Insulin Resistance & Infertility
Long term elevated insulin leads to insulin resistance. If you missed Part 1 that talked about insulin surges and root causes, then I recommend reading Part 1, but in general, this can happen in both the lean individual and the overweight. It is important to understand the signs of insulin resistance and use these signs to help monitor your progress.
You may be insulin resistant if:
- You eat and you get tired
- You eat and you get energized
- You get shaky between meals
- You crave sweets
- You crave bread
- You crave chocolate
- You need coffee in the morning
- You get headaches in the afternoon
- You stand up and get dizzy
As you change your diet and lifestyle, you should be able to remove some of these off of your list of symptoms and thus know that you are making progress. Infertility is a hard emotional and psychological battle in and of itself, but waiting and waiting without knowing if you are making any progress can be enough to want to give up. I recommend having a full list of symptoms and signs that you can monitor in order to keep your head up and know that you are on the right track.
STANDARD TREATMENT FOR PCOS
I am not a traditional physician, but based upon patient experiences and reading WebMD (just kidding but serious), the standard treatment for PCOS with regards to fertility most often begins with prescription medications.
Metformin, or Glucophage, is one of the common prescriptions utilized to help in PCOS. It is a diabetes medication that is used to help decrease blood sugar levels and insulin levels. Remember the natural version of metformin is diet and lifestyle changes and finding your cortisol triggers like allergens, inflammation, toxins and leaky gut.
Clomid, or Clomiphene is the most widely used fertility drug. The purpose of clomiphene is to induce ovulation in someone with irregular or non-existent cycles. It does this by blocking estrogen receptors in the brain (hypothalamus) which in turn tells the brain to make more LH and FSH, which often stimulates ovulation. When you have had chronically elevated estrogen which often leads to progesterone insufficiency, a common scenario in women and infertility, your estrogen levels don’t drop low enough during the second half of your monthly cycle to stimulate the brain at the right time. Also, if you are too stressed, you won’t make sufficient progesterone which won’t allow your body to support a fertilized egg. The drug choice is Clomid, but the natural choice is decreasing your estrogen detoxification in and out of the liver, while decreasing your stress and supporting the adrenals.
If I told you that these prescription approaches never work, I would be lying. But to say that they are neither natural nor holistic is completely accurate. With PCOS, often IVF is recommended, but if the core problem is a lack of ovulation, then I always recommend that you get ovulation started normally again and then give nature a chance. If IVF is still required, then your baby will benefit from a more balanced insulin and hormonal environment and you will benefit by having less risk of gestational diabetes.
Treatment for PCOS without consideration of fertility most often includes metformin and birth control pills. This is a short term remedy but not a long term solution. The reason is that when someone decides they want to get pregnant and stop birth control use, most of the time the PCOS symptoms rush back to their previous levels or more and infertility remains.
Only You Know You
I spend a lot of time with each patient because I feel that a 6-10 minute history isn’t enough. After doing a full 30 minute history, during my initial 2-hour appointment, I get to know each patient and without fail I learn something more about their history that often alters the treatment. Even after multiple hours of treatment and history, you will always know more than your physician about your body. This is important in the diagnosis and management of PCOS.
I put such an emphasis on PCOS in cases of infertility because; it is generally a diagnosis of exclusion. If you don’t check for it or simply know that you have it, you may not get to a PCOS diagnosis for quite some time.
It is important that each patient is examined for total body health, especially in PCOS and infertility because if you only look at symptoms like fatigue, then your doctor may be looking for thyroid issues or adrenal fatigue. If you only look at depression, then you may get an anti-depressant which doesn’t help your infertility. If you mention the symptom of acne, then you may end up on topical antibiotics or a prescription strength benzoyl peroxide. All of these prescriptions alter internal hormones and further cloud and complicate your individual picture of infertility. Using a natural and drug-free approach to infertility gives you the clearest picture of what is truly going on inside of the body.
The Natural Approach to PCOS and Infertility
PCOS isn’t a condition that develops overnight. If you had one insulin spike, then you wouldn’t develop PCOS. But, consistent and chronic insulin spikes lead to PCOS. Once you develop consistent insulin spikes or insulin insensitivity, it’s not an overnight trip back to health. Restoring your blood sugar regulation takes dedication and discipline, but I believe there is no better motivation than trying to conceive.
One caveat is that while some patients may get pregnant almost immediately, it may take many months to conceive for others. The benefits of taking control of your blood sugar is not only that you will have a regular menstrual cycle, decreased androgens (excess hair) and increased fertility, but you will have a better, more healthy, body composition of lean muscle and a decreased risk of diseases later on in life.
Diet for PCOS and Infertility
In PCOS and infertility I recommend patients go at this 100%. The concept is simple; lots of vegetables, healthy meats, good fats and organic foods. This is one time when I don’t let the excuse of healthy food being expensive come into play. If you can conceive without something like IVF you are going to save 10-15 thousand dollars and if you still need to use IVF or a similar method, you will save money by having a healthier pregnancy and baby. So either way it is saving you money!
Your diet should be a Paleo-type diet with no grains, no processed sugars and overall, a significantly lower carbohydrate. The carbohydrate intake varies by person, but for the average female trying to fight PCOS and infertility, total carbohydrate load should remain between 50 and 100 grams of carbohydrates per day. For all trying to conceive, I do recommend healthy dairy sources of fat, including healthy raw milk and grass fed butter.
A Lifestyle of Stress
Much of what needs to be changed has to do with stress. It has to do with emotional, physical and chemical stress. If you have a stressful job, you may want to consider taking a vacation. If you have other relationships that are stressful, mend those relationships. If you have pain anywhere in your body, that is also a form of stress. Do what you need to do to become pain free. Chemical stress is where the diet and organic eating comes into play. Elimination of toxins from cosmetics, toothpastes, and other household products will help too.
Lastly, if you are stressed about getting pregnant, try and mitigate that by coming up with a plan that includes a physician that is knowledgeable about holistic health and taking a total body approach and can help you with your PCOS and possible other imbalances. You can start your diet and lifestyle modifications on your own, but once you have those under control, finding someone that can help will provide the best results.