Episode #157: How Losing Weight Can Support Your Cycle & Conception

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.