Episode #105: Working with Your Doctor: Maximizing Medical Support for PCOS

4:27.5 to 39:57.0
Episode #5- PCOS and Your Doctor

We spend a lot of time talking about natural ways to reverse our PCOS. But what about medical intervention and treatments that your doctor can prescribe? And how does that weave in to naturally healing your PCOS? Can they go hand in hand, or are they mutually exclusive? That is what we’re going to be talking about in today’s episode.

You’re listening to the PCOS Repair podcast where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help. Sprinkled in Hi, I’m Ashley Korcek, and with many years of medical and personal experience with polycystic ovarian syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their body in a whole new way.

With the power of our beliefs.

Our mindset and our environment and the understanding of our genetics, we can heal at the root cause.

First of all, let’s just kind of recap why a natural approach is so important. When we look at lifestyle, it’s the only way to entirely treat our PCOS. It gets to the root cause. It balances all the hormones. It alleviates and lessens all of the symptoms. It’s not picking and choosing one thing and not addressing other things. This is really important because when we start looking at medical approaches, that is not the case. So when we look at creating an environment that is healing to our PCOS, that nourishes our body, that allows our hormones to move back towards balance, that boosts our fertility, helps us to manage our weight and alleviate all the other symptoms. We aren’t just targeting a symptom with a bandaid. We are also setting ourselves up for less risk going forward. So, for example, if you’re wanting to repair your fertility and you’re using a lifestyle approach, not only do you balance your hormones, start to ovulate, have regular periods, find out you’re pregnant, but now you have also set your body up for a healthy pregnancy. You’ve reduced your risk of miscarriage, and you’re also reducing your risk of complications during pregnancy.

This is why I love the natural approach to PCOS, but it does not exclude medical assistance. My background is a medical provider. I have treated patients with all sorts of prescriptions and procedures, and I find medicine to be a modern miracle. There are so many amazing things that we can do for our patients, but it’s so important to help people find a way to be doing their part at home to create health so that they can thrive. Okay, so now that we kind of know where all these pieces fit together, let’s talk about how your doctor can fit into how you want to manage your PCOS. There is not a cookie cutter one way to do that. You get to have a choice. You get to choose how much or how little you want medical intervention. Now I urge you to always seek your doctor’s opinion or seek a second opinion if you aren’t sure you agree with what your doctor is saying or wanting to do because they have medical training, they are looking at your entire health, they’re looking at everything. And so you want to always take your doctor’s advice. However, this episode, we’re really going to be talking about how to have those conversations with your doctor so that the way that you want to manage your PCOS is not pushed aside with the way that they normally address PCOS in their clinic.

So when someone shows up with PCOS, a doctor may say, look, you’re having a regular period that puts you on the pill. Problem solved, right? Well, maybe that’s not what you want to do. There’s really no health benefit of going on the pill unless you’re not having periods. And your doctor may be concerned that you’re never shedding your endometrial lining. And that is the conversation you’ll want to have with them. So it’s not do it or don’t do it. You definitely want to have these conversations with your doctor, but just because the pill is their solution to irregular period does not equal you must go on the pill. So this is why we want to have these conversations. I hope that makes sense. But you definitely want to seek your doctor’s advice and counsel on all of these topics, including starting any sort of new diets or exercise plan, because they are the one that knows the most about your health. The information here in these podcast episodes is to help you to start asking the right questions so that you can start creating an environment that’s going to help your body thrive. It’s not to say don’t listen to your doctor or that you don’t need a doctor.

So don’t take that away from this because you definitely want to run these ideas by your doctor. But what we really want to see is how do these two parallel ways of managing your PCOS a natural approach and a medical approach. How can they dance together to create your best outcome? And how to create a method that’s going to work for you. Not only like success, as in you want to get pregnant and you get pregnant, but what is going to feel good for you. It’s not going to drive you crazy. That’s going to fit into your lifestyle, that makes you feel comfortable with the choices that you’re making for your body. So the first step is to really take ownership for yourself, of becoming informed and being an active participant in the decisions that you’re making. When it comes to your PCOS, a lot of the options, both medical and lifestyle, have choices. And so because of the syndrome, because everybody is different, because there’s no one size fits all when it comes to PCOS, the most important step is number one, and that is that you take an active role in the decision making because it’s usually not black and white it’s usually not.

This is the only solution that you can go with. It’s not a one choice situation. It’s really many options that you are going to have to make that choice. What I see the most is when women want a certain outcome, a certain treatment, more than a treatment, they want a certain result. They make three main mistakes, and that is they don’t stand up for themselves. They go to a various provider. Maybe it’s a traditional medical doctor, maybe it’s a functional medicine doctor. Maybe you’re listening to me and you’re thinking, I’m going to give you all the solutions. That’s the first mistake. You want to gather information, you want to get people’s input, and then you want to speak up and ask the questions that you need for yourself. Okay? Because no one else has the answers for you. But they have training, they have experience, and they can help you significantly. But you have to remember which one of these providers you’re talking to. Are you talking to your medical doctor that is thinking about diagnosis and making sure that everything that is potentially harmful is being taken care of? That’s why they are very important.

They’re really going to come into play when we talk about risk factors? Or are you talking to a functional medicine doctor who may be more prone to drawing the labs that you want drawn and monitoring your health in a preventative manner? Or are you listening to someone like me where you’re really looking at those other two options being great, but let’s focus on that environmental bubble of how we can be doing that extra piece that’s really going to give us a huge impact on creating health, balanced hormones and reversing our PCOS from a more natural standpoint. The second problem that I see or the second mistake that I see is opting for the bandaid treatment and expecting an all inclusive result. There’s nothing wrong with the bandaid treatment. Now, there are some side effects. There are some things to consider, but I hear a lot of people on social media bashing these bandaid treatments, such as birth control. There is a time and place for birth control. And each woman. We live in an age, luckily, where we get to make informed decisions. So the only mistake is not to take it or not to take it, but to make that informed decision of what is right for you at this point in your life.

And then the third mistake I see is people not getting the support that they need, not knowing where to get the support or not creating a team. I think a lot of times we look for that one person that’s going to give us all of the answers. And like I just alluded to there are experts in different areas. And when it comes to PCOS, there’s going to be people who can help you do a natural approach to PCOS management with nutrition and exercise and managing the bubble that you create for your environment. And then there’s going to be a part of your team that medically manages your PCOS, if you need any prescriptions, if you need any specific monitoring, if you’re trying to get pregnant, when you become pregnant, if any special tests or things need to be ordered to ensure that everything is going smoothly, you need someone who can do all of that medical in person health care treatment. And then you may want to include people who are going to support you, going to hold you accountable and things like that so that it can create a whole team. Sometimes I see women get frustrated when the one person, typically their doctor isn’t providing all of those things.

So I think it’s really important to realize that your doctor is not there to be your health coach. They’re not going to be your accountability buddy and cheer you on. And they’re really not the person to go to for nutrition advice. Now they may have some weigh in on that’s not a good diet for you. And this is why, in other words, if you have really high cholesterol, although there are stories of people doing keto and having to lower their cholesterol, there’s also some risk involved in that. And your doctor is probably going to recommend a lower fat, although maybe a low carb diet would be good, maybe it wouldn’t, but they’re not going to necessarily recommend a keto diet, but they are going to have some general direction to kind of point you in. But then that’s where their expertise stops and they may pass you on to or recommend a nutritionist. So in order to speak up for yourself and feel confident having these conversations with your doctor, there’s a couple of things that I really recommend leading into your appointment at your first appointment or leading into your next appointment, or if you’re feeling like you’re currently in limbo, because that’s what I hear from a lot of women with PCOS is they feel like they are in limbo, not sure if they should make an appointment or if they should follow up because they’ve been given the diagnosis with no real clear next step.

Maybe they were told you have PCOS. There’s not much we can do about it. You can take the pill if you want to come back when you want to get pregnant, and we’ll give you premade. I hear that scenario so often. And those women feel like they’re in limbo, they don’t know what to do. And ideally, the thing that they would do right then is just follow a lot of the steps that we talk about here on the PCOS Repair podcast, where they’re creating an environment that is really nourishing and supportive of their body’s needs. And then whatever their goals are, whether it’s increasing their fertility because they’re ready to get pregnant, whether they want to drop a few pounds, whether they want to go ahead and get laser hair removal, but they don’t want the hair to immediately grow back. They are setting themselves up for balanced hormones so that they can kind of move on past these PCOS symptoms. So going back to as you speak up for yourself and gain that confidence, it may start with having been given the diagnosis. And now it’s time to just make a follow up appointment because you are ready to have a deeper conversation with your doctor about your next step.

Some things that are really helpful when it comes to talking to your doctor is having tracked your cycle. When you say something like, I have irregular cycles, doctors hear that all the time. If you come in and you say, I had a 60 day cycle in February, I had gone since December, and then late February, I had a cycle, I had a period, and now it’s June, and I haven’t had one since. And I don’t remember exact dates, but that was a fairly typical pattern for the year prior. You’re going to get your doctor’s attention much more than if you’re just like I have irregular periods because a lot of women have irregular periods, but they bounce between 25 and 35 days. And we don’t get too excited about that in medicine. But when you start having many months between cycles, we start to become a lot more interested in running labs and working that out. So having that data and having that information is really helpful. Then think about the symptoms that you are having and specifically ask how each one of those that is bothering you, maybe not all of them are bothering you enough that you want to address them, but ask about how you would address each one of those.

So if facial hair is a concern, how would your doctor recommend addressing facial hair? Or if acne is a concern, or if weight is a concern, or if your cycle is a concern, ask them what they would offer, what they would recommend. You don’t necessarily have to take them up on it. And then my favorite question for the doctor is, how would that benefit me? Or another way of asking it is if they say, well, some people are candidates for this, but you’re really not a candidate for that, then you can say, well, what would make me a candidate for that? What is different about my situation that makes me not a candidate? And an example of this would be someone that says, well, sometimes I recommend metformin for people. And this isn’t exactly true because people go on metformin all the time. But bear with me on this example. They’ll say, I recommend metformin for a lot of people that need to lose weight. But your blood sugars are so low and in the normal range, I really don’t think it’s going to help you. So there you have an answer and you can say, okay, well, should we be checking my blood sugar, like every year, or how often should be checking my blood sugar to make sure that it remains low where I wouldn’t need metformin.

And again, you don’t have to choose to go on metformin, but these are the kind of conversations to help keep the ball rolling with your health care provider so that they don’t just go, okay, well, you have PCOS and sorry, make a follow up if you ever need anything else, because that’s a lot of times how these appointments go. So the next step is having an idea of where do you want this to go? And ideally, from a medical standpoint, what we would want is for your doctor to run initial tests. When they run initial tests, they are looking to both diagnose PCOS, but also to rule out other things. If they’re not running tests and they’re just running maybe one or two labs and going off of your symptoms, we might be missing something that’s mimicking PCOS but is actually a different disorder. Now maybe you treat it the same way and they get lucky, but maybe something in your symptoms is just not showing something else that’s going on. So really, the purpose of running labs and tests is to rule out other things. And PCOS almost becomes a diagnosis of exclusion, meaning we excluded all the other possibilities for the symptoms that you are experiencing.

And instead, since all of those were normal, we are left with PCOS. So to rule out other things, you’re going to want to make sure that you request a TSH, which is to rule out a thyroid disorder. Now ideally, you’re going to also run a T4 and T3 tests, and you’re going to work that up a little bit more. But most physicians are not going to order a full thyroid panel until they’ve at least checked a TSH. Now someone with irregular cycles, I would rather just run a full thyroid panel. You can request that. If they say, oh, no, TSH is enough, roll with it for now and then see where it comes back. If it comes back on one of the edges of the normal range inquire about it more, maybe ask that’s kind of on the edge there. Do you think it’s worth looking into that a little bit more? I would love to see them run a cortisol to rule out Cushing’s disease, especially if weight is a concern. So something like cortisol may be a difficult test to run. It’s a little annoying to the patient. Sometimes they do a urine cortisol, so sometimes doctors shy away from ordering these things.

But if you ask for it, chances are your doctor is going to be like, sure, we can take a look and see if everything looks okay. And then another one is prolactin to rule out a benign tumor that may be causing a hyperprolactinemia. Basically, you have high prolactin in your bloodstream. Sometimes this can be caused by usually a benign small tumor. But there are things that can cause this that are not PCOS related. So it’s worth looking to see if prolactin is elevated and everything else looks fine. Maybe that’s where your symptoms are coming from. Never a bad idea to order an HCG less so with people that already know they have PCOS. But a lot of times the symptom flare is because of pregnancy. And when you have irregular periods, it may seem normal that you haven’t had a period in a while. And it may not be because your periods are regular. It could be because you’re pregnant. So the other one that I like to throw out there again, some doctors are going to be happy to order this, and some are going to say not necessary is insulin like growth factor one, and this rules out excess growth hormone.

Now, the typical tests to test for PCOS are going to be your testosterone and SHBG, which is the sex hormone binding globulin, the AMH, which is the anti-mullerian hormone. This can often be elevated in PCOS, but a low value could actually indicate premature ovarian failure. And so these are going to be things where if you’re planning on having kids and that your doctor is like, oh, we’ll just give it some time, and then they run a lab like this. They may feel, let’s go ahead and start fertility treatments earlier. That’s why some of these labs that aren’t necessarily mainstream labs are still possibly important to be running, just to give you more information to work with. That said, if you’re done having kids, that may not be as important in your conversation with your doctor. Fsh, which is follicular stimulating hormone, luteinizing hormone. You’re looking really for the ratio between those two, all your estrogens, which may be normal or elevated in PCOS. And that’s actually kind of interesting to know if you’re a PCOS, estrogen dominant or estrogen normal. Those are kind of interesting things for you to know from a natural approach to your PCOS.

This is a really important one and one that I had never actually heard of all through PA school, even though I spent quite a bit of time in women’s health. First time I heard this one was when I was working in dermatology. I worked up so many women for PCOS because anyone that came in interested in laser hair removal or any female that was complaining of adult onset acne, our suspicion in the office was very high for PCOS, and so we would work them up partially from the standpoint of I didn’t want to be doing laser hair removal on someone if it was just going to come back without explaining to them what was going on and why they had the hair in the first place. And what to expect from treatment is going to be different than someone who does not have PCOS. Doesn’t mean I can’t treat them, but they may not have as much reduction permanently, they would still have reduction, but they may be looking at doing a lot more touch-ups in future. So one of the labs that my supervising physician recommended and that I would order on my patients when I was evaluating them for possible PCOS.

And if this is elevated, a lot of times we’re looking at more of a stress response and an Adrenal type of PCOS. And then this is the next section when we look at monitoring PCOS health that your doctor really is going to play an important role. So with PCOS comes several risk factors for developing things like type two diabetes, high cholesterol, and cardiovascular problems, as well as uterine cancer, endometrial cancer. And so we want to be watching for things like that, even if you’re not actively having other concerns about your PCOS symptoms. So that’s something that you would want to work out with your doctor. Now maybe it would look like something where they test you initially, they work you up for diagnosis, they rule out everything else. And then if you’re not looking to start infertility treatment and there’s really nothing else they’re going to do for you right now, then maybe they would set you up with a six month or a year follow up just to run some repeat labs to kind of see if anything is trending in a certain direction. For most of these labs, the normal range is large enough that it can be very difficult to determine if this is normal for you or if you have adjusted enough.

And with hormones, our bodies are very sensitive to it, and so a small adjustment can have a large impact. And so it’s really more important to see trending of labs more than just one lab at one date and time and then not check them again. So rechecking them is a good idea. Now rechecking them in a month probably not going to see a whole lot of change, maybe six months. But I would probably see most people push it out to a year, depending on what the objective is. Again, this is why it’s really important to have these conversations with your doctor. And then after a year, if everything is holding steady, they might push it to two years or three years and then eventually push it out to maybe testing every five years just to monitor especially these areas of risk factor with running a lipid panel, checking your hemoglobin a1c, and looking at are you developing any hypertension and so forth. Now I saved this one for the last because I don’t find it highly important, but that is to do an altar sound to assess the ovaries for cyst. I think a public ultrasound is a really good test for women who are considering infertility treatment or are having trouble getting pregnant or getting diagnosed with PCOS.

But the finding of cystic ovaries is not that exciting to me. There’s really not a whole lot to do about it, and it doesn’t usually cause a lot of problems. Usually the ones that people find really painful are an ovarian cyst, which is different from cystic ovaries. They’re often confused by people, but cyst is actually a true cyst, whereas what we see with polycystic ovaries is actually halfway matured follicles and usually that’s not very uncomfortable. Now, many women may have a little bit of endometriosis or just really painful periods. They think it must be the cysts that are hurting during ovulation or during different parts of their cycle. But oftentimes it’s just a painful period, and the cysts are not necessarily the cause. So I don’t really get too excited about the cyst. However, a pelvic alter sound can be very beneficial in making sure that everything else is normal, making sure that you do have two ovaries, making sure that you have healthy fallopian tubes, making sure that your uterus is in appropriate shape and placed appropriately, and there’s not other things on getting pregnant harder. And so doing that, ultrasound at least once to kind of assess the basic anatomy.

It can be a really helpful assessment. So then the next thing that your doctor is going to want to talk about, of course, is if you need any specific treatment. So the big one is, of course, birth control and metformin. These are offered to most women with PCOS. That diagnosis is determined. Metformin has been shown to reduce risk factors. So doctors like to start people on metformin, even if labs come back fairly normal when it comes to blood sugars and prediabetic screenings, because there have been studies that show that metformin can be preventative. And there’s also been indication that maybe it can help weight loss. And so if weight loss is a goal of the patient, then metformin may be a good solution. On the flip side, a lot of patients have a hard time with metformin. It can cause a lot of GI, upset, constipation, diarrhea, stomach pain. And so patients don’t necessarily love taking it. This typically subsides if patients stick with it for a period of time. So talk to your doctor about what they’re seeing with their other patients, of how long and what dosing. Sometimes doctors will cut back the dosing and kind of work you up slower if you’re struggling.

And of course, ask the question, Why do you think this is a relevant treatment for me? Because if you’re struggling with it, I would like to know at least, are you just putting me on this because the research shows that women with PCOS should be on this, or do you have what is your feeling on why I should be on this and see if it’s something that you feel is a good fit for you. Now a lot of people are saying lifestyle approach, you don’t need metformin. I do want to say here that, well, if you have a really healthy approach with the lifestyle for PCOS, you may not need metformin. However, stopping metformin or choosing not to take metformin is definitely a conversation to have with your doctor. There is a threshold at which metformin is probably needed to be protecting your arteries and protecting you from heart disease if you are starting to become prediabetic and you definitely may need a medication at that point. Now, there’s many other ones to choose from if metformin is not working for you, but definitely don’t just say, oh, a lot of people are given metformin and my doctor gave me metformin and a lot of people are saying they don’t need it because it’s just an option.

Some people actually do need it. And so I think that sometimes all of that conversation of if you’re having symptoms with it, then just toss it out and don’t take it anymore can be harmful. And we need to make sure that we at least talk to our doctor’s office about the fact that you’re struggling with medication and see if it’s something that they feel is needed based on your prediabetic screenings. And if they feel like it’s needed, maybe there’s an alternative if you’re struggling to manage with hormone from the side effect profile. Okay, so the other medication would of course be birth control. And this has two benefits. Of course, if you’re not wanting to become pregnant, it can help protect against that. Also, if you are having irregular, really miserable periods and you’re not wanting to get pregnant right now, it may not be a bad choice for you. But I want you to keep in mind that even if it’s keeping your cycles more manageable, the PCOS is not being treated by the birth control. In fact, the birth control might be making your PCOS a little bit more difficult to treat later.

It is overcomeable and we really have to choose what’s right for us right now. And what was right for us right now usually does take into account what we want down the road. But sometimes we need to do what we need to do right now. When I wanted to get through PA school, having a baby would have been a very difficult thing at that time. I wasn’t really going to be able to take time off if everything went smoothly. Maybe you’d only take a week or two off and that would be hard enough as it was. But of course, things don’t always go smoothly and being put on bed rest would potentially have me forfeit a lot of my clinical rotations that would have to be made up and limited availability going forward. So those are just things where birth control was a good option at a time in my life, and I don’t want women to feel like they have to choose their health or birth control. Informed decision, however, is really important. And understanding that birth control does kind of take over the control seat when it comes to your reproductive hormones. And sometimes your reproductive hormones don’t start up naturally again on their own afterwards.

And you may struggle a little bit to regain fertility and regular cycles. And again, there are ways of overcoming that with things like Clomid and other medical options, as well as giving your body some room for healing for a more natural approach. So those are things where you can kind of cross that bridge when you get there, but just understanding that some women with PCOS do struggle to go off of birth control. And so it’s not without its own side effects and things to think about. Then of course, if you’re trying to get pregnant and have been struggling to get pregnant, you have a diagnosis of PCOS. Your doctor may either refer you to a fertility specialist or may prescribe something like Clomid or letrozole. If a couple rounds of those don’t do the trick, they may suggest IUI or IVF. If you’re looking for weight loss, or if your doctor feels like weight loss would be beneficial for your PCOS management, they may talk about diet and exercise. Typically, doctors don’t have a lot of great insight into that. It is not an area that they spend a lot of time learning about in medicine.

There is so much to learn in medical school that this area is left to the nutritionist and the exercise physiologists, the Pts and things like that to step in and assist patients as part of the healthcare team. And also, your doctor may, on that same discussion, bring up something of weight loss surgery, like bariatric surgery, if a lot of weight is needed to be lost in order to see some improvement in symptoms. So those are some conversations your doctor may have with you. And knowing what conversations might come up can help you to prepare for your appointment and think about what it is that you actually want from your doctor. So then circling back around to naturally managing your PCOS through lifestyle. We talked a lot about this in the last two to three episodes, and I will link those episodes below in the resource section. But here I want to discuss why this method is so important and powerful. As you saw in the options above, it’s a piecemeal bandaid. Here a little bit of improvement. Their approach to managing your PCOS where when we start to look at creating an environment where our hormones start to balance themselves, it’s a cascade of improvement.

Improving something like, say, your insulin or your inflammation is going to in itself reduce body fat. When we reduce body fat, our body functions better. We reduce inflammation even more and we start to see less bloating, less discomfort. After eating, we start to see our energy improve. As our insulin starts to balance, we notice we have less cravings. When we have less energy crashes. And when we have less insulin circulating our body, our LH and FSH ratios self correct, allowing Ovulation to occur. Now I’m big picture simplifying things here a little bit, but that’s what we see as we start to make simple lifestyle changes as compared to trying to force something over here with the medication and force something over here with the medication. And that’s not to say the meds are bad. In fact, like I mentioned, they may be needed, but when we see a lifestyle approach in action, it’s like this beautiful Symphony with all of its instruments finally in tune again and everything is working together and you just see this positive cascade upward spiral of improvement that just starts to feel good in your body instead of filled with medication side effects.

The other thing I want to mention here is that fertility treatments don’t come without their own downside. They can mess with your hormones and PCOS symptoms just as much, if not more, as birth control. So when we think I’ll just do fertility treatments when I need to, yes, they are there for you at that point, and I am so thankful that they are because they can lend huge benefit and results for people. But it’s also important to consider that what our body really needs is care and nourishment to support our fertility. And infertility treatments typically are kind of harsh and they take a forcing approach, attempting to manipulate our bodies to do something that our body is already hesitating to do. So it has a different feel to it. And again, they are so important and needed and I’m so glad we have them. But it’s important to also understand when and where you want them to fit into your PCOS journey. I’m not against infertility treatments at all. In fact, I was all set up and ready to start walking down that path myself. What I’m merely suggesting is that maybe we jump to them too quickly and we would have better outcomes if women did three to six months of lifestyle adjustments to get as far as they could.

Without the infertility treatment, I think we would see less women needing infertility treatment and then those that did need the extra assistance would likely respond a lot quicker with a lot more success. And then the other consideration is, what about after you do get pregnant? Now the plus side is that if you’re already undergoing infertility treatment, chances are you’re going to have more monitoring to reduce the risk of miscarriage. However, I have seen a lot of people given clomid and letrozole without a lot of monitoring, so sometimes that doesn’t go hand in hand. This is why I love a lifestyle approach, because it also reduces the risk of miscarriage and when partnering with your doctor can also provide you the assistance of being monitored. As you found out that we became pregnant and ensure that you have a healthy pregnancy. So there you have it. While I am a strong supporter and believer in a natural lifestyle management of PCOS. I also believe that medicine can play a very helpful and a needed role in your PCOS care. As I conclude this episode, let’s do just a quick recap because we covered so many different facets of managing your PCOS.

First of all, remember who you’re talking to doctor versus preventative functional medicine. Both are very important, but they don’t always have a lot of crossover and you may need to be the bridge between the two as you pick and choose what works best for you and as you listen to the advice that they’re giving you, your MD is there to rule out other diseases and to provide supporting findings that eventually lead to the diagnosis of PCOS. They’re going to offer you treatment options and then we want to have them monitor for health risks and provide appropriate treatment over time. Lifestyle is up to you by creating an environment that your body can thrive in. And that is exactly what the PCOS Repair podcast is here to assist you with. So if you found this episode helpful, be sure to subscribe so that you don’t miss our next episode where we will discover the difference between labs and symptoms, which one you really want to pay attention to, and how to use that information to reverse your PCOS and live symptom-free. Until next time, bye for now.

Did you know that studies of PCOS epigenetics have shown that our environment can either worsen or completely reverse our PCOS symptoms? I believe that although PCOS makes us sensitive to our environment, it also makes us powerful when we learn what our body needs and commit to providing those needs. Not only do we gain back our health, but we grow in power just by showing up for ourselves. This is why I’ve created a guide for you to get started. My PCs Fertility Meal Guide can be found in the show notes below. I want to show you how to create an environment that promotes healing while still being able to live a life that you enjoy. This guide is completely free, so go get your copy now so that you can step into the vision that you have for your life and for your health.

40:01.0 to 49:56.0
Episode #7- PCOS Labs vs Symptoms

There is so much focus on getting your doctor to order all the right labs when you have or think you may have PCOS polycystic Ovarian syndrome. But is blood work really as important as it’s themes and if so, what labs really need to be ordered? These are great questions, and today’s episode is going to cover all things PCs labs and what you really need to know and pay attention to as you monitor and reverse your polycystic Ovarian syndrome.

You’re listening to the PCOS Repair podcast where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help. Sprinkled in Hi, I’m Ashlene Korcek, and with many years of medical and personal experience with polycystic Ovarian syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their body in a whole new way. With the power of our beliefs, our mindset and our environment, and the understanding of our genetics, we can heal at the root cause.

First of all, how does blood work actually assist with the management of PCOS? First and foremost, we run labs to rule out other possible causes of symptoms and to rule in the diagnosis of PCOS. Once we’ve done that, then they help us to monitor and make sure that we’re not needing to add in medication. If things like prediabetes starts to occur or heart disease starts to occur, or if you require assistance from a fertility standpoint or other medical assistance, then we can add those in as well. And we’re going to want to monitor the hormones, the labs and everything to make sure that what we are trying to do is working. But what do these labs actually tell us? In some ways, they tell us a great deal, but in other ways, they don’t tell us a whole lot. It’s important to remember that when we’re talking about hormones and the endocrine system and the metabolic system, even a slight shift from your normal can lead to a huge impact in symptoms and overall health. And so what we end up seeing is that there is such a wide range of normal in these labs that you may be having symptoms and the labs may be more or less normal.

So what we want to do is take it all with a grain of salt and take both what the body is telling us through symptoms as well as what medical science can tell us through lab work and other tests to put it all together to get a clear picture of what’s going on with your PCOS. So what labs should you order anyway, and why? So there’s kind of a couple of categories of tests there’s the ones that are going to rule out other disorders, like all of your thyroid panels. Those can really be taken at any point in time. Then you’re also going to be looking at, really, the reproductive test and this is going to include testosterone, LSH, FSH. And those are going to be really beneficial on days two and three of your cycle. So if you don’t know when your cycle is, take your best guess. You can monitor your cycle for maybe a month or two leading up to your doctor’s appointment. And you may see some adjustments in your temperature, your basal body temperature. And you may be able to see kind of a cyclical pattern in that that may indicate where your body wants to have a cycle.

And that might be a good time to test. This is not a hard and fast rule of when you need to test, but you are going to get a more accurate read on the test that you’re ordering for reproductive hormones if you have them drawn on day two to three of your cycle. And then the third grouping of lab tests is really more about monitoring overall health and seeing if medical intervention becomes necessary. And this is going to include monitoring for all of the PCOS risk factors. So we know that women with PCOS have a higher likelihood or higher risk of developing type two diabetes, of developing hypertension, high cholesterol, heart disease, and certain kinds of reproductive cancers like endometrial cancer is we want to be screening for those in a consistent way. And I think that’s one of the places where we often have to drop the ball with PCOS. We see someone in their 20s and 30s or maybe even earlier, and they don’t really need constant screening for these things. But nobody sets up a plan for when we should. And that should probably be communicated to you. And if it’s not communicated to you, it’s a really good question of how should we monitor this because of the risk factors involved.

All right, so that’s what labs and why. And I’m going to link a free resource for you in the resource section below in the Show Note. And that resource is going to be called your PCs Advocate Checklist. And there’s just a bunch of great information there about how to go about getting the right labs tested, talking to your doctor and all of those things, as well as one of the previous episodes about how your doctor fits into your PCOS journey, even if you’re wanting to heal your PCOS in a more natural way. And I will link that episode as well in the show notes below. So now you’ve had your labs ordered and you have your results. Now what what do you do with these results? So first of all, reevaluate your symptoms. Are the lab results consistent with what you’re finding in your symptoms? Probably not exactly. And that’s because symptoms will show up long before we will get an abnormal lab test. So while it’s important to run these blood tests in order to rule out other diagnoses, in order to get a baseline for your PCOS and in order to monitor for long term risk factors that are associated with PCOS.

Your symptoms are really what’s important for assessing what your body needs to balance your hormones and to reverse your PCOS. So what symptoms should you take note of? So there are some main PCOS symptoms, such as growth of facial hair, body hair. They can be really annoying and signs that you have excess androgens but they aren’t necessarily the best way to assess how your body is doing and how your efforts to manage your PCs naturally are playing out. This is because they don’t respond very quickly to changes. You can be doing amazing with your hormones, and your hormones can be way more imbalanced and be doing so much better. But you’ll still have the problem of hair growth for months. In fact, you may never fully get rid of it unless you do laser hair removal or electrolysis. And then if your hormones are balanced, you can see that it doesn’t really return. But you may not have any great feedback, especially initially when it comes to hair growth. So some better symptoms to be aware of. Is your cravings hunger? Are you constantly hungry or do you not have an appetite at all and yet you still have cravings?

What is your energy? Do you have certain energy slumps throughout the day? Do you have low energy all the time? Do you wake up feeling very lethargic? Or do you wake up feeling fine, but then have a really lethargic slump midway through the morning or maybe in the mid afternoon? How is your mood? Do you naturally feel fairly positive about things? We can work on feeling positive, but some of us just naturally feel hopeless, feel like as hard as we try, we’re just pushing uphill all the time that we almost are living under a cloud. And these can be things that because we actually have a chemical imbalance. And so we want to pay attention to these signs that our body is giving us through our mood. They’re important to pay attention to. Do you get bloating? Do you just blow throughout the day? Do you have bloating after meals, after certain foods, things to pay attention to? Is does your body deal with bloating? Stomach pain, even if you don’t really have a lot of bloating? Maybe you just feel a lot of discomfort after eating, or maybe there’s discomfort before eating. Do you get frequent headaches now?

There’s always a cycle headache and there’s headaches because of not enough sleep, or you’re used to drinking more caffeine and you didn’t get your caffeine at eight. I’m talking about headaches, where you can’t really pinpoint why you’re just constantly getting headaches and then even your cycle. Now this one can take a little longer. You can see from the list above, those are things that you could evaluate about yourself today. But your cycle is going to take a month or two to really see. Is it normalizing? Is it getting more or less regular? Is it getting lighter or heavier or more or less painful? Those are things that you can take note of your cycle over a couple of months, and it can still give you some amazing feedback, although not quite as quickly as the other symptoms listed before. So okay, great. Now you know what symptoms, but what do they tell you about your hormones? They really indicate what’s going on at the root of your symptoms, what’s going on in your metabolic system, your insulin, your inflammatory system, your cortisol system, your body’s response to stress, your body’s response to the food that you’re eating, what your body is craving more of or wanting less of.

So things like is it an insulin effect? We will be discussing that one in more detail in the next episode, so stay tuned for that. Is inflammation? Do you have disturbances in your nutrients and in your hormones, or is your body struggling with current stressors in your life? So the takeaway here is that while labs are extremely important and we don’t want to not have them ordered, I hear so many people focusing on meeting their doctor to order labs, and they’re spending months of frustration because the doctor doesn’t want to order a lab that they think they need or insurance won’t pay for a lab that they want. And the truth is that although that can provide helpful information as long as the basic medical considerations have been covered, such as ruling out other disorders and ruling in the fact that you do actually have PCOS, then we don’t need to waste any other energy on lab management other than making sure we have regular monitoring. Maybe once a year. If things are staying stable, maybe closer to every three or five years, depending on what your doctor feels comfortable with, then we want to just focus on our symptoms.

They are going to tell us from the day to day what our body actually needs so that we can respond in real time. So what do you do now? I want you to go back, if you haven’t already listened to them, or if you need a refresher, to go back and listen to episodes three and four where we talk about the PCOS root causes and lifestyle medicine and how to go about understanding your PCOS root cause. I will link to those episodes below, as well as the PCOS root cause quiz, because this quiz is going to help you to determine what primary factors are currently affecting your PCs hormones so that you can put your energy on things that are really going to make a difference in your house. So I know this is a short episode today, but I really think it’s important that we don’t get so hung up on the labs and that we really realize that symptoms is our body’s language and communication with us. It’s direct feedback of how our body is doing and when we have a symptom. Our objective should be to learn to tap into it and hear our body and then with a little trial and error figure out what it is our body needs.

And that’s why I’m here. The PCOS Repair podcast is here to help you learn more and more about your PCOS root causes and how to heal your PCOS and reverse your PCs naturally. So if you’ve been enjoying these episodes be sure to subscribe so that you get notifications when the next episode is released because the next one is going to be all about how to get pregnant when you have PCOS. I know a lot of you are going to want to hear that one. So until next time, bye for now.

Did you know that studies of PCOS epigenetics have shown that our environment can either worsen or completely reverse our PCOS symptoms? I believe that although PCOS makes us sensitive to our environment it also makes us powerful when we learn what our body needs and commit to providing those needs. Not only do we gain back our health but we grow in power just by showing up for ourselves. This is why I’ve created a guide for you to get started. My PCs Fertility Meal guide can be found in the show notes below. I want to show you how to create an environment that promotes healing while still being able to live a life that you enjoy. This guide is completely free so go get your copy now so that you can step into the vision that you have for your life and for your health.

50:00.0 to 01:15:55
Episode #18: PCOS & Birth Control

Hormonal birth control is the primary option offered by health care providers to assist women with PCOS symptoms. But there is a lot to consider when you’re deciding whether to start or stop taking hormonal birth control, how to manage the symptoms, how to prevent pregnancy without having to use hormones, and so much more. That, my friend, is why I wanted to record this episode because it’s going to cover all things hormonal birth control and PCOS, and ultimately how to create the lifestyle and incorporate or not incorporate these things as they work for you. All right, let’s get started.

You’re listening to the PCOS Repair podcast, where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help. Sprinkled in hi, I’m Ashlene Korcek, and with many years of medical and personal experience with the polycystic ovarian syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their bodies in a whole new way. With the power of our beliefs, our mindset and our environment and the understanding of our genetics, we can heal at the root cause.

There are many types and formulations of hormonal birth control, and we’re going to go over those. But first, I just want to discuss how these hormones work in regard to PCOS. Essentially, when you take a synthetic hormone, meaning that it doesn’t exactly match the ones that your body produces naturally, you are taking a pill or you have some sort of mechanism that’s delivering these synthetic hormones. And they often vary in the dose in combination in an attempt to mimic a natural cycle. By doing so, these synthetic hormones basically take over and override your natural hormone cycle. This is how they were designed to work in order to prevent pregnancy for PCOS. The medical community feels that this may be beneficial and that it can override some of the frustrating symptoms of PCOS. But while this may be helpful for symptoms such as irregular periods, heavy or painful periods, and even it may help with things like acne or hair struggles, there are a few problems with this. The hormones of birth control are just the tip of the iceberg. So it’s kind of like playing whack a mole instead of getting to the root of the problem and addressing it there.

The second problem is that these synthetic hormones can deplete your nutrients and have other side effects on our health. And when we go to stop them, our natural hormones may not restart the way we want them to. That said, it is not horrible to take birth control. And as long as you understand that it’s not actually addressing your PCOS, if it makes life easier to live, then it may be an excellent option for you. And then let’s not forget the original reason that women may want to use birth control. That’s right, they may want to prevent pregnancy. And hormonal birth control can be an easy and effective way of doing that. So let’s discuss the different options you have for birth control, preventing pregnancy that is. And then we’ll talk about how to consider your options in regards to your PCOS symptoms and what may or may not be helpful to you. So first of all there is non-hormonal options such as the fertility awareness method or another way it’s called a FAM. This is often talked about by more natural, pathetic or functional medicine or nonmedical fertility experts. The problem is with PCOS there are some serious drawbacks.

The whole idea of FAM is that you know where you’re at in your cycle so that you know which days you’re potentially fertile and you’ll usually hear them spout off about how well you’re only fertile one to two days out of your cycle. Well, while that is true, you actually have about a week, careful to not get pregnant out of your four-week cycle. So there’s that to keep in mind and it really only works if you know where you’re at in your cycle. And this breaks down when you have PCOS and you have in your regular cycle and you don’t know where you’re at in your cycle. So I do not recommend FAM for any woman with PCOS who is not okay with a surprise pregnancy. Then you have some non-hormonal other birth control options. The primary ones being the condom, the diaphragm, the female condom and then there is the Copper IUD. So these are options that help to prevent pregnancy. The Copper IUD has the highest effective rate of the ones just mentioned. However, there are some issues with it, and that some people find that it makes their periods heavier. And some women found that it just wasn’t maybe some more cramping or some discomfort or just some symptoms they didn’t love about it.

Then you have your hormonal options. These are going to include the pill which has various forms and combinations and multiple or single hormones to help to override your natural hormones so that your body is prevented from you actually getting pregnant. Next, you have the implant. And the implant is like a little capsule that they actually put under the skin, usually in the arm, and that slowly releases a small amount of hormone and it’s nice because you can go several years before you have to replace it or take it out. Downsides are that some people find it I think it’s a primary progesterone. The original one was a primarily progesterone-based pill and some women find that a progesterone only form of birth control had effects of weight gain and acne. And so some women love it because they don’t have to think about it again for quite a while. Other women don’t love it quite as much because of the side effects that it gives. The other options include things like the ring. So this is an estrogen-based product that is literally a ring and you kind of squeeze it so that you can insert it into the vagina and then it sits around your cervix and so it tucks way up in there.

So you shouldn’t be able to necessarily seal it. And then you just kind of loop a finger around it and pull it out when you’re ready to take it out. Typically women will leave it in three weeks, take it out for a week so they can have a period, and then put it back in or put the next one in. You get a prescription of it and so you get your next one and you put the next one in. You can leave it in for four weeks and then skip your period as well. Then there’s the intrauterine devices or IUD. And the IUDs. There’s the copper one that we mentioned, which is non-hormonal. And then there are two that I’m aware of on the market, although I’m not currently in the office recommending all of these things or prescribing all of these things. And so there’s always new items coming on the market. But the last I heard there was more now and Skyla. So those two are just a difference in how many years they can stay in. But they are both a progesterone-based hormones, IUD and they work by basically inserting this little, it looks like a little tea and it goes through the cervix and sits in the uterus and it keeps the uterine lining from getting very thick.

That is one effect that it has. The copper IUD does that as well. In addition, the Skyla and the Moreno, they release a small amount of hormone over the amount of years that they are designed to be left in. And during that, they override some of the hormonal components as well. The difference with this is that many women will still ovulate with the IUD. And although they are progesterone only, there tend to be less side effects than with the implant. Or with our next one that I will mention, which is a shot. So you can get something called the depot shot. The depot shot is a progesterone shot that works for I’m going to forget the amount of time, so I’m just going to say a designated amount of time. And you just get that shot routinely so that you’re able to again avoid pregnancy. And then if the shot wears off, you need to get it again. So those are the hormonal options. There are so many different variations of those in each of those categories, but those are the hormonal options to prevent pregnancy. Now, they are often recommended for women with PCOS by their healthcare provider because they can get in there and they can level out or kind of override those hormones that are leading to a lot of symptoms.

However, if you’ve listened to some of the earlier episodes, especially episodes where we’ve talked about the root cause, they don’t get in and they don’t address anything like insulin or cortisol or any of your metabolic hormones. They don’t decrease inflammation. In fact, there’s a lot of studies that indicate they may increase inflammation, and they don’t restore your nutrients.
In fact, they can deplete your nutrients. So what kind of considerations are a good idea when you’re thinking about going on birth control or needing birth control and having PCOS? Here’s the thing. If you are looking to avoid pregnancy, then hormonal birth control may be a very good option. The non-hormonal ones can be cumbersome, difficult, less effective because they require last-minute action on your part to make sure that you use them at the right time. And they tend to be less effective. Again, broad statements, not always the case if you’re wanting to use hormonal birth control because we have to look at the big picture of our life. And if the big picture of your life, it’s going to be better if you just use uphill or an IUD or something, then I suggest that you approach it in a way of experimentation.

It takes a few months with any of these options to really determine how it’s going to work with your body. As an example. I was getting ready for my wedding. And so I wanted to go on the form of birth control that we were going to use a few months prior. Because I wanted to make sure that it didn’t make me break out with Acne. That I had time to stop the pill prior to our wedding and try something different if it wasn’t going to be a good fit. Well, that kind of backfired on me, because it turns out for the first three months, I was completely fine. And right about our wedding. I started getting a lot of issues with the medication I was taking. I was becoming really nauseous, and so I almost felt like I had constant morning sickness. I didn’t realize that’s how it felt, but after having three kids, that’s how it felt. I was car sick. I just kind of felt I was like, I just feel green. I felt kind of icky all the time. It also made me crazy emotional. Like, I would be sitting on the couch and I would just burst into tears.

And this was after we were married, and my husband would come home from what he was doing, and he would find me just crying on the couch, and he’s like, what’s wrong? And I would start laughing, crying, and I’d be like, Nothing is wrong. I just can’t stop crying. And I kind of think it’s funny, but it’s kind of weird, and I don’t know what to do about it. I think I’m going crazy. I literally can’t think of something that’s wrong, but I just have this need to cry. And the newly married guy, he had no idea what to do with me. And so we both decided that I probably needed to go on a different form of birth control. So then I got an appointment, went down, and talked them into it because at the time, they did not give IUDs to women that had not had babies yet. And so they did, but it was not a mainstream thing at that point. And so a lot of providers didn’t really want to. They had done it a couple of times. I got them to agree to do it. They’re just like, it’s just more painful. And I’m like, I can deal with the pain.

Just I need something different than the pill. So I got my IoD. I loved it, had no problems with it, had it for four years. And then we decided we wanted to have a baby. So at that point is when I started having symptoms. And we’ll talk about this a little bit more as we talk about how to come off of birth control. I didn’t know. I had no idea. That one, I had never formally been diagnosed with PCOS at this point, looking back, I had several indicators. I should have been diagnosed by two different doctors that I saw back in high school, but I wasn’t. So at this point, I was kind of in the dark about my hormones having any sort of disruption. And when I went to have the IUD removed, I was fine for the first month. And then I started having really heavy periods, like really heavy. And I started gaining weight like crazy. I didn’t know people could gain weight that fast, especially when I hadn’t changed how I was eating, hadn’t changed how I was exercising. But I gained £40 over six weeks and I was just at a loss, nothing fit.

I just wanted to be pregnant. And here it’s like now almost three months since I went off the birth control and I’ve just gained £40. I feel horrible. I’m having horrible periods. Like, what the heck is going on? So that took me a while to kind of settle down and figure that out. And honestly, I didn’t really get it under control or figure it out because I was just kind of blindsided and not sure what was going on. I just thought my body was going crazy and I didn’t really figure it out until I finally was diagnosed with PCOS several months later. So that brings me to the try them out, see what works for you. And then all of this knowledge that we’re talking about today is so powerful for you to have because what it will allow you to do is make informed decisions of what your life needs right now, what you will be facing with that decision in the future, and how you’re going to manage it. Because here’s the thing. If I had known what I know now, the IUD would not have been a big deal to show that further.

So then had my first baby did not go back on birth control, got pregnant very easily after a very difficult time with my first, and I had a surprise with my second because I was managing my hormones so well. And then after two, we were selling a house, moving for a year, moving again, and two was enough at the moment, and I needed something to make sure that we didn’t have another glorious surprise right away and have a third. And so we were living in New Mexico for a year. I went back on the IUD because I had done well while I was on it, and I knew so much more about my hormones that I felt fairly confident, although I was a little nervous because I hadn’t actually tested this theory yet, I felt pretty confident that I knew what I was doing to come off of it. So then I had that for about a year, and then we were ready to try for baby number three. We had just moved again and we were just getting settled for a new provider, had it removed, and it was easy. I went straight into even four weeks prior to really, I’m always managing my hormones, but four weeks prior to having my IoD removed, I really went into full, just care for my body, getting the nourishment I needed, focusing on Destressing and managing the inflammation and doing all the things.

So once I had it removed, I had two regular cycles and then found out that we were having baby number three without gaining £1. In fact, I think I lost about £5 through all of that. Just healthy caring for my body without necessarily meaning to. It wasn’t like I didn’t have any weight to lose. It was not my focus. I wasn’t like, I am going to lose £5. It just came off because I was doing all the things that my body needed to be in balance, and then an easy, healthy pregnancy. And then afterward, we knew we were done having kids. And that brings me to the final options for birth control. When you know that you no longer want pregnancy to be an option for you and you’re ready to prevent it permanently. Of course, there are options, like tying your tubes, hysterectomy, or having your partner get a vasectomy. So those are all options, but they’re not options when you’re in your early 20s, even your early 30s, if you’re still in that career mode and not ready for a baby, but you’re also wanting to leave that option open for the future. So there are a lot of accounts out there that birth control can be very scary for women with PCOS, and it’s pushed on us at a young age.

I think being on it for years and years and years when birth control isn’t even the option, it’s probably not a good idea and probably not serving a great purpose. But when we’re looking at our overall lifestyle, if it is helping your symptoms, if it is allowing you to participate more fully in your life because it’s keeping certain symptoms under check, then there’s reasons to take it. And so you’re balancing the pros and cons. If you’re having a hard time with your PCOS, I would encourage you to consider natural methods of managing your PCOS before turning to birth control. But if it helps, in addition, to add that layer of support by taking hormonal birth control and it adds to the quality of your life, then you can definitely take hormonal birth control in addition to your lifestyle management. Then if you’re actually looking for birth control, all of these options that we’ve mentioned today are viable options. It’s just a matter of deciding which one fits you best and then being willing to give it a try for three months. And if it’s not working out well, to try something else. What I would advise you not to do is get in your head about it.

If we tell ourselves, I need this, but it’s not good for me, we start to create a resistance about it and it’s not going to work out for us anyway because we’re going to have this mindset of, I need to get this thing out of me. I need to stop taking this. And we start focusing on every little thing and we’re sure it’s the birth control and we have to let it go and just be like, you know what, this is the right choice for me. And then if you’re like, this right choice for me is giving me weird side effects. I think I need to find a different rate choice for me. It allows us to be really present with what’s happening instead of deciding in our head already how it’s going to go. Okay, so then what happens when you’re ready to go off of birth control? Well, I kind of touched on that with my story, but when you want to go off of birth control, in fact, actually while you’re even on birth control, you want to be making sure that you are caring for your body, being extra good with your nutrients, really watching that you’re managing your symptoms and that they are staying under control the way you want them to.

Otherwise, you may need to readjust your plan. And then as you get ready to discontinue birth control and now depending on what type you chose, if you’re on a pillow, you can stop it whenever you want, right? You have the IUD or the implant that goes and make the arm, you’re going to have to have it removed. If you got the depot shot, you’re going to need to wait till it wears off. If you have the nouveau ring, you can stop it again at any point. The ones where the nouveau ring or the pill where they kind of mimic a cycle and you may take them away. So you can have a withdrawal lead every cycle or every month. Those ones may be the best thing to do would be to let it finish out the cycle that you’re on and then don’t put it back in or don’t continue taking it at that point, but that’s completely up to you and how you want to do it. At that point in time though, we have to be prepared for there may be a little bit of a rocky road and when we know that going in, there’s a calmness about it.

Yes, I’m going to have to deal with that and I’m going to make sure that I have room in my schedule for like three months of dealing with the rocky road. And when I’m ready to start thinking about starting a family, I’m going to get rid of my birth control somewhere in the three to six to twelve months, depending on how you feel about it. So if you’re someone who’s like, I want to really have a good chance of having a baby by this point, then maybe take it out a year ahead of time. If you’re someone who’s like, I don’t want to even think about having kids until this point, then if you’re okay with it taking a little longer, that’s okay. Just be aware it can take somewhere between three months to a year to really get your cycle going strongly after birth control. If you have PCOS, some women, easy, no big deal, others, it’s a bit of a struggle. My recommendation is to give yourself those cushions of time based on your personality, your planning, what you’re wanting, and then don’t go on infertility medications during that window of recovering your cycle.

Let your cycle have the time, and like I said, it can take up to a year to really rebalance itself and it’s going to need help from you. It’s going to need the proper nutrition, it’s going to need proper care of your health of all the things we talked about in the other episodes, but it’s going to need all of that from you in order to regain a healthy cycle after being on birth control. And then you should at that point have most likely continued to have regular periods regained ovulation and be ready to try for a family. Now if you still are not having perfect ovulation and your periods are a little bit wonky during this time, you can definitely not be preventing pregnancy if you’re okay getting pregnant at this point. But if you’re like, okay, I’m just going to see what happens for this year and then we’ll actively start really timing things correctly. And if things are still not happening and you want to start seeing infertility treatment centered, then by all means, everything you’ve done leading up to that will have set you up for so much more success than the typical scenario that I hear.

The typical scenario that I hear is someone stops birth control, their period is all messed up. They have a similar situation that I had of like, weight issues or other PCOS symptoms really just like, blossoming. And they can tell something is wrong, they don’t know what it is. They go through the infertility specialists. The infertility specialist says, oh, but you have PCOS, you’re going to have a hard time getting pregnant. And they start the monochroma or lectrosol. And now what’s happened to your body is you literally are just jerking it around. You were on birth control. You stopped birth control. Where did my hormones go? Like, what’s going on? Oh, I’m supposed to make hormones? Oh, no one told me that. Thanks for the notice. And then it’s like trying to figure that out. And then all of a sudden it’s got coma or lecturers or different medications prove a different medication coming at it, and it’s like, whoa, what’s happening now? It doesn’t know what to do. And it creates chaos. And you get yourself in this cycle of insanity where it just needs a pause, it just needs some healing, it just needs some nourishment.

And then once the dust has settled, yes, you have PCOS, you may need some additional infertility assistance. But letting that settle, letting there be a pause, letting yourself get kind of the lay of the land and then proceeding with infertility treatment is going to do wonders for your health, for the success and for the outcome that you’re looking for. So that is my recommendation as you go off of birth control. And there’s a lot of ways you can do that, but those are some general considerations of just how to approach it so that it goes smoothly for you, so that it’s less stressful for you, and so that ultimately your body is cared for during the process. So what we are looking for after going off of birth control is an ovulation. All right? You may have some irregular bleeding. You may have periods that are shorter than they used to be, longer than they used to be. You may feel like you’re missing periods, but ultimately, what we are looking for is ovulation. And so as soon as you go off of birth control, this is a really good time, especially if you’re giving yourself that space, that window of time to recover from the birth control is to then be looking at monitoring your cycle through something like obvious or basal body temperature.

We’ve talked about that in previous episodes, but being able to determine if ovulation has in fact happened, if you are having ovulatory cycles, that is an extremely good sign that your body is doing well. Even if you’re still having some other symptoms, like some acne or some hair issues, if you’re seeing those ovulations come through every month, that is an extremely good sign that your body and your PCOS is in pretty good health. A period is just the bleeding that happens about 14 days after you ovulated. In fact, it’s like exactly 14 days after you ovulated. And so when we see that we’re having a regular cycle, that makes us think, oh, we’re probably not ovulating because finally we just had a breakthrough bleed. And so that’s where if we’re seeing really regular periods, that’s a good indication that you’re ovulating. Although it’s not 100%. So I would still monitor for the ovulation itself. One of the best things that you can do as you’re coming off of birth control is to focus on the nutrition, the meal plans and things that I give my clients. These are just so richly packed with nutrients. But in addition to those taking a prenatal vitamin, taking an extra B vitamin, or making sure that you’re getting folate and that you’re getting enough magnesium and that you’re getting enough omega three S, making sure your body is getting enough nutrients on a routine basis is going to be so very important.

Birth control can kind of affect our gut, so our GI tract, as we’re absorbing food, can be affected by birth control. This is why when we take birth control, if we’re on antibiotics, we have to be careful to use other forms of contraceptive, because antibiotics also affects how well things are absorbed, and so we can throw each other off and the nutrients may not be getting absorbed. In fact, studies have shown nutrients do not get absorbed quite as well when we’re on birth control. And so we are depleting our nutrients. And our Western diet is already very void of all nutrients. We really want to make sure that we are getting nutrients through the foods that we’re eating. Our body absorbs those ones the best, and then also making sure that we have some vitamin supplements to be getting and kind of covering the basis of the rest. And there you have it, my friend. Those are some considerations of how to approach birth control with PCOS. I know you’ve probably heard other people say avoid birth control if you have PCOS. Yeah, I’m all for avoiding birth control if you have PCOS. I tried to avoid birth control whenever possible, but there was also a time in my life that I was in professional training and that we were not ready to start a family.

And I needed something that was convenient because I was working really hard and our life was very busy. We live in the world that we live in, and so there are times in our lives where we have to look at the big picture and we have to find the choice that’s right for us. And that’s very different from person to person. And so I hope that this information empowers you to know that if you do choose to go on hormonal birth control, that doesn’t mean that it will wreck your hormones forever. There may be some recovery on the back end of it. So if you don’t need to be on hormonal birth control, I mean, that’s always probably easier. I. Definitely don’t recommend it to patients who are not meeting contraceptive. However, if someone is really struggling with certain types of symptoms, like irregular periods, and that is getting in the way of regular life. Like, I know I’ve had times in my life where my period was getting in the way of life and that in itself was reason to take action and to be on something that helped to control that. So those are all things that we want to be considering.

Each and every one of those considerations comes into our final decision of what is right for us right now. And then I hope that gives you hope and empowerment to know that on the back end there’s a lot that you can do and helps you kind of feel at peace with your decision. Because ultimately, when we feel conflicted, things don’t work out well for us because we sit and think about them too much and it just becomes a stress in of itself. So there you have it, my friend. PCOS and birth control. How they work together may or may not be helpful for you, how to consider which might be the right option for you, and then ultimately how to kind of talk that through with your doctor to see what’s available and to see what they think is going to be a good fit if you choose to go on hormonal birth control. All right, so if you found this episode helpful, I invite you to hit the subscribe button. We have some excellent topics coming up in the future and I look forward to sharing those with you soon. Until then. Bye for now.

Did you know that studies of PCOS epigenetics have shown that our environment can either worsen or completely reverse our PCOS symptoms? I believe that although PCOS makes us sensitive to our environment, it also makes us powerful. When we learn what our body needs and commit to providing those needs, not only do we gain back our health, but we grow in power just by showing up for ourselves.

This is why I’ve created a guide.

For you to get started. My PCOS Fertility meal guide can be found in the show notes below.

I want to show you how to.

Create an environment that promotes healing while still being able to lose live a life that you enjoy. This guide is completely free, so go get your copy now so that you can step into the vision that you have for your life and for your health.

01:16:00 to 01:28:58
Episode #20: The PCOS Diagnosis Dilemma

Being diagnosed with PCOS is a big deal. You’ve just been told that something isn’t working properly with your body, but your doctor probably just ran a few tests, gave you the diagnosis, and jumped straight to discussing Medicare patients and procedures and treatment options. But they just skipped over the most important question of all, and that is why. Why is your cycle off? Why aren’t you ovulating? Why are your hormones not supporting a healthy pregnancy? Why are you having all of these symptoms? That is exactly what we will cover in today’s episode how to uncover the why behind PCOS and not just get a diagnosis.

You’re listening to the PCOS Repair podcast, where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help. Sprinkled in hi, I’m Ashlene Korcek and with many years of medical and personal experience with polycystic ovarian Syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their bodies in a whole new way. With the power of our beliefs, our mindset and our environment, and the understanding of our genetics, we can heal at the root cause.

Welcome back to the PCOS Repair podcast, where I’m going to walk you through a full workout for understanding why your hormones are out of balance and how to get started fixing them. Did anyone ever ask why your body is struggling when they give you the PCOS diagnosis? I’m guessing no. To discover your PCOS root cause, we need to start by asking the question why are you having period problems? Why are you having infertility? Why are you gaining weight? Why can’t you lose weight? Why are you having hair problems? Why are you having acne? Why? Doctors seek to label your collection of symptoms with a diagnosis. That’s kind of the first step in the medical community. That way they can then justify the treatment that they offer. This leads to medications and procedures and options to address these unwanted symptoms. The problem is that those medications when it comes to PCOS, don’t treat the root issue. Now, if you have hypertension or other medical disorders, it works great. But with a syndrome where your body is not responding well to its environment, why becomes very important and it’s often skipped over. So in this episode, we are going to look at the difference between just getting a label, aka the diagnosis, and actually getting a full PCOS workup that leads to the understanding of what it is that your body is lacking and what it needs in order to thrive.

So, medical professionals, they go through a lot of training and they learn to put together puzzle pieces. It’s actually really fun and fascinating how well they can kind of just feel out what is going on just through symptoms to then start down a track of ruling in and ruling out various possibilities that could be going wrong with the human body and they take all these puzzle pieces and then they run labs and they order tests and they come to a diagnosis. So don’t get me wrong, this PCOS diagnosis is a very important piece of the puzzle when it comes to healing your hormones. It’s just that the next step is equally important. Understanding why your hormones are off and what your body needs to function properly is ultimately what we need because what we want is to start to actually feel better in our bodies. And the diagnosis is great. It tells us what’s wrong, but it doesn’t fix the problem. When we seek to understand why our body is struggling, then we can provide it with the care that it needs. Your body wants to function properly. It wants to be healthy. It works very hard to survive and even to thrive.

But something is hurting it and it’s doing its best, but it needs some help. It needs either something added or something removed that just isn’t working for it in its environmental bubble. So before we jump to medications and procedures, let’s make sure that we’re getting that full work up and understanding what maybe we need to be doing differently and what’s going on at that current primary root cause of our hormone imbalance. Okay, so what’s included in a full PCOS workup? I mean, just like your doctor started with labs, not just the labs that are going to provide the diagnosis of PCOS, but the labs that are going to exclude or rule out other potential issues that could be leading to similar symptoms are also important. We’ve talked about some of these labs. We’ll probably talk about them more in future episodes, but I will list them in the show notes. But we’re not going to go over them in detail today. I just want to point out that labwork is valuable to have done, mostly so that we know what we’re dealing with. That it is looking like you have PCOS, that it’s not looking like the symptoms and the imbalances are caused by other health or medical problems.

Imaging is important. Knowing whether or not you have cysts on your ovaries is not all that exciting. But it is really important to know if there are any other causes of why you might be having irregular cycles or if you have any other indication of something that could cause a fertility problem. So they can look kind of an overall pelvic ultrasound and look and make sure all the structures look okay. But then the part that’s often missed, other than just the initial decision to start working up for PCOS, the symptoms are often not looked at. Again, in terms of helping us to know what your body needs. And honestly, they’re the most important part. When we start to see symptoms of PCOS, we think of the common ones irregular periods, hair growth on the face or body, loss of hair on the head, acne fertility problems, weight struggles, and even mood disturbances such as increased anxiety or depression, energy problems, things like that. These are important for thinking, OK, maybe we should work out the patient for PCOS, but they’re less important for knowing what is going on in the root cause. What we want to look at in the root cause is more the type of questions that I ask in the PCOS Root Cause Quiz and I go beyond that, even when I’m talking to clients.

One on one of what is really going on in your body day today? What are your energy levels? What are your cravings? What are your hunger cues? And when are you the most hungry? When are you craving certain things? How is your body responding to its environment throughout the day? Are you feeling stressed and anxious? Is your body having a physiological response? Like are you having a flight and fight response to your stress levels? Even if you think that you’re handling them? Is your body handling them? Do you get energy crashes and energy highs after certain things that you eat? There are a lot of things like this that start to tell us about aches and pains, headaches, and so many things that tell us what is going on in your body. And so that leads us to where things need to be adjusted, where things need to be improved to support our body’s health. So those are the symptoms that we want to be looking at. They help us to discover the PCOS Root Cause, which is so exciting because it allows us to no longer feel frustrated and hopeless, but to just kind of know these are the things that we need to do.

And we don’t just rely on a band-aid treatment, but we’re able to actually get in there and assist our body so that we’re not just trying to cover up symptoms with a medication or force ovulation by taking a medication. And instead, we’re actually helping our body to get the nutrients it needs, gets the care that it needs, and function in a rhythm that works for our body. A lot of it is just small tweaks, but it adds up to a big difference when we create that environment that works for our own bodies and everyone’s different. But those are things that can have a huge impact on how we feel, how our body functions, and even our longevity in reducing long-term risk factors of PCOS. So the best place to start learning what questions to ask and how to start listening to your body is actually to take the PCOS Root Cause Quiz and start learning what your current primary root cause is. And that way you can begin to address your body where it’s needing assistance. Okay, so then how do we treat PCOS? So we’ve gone through a full workout and now where do we get started?

So medications to assist with ovulation aren’t bad. I just want to make it clear that it’s not either or. I do recommend once you’re diagnosed with PCOS, or even if you’ve been diagnosed for a while and you’ve been trying other treatments, that is when you really decide to focus on a natural approach. Maybe give yourself a few months of just doing that. Some of the medical options can kind of make it harder to kind of see if things are improving and if your natural approach is working and where you may need to make some adjustments. Of course, don’t stop any medications or treatment plans without talking to your doctor first. But if you kind of wrap up what you’re currently doing and you’re like you don’t want to take a little break, I’m going to focus on my health. I really recommend doing that for somewhere between three and six months at a minimum, before jumping ship and trying something else. It takes a little while for your body to settle in again. Medicine like metformin, birth control, Clomid, letrozole, they all have their place. And they’ve helped thousands of women with PCOS with various aspects of health and happiness that they’re looking for in modern medicine is a miraculous thing, but it doesn’t replace good natural care for our bodies and health.

So choosing a healing lifestyle that you can provide your body better care with can go hand in hand with these medical treatments, or it can be used by itself to manage your PCOS. So simple adjustments to what you eat, quality of sleep, and stress management, can have this tremendous improvement on your PCOS fertility and other symptoms. And this is why life management is actually the first recommendation in most PCOS medical literature, which is really exciting that they’re starting to recognize that in the literature for PCOS and not just jumping to some of the things that we normally get offered, like birth control, Clomid, letrozole, IUI, acne medications and so forth. So what the studies are showing is that a natural approach is the best way to lose weight, maintain weight, boost fertility, manage other PCOS symptoms, and reduce the long-term risk factors. These studies are also showing that taking a natural approach to PCOS management can reduce the risk of miscarriage when you conceive naturally and have better health for the mom and baby throughout pregnancy. But let’s think here practically, it’s really not that you were able to get pregnant naturally or not need medical assistance in that it’s that you incorporated that natural approach.

So what we’re seeing in the literature, even though they’re usually focusing on one thing, is that when we take the time to put the effort into also giving ourselves a healthier approach to managing our PCOS naturally, we’re seeing better outcomes overall. So in other words, and we’ve talked about this in other episodes, but you take climate, it can cause ovulation, which can lead to a pregnancy, but it hasn’t addressed all the other issues. When we take a natural approach, we are addressing inflammation, insulin response, and hormone balancing, and we’re learning the habits and what we need to be doing, and that carries into pregnancy. So we reduce our chance of miscarriage, reduce our chance of pregnancy, complications like gestational diabetes or preeclampsia or preterm birth, and things like that. So it all just works nicely together. But if you’re doing all the natural things and then you take a little med to give you a little additional boost in that ovulation, that’s not going to counteract all the wonderful things that you’re doing to naturally boost your health for your PCOS. The research merely suggests that if you repair your fertility enough to get pregnant, chances are that you’re balancing your hormones adequately to sustain a healthy pregnancy determined.

And you can be doing that even if you do also include infertility assistance in your journey to becoming a mommy. So it’s not an either-or, it’s just showing how important it is to also be addressing that root cause of hormone imbalance, whether it’s insulin or inflammation or stress response or even just nutritional deficiencies and hormone disruption through various things like if you’ve been on birth control before or taken other hormone therapies or even been through several rounds of infertility treatment. Sometimes our hormones just get a little bit out of whack and they need a little assistance getting back in sync. But basically, there’s nothing wrong with thinking about infertility assistance while adjusting your lifestyle. So get started with a full workout and then decide which path sounds and feels best to you as you move forward. Okay, so we’ve been talking a lot about a natural approach. What exactly do we need to do there to get started? So there are several health changes that can have a wonderful impact on your PCOS fertility, but food is a big one and it’s a great place to start. You don’t have to be perfect, but the combination of carefully choosing and avoiding certain foods that can nourish your hormones back into balance is an incredible how much impact it can have.

So nutrition can both balance hormones, restore depleted nutrients, balance blood sugar, reduce the insulin effect, as well as reduce inflammation, and it can even address several of the components of stress that your body may be struggling with. So it is a great place to start. And I’ll link to the meal guide that I have for PCOS in the Show Notes below so that you can grab that and start learning what type of nutrients is going to be ideal for PCOS. Then if you really want to get to the root cause and reverse your PCOS, like I said, start by taking the PCOS Root Cause Quiz which I will also link to in the Show Notes below. Well, there you have it, my friend. It is so important to get a full PCOS workup so that you don’t just have a diagnosis, but also have the information that you need to start providing your body with the care and nourishment that it needs. If you found this episode helpful, be sure to subscribe to the podcast so that you’ll be notified each week when the next topic is available. And if you have any questions about the information in this episode or any other of the episodes or PCOS in general, please head over to Instagram at Nourished to healthy and leave me a comment or a DM because I love connecting with you over there and continuing the conversations about all of these important PCOS topics.

And until next time, bye for now.

Did you know that studies of PCOS epigenetics have shown that our environment can either worsen or completely reverse our PCOS symptoms? I believe that although PCOS makes us sensitive to our environment, it also makes us powerful. When we learn what our body needs and commit to providing those needs, not only do we gain back our health, but we grow in power just by showing up for ourselves. This is why I’ve created a guide.

For you to get started.

My PCOS Fertility Meal guide can be found in the show notes below. I want to show you how to create an environment that promotes healing while still being able to live a life that you enjoy. This guide is completely free, so go get your copy now so that you can step into the vision that you have for your life and for your health.