PCOS Diet: Your Gut Health and Fertility

Has anyone ever talked to you about how your diet, specifically your gut health can affect your fertility with PCOS? Not really, you say? That’s not surprising. The problem is, many doctors just don’t have the time or the bandwidth to cover this important information.

So for today, to show my support for you, I want to share some insight in to the importance of your gut health and how it may be impacting your fertility.

What is PCOS (Polycystic Ovarian Syndrome)?

PCOS (Polycystic Ovarian Syndrome) is a condition that has a variety of factors; insulin resistance, elevated testosterone and infertility being some of the highlights (although those would be better named as lowlights, wouldn’t they?). It is one of the most common causes of female infertility. PCOS expresses itself differently for many women and has different types. When getting treatment for your infertility with PCOS, it’s important to get your type figured out so you can get the most straight-forward fertility plan.

What is infertility?

Infertility is defined by the Centers for Disease Control (CDC) as not being able to get pregnant within one year of having unprotected sex. And for those who are over the age of 35, not getting pregnant after six months of trying.

Gut health and fertility

Alright, now that we have that cleared up, let’s talk about your diet and gut health and fertility. It doesn’t seem like those would have much in common, would it? That’s exactly why we need to talk about it, because you’re right, at first glance it doesn’t seem like there would be a connection and that’s why this topic is getting pushed under the bus way too often. But you are lucky, because you are here and you are getting this front-line information for your fertility, so congrats to you!

When we are talking about the connection between your gut health and your fertility, the first thing to understand is that fertility is not just about your lady-parts!

What do I mean by that? Basically, there is so much more going on in your body that needs to be explored for fertility purposes other than just your ovaries, uterus and reproductive hormones. It’s important to take a holistic view of your body to understand what is affecting your fertility health and how to fix it. That’s when your fertility chances can open up.

That’s also why today we are going to explore how gut health impacts your fertility, particularly with PCOS.

What is gut health?

Gut health refers to the microbiome inside your digestive system. As Harvard Nutrition puts it, we have trillions of microbes of thousands of different species. These microbes are living inside of you doing a fantastic job (usually) of keeping viruses and bacteria from harming you and making vitamins for you to use so you can stay happy and healthy.

So what’s the big deal?

Well, we need to go back around 120 years ago. Up until this point in history, humans had to figure out how to keep food fresh. This meant foods needed to be eaten right away, or they needed to be preserved through canning or fermentation.

Fermentation is the process of harnessing healthy bacteria to create long-lasting shelf-stable food. That fermentation process creates millions of microbes in just one jar of sauerkraut (just for example). So throughout human history, humans were eating many microbial-rich foods which allowed their guts to be happy and overrun (in a good way) with these microbes.

Then, around 120 years ago the refrigerator was invented. It brought many positive changes to the world in the form of food safety, food security and convenience. But it also reduced our dependence on fermented foods. Now, years later, we are starting to see the effects of generations who have been exposed to less fermented foods and lower amounts of microbes on a daily basis.

Which brings us to…

How does gut health affect fertility?

—> Reason #1: Gut Health Impacts Estrogen Balance

The reason you need to care about estrogen is that too much estrogen in the body causes progesterone to lower. If you don’t have enough progesterone then you won’t ovulate and you won’t be able to carry a pregnancy forward. So get your note pad out and start taking notes!

There is fascinating research into this system called estrobolome in your body. This estrobolome is apart of your gut microbiome and its main function is to help regulate your estrogen levels.

Your body loves just the right amount of estrogen, not too much and not too little. Well, all day long your body is making estrogen and then the estrogen gets broken down and taken out of the body. It’s the role of the estrobolome to regulate how much estrogen leaves the body and how much estrogen stays to maintain a nice balance.

If you have some dysbiosis going on or too little of the healthy microbes in your gut, that can lead to your body’s estrogen regulation getting out of balance, causing progesterone to lower and your fertility to plummet.

—> Reason #2: Gut Health Impacts Inflammation

Your gut is a gateway from your body to the outer world. Think about it. Your mouth is an entrance in to your digestive system. Anything that goes inside needs to be evaluated by your body’s defense systems to see if it’s safe to enter your body. Your gut has a lot of important immune factors to do just that. If your immune system in your gut is impaired by viruses or bacteria and then starts getting confused and calling out things that aren’t bad, and letting things in that are, that’s when you get inflammation.

Oxidative stress is a component of inflammation and fertility as well. Oxidative stress is when more free radicals are being made in the body than taken out of the body.

Oxidative stress and inflammation can be affecting your fertility because the larger number of free radicals can reduce egg quality.

Inflammation may also show up in your body in the way of endometriosis. Endometriosis is a condition when uterine cells travel outside the uterus. They can implant on other areas of your body like your ovaries or even block your fallopian tubes which then reduces your fertility.

—> Reason #3: Gut Health is Important for Insulin-Resistance

While not every woman with PCOS has insulin resistance, it is so common that I want to be sure and include it here. Insulin-resistance means you have too much insulin in your body. Your body is not responding to the insulin and therefore you have extra blood glucose (sugar) running through your body and so then you make more insulin. It’s a viscous cycle!

The big red flag with insulin resistance and fertility is that the higher the insulin you have, the more that insulin runs over to your ovaries and tells them to make testosterone. The more testosterone you have in your body, the less often you will ovulate. If you don’t ovulate, that means no egg will be released and no baby can be made. So getting that insulin-resistance is vital to your fertility!

Alright, you now know the incredible importance of supporting gut health for fertility. But now you want some action steps, don’t you? That would make you feel a lot better, I’m sure. So let’s talk about it.

What do you do to support your gut health?

—>Talk with a trusted provider

You first want to talk with a provider who can help you understand what your gut is telling you and how to get a plan forward to support your individual picture.

You may have symptoms like constipation, or diarrhea or stomach cramping that shows you that it’s obvious something is wrong. But you may have symptoms that you didn’t realize were causing a problem. Like, when is constipation a problem? When do you know that the amount of bloating you have is not normal? These questions should be answered between you and a trusted healthcare provider.

—> Eat a diet full of fiber

Alrighty, here’s something you can start doing right away. Fiber-rich foods are wonderful for supporting the friendly-microbes you have in your digestive tract. The bacteria love to eat off of fiber, they get really happy and start multiplying.

Fiber-rich foods are foods like:

• Vegetables

  • Don’t forget about the skin! That’s where a lot of the fiber is in many vegetables. Like carrots for instance. Do you peel carrots? There’s really no need and you can get an extra healthy dose of fiber if you stop peeling them.

• Whole-grains

  • Think about foods like oatmeal, whole-grain breads, quinoa, and brown rice. Whole-grains also do a great job at balancing blood sugar and helping with insulin-resistance so it’s a win-win.

• Fruits

  • Be sure to eat fruits in their whole form. Sure, a glass of juice is fine, but not if you want to be increasing your fiber because it doesn’t actually contain any of the fiber. That fiber was all stripped away in the juicing process.

—> Eat fermented foods

Fermented foods are the original probiotic. They are what has sustained human microbes for thousands of years. Keep the tradition going! The nice thing about fermented foods is that they are so chock-full of microbes that even a small serving, about a tablespoon, per meal is a great addition to your gut health.

Consider adding in fermented foods, like:

• Yogurt

• Kefir

• Kimchi

• Sauerkraut

• Kombucha

• Kefir water

• Raw apple cider vinegar (in even smaller amounts than the serving size I mentioned above, about 1 teaspoon dissolved in a little water is a good amount).

You may be one of those people who starts eating fermented foods and doesn’t feel very good. Maybe you start getting headaches, angry, irritable. These are signs that you have a histamine intolerance. A histamine intolerance is when you react poorly when you eat histamine-rich foods which, unfortunately, are fermented foods. If this is you, then you need to talk with a provider to figure out what your specific body needs.

Gut health is fascinating and it’s something you want to be more familiar with if you want to change your diet to help repair your PCOS and optimize your fertility.

If you need help figuring out what your body and gut specifically need, sign up for a free virtual 1-1 session with me, Dr. Potter. We will talk about what’s been affecting your fertility the most and what’s been missing from your care that is keeping you from getting pregnant. You will also walk away with clear, step-by-step guidance on what to do in order to boost your fertility.