Hi, and welcome back to the PCOS Repair Podcast, where today we’re going to get into a topic that we all feel from time to time, but we often don’t fully understand how it affects our hormones and what’s going on in our body — and that is stress. We’re not just talking about feeling overwhelmed or anxious, although that can play a part. We’re going to get into the actual science today of how the stress response system is wired to work with your hormones and how it often impacts the balance they’re already lacking when it comes to PCOS — specifically your metabolic health and fertility — and why it’s so important to understand this when it comes to healing your PCOS hormones, identifying your root cause, and ultimately feeling better in your body so it can work with you instead of against you.

In this episode, I’m going to be breaking down some fascinating research from an article titled Stress: Endocrine Physiology and Pathophysiology so we can better understand what’s actually happening in our body during stress, how our body perceives it, and how it can derail your hormone healing journey if not addressed intentionally.

This episode is going to be more scientific in approach. Sometimes we talk about mindset and action steps; today is about understanding the why — because until we grasp what’s happening in our body, advice like “manage your stress” or “take care of your emotions” can feel vague and repetitive.

What happens in the body during stress?

This article clearly outlines the endocrine stress response — your body’s survival system. When your brain senses a threat — whether it’s physical danger, an emotional trigger, or system overload — it activates two major systems: the sympathetic nervous system and the HPA axis (hypothalamic-pituitary-adrenal axis).

Here’s what happens step-by-step:

• Step 1: The hypothalamus sends a signal to the adrenal glands to release adrenaline and noradrenaline — the “fight or flight” hormones. These increase heart rate, raise blood pressure, and mobilize glucose into the bloodstream for quick energy. If you haven’t eaten in a while, your body breaks down glycogen from your liver so it feels like you just ate a candy bar — giving you a surge of energy.
• Step 2: Pain receptors are dampened so you can keep going without being distracted by discomfort.
• Step 3: The HPA axis activates. The hypothalamus signals the pituitary gland to release ACTH, which tells the adrenal glands to release cortisol — your primary stress hormone.

Short-term, these are helpful adaptations. But when stress becomes chronic, things start to go sideways — especially if you already have underlying hormone imbalances like PCOS.

Why PCOS makes stress more impactful

PCOS is a genetic predisposition that already tilts hormone balance toward irregularity. While everyone’s body experiences this stress response, women with PCOS are more susceptible to disruption because their baseline hormone regulation is already less stable. That means lifestyle and environmental stressors hit harder.

Cortisol, insulin, and PCOS — the critical connection

Cortisol plays a big role in regulating glucose. Under stress, it increases blood sugar so your body has quick fuel for a threat. The problem is that emotional stress doesn’t usually require this extra glucose, so your blood sugar spikes unnecessarily. Over time, this repeated spike makes your cells less sensitive to insulin — leading to insulin resistance.

For women with PCOS, who often already have insulin resistance or a tendency toward it, chronic stress and elevated cortisol add fuel to the fire. Elevated insulin triggers the ovaries to produce more testosterone, which disrupts ovulation, promotes weight gain (especially around the midsection), and worsens inflammation. Now we have a cycle where stress worsens insulin resistance, inflammation, and weight gain — all of which then worsen PCOS symptoms and add even more stress.

What counts as stress?

• Physical: Sleep disruptions (new baby, shift work), chronic illness, injuries.
• Mental/emotional: Work overload, school pressures, relationship conflicts, financial strain, an overbooked schedule.
• Perceived stress: Over-restrictive dieting, sudden intense workouts after being sedentary.

Both short-term stress (a single busy week, an isolated conflict) and long-term stress (constant overcommitment, ongoing job strain, relationship turmoil) affect hormone health, but chronic stress is where the most damage happens.

Stress, the HPA axis, and hormone disruption

Constant fight-or-flight mode dysregulates the hippocampus, leading to:

• Fatigue that doesn’t improve with sleep
• Poor workout recovery
• Sugar or salt cravings
• Trouble falling asleep or waking too early
• Low mood or anxiety

This happens because chronic cortisol disrupts almost every hormone system — blunting thyroid function, altering estrogen and progesterone, suppressing melatonin, and dulling hormone receptor sensitivity. Communication between hormone systems becomes sluggish, like trying to talk underwater.

Managing stress as hormone therapy

This isn’t just about self-care baths. The article emphasized lifestyle structure:

• Nutrition that supports steady blood sugar and provides adequate nutrients
• Movement that relieves stress rather than adding to it (walking, strength training, active recovery)
• Consistent quality sleep
• Daily rhythms that prevent constant urgency and allow recovery time

The goal isn’t to remove all stress but to set up your life so stress becomes manageable and less physiologically disruptive.

The key takeaway

Your endocrine system is always listening. Stress — whether big and obvious or small and persistent — is a hormone disruptor. If you’re doing “all the right things” for PCOS but still feel stuck, unpredictable, or like nothing works, stress may be a missing piece. The good news: your stress response system can be repaired, and it’s a powerful part of your PCOS healing journey.

If you found this episode helpful, hit the subscribe button on your favorite podcast platform so you get notified when new episodes drop. And if you want to connect or share your thoughts, you can find me over on Instagram at Nourish to Healthy. Until next time — bye for now.

So without further ado, let’s dive in. Insulin resistance is one of the most common causes of PCOS. Even in research, it’s shown that somewhere between 70% and 80% of people with PCOS have insulin resistance. Let’s take a step back and ask: what does it actually mean to have insulin resistance? Insulin is a healthy hormone. It’s something we want our bodies to have—it’s not the enemy—but it can struggle to function properly.

Here’s how it works: when we eat something, it turns into blood sugar in our bloodstream. That blood sugar signals our pancreas to release insulin. Without insulin, our blood sugar can’t be used by the body. So the food we eat becomes blood sugar, but it’s useless unless insulin tells our cells to open up and absorb it. That’s how our muscles, brain, and other parts of the body get energy. Without insulin doing its job, we feel depleted, low energy, and lethargic—similar to how we’d feel with low blood sugar, even though blood sugar is present but not being used properly.

Insulin sensitivity means our cells respond well to insulin. For example, let’s say you eat something, your blood sugar rises, and your pancreas releases insulin. If you’re insulin sensitive, your cells—like your muscle cells—get a little nudge from the insulin and open up to absorb the sugar. That’s a healthy, efficient system. But as we start to become more insulin resistant—and remember, this is a spectrum—it doesn’t happen overnight. It starts gradually. So what insulin resistance looks like is this: your blood sugar rises, insulin is released, but the cells ignore it. The pancreas pumps out more insulin, shouting louder to get the cells to respond. The more insulin it takes to get the job done, the more resistance you’re developing. Eventually, it takes so much insulin that you officially reach insulin resistance. We can test this through insulin and glucose levels. If blood sugar stays elevated, it’s a sign that insulin isn’t doing its job well enough.

Now, as insulin resistance worsens, we move along the spectrum toward diabetes. At the diabetic stage, your pancreas might not be able to produce enough insulin anymore. The cells aren’t listening, and now your pancreas is tired from all the work. That’s when both insulin sensitivity and production are compromised.

So how do we test for insulin resistance? We have a few options. Glucose tests and insulin tests can be done in fasting or non-fasting states. A fasting glucose test, typically done in a doctor’s office, tells us how effective insulin was at clearing sugar from the bloodstream. If fasting glucose is high, it means insulin didn’t do its job. High blood sugar damages our blood vessels, so this matters. We can also test blood sugar with finger pricks, especially after meals. This is more common in people managing diabetes and less often used in early PCOS, but it’s still a helpful tool.

Another option is a fasting insulin test or an insulin challenge test. The latter is similar to what’s done in pregnancy—you drink a sugary solution and your insulin and glucose are measured over time. This helps us see how much insulin is being produced and how well your body is responding. The problem is, if we only test glucose, we can miss insulin resistance until it’s already advanced. For example, blood sugar might look normal, but only because your body is releasing large amounts of insulin to keep it there. We don’t know how hard insulin had to work unless we measure it.

That’s where a continuous glucose monitor (CGM) can be incredibly helpful. CGMs don’t measure insulin, but they show glucose trends throughout the day—after meals, during sleep, and during stress. If you eat something sugary and get a big spike followed by a sharp crash, it likely means your body overproduced insulin. That’s a red flag for early insulin resistance, even if lab tests haven’t caught it yet. Your average blood sugar might be fine, but these swings can tell us a lot.

Most insurances will cover CGMs to some extent. Out of pocket, they may cost $75–$90, but insurance often brings that down to $30–$36. You don’t need to wear one all the time. I usually recommend wearing one for 4–6 weeks—two to three sensors, each lasting two weeks. The first week or two is just observing normal life and how food and routines affect your glucose. The second round can be used to experiment and implement changes.

If you see a spike and crash after eating something like an apple, it means your insulin likely overreacted. Your body overcompensated, removing more sugar than necessary, and now you’ve crashed. This shows that insulin resistance is creeping in, long before lab work might catch it.

This gives us a powerful tool to recognize early patterns. Labs like hemoglobin A1C are averages of blood sugar over three months, which won’t catch swings or early issues. The CGM shows how your body is functioning in real time.

Now, let’s talk about symptoms. Classic insulin-related symptoms include fatigue, sugar cravings, weight gain, and brain fog. You might feel a boost after eating and then crash—that’s a blood sugar rollercoaster. Cravings often follow because your body wants to repeat that sugar high. Insulin also signals the body to store fat, so weight loss becomes more difficult. Irregular cycles are another key symptom—excess insulin triggers more androgens, disrupting ovulation.

So how do we manage insulin resistance in PCOS? Nutrition is the cornerstone—it’s the most talked about and rightly so. But movement is also crucial. Exercise helps your muscles become more insulin sensitive. Active muscles respond better to insulin. If you’re sedentary, your muscles are sluggish and less responsive. Strength training and regular movement improve circulation and insulin sensitivity.

Sleep is another major factor. Poor sleep increases stress hormones like cortisol, which then raises insulin levels. This worsens PCOS symptoms. Certain supplements and medications can also help—inositol, berberine, chromium, and metformin are common options. These work differently for everyone. Some people find them too strong at first, experiencing symptoms like brain fog or feeling weak, especially if their body is used to higher blood sugar levels.

You may need to start with a low dose or take them every other day, ideally under the guidance of your healthcare provider. Using a CGM while starting supplements is a great idea—it helps you understand how your body is responding. You’ll know if your blood sugar is dropping too fast and whether that’s what’s causing your symptoms.

All these supplements—inositol, berberine, chromium, metformin—aim to lower blood sugar. Don’t take them all at once. Introduce one at a time, start with the stronger one, and work with your provider to see what works best for you.

Lastly, tracking your progress is key. That includes tracking your cycle, symptoms, labs, CGM data, and even body composition. All of it gives you a clearer picture.

I hope this episode helped you better understand how insulin works, where it starts to go wrong, and how to recognize the early stages of resistance. Even though we’ve talked about insulin many times, I know it can still be confusing. People often say, “My doctor tested me, and I’m not insulin resistant,” but they don’t realize the limitations of that testing. Even with a CGM, we’re making inferences based on blood sugar behavior—but it’s still a much clearer window into what’s really going on.

If you have follow-up questions, you know where to find me—over on Instagram @nourishhealthy. And if you found this episode helpful, please hit subscribe on your favorite podcast platform so you’ll be notified each week when a new episode is released. Until next time, bye for now.

Welcome back to the PCOS Repair Podcast. Today, we’re going to dive a little deeper into PCOS and insulin resistance. First of all, I know this can sound like a broken record—we talk about insulin so much here on the podcast—but it’s one of the key hormones that’s so dependent on lifestyle. And even beyond PCOS, this is a broader societal issue. But when it comes to PCOS, insulin resistance is such a root cause factor for almost everyone. The tricky thing is, it doesn’t have one specific look on the outside. It’s not just people who are overweight, or who eat a certain way. There are so many nuances to insulin resistance and PCOS, and that’s exactly what we’re going to talk about today.

So without further ado, let’s dive in. Insulin resistance is one of the most common causes of PCOS. Even in research, it’s shown that somewhere between 70% and 80% of people with PCOS have insulin resistance. Let’s take a step back and ask: what does it actually mean to have insulin resistance? Insulin is a healthy hormone. It’s something we want our bodies to have—it’s not the enemy—but it can struggle to function properly.

Here’s how it works: when we eat something, it turns into blood sugar in our bloodstream. That blood sugar signals our pancreas to release insulin. Without insulin, our blood sugar can’t be used by the body. So the food we eat becomes blood sugar, but it’s useless unless insulin tells our cells to open up and absorb it. That’s how our muscles, brain, and other parts of the body get energy. Without insulin doing its job, we feel depleted, low energy, and lethargic—similar to how we’d feel with low blood sugar, even though blood sugar is present but not being used properly.

Insulin sensitivity means our cells respond well to insulin. For example, let’s say you eat something, your blood sugar rises, and your pancreas releases insulin. If you’re insulin sensitive, your cells—like your muscle cells—get a little nudge from the insulin and open up to absorb the sugar. That’s a healthy, efficient system. But as we start to become more insulin resistant—and remember, this is a spectrum—it doesn’t happen overnight. It starts gradually. So what insulin resistance looks like is this: your blood sugar rises, insulin is released, but the cells ignore it. The pancreas pumps out more insulin, shouting louder to get the cells to respond. The more insulin it takes to get the job done, the more resistance you’re developing. Eventually, it takes so much insulin that you officially reach insulin resistance. We can test this through insulin and glucose levels. If blood sugar stays elevated, it’s a sign that insulin isn’t doing its job well enough.

Now, as insulin resistance worsens, we move along the spectrum toward diabetes. At the diabetic stage, your pancreas might not be able to produce enough insulin anymore. The cells aren’t listening, and now your pancreas is tired from all the work. That’s when both insulin sensitivity and production are compromised.

So how do we test for insulin resistance? We have a few options. Glucose tests and insulin tests can be done in fasting or non-fasting states. A fasting glucose test, typically done in a doctor’s office, tells us how effective insulin was at clearing sugar from the bloodstream. If fasting glucose is high, it means insulin didn’t do its job. High blood sugar damages our blood vessels, so this matters. We can also test blood sugar with finger pricks, especially after meals. This is more common in people managing diabetes and less often used in early PCOS, but it’s still a helpful tool.

Another option is a fasting insulin test or an insulin challenge test. The latter is similar to what’s done in pregnancy—you drink a sugary solution and your insulin and glucose are measured over time. This helps us see how much insulin is being produced and how well your body is responding. The problem is, if we only test glucose, we can miss insulin resistance until it’s already advanced. For example, blood sugar might look normal, but only because your body is releasing large amounts of insulin to keep it there. We don’t know how hard insulin had to work unless we measure it.

That’s where a continuous glucose monitor (CGM) can be incredibly helpful. CGMs don’t measure insulin, but they show glucose trends throughout the day—after meals, during sleep, and during stress. If you eat something sugary and get a big spike followed by a sharp crash, it likely means your body overproduced insulin. That’s a red flag for early insulin resistance, even if lab tests haven’t caught it yet. Your average blood sugar might be fine, but these swings can tell us a lot.

Most insurances will cover CGMs to some extent. Out of pocket, they may cost $75–$90, but insurance often brings that down to $30–$36. You don’t need to wear one all the time. I usually recommend wearing one for 4–6 weeks—two to three sensors, each lasting two weeks. The first week or two is just observing normal life and how food and routines affect your glucose. The second round can be used to experiment and implement changes.

If you see a spike and crash after eating something like an apple, it means your insulin likely overreacted. Your body overcompensated, removing more sugar than necessary, and now you’ve crashed. This shows that insulin resistance is creeping in, long before lab work might catch it.

This gives us a powerful tool to recognize early patterns. Labs like hemoglobin A1C are averages of blood sugar over three months, which won’t catch swings or early issues. The CGM shows how your body is functioning in real time.

Now, let’s talk about symptoms. Classic insulin-related symptoms include fatigue, sugar cravings, weight gain, and brain fog. You might feel a boost after eating and then crash—that’s a blood sugar rollercoaster. Cravings often follow because your body wants to repeat that sugar high. Insulin also signals the body to store fat, so weight loss becomes more difficult. Irregular cycles are another key symptom—excess insulin triggers more androgens, disrupting ovulation.

So how do we manage insulin resistance in PCOS? Nutrition is the cornerstone—it’s the most talked about and rightly so. But movement is also crucial. Exercise helps your muscles become more insulin sensitive. Active muscles respond better to insulin. If you’re sedentary, your muscles are sluggish and less responsive. Strength training and regular movement improve circulation and insulin sensitivity.

Sleep is another major factor. Poor sleep increases stress hormones like cortisol, which then raises insulin levels. This worsens PCOS symptoms. Certain supplements and medications can also help—inositol, berberine, chromium, and metformin are common options. These work differently for everyone. Some people find them too strong at first, experiencing symptoms like brain fog or feeling weak, especially if their body is used to higher blood sugar levels.

You may need to start with a low dose or take them every other day, ideally under the guidance of your healthcare provider. Using a CGM while starting supplements is a great idea—it helps you understand how your body is responding. You’ll know if your blood sugar is dropping too fast and whether that’s what’s causing your symptoms.

All these supplements—inositol, berberine, chromium, metformin—aim to lower blood sugar. Don’t take them all at once. Introduce one at a time, start with the stronger one, and work with your provider to see what works best for you.

Lastly, tracking your progress is key. That includes tracking your cycle, symptoms, labs, CGM data, and even body composition. All of it gives you a clearer picture.

I hope this episode helped you better understand how insulin works, where it starts to go wrong, and how to recognize the early stages of resistance. Even though we’ve talked about insulin many times, I know it can still be confusing. People often say, “My doctor tested me, and I’m not insulin resistant,” but they don’t realize the limitations of that testing. Even with a CGM, we’re making inferences based on blood sugar behavior—but it’s still a much clearer window into what’s really going on.

If you have follow-up questions, you know where to find me—over on Instagram @nourishhealthy. And if you found this episode helpful, please hit subscribe on your favorite podcast platform so you’ll be notified each week when a new episode is released. Until next time, bye for now.

Hi, and welcome back to the PCOS Repair Podcast. Today I’m excited because I get to share one of my favorite kinds of episodes, and that’s a real-life PCOS story. Today I get to share about one of my former patients, Rachel. Her story is especially powerful because it highlights one of the areas of PCOS that often gets overlooked—chronic inflammation. I specifically like her story because it deals with a very generalized type of chronic inflammation, and as you’ll see, it’s the type that most women probably encounter. We addressed it in a way that’s both accessible and effective, and probably the best fit for many people dealing with chronic inflammation.

When we think about root causes, we all have all of them to some extent. It’s just a matter of which ones are currently engaged and causing our PCOS to show up in disruptive ways. We all can have stress responses, increased inflammation, insulin dysregulation, and hormonal or nutritional deficiencies. The question is which of these are the most prominent in our current lifestyle.

All right, let’s get into Rachel’s story. Like all PCOS stories, hers includes a lot of frustration, but the key difference that really led to Rachel’s eventual success was her resilience and her patience with trying and fine-tuning what was going to work for her. She came to me when she was about 35 years old—just about to turn 35—and she had been trying to conceive for over a year without any success. She was beginning to really feel the stress and pressure of, “I’m 35, I waited to have kids thinking I could when I wanted to, and now I’m struggling.”

When she talked to her OB-GYN, they told her she needed to lose a little weight. She was about 50 pounds overweight, so they told her, “Lose around 30 pounds and you should be good to go.” There was no urgency, no real support offered. They didn’t take into account her age, even though she brought it up. The information was vague at best, and there was absolutely zero guidance on how to lose the weight or what ways might work best for her—just some vague reassurance that it was going to happen, that this was normal and she’d be fine.

After a few more months, Rachel just had this strong feeling that something wasn’t right and that she needed to get to the bottom of it. That’s when she and I started working together. She was having irregular cycles and felt like her digestion was a total mess. It was unpredictable—some days she was massively bloated, other days she seemed okay, but she still felt tired and bloated most of the time. In her words, she said, “I feel tired, but I’m not sleepy.” It wasn’t something a good night’s rest would fix. She said she slept fine, but still felt sluggish and weighed down every day.

She’d had some skin issues when she was younger, but they’d mostly calmed down. She mentioned that at certain times of year she would get eczema—usually around her cycle or during extreme stress—but other than that, she didn’t really have many symptoms of inflammation besides the bloating and fatigue. She was eating relatively clean. She said, “I’ve Googled everything, I’ve researched, I’ve watched people talk about how to eat clean.” She exercised daily—some days were better than others—but she always went for a walk or did stretching or yoga. She lifted weights three times a week and tried to get in some strenuous cardio twice a week. Despite all of this, she felt like nothing was working. And you could tell by everything she was trying that she was highly committed and motivated.

So our first step was to look beyond surface symptoms. We ordered some functional labs and reviewed her symptoms in more detail. What we found was interesting. She had elevated inflammatory markers. She didn’t show any food sensitivities, but she had a lot of gut imbalances. So we looked at ways to improve her digestion and reduce her low-grade inflammation. She had some chronic stress—who doesn’t, right?—and she had ongoing immune responses. She experienced seasonal allergies and caught every bug she came across. These things pointed to areas we needed to address.

Like with most root causes, the takeaway here was that her body was not thriving in her environment. Something was inflaming it. And when the body is inflamed and not thriving, it tends to shut down reproduction. Plus, when you’re a little overweight and dealing with insulin resistance just from that alone, it adds to the hormone imbalance and increased androgens. So it wasn’t just about fertility—it was an entire web of inflammation, stress, and weight that was keeping her stuck.

Because she was already doing a great job with her movement, we focused first on food. Based on her inflammatory markers, we did some elimination testing. I guided her through my PCOS Detox protocol, which you can find at pcosdetox.com. It helps you identify what foods support your body and which ones don’t. She didn’t find any foods she needed to cut out completely, but we definitely found ones to minimize. That can be harder to spot since the reaction is subtle—it’s not like lactose intolerance where the symptoms are obvious. It was more like, “When that food crept back in, I just didn’t feel as good.”

We focused on a very anti-inflammatory diet—making sure the foods she ate helped fight inflammation and didn’t contribute to it. Then we worked on gut repair. If you’ve been on birth control or antibiotics, even just once a year, and you’ve never worked to repair your gut, it’s time to address that. So we focused on probiotics, gut-healing foods, and supporting her microbiome. When the gut starts functioning better, everything else improves—nutrient absorption, energy levels, bloating—all of it starts to fall into place.

We also made sure not to overlook sleep and stress. Rachel began making time to quiet her mind and manage her stress. To give you a sense of timeline, we spent about a month assessing everything. Labs, food exploration, and some habit adjustments all happened pretty early on. Then we created a lifestyle outline tailored to her—what she liked to eat, how her day flowed, what she had time for—and implemented it gradually.

Once she was fully implementing her plan, it took a couple of months for her body to really settle in and start recovering. Around four months in, her cycle became regular, and at eight months, she became pregnant naturally. That’s a fairly typical path for this kind of approach.

What stood out to me about Rachel’s story—and why I’m so grateful she let me share it—is that she didn’t have any glaring food sensitivities or unusual test results. Her microbiome was simply off, likely due to birth control and a few courses of antibiotics, and her body was inflamed. Once we addressed that, she began tolerating foods much better, and as her body became less inflamed, she was able to start losing weight.

Around the two-month mark, we carefully reduced her calorie intake—nothing drastic. You don’t want to overhaul everything all at once. From months two to eight, she lost 25 pounds. That’s about four pounds a month—roughly one pound per week—which is a great, steady rate. Of course, it wasn’t linear. Some weeks she lost three pounds, some weeks none. That’s totally normal. But by the time she got pregnant, she’d lost between 20 and 25 pounds.

And the weight loss didn’t feel forced. She told me, “Once the inflammation was addressed, the weight just came off. Yes, I had to be mindful, but my body wanted to lose the weight.” That’s the shift we’re looking for—when your body is working with you instead of against you.

When I asked Rachel what her biggest takeaways were, she said, “Don’t ignore gut health.” For her, healing her gut made her feel like a different person. She also said she was surprised she didn’t have to be perfect. She didn’t have to cut out entire food groups forever. She just had to create balance—more anti-inflammatory foods, fewer inflammatory ones. Consistency mattered more than perfection.

And finally, she said food became something to enjoy again. Before, she felt like food punished her—it made her bloated and uncomfortable. But after healing, food became a way to feel better, to support her health and her body. That mindset shift was huge.

So as we wrap up, if you’ve been feeling discouraged—like all the things that taste good are “bad” for your PCOS—I hope Rachel’s story inspires you. Food can actually make you feel good. It can be healing, nourishing, and empowering. Whether you’re working on fertility or managing your PCOS symptoms, understanding what your body needs and giving it that support can feel like a massage from the inside. You can finally feel good in your skin.

Rachel’s story is proof that healing from the inside out is possible—and it doesn’t have to take forever. In just a few short months, she completely transformed her health. Every journey is different, but I hope this episode helps you feel supported and inspired.

If you found this episode helpful, please be sure to hit that subscribe button so you get notified each and every week when a new episode becomes available. And until next time, bye for now.

Hi, and welcome back to the PCOS Repair Podcast. I’m excited about today’s topic because it’s one that often gets confusing and miscommunicated—especially in healthcare settings. Doctors may say one thing but leave a lot of room for interpretation, and that’s where myths, misconceptions, and misunderstandings take root. So today, we’re diving into how weight affects your cycle and, in turn, your fertility. We’ll explore what to do about it, how it all fits together, and how to approach it with confidence—so you understand what tools to consider and, most importantly, how to avoid doing further harm. Let’s dive in.

The question I get all the time is: “Will losing weight help me get pregnant or get my cycle back? Because that’s what my doctor said.” And the short answer is—yes, it can. In this episode, we’ll unpack how that works, when it works, and most importantly, how to approach weight loss in a way that is both effective and sustainable, without making your hormone imbalance worse.

This is where things get dangerous. There’s a lot of bad advice out there when it comes to weight loss. For women with PCOS, the relationship between weight and hormone imbalance is much more complex than it is for someone without PCOS. For example, take a man who’s gained a little weight from eating too many calories. He can just reduce his intake and lose the weight. But for women with PCOS, it’s a lot more nuanced.

So how does weight affect the cycle and fertility?

First, I want to be clear—weight does not cause PCOS. Losing weight doesn’t automatically resolve PCOS. A lot of women leave their doctor’s office with the idea that they’re overweight because they have PCOS, or that their weight is causing their PCOS, and if they could just lose weight, the condition would go away. But that’s not how it works. There’s a wide range of body sizes among women with PCOS. Someone very thin can have severe symptoms, while someone overweight may only have mild or moderate PCOS. The severity of symptoms does not directly correlate with weight.

Excess weight is often a symptom of underlying issues like insulin resistance, inflammation, stress response, hormonal disruption, or nutrient deficiencies. And when weight gain happens, it can worsen those root causes—creating a feedback loop. More fat increases inflammation, exacerbates insulin resistance, and makes stress harder to manage. This is why many providers say, “Lose weight, and things will improve.” But they often skip over the fact that the root causes were already there, and addressing those—not just the weight—is what truly matters.

That said, understanding how excess fat affects the cycle and fertility is important. Sometimes, reaching a healthy body weight may even involve gaining a few pounds or shifting your body composition.

Excess fat influences estrogen levels, increases insulin, which in turn raises testosterone and estrogen production, and elevates LH levels—leading to suppressed ovulation. Estrogen is crucial in the first part of the cycle, so when it’s out of balance, it becomes harder for a follicle to mature. Even if LH is present to trigger ovulation, the egg may not be fully developed. This hormonal imbalance prevents proper ovulation and sets off a chain reaction that disrupts the rest of the cycle.

Inflammation is another factor. It not only increases androgens but also lowers egg quality. The cycle is a three-part process: preparing the egg, ovulation, and then implantation. If any part gets disrupted, the rest of the cycle can’t proceed properly. That’s why fertility struggles can persist even if ovulation technically occurs. Implantation also requires hormone signaling, which is interrupted when inflammation or other imbalances are present. Egg quality is essential—not just for conception, but to carry a healthy pregnancy to term. A poor-quality egg may lead to miscarriage because the body recognizes the issue early on.

So, what does a healthy weight for fertility actually look like?

We’re not talking about being ultra-thin. You don’t need to be a size 0 to improve your cycle. Sure, you can pursue lower body fat for fitness goals, but that’s separate from the fertility conversation. For fertility, you don’t have to go to extremes. Someone at 30% body fat may benefit from lowering it to 22% or 20%, but dipping below 20% can sometimes hurt fertility.

Personally, my cycle thrives between 17–19% body fat—which is very low for women. But once I creep above 22–23%, my symptoms flare. Everyone has a unique threshold, and it takes some trial and error to find your sweet spot. Most women do well in the 20–25% range, though some may remain fertile at 25–30%, especially if they’re coming from a higher weight.

Interestingly, if someone has a significant amount of weight to lose, just dropping 5–10% of their body weight can dramatically improve cycle function. For instance, losing 10–20 pounds when you weigh 200 can make a measurable difference. That might be enough to resume ovulation and get pregnant, even though your weight is still above ideal. But remember, just reaching a short-term goal doesn’t mean your hormones are fully balanced.

So, how do we lose weight safely and in a way that supports our hormones?

First, you have to understand your root causes—whether it’s insulin, inflammation, stress, or nutrient deficiencies. If you don’t know what’s driving your symptoms, it’s difficult to make meaningful changes. A great place to start is the PCOS Root Cause Quiz, which I’ll link in the show notes. Inside my Bootcamp program, we go deeper with a full assessment to help you prioritize what to address first.

Once you understand your root cause, the next step is to lose fat without stressing your body. Cutting calories drastically may result in weight loss, but you’ll likely lose muscle and bone density along with fat. That’s not what we want. Weight on the scale doesn’t matter—body composition does.

Our body knows the difference between fat and lean mass. It also knows when we’re malnourished. If you starve yourself, your body panics—it becomes resistant to change, ramps up stress hormones, and holds on to fat. So instead of extreme dieting, focus on balanced meals that stabilize blood sugar and replenish missing nutrients.

Incorporate movement—both resistance training and gentle cardio like walking or agility work. Stay active throughout the day, not just in workouts. Prioritize sleep and recovery. Don’t push yourself to the brink. A stressed body won’t ovulate, no matter how much weight you lose.

If fertility is your goal, you also need to track your cycle. If you’re not ovulating, or if your cycles are irregular, that’s your starting point. Track your basal body temperature, use hormone test strips, or explore other hormone tracking tools. Pay attention to how consistent your cycles are—not compared to someone else’s, but compared to your own pattern. Also track PMS symptoms, mood shifts, and energy levels throughout the month. These markers tell you more than the scale ever could.

To recap, yes—losing weight can improve your inflammation, insulin resistance, stress response, and nutrient balance. These improvements help regulate your cycle and increase your chances of getting pregnant. But it’s not just about the number on the scale—it’s about how your body is functioning.

You can track body fat percentage using tape measurements, home devices, or more advanced tools like a DEXA scan, which also assesses muscle and bone mass. I personally do this once a year to stay on track. But what matters most is consistency and sustainable progress.

A key point: weight is a symptom of PCOS, not a root cause. But unlike acne, which doesn’t worsen your root cause, excess weight actually feeds back into and worsens hormonal imbalance. That’s why managing it can create such positive ripple effects.

You don’t need to become ultra-thin. Even a 5–10% reduction in weight can yield big changes. Studies show that 86% of women who weren’t ovulating began to ovulate again after modest weight loss. That’s powerful. But again, we’re not talking about crash diets or getting to a size 2.

And that brings me to a topic I’ll be covering soon: weight loss medications like Ozempic. Spoiler alert—they may reduce the number on the scale, but they also result in significant muscle loss. That hurts your long-term metabolism and hormone function. I’m still reviewing the research, and I’ll go into detail in an upcoming episode. In the meantime, feel free to DM me your questions on Instagram @nourishtohealthy.

Ultimately, the best approach to PCOS-related weight loss is one that is gentle, sustainable, kind, and rooted in nourishing your body. When we prioritize healthy habits over quick fixes, we create fertile ground for our hormones to flourish, our cycles to normalize, and our bodies to thrive—not just for conception, but for lifelong wellness.

I hope you found today’s episode helpful. If you did, hit that subscribe button and come say hi on Instagram @nourishtohealthy. I love hearing from you.

Until next time, bye for now.