have a combination of the male and female sex hormone in the body. However, women tend to have higher levels of the female sex hormone estrogen. Incase of PCOS/ PCOD though, the male sex hormone anderogen tends to be elevated. This leads to symptoms like hair fall, facial hair- growth and infertility.
The activity of estrogen varies from person to person and is predominantly depended on your diet. There is a certain gut microbe that secretes an enzyme called β- glucoronidase. This enzyme is responsible to activate estrogen in the body.
Just the right amount of estrogen is essential for multiple functions in the body. Too much estrogen leads to symptoms like endometriosis (thickening of the uterus lining), extreme menstrual cramping and endometrial hyperplasia. The later condition raises your risk for endometrial cancer.
Too less estrogen leads to symptoms like irregular periods, weight gain and acne. Women with PCOS could have excess estrogen activity or very limited estrogen activity in the body. Both conditions however can be fixed with a good nutrition plan.
5) Pregnancy cures PCOS:
MYTH: I remember a child (19 year old) come to my center once with her mom. She was struggling with irregular periods and obesity. Her gynacologist told her not to worry about irregular periods and it will fix itself once she gets pregnant.
This is so far away from the truth and misleading. PCOS symptoms manifest due to your lifestyle and if you do not consciously work on fixing your lifestyle, the symptoms wont go away by themselves.
Firstly PCOS interferes with fertility. Women with PCOS have a harder time conceiving. Unless they make nutritional changes to change the gut microbiome, drop additional body fat and make lifestyle changes, conceiving is harder. Watch this video to understand how body weight plays a role in PCOS symptoms:
Women also may experience low libido (loss of desire to have sex) ,extremely sore breast tissues and depression. All of these add to feeling guilty and drop in mental health. At this point, it is better to work with a nutritionist who understand's hormonal fluctuation during PCOS and works to help women fix this issue before planning a baby.
Even if they do conceive, chances of developing gestational diabetes and high blood pressure are prominent among women struggling with PCOS. This puts the fetus at risk further.
It is best to make lifestyle changes first and plan a baby once PCOS symptoms stop showing.
6) You must start contraceptives to reverse PCOS:
MYTH MYTH MYTH: My team and I offer free consultations to clients a few times a week. Often I am consulting a client who does not believe the power of lifestyle changes and nutrition. They want to jump start on medication immediately.
You should see me poring my heart out to strangers on the phone and practically begging them not to get on medication. Watch one of my clients experience with contraceptives here:
Her story is not one of a kind example. Contraceptives are not a solution to your PCOS. In most cases they make your condition worse. Granted some women might need them in extreme cases. But they should only be considered after lifestyle changes and a right nutrition plan have failed to work (I have never come across such a case though).
Here is some fantastic advice by Dr. Nitu Bajikal with regard to making nutritional changes. Ask yourself before considering supplements, did you make all of the nutritional changes mentioned by Dr. Bajikal?
Reach out to me if you need help customising a meal plan as per your goals and lifestyle.
7) A low- carb diet is the best for PCOS symptom management:
MYTH: This is a very unidirectional way of looking at a much bigger picture. This school of though comes from people who believe that carbs cause an insulin spike in the body. This insulin spike has been linked to PCOS and weight gain.
But let us look at a bigger picture here. From point number 4, we know that the gut microbiome plays a vital role in estrogen modulation.
The gut microbiome feeds only on 'prebiotics'. Prebiotics are not found in proteins or fats, but in carbs alone. Particularly in fiber and resistance starch. You can read more about the same here:
You need prebiotics to fix your gut and have to get these from food alone. NOTE: these are not the same as PRObiotics. The only way you can get them is through fiber and resistance starch based foods.
Besides estrogen, androgen production is also modulated by the gut microbiome. Now that you know how important fiber is, eliminating the same from your diet and instead replacing the same with proteins and carbs has detrimental effects on the gut.
If you though carbs cause an insulin spike in the body, watch the below video to understand how animal proteins cause more of an insulin spike in the body than carbs do:
Fad low- carbs diets may help with temporary weight loss but lead to long term hormonal and gut dysbiosis. Stick to a whole- food plant- based diet instead that is high in fibrous carbs and resistant starches. My client thrive on the same while still continuing to drop weight.
8) Fibroids and ovarian cysts are irreversible:
MYTH: Fibroids are benign tumours found in the intramuscular walls of the uterus. ovarian cysts are more prominent around the ovaries and are empty egg sacks.
Women without PCOS may also have fibroids and cyst formations around the uterus. In fact, fibroids are so common that one in two women have it. Alcohol and red meat consumption, coupled with a low fiber diet increases the risk of fibroids.
In most cases, the above are not painful and disappear by itself as women age. Adding 300 minutes of physical fitness per week with a change in diet is often the first line of treatment for fibroids. Adding exercise alone has been correlated to a 40% decease in the rate of fibroids.
Medication and surgeries are only suggested with clients fail to follow lifestyle modifications and the pain from fibroids is unbearable.
Note here, not making lifestyle changes and instead opting for surgery is a short term result. If you continue to follow your old lifestyle, the cysts will return post surgery.
9) Women with PCOS always gain weight:
MYTH: While excess body fat has been associated with PCOS, its not necessary that women with PCOS are always obese.
There is something tricky here though. We predominantly have two kinds of fat distribution pattern in the body. The layer of fat right below our skin is called the 'subcutaneous fat'. This is visible to the naked eyes and we often associate this as being obese.
There are also fat cells distributed in between our internal organs. This kind of fat cells, called visceral fat, are not visible to the naked eyes but extremely dangerous. Look at this diagram to understand more:
People who have minimal amount of subcutaneous fat might appear skinny. But this does not guarantee that they have minimal visceral fat.
Excess visceral fat cells act the same way as subcutaneous fat cells do. They do are associated with hormonal fluctuations and excess androgen activity. Excess fat cells also reduce the activity of SHBG (sex hormone binding globulin) in the body.
SHBG is a type of protein that binds with excess sex hormones, including testosterone in the body and makes it available only when needed. Low SHBG activity in the body has been associated with excess free floating sex hormones in the body.
You can get an idea about your visceral fat by checking your body fat percentage (any good gym will have a BCA machine to test the same). Elevated cholesterol levels could also be associated with visceral fat.
10) PCOS is associated with low libido:
TRUTH: If you do not have the desire for sex or are experiencing painful intercourse, low libido and other sexual dysfunction, please please please understand that your feeling is valid and justified.
60% of women with PCOS experience sexual dysfunction of some sort. The reason for the same could vary from obesity to low estrogen activity. If you are taking contraceptives or other hormonal supplements, then they could add fuel to the fire too.
The stress of trying to get pregnant and irregular periods only makes symptoms worse. Instead of feeling insecure about your body or guilty about not satisfying your partner, it is best to have an open discussion with them.
I highly also suggest working with a therapist while you are making lifestyle changes to heal your body.
PCOS is reversible and very much treatable. Besides this, you are not alone. Year after year, PCOS cases are on the rise and this only goes to say how much lifestyle changes impact PCOS symptoms.
Feel free to reach out to me with further questions or comment below for any clarifications.
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