How to Reduce the Damaging Effects of PCOS on Fertility Through Diet and Herbs

How to Reduce the Damaging Effects of PCOS on Fertility Through Diet and Herbs

Polycystic Ovarian Syndrome may be one of the most complex female health issues of our time. It is the most common endocrine disorder in women of reproductive age. PCOS is accompanied by a variety of different health issues, many of which directly impact fertility. Classic PCOS presents with obesity, polycystic ovaries (multiple ovarian cysts that look like a strand of pearls), elevated levels of androgens and absent or irregular menstrual cycles. Not all women who will go on to be diagnosed with PCOS will have these issues though.

What Causes PCOS?

Doctors are unsure of what causes PCOS, but information suggests there are several links including genes, possible abnormal fetal development, insulin resistance and inflammatory response contributing to the cause. We know that insulin resistance plays a key role in PCOS, but what leads to the development of this has not been pinned down. PCOS is also negatively affected by diet, lifestyle and exposure to certain environmental toxins. PCOS directly impacts fertility, but has serious health implications as well, especially if left untreated.

Genetic Predisposition and Abnormal Fetal Development
Women whose mothers, sisters or grandmothers had PCOS are at a higher risk for developing PCOS. Research suggests that exposure to excessive amounts of male hormones (androgens) by the developing fetus may alter proper gene expression. This means that the affected genes will not function correctly later in life, which may cause PCOS during the reproductive years of a woman’s life.

A recent, first of its kind genome-wide association study of PCOS has identified two areas of DNA that leave women of European ancestry susceptible to developing PCOS. The researchers also found one region of susceptibility in the DNA of Chinese women. Of particular interest was one area of DNA that contains the gene for the hormone FSH (follicle stimulating hormone). This finding provides evidence of disruption of the pathway that regulates FSH and in turn ovarian function which plays a crucial role in the development of PCOS.

The human genome project has allowed researchers to pool more than 700,000 genetic markers from the DNA of thousands of women with PCOS. This is what helped them identify regions of genes associated with PCOS.

“For a number of years, researchers had been thinking that it was testosterone produced by the ovary that was a major problem in PCOS, but our study did not find signals for genes regulating testosterone… In contrast, we did find a signal for the FSH gene, which is produced in the pituitary gland at the base of the brain. This suggests that FSH, in either how it acts on the ovary or how it is secreted, is very important in the development of PCOS. This is a new way of thinking about the biology of PCOS.”
– Dr. Andrea Dunaif

Researchers are planning on mining the DNA of women of African ancestry with PCOS next to see if there is a shared genetic basis for PCOS over other ethnicities. Doctors plan to use all of this research to identify girls who may be at-risk for developing PCOS and create a medical treatment protocol to cure it.

Another interesting study of 235 women with PCOS sought to discover if there is a link to the development of PCOS later life that may be influenced by factors beginning in the womb. The women were divided into two groups. The groups were categorized by: 1. obese women with elevated androgens, elevated LH and testosterone, and 2. by thin to normal weight women with elevated LH and normal levels of androgens. The results of the study showed a pattern in both the mothers weight and baby’s birth weight and fetal gestation time. The women in group 1 had above-average birth weight and were born to obese mothers. The women in group 2 were born after 40 weeks gestation. The conclusion was that events occurring during fetal development may have long-term effects on endocrine function later in life.

Insulin Resistance
Insulin is a hormone produced in the pancreas and is responsible for signaling cells in the body to function correctly, most importantly to convert glucose to energy and to control their growth. It also plays a key role in the metabolism of carbohydrates, lipids and proteins.

Insulin resistance happens when the body’s cells become resistant to the effects of insulin. When this happens, higher levels of insulin are needed so that insulin can have the proper effects. At this point, the pancreas must overcompensate, working harder and harder to produce more insulin.

Insulin signals the ovaries to secrete testosterone and inhibit hepatic sex-hormone binding globulin (SHBG) production which leads to an increased level of circulating testosterone. This is why many women with PCOS experience acne, facial hair growth and male pattern baldness (hirsutism). Excess insulin in the bloodstream also signals the ovaries to release more estrogen which can suppress ovulation.

Low-grade Inflammation
It has also been found that women with PCOS have low-grade inflammation, which may be a cause for insulin resistance. White blood cells produce substances to fight infection, this is known as inflammatory response. In some predisposed people eating certain foods, or exposure to certain environmental factors may trigger an inflammatory response. When inflammatory response is triggered, white blood cells produce substances that may contribute to insulin resistance and atherosclerosis.

Signs, Symptoms and Health Risks

Signs and Symptoms of PCOS

  • Irregular menstrual cycles
  • Absent period
  • Anovulatory cycles
  • Abnormal mid-cycle bleeding
  • Excessive or heavy menstrual bleeding
  • Alopecia (balding)
  • Hirsutism (excessive body hair)
  • Acne
  • Acanthosis nigricans – a darkening of the skin in the armpits, back of the neck, or groin
  • Polycystic ovaries
  • History of ovarian cysts
  • Mood disorders
  • Obesity
  • Recurrent Miscarriage

Health and Fertility Risks Associated with PCOS

  • Infertility
  • Menstrual cycle irregularities
  • Possible increased risk for endometrial and breast cancer due to unopposed estrogen
  • Cardiovascular disease
  • Diabetes
  • Gestational diabetes

How is PCOS Diagnosed?

When PCOS was first discovered it was named Polycystic Ovarian Syndrome because of the presence of polycystic ovaries seen by ultrasound. Over time doctors began to realize that PCOS was a complex array of health issues. To date there is a push by doctors to change the name of this condition. “Patients read into the name and just think, ‘Okay, this is about my ovaries, it’s really not about anything else…’ But from a doctor’s perspective, the most worrisome aspects of the disorder are the long-term consequences, such as diabetes.,” said Dr. Melissa Goist, ObGyn. (Livescience, 2013). This led to certain criteria that must be recognized to be diagnosed with PCOS, rather than just the presence of polycystic ovaries. In fact some women with PCOS do not have polycystic ovaries. In order to be diagnosed with PCOS the following should be evaluated by your healthcare practitioner:

Pituitary and Ovarian Hormone serum levels:

  • Luteinizing Hormone (LH)
  • Follicle Stimulating Hormone (FSH)
  • Estradiol
  • Progesterone
  • Prolactin

Circulating Androgens:

  • Free testosterone
  • Free androgen index (FAI): 17-hydroxyprogesterone
  • Sex hormone binding globulin (SHBG): 24 hr. urinary free cortisol
  • Dehydroepiandrosterone sulfate (DHEA-S)

Endometrial Biopsy
Glucose Tolerance Test
Thyroid Panel
Blood Lipid Profile

Are you wondering what your test results mean? Please talk to your doctor in detail about what your test results mean for your fertility. Some doctors may tell you that you have mild PCOS. Women may have some or all of the symptoms of PCOS, some may have normal menstrual cycles and some may not. Testing is the best way to find out if you have PCOS for sure or not.

Click here to learn more about the different presentations of PCOS…

How PCOS Affects the Menstrual Cycle

What happens in a normal menstrual cycle?

In very simple terms the hypothalamus produces GnRH (gonadotrophin-releasing hormone) which signals to the pituitary to produce LH (luteinising hormone) and FSH (follicle stimulating hormone). The release of GnRH is pulsatile in women with regular menstrual cycles. The normal pulsatile release of GnRh signals some of the follicles in the ovary to begin maturing and for the ovaries to release estrogen and progesterone. This estrogen/progesterone signal is recognized by the pituitary gland. As the follicles begin maturing they release and increase the hormone estrogen over time. The rising estrogen level signals the pituitary gland to curb the release of FSH. This communication allows for ovulation to occur. In women with PCOS the menstrual cycle follows a different pattern of endocrine function and communication.

What the menstrual cycle is typically like in a woman with PCOS…

In women with PCOS the menstrual cycle starts off irregular, with the hypothalamus releasing GnRH in a higher than normal pulsatile frequency. This allows for increased LH and decreased FSH, which in turn leads to excessive production of the androgens androstenedione and testosterone. This causes the follicle to only mature some, but not enough to achieve full maturity in order to be released for ovulation. This also allows for continued increase of estrogen, primarily estrone. During a woman’s reproductive years, estrone levels are relatively low. Typically we associate estrone with menopause, not the the fertile years of a woman’s life. The higher levels of androgens and estrogen create a chronic state of low to very low progesterone and anovulatory cycles.

Classic polycystic ovaries are a result of chronic anovulation. Endocrine function is imbalanced from the very beginning of the menstrual cycle causing mild to severe hormonal imbalance, depending on the individual.

Excessive levels of estrogen may also cause uterine hypertrophy, also known as endometrial hyperplasia. Unopposed estrogen may cause excessive cell proliferation of the endometrium. The endometrium is the innermost layer of the uterus that is shed as menses during menstruation. Endometrial hyperplasia may cause heavy menstrual bleeding or prolonged bleeding during menstruation. The uterus may become bulky and larger than normal.

Medical Options for PCOS

Anovulatory Cycles

    Oral Contraceptive Pills (birth control) are the number one most prescribed medication to regulate menstruation in women with PCOS. While this may help to create a regular menstrual cycle (which is important) it prevents pregnancy. This is not helpful for women with PCOS who are trying to conceive. OCPs do not solve the root of the problem and may actually cause long-term reproductive health problems.

    Other hormonal medications may be commonly used as well. This is determined by case.

    Clomid is commonly used for women with PCOS to hyperstimulate the ovaries to ovulate. Once again the problem we encounter here is that Clomid does not resolve PCOS, though it may help a woman to get pregnant.

Ovarian drilling done by laparascopic surgery. This is done with the intent to stimulate ovulation.

Insulin Resistance

    This drug is commonly prescribed for women with PCOS, even if they are not insulin resistant or have any signs of type 2 diabetes. Metformin helps to control the amount of glucose in the blood. Metformin is used to treat type 2 diabetes. PCOS can often be helped by specific diet changes, similar to a diabetic diet. Metformin comes with risks and side effects, please talk to your doctor in detail before choosing to use Metformin to control PCOS. Many natural therapies may be used with Metformin with your doctor’s approval.

    Note: Long-term treatment with Metformin has been shown to cause malabsorption of vitamin B12 in some patients. Before choosing to use this medication, talk to your doctor about the long-term goal and duration of treatment.

There are a variety of other medications prescribed depending on the symptoms of PCOS. There are medications for hirsutism or alopecia, weight gain and more. Your doctor can provide you with specific information on medications.

Learn to Eat a PCOS Fertility Diet

Eating a specific PCOS Fertility Diet is one of the best things you can do to improve your chances of becoming pregnant.

Eating a specific PCOS Fertility Diet is one of the best things you can do to improve your chances of becoming pregnant.The biggest part of the problem with PCOS is insulin resistance. Resistance to insulin increases the body’s insulin levels which can have a negative affect on ovulation by limiting the maturation process of an egg and in turn delaying or preventing ovulation from taking place. Insulin resistance also makes it difficult for the embryo to attach properly to the uterus for implantation.

This has a direct impact on your fertility and ability to conceive.

Women with insulin resistance are 4-5 times more likely to have a miscarriage.

PCOS is also a huge red flag for the beginning of type 2 diabetes.

I do not say all this to scare you, but I do want you to know that this is a serious matter. Fortunately, there are many natural options you can do on your own to turn this all around. The biggest step you can take is to change your diet to a PCOS diet.

The benefits of following a PCOS Diet are:

  • Increases the rate of spontaneous ovulation
  • Significantly improves the environment of the uterus, preparing it for implantation
  • Increases the likelihood of a healthy conception
  • Decreases the potential for miscarriage
  • Helps to prevent insulin resistance from turning into diabetes

PCOS Diet Guidelines

1. Balance your daily protein intake with an equal amount of carbohydrates

This will help to eliminate the insulin yo-yo. When you eat equal amounts of protein and carbohydrates this helps to keep your insulin at a balanced level, thus increasing your fertility.

A low-carbohydrate, high-protein diet helped insulin resistance. A high-carbohydrate, low-protein diet made insulin resistance worse.
– Medical Journal Metabolism; no. 12: 1481-1487

A diet containing 25% carbohydrates improved insulin resistance, whereas a diet that included 45% carbohydrates did not.
– International Journal of Obesity and Related Metabolic Disorders; 20 no. 12:1067-1072

The types of carbohydrates you choose are also an important factor. Choose whole grain, or sprouted grain products. They contain more protein and fiber (better for balancing insulin levels) than their processed counterparts. Avoid processed carbohydrates, especially the white variety (white flour, rice, potato, etc.) which cause a spike in insulin levels and provide little to no fiber, or nutrients.

Some examples of whole grain and sprouted grain products are:

  • Ezekiel breads
  • Spelt
  • Quinoa
  • Millet
  • Brown Rice
  • Buckwheat
  • Amaranth

The best place to find these foods are at your local health foods store or Whole Foods Market.

Make sure the proteins you are eating are complete and organic. Organic meats and dairy contain essential fatty acids and will reduce the negative impact on hormonal imbalance.

2. Eat foods low on the glycemic index and glycemic load list

Blood glucose rises and then falls when you eat a meal containing carbs. How high it rises and how long it remains high depends on the kind of carbs (glycemic index, GI) and the amount you ate (glycemic load, GL). Low glycemic index foods are carbohydrates that break down slowly in the body, and don’t cause such a dramatic spike and then drop in insulin levels. The glycemic load takes into consideration the amount of the glycemic index food you consumed and how that affects your blood sugar. The glycemic load combines both the quality and quantity of carbohydrate into one ‘number’. It’s the best way to predict blood glucose values of different types and amounts of food.

The serving size of the amount of carbohydrates consumed really matter here. Be sure to eat no more than 100g of low glycemic index carbohydrates a day if you have insulin resistant PCOS and are overweight. Increase the amount of low glycemic index carbohydrates consumed a day to over 100g if you are thinner or underweight.

Some examples of low glycemic index foods are:

  • Kale, broccoli, asparagus
  • Beans and lentils
  • Grapefruit and apples
  • Walnuts and almonds

Processed carbohydrates that break down quickly make insulin levels jump dramatically.

Avoid foods that have a high glycemic index such as sugary and starchy foods such as: pancakes, syrups, sugar, white potatoes, jams, scones, white bread products, pasta, soda, alcoholic beverages.

Click here to learn how to make low GI fertility smoothies friendly for PCOS…

3. Eat a diet high in fiber

Fiber helps in two ways with PCOS. The first way it helps is by slowing down the digestion of sugars in the body, so there is no spike in insulin. The second way fiber helps is by promoting healthy estrogen metabolism which aids in the reduction of elevated levels of androgens.

Great sources of fiber are: broccoli, celery, whole grains, Ezekiel bread, apples, and dark leafy greens.

4. Eat 5 meals a day

PCOS portion size plateBy eating more often, the body will not go into fasting mode. When you look at the way most Americans eat, it is usually three big meals a day. With such a large gap of time between meals the body goes into fasting mode which may cause the metabolism to become imbalanced.

Your five meals a day should consist of three regular meals and two healthy snacks, or 5 small meals. The first snack should be eaten in the mid-morning before lunch and the second snack to be eaten less than an hour before bed. At each meal a day be sure you are eating a serving of protein (3-4 ounces), a low GI/GL carbohydrate (1/4-1/2 cup or serving size), and vegetables (1 – 1 & 1/2 cup).

Here is what the 5 meals a day could look like:

  • Breakfast (right away, when you wake up): 2 eggs scrambled in 1 tsp. coconut oil with spinach and 1/2 cup of black beans
  • Snack: Smoothie with unsweetened coconut or almond milk, 1/2 of a peach, 1/4 tsp. of ground cinnamon, hemp protein powder and spirulina
  • Lunch: Organic Turkey lettuce wrap with celery sticks and hummus on the side
  • Dinner: Organic chicken with steamed broccoli and half a cup of baked yam
  • Snack (less than an hour before bed): organic unsweetened yogurt with half a serving of low glycemic index fruit (blueberries, raspberries, papaya) and 1/2 tsp. chia seeds

Alternately, you could have your last snack between lunch and dinner, eating your dinner right before bed. Find out what works best with your lifestyle.

5. Eat essential fatty acids daily

Eating essential fatty acids (EFA’s) helps you to lose weight, aids hormonal balance, and are important building blocks for the body to create a healthy environment for conception.

The best source of omega-3 EFA’s is Cod Liver Oil, and omega-6 EFA’s is Evening Primrose oil.

Cod Liver Oil– Take 1 capsule daily with one of your meals. Cod Liver Oil is a rich source of DHA which is essential for a developing baby’s brain health. You can take this daily and during pregnancy.

Evening Primrose Oil– Take 1500mg of this oil from day one of your cycle (menstruation) till ovulation. Evening Primrose Oil helps to increase cervical mucous and metabolic function. Use in addition to flax or cod liver oils.

6. Exercise for 30 minutes, 5 days a week

Exercise helps PCOS by improving insulin sensitivity, increasing metabolism and helping to shed any excess weight. Both aerobic and resistance exercises are good. Researchers found that participants of resistance exercises showed better improvement in insulin sensitivity than with aerobic exercise alone.

Avoid excessive exercise programs because too much exercise overworks the adrenal glands which increases inflammation and in turn makes PCOS worse. Restorative exercise programs are best. You could walk and lift weights, or take a Pilates class and run on the treadmill, or do some Zumba and then Fertility Yoga. Discover what you enjoy doing and do this 5 days a week for at least thirty minutes a day.

7. Eat Organic

You will be eating a high protein diet, so it is essential that any animal proteins (meats and dairy) you are eating are organic. In commercial meats there are large amounts of added hormones (estrogens) that make the animals grow bigger, faster, and produce more milk. With PCOS there is usually a progesterone deficiency and adding more estrogens can make it even worse.

Studies have shown that organic foods contain more vitamins, minerals and healthier proteins.

8. Quit Coffee

Caffeine increases estrogen levels. A study from Fertility and Sterility shows that drinking just two cups of coffee a day boosts levels of estradiol, a natural estrogen. Women who drink 4-5 cups of coffee a day produce 70% more estrogen in the follicular phase of the menstrual cycle (when the body is trying to produce a viable follicle for ovulation, which is already an issue for women with PCOS.)

If you need help getting off the bean, check out Teeccino. It is a coffee alternative that tastes great and is alkalizing for the body.

Click here to learn more about Teechino and other herbal coffee alternatives…

PCOS Herbs and Supplements

Important note: It takes at least 6-12 months of consistent lifestyle and diet changes, along with natural therapies to bring about real change in the body when living with PCOS.

In addition to eating the PCOS diet, supplements have shown to be effective in helping those with PCOS boost their fertility and give birth to healthy babies. The overall goal with PCOS is to balance blood sugar levels, maintain hormonal balance, promote healthy digestion for improved estrogen metabolism, while also working to promote regular ovulation and menses. Adaptogen herbs are also important, this is because adaptogens increase resistance to mind-body stress and enhance overall vitality and health through non-specific adrenal (known as stress glands) support. Plants recognized as adaptogens help to normalize the body’s functions, most importantly the endocrine system, even during diseased states, are non-toxic, nutritive, and have been deemed safe for long term use.

Herbs and supplements are not meant to be a substitute for dietary and lifestyle changes! If diet and lifestyles changes specific to PCOS are not in place, herbs and supplements cannot aid the body properly!

Supplements That Are Beneficial for PCOS…

Whole Food Multivitamin
A major part of decreasing the effects of PCOS on your health and preparing the uterine lining is to take a prenatal multivitamin. Making sure your body has all of the nutrients necessary is a lot easier when you are taking a whole food multivitamin. Synthetic multivitamins won’t have the same effect.

Other vitamin and mineral considerations…

    This trace mineral enhances the action of insulin. Some studies have shown supplementing with chromium may improve blood sugar control. In one study, women with PCOS were given 1,000 mcg per day of chromium for two months and in that time results showed improved insulin sensitivity by 30% in average weight women and by 38% in obese women with PCOS.

    Foods that are high in chromium are onions, tomatoes, brewer’s yeast, oysters, whole grains, and bran. Most foods contain very little chromium, so supplementation may need to be considered.

    Calcium and Vitamin D
    Both calcium and vitamin D play significant roles in the health of many parts of the body. Where PCOS is concerned, calcium protects cardiovascular health. Vitamin D plays a role in glucose metabolism. Studies have shown that people with type 2 diabetes are often deficient in vit. D. A small study of 13 women with PCOS showed that 7 out of the 9 who had absent or irregular menstrual cycles, had a return of normal menstrual cycles within two months after being given 50,000 IU once or twice per week of vitamin D and 1,500 mg per day of calcium. This is a marked improvement! Of the 13 women, 5 were shown to be vitamin D deficient.

    Good food sources of vitamin D are cod liver oil, eggs, salmon, mackerel, tuna and whole fat yogurt or other dairy products.

    Vitamin D can also be obtained for free by sitting out in the sun for 15 to 20 minutes per day. Forget using sunscreen it will actually block the ultraviolet light that is needed to produce Vitamin D. The warm sun helps your skin to create Vitamin D3 that is then transformed into the active hormone form of Vitamin D by the kidneys and the liver. In fact, by being out in the sun for just a few minutes a day, a woman’s body can create between 10,000 to 25,000 IU of Vitamin D.

    Calcium can be found in kale, turnips, collards, mustard greens, kelp and wakame seaweed. Hiziki, a type of seaweed has 10 times more calcium than a glass of milk.

Herbs and supplements that promote hormonal balance and support regular ovulation:

    Cod Liver Oil

    Again, cod liver oil is a rich source of omega-3 EFA’s. Eating omega-3 essential fatty acids can help to lose weight, balance hormones, and creates a healthy environment for conception. Omega-3 EFA’s have been shown to aid hormonal regulation and reduce inflammation.

    Licorice root (Glycyrrhiza glabra)

    Licorice root helps the body to maintain proper hormone production and release. Licorice also supports healthy insulin levels and liver health which is important for women with PCOS.

    Maca (Lepidium meyenii)

    Maca works to balance estrogen and progesterone in the body which may help to encourage a healthy menstrual cycle. Maca is an adaptogen and an incredible fertility superfood. It helps to balance the hormones, but does not contain any hormones itself. It is able to do this by nourishing the endocrine system.

    Vitex (Vitex agnus-castus)

    Vitex (Chaste Tree Berry) is one of the most powerful herbs for women’s fertility and menstrual health. There are numerous studies and testimonials of Vitex and its effects on the body. Vitex supports hormonal balance in the body by having an effect on the hypothalamic-pituitary-ovarian axis (hormonal feedback loop), correcting the problem at the source.

    Tribulus (Tribulus terrestris)

    Tribulus has been found to help encourage regular ovulation in infertile women when used prior to ovulation. This herb has been found to be wonderful in aiding women with menstrual irregularities, improving the timing of the entire menstrual cycle. Tribulus has also been found to be a nourishing tonic for the female reproductive system as a whole, especially concerning the ovaries.

    White Peony (Paeonia lactiflora) and Licorice Rt. (Glycyrrhiza glabra)

    Most clinical trials have found that when White Peony is combined with Licorice Rt., it performs better, especially for relaxing muscles, reducing painful menstruation, as well as lowering serum and free testosterone levels in women with PCOS.

    Natural Progesterone Cream

    Progesterone cream can help to oppose estrogen dominance that may occur in some women with PCOS. Through the topical application of progesterone cream one can mimic a natural cycle and help the body to establish its own cycle, including ovulation, once again. Dr. John Lee believed that with progesterone cream, along with changing to a PCOS specific diet and regularly exercising, PCOS could become obsolete.

Healthy Estrogen Metabolism


    DIM balances the hormones and aids in the breakdown of estrogen. Estrogen is a major culprit to many of the fertility issues women face today including PCOS. Unopposed estrogen has been shown to cause menstrual cycle irregularities and in more advanced cases, endometrial hyperplasia. Removal of excess estrogen is vital to overall hormonal balance in women with PCOS.

Insulin Resistance

    Cinnamon (Cinnamomum spp.)

    A pilot study published in 2007 by Fertility and Sterility showed cinnamon to greatly reduce insulin resistance in women with PCOS. Another study suggests cinnamon may also reduce insulin resistance by slowing the movement of food from the stomach to the small intestine. This slows the breakdown of carbohydrates, which is important for people with diabetes and women with PCOS.

    Gymnema (Gymnema sylvestre, G.sylvestris)

    Gymnema has been used for hundreds of years to reduce high blood sugar. This herb has a “sugar blocking” action on taste buds and the small intestine. Gymnema blocks the typical paths that sugar molecules take during digestion, delaying the absorption of sugar. It works by stimulating the regeneration of pancreatic cells that produce insulin, which aids in more insulin production; in turn stimulating production of enzymes that help with the uptake of glucose into cells; and then prevents stimulation of the liver to produce more glucose. Gymnema also appears to have a lipid-lowering effect, which aids in weight loss.

Hirsutism and Endometrial Hyperplasia

    Saw Palmetto (Serenoa repens)

    Saw Palmetto has been found to inhibit DHT production by reducing 5 alpha-reductase production, which may help prevent hirsutism in women with PCOS. This herb also helps to reduce endometrial hyperplasia and hormonal acne symptoms.

To purchase a harmonizing herbal blend supportive of hormonal balance click here…

Inflammatory response
Because women with PCOS usually have low-grade inflammation constantly present in the body, it is important to support the body by promoting a healthy inflammation response. Some foods are known to trigger inflammation in the body. If you have food allergies, avoid foods which you are sensitive to because they trigger an inflammatory response.


    Omega essential fatty acids decrease the risk of inflammation, especially omega-3 and 6. Getting enough essential fatty acids in the diet may help, both through foods you eat and through supplementation.

    Systemic Enzyme Therapy

    Systemic Enzyme Therapy or using systemic enzymes is another option. Systemic enzyme blends work as a biological response modifier; working with the bodies own immune defense system to moderate inflammatory response. They also break down the proteins in the blood that cause inflammation.

    Royal Jelly and Bee Propolis

    Royal jelly and bee propolis have been shown to reduce inflammation and naturally boost the body’s immune system. They may also aid in hormonal balance through endocrine system support.

Click here to learn about other herbs helpful for women with PCOS…


PCOS is a complex female health issue. It consists of many different health concerns and risks. If permanent diet and lifestyle changes are implemented, these risks and health issues may become obsolete. There are many ways to support the proper health of a woman’s body that is dealing with PCOS. Important key tips…

1. Make sure your doctor performs the correct tests and you get a proper diagnosis.

2. Follow a PCOS specific diet to help decrease insulin resistance, balance weight, and improve estrogen metabolism.

3. Promote hormonal balance and support regular ovulation through supportive herbs and supplements.

4. Support a proper inflammatory response.

5. Stick to your plan, believe in yourself, only you have the ability to change your circumstances!

View All References


Let your voice be heard... Leave a brief comment or question related to this article.

Current day month [email protected] *

 characters available

  1. Hi, I am 29 years old Indian girl. I was diagnosed with PCOS 3 years back. Is there any chances of complication if I wait for another 1 or 2 years before conceiving. Should I try now to conceive ? My cycle ranges from CD30 to CD40.

    • Dear Parna,

      Waiting to conceive would allow you time to follow your natural fertility program, such as one suggested in this guide, and to make many important dietary and lifestyle changes to support the body in achieving and sustaining a healthy pregnancy. Whether you try to conceive now or wait is truly up to you!

  2. Hi, I was diagnosed with pcos due to irregular menses 4 years ago. my cycle ranges from CD30 to CD45. since then we have been ttc but never succeeded naturally. we have done ivf 4 times and bfp thrice but miscarried within first trimester.
    we plan to continue with ivf, what can we do to improve our chances?

    • Dear Mich,

      I am sorry to hear of your losses and all you’ve been through!

      If I may be frank and honest, the #1 thing you can do is allow time to heal the body! The tips shared in this post under Learn to Eat a PCOS Fertility Diet and beyond are wonderful to consider. It is important to support your body in re-learning balance by promoting healthy hormonal balance, a healthy uterine lining, regular ovulation, improved estrogen metabolism, reduced cravings for sweets and improved digestion, all of which you will learn how to do from these tips. These are tips that can also be useful for preparing for another IVF.

  3. Hi. I’m a norwegian girl, so I’m sorry for my english writing. I’va had pcos for ten years. Now I’m 27 years old. I’m Lean and my eastradiol are low. Last time I had menstruation was summer 2014. Please help me. What to do?

    • Dear Marthe,

      While the tips in this guide may be helpful, we offer a guide Important Natural Health Tips for Women with Lean PCOS that may be a better place to start. It offers an explanation of how a lean women can have PCOS in addition to natural therapies to consider.

      If you are still unsure of where to begin, or how to proceed, please consider working one on one with our fertility herbalist who can lay out an entire natural fertility program for you based on your specific fertility health needs. This if offered through a Fertility Consultation.

  4. Hi, I am 16 years old and Ive been suffering from PCOS as long as I can remember. The symptoms are irregular periods, enlarged clitoris and excessive hair growth all over the body, especially along my jawline and bald patch on my forehead. Its really embarassing to go out and some of my friends tend to notice these abnormalities and question me and I immediately feel ashamed. Could you suggest a remedy? It would be really helpful if its something related to diet and natural. Thanks! Stay blessed 🙂

    • Dear Rida,

      We recommend anyone interested in natural therapies under the age of 18 work with a natural health care practitioner in conjunction with their medical doctor. As a teen you are still developing in many ways, including hormonally. We cannot suggest our products because there are too many changes taking place in the teen developing body.

      That said, do consider modifying the diet and the PCOS Fertility Diet discussed in this very article.

  5. I am 39 years old and was diagnosed with PCOS years ago. My cycles got regular with the BCP. I have been off the pill for year now after having children. Since then my cycles have been really off. They started semi-normal, but then I went to having a cycle every 2 weeks!!! And very heavy bleeding. My doctor wouldn’t put me on the pill since I was still nursing. He then gave me something (progesterone???) to stop the bleeding. Now I haven’t had a cycle in over 3 months!!! I have also stopped nursing! Should I get on the pill? I feel very hormonally- “off” and it sucks. I am also overweight and have sporatic pimples along my jawline… Blech.

    • Dear Emily,

      I am sorry you are challenged by this! How hard with wee ones!

      If the medication you are on is making you feel so bad, I encourage you to make sure to tell your doctor and ask that he help you transition off of it.

      Given breastfeeding has stopped, the tips outlined in this very guide above could be considered. We also have a Natural Fertility Consultation program that you may find helpful. Participating allows one of our master herbalists to outline a 3-6 month fertility program with you. Learn more about a Fertility Consultation here...

    • I only took the medication ONCE and it made me stop have menses. So…. IDK if I should go on the pill now or what? I just purchased a lot of supplements to help me (i.e Royal Jelly, Cod Liver Oil and Chaste Berry, and Maca)

    • Hello again Emily!

      This is why talking to your doctor may be helpful although he/she is likely to suggest trying a different birth control again. As I shared the dietary and lifestyle tips in this very guide can be considered while you decide whether to make an appointment or not.

      Royal Jelly, Cod Liver Oil, Vitex (Chastetree berry) and Maca can all be taken together as suggested by the manufacturer of the supplements purchased. The dietary changes are important as well! Consider our 21-Day Fertility Diet Challenge as an easy place to start. It simply challenges you to add several foods to your daily diet rather than make a radical shift all at once.

  6. I am 27 years old and I have endometriosis and PCOS. In 2014 I had laparoscopy surgery – which helped a lot with the pain I was having with endometriosis. But now I suffer from constant spotting!!! My periods are regular but I spot during the entire month and will sometimes bleed during intercourse. It is VERY frustrating. I have been put on metformin, progesterone, and other various medications but nothing seems to help.

    • Dear Melissa,

      I am sorry for all you are dealing with!

      Endometriosis and PCOS both are caused by hormonal imbalance (in part) which can cause spotting. Given all you have tried and that we need to take a holistic approach to suggesting natural therapies – looking at diet and lifestyle, stress levels, all that has been tried and natural therapies and medications currently being used – the very best way we are able to offer support is through a Fertility Consultation. This allows for the opportunity to work one on one with a fertility herbalist who can look at the aforementioned areas of your health and suggest a 3-6 month natural fertility program. To learn more about and book a Fertility Consultation, click here…

  7. I have been diagnosed with PCOS and have been TTC our first for a year. I’m 26, healthy weight and no IR. My cycles are long (35-45 days), but I ovulate, usually on CD 22-27. My hormones are out and my ovaries are large and have lots of follicles. The fertility doctor says PCOS isn’t causing my infertility because I ovulate. Can PCOS affect egg quality? What could we take to help us conceive?

    • Dear Sarah,

      Both lean and overweight women with PCOS can experience many of the same symptoms associated with PCOS, to varying degrees, which are:
      hormonal imbalance causing irregular menstrual cycles, elevated levels of male hormones called androgens (testosterone), estrogen and luteinizing hormone (LH), low levels of follicle-stimulating hormone (FSH), cysts on one or both ovaries, ovarian pain or enlarged ovaries, severe acne, male pattern facial and body hair growth (hirsutism), anxiety and depression, weight gain and difficulty losing weight with no known cause (even if just slight gain) and insulin resistance to name several (but not all). Each of these to varying degrees can impact one’s ability to conceive naturally. If progesterone levels are out of balance after ovulation or egg health is poor, conception may not happen even when ovulating regularly. If for example a cycle is 35 days and ovulation occurs on day 27, this is an 8 day luteal phase which practitioners consider too short for sustaining pregnancy. That said, hormonal imbalance can impact egg quality, yes.

      PCOS is truly mysterious and hard because it presents so differently in each woman who battles it. What is known and believed across all health/healing paradigms is that modifying ones diet is key. Many healthcare practitioners feel that if many women with PCOS made lifestyle changes and followed a PCOS Diet that they could rid themselves of the issue. Such a diet and these lifestyle changes are shared in this very guide.

      I hope this is helpful and if you are still unsure of where to begin, or how to proceed, please consider working one on one with our fertility herbalist who can lay out an entire natural fertility program for you based on your specific fertility health needs through a Fertility Consultation.

  8. I’m 27 years old I was diagnosed with pcos since I was 14 years old and my period been irregular. I had 2 surgery one when I was 18 to remove a cyst and one last year they also find out that I have endometriosis. So after my surgery last I was on clomid for 3months I didn’t get pregnant with it. Hubby and I been trying to get pregnant for 3 and half years. I was taking vitex and maca in October for one month and got pregnant but I miscarried at 7weeks due to low progesterone. So my doctor suggested that I need to take clomid again did that for 6 months. But now I started it taking vitex and maca for two months I ovulated but this month my temperature is upside down I need some advices pleas

    • Dear Ziya,

      I am so sorry to hear of your loss!

      Clinical use of Vitex has shown us that it take time for this herb to be effective. It is a fertility herb that supports the healthy function of the endocrine system, the system that coordinates the balance of hormones. Vitex is best used consistently for at least 3 months and often longer, up to 6 months to a year. It is also known to be most effective when diet and lifestyle are optimal. Given this, consider the tips in this very guide for modifying the diet and avoiding lifestyle factors that contribute to having excess hormones in the body.

      Along with Vitex and Maca, progesterone cream could be considered. It is a way to directly influence progesterone levels. It may be worth talking to your doctor about in lieu of trying Clomid if you are not wanting to do that just yet.

      I hope this guide is helpful!

  9. I am diagnosed with PCOS and trying for IVF now ( 9yrs of TTC and 3 miscarriages on 9th week) .My periods are irregular and I have very less bleeding. It is more like spotting.And I have hypothyroidism beginning stage. So I am on metmorphin (1500mg) and Thyronorm 25mcg and myoinositol (OVASITOL) medication. Then I came across info regarding fertility kit , macaroot and vitex and prime rose oil. Just wanted to know whether i can use these along with my existing medication (metmorphin tablets for insulin resistance)..

    • Dear CMA,

      It would be best to discuss the use of Maca, Vitex and Evening Primrose Oil with your healthcare provider given you are taking prescription medications and trying/preparing for IVF. We do not suggest starting herbs in IVF or using them with medications without guidance from your healthcare provider.

      The tips in our guide Natural Ways to Support Your Body Through an IVF Cycle may be worth considering too as you continue through IVF.

      Best Wishes!

  10. Thank you so so much for this info!! I am 20 and was diagnosed with PCOS a year ago after not having my period for 4 years. I had no idea about the insulin resistance associated with PCOS – it was never mentioned! I am a healthy weight but I eat healthily (mostly plant-based) and exercise up to 5 times a week. I am frustrated because the acne on my chin hasn’t cleared up and I simply can’t manage to budge the extra weight I do have, especially around my stomach. After reading this page I have booked an appointment to find out whether this could be because of insulin resistance. How do I approach this with my doctor, especially if he is reluctant to talk about the link between PCOS and IR?

    • Dear Laura,

      You are welcome to share this guide with your doctor! I can’t imagine he will be reluctant to this discussion though as one of the major factors pointing toward PCOS (with others of course) is a woman’s insulin levels and we have learned that all women, whether lean or carrying extra weight, can have elevated insulin levels.

      I hope your appointment goes well!

  11. I haven’t been officially diagnosed with PCOS. Prolactin and thyroid levels came out normal in the blood tests, but my androgen levels are higher than normal. That was really the only sign that prompted my doctor to order an ultrasound. Those results came out pretty normal, though there were signs of small ovarian follicles. It’s just been so frustrating not getting an official diagnosis — I feel like there’s been some unexplained weight gain all of a sudden, and my menstrual cycle is incredibly irregular without birth control. (I was getting it every two weeks). I guess without any prescription, I will just rely on the diet and exercise aspect of dealing with PCOS.

    • Dear Laina,

      I am sorry you are frustrated! Dietary changes and exercise are fantastic and many do see significant changes while making them. A great place to start!

      Saw Palmetto can be useful for women with elevated levels of androgens whether PCOS is diagnosed or not. Consider learning more about Saw Palmetto..

      It may be most helpful however to consider working one on one with a fertility herbalist who can guide you in the right direction, on the right program, for your specific fertility health needs. This if offered through a Fertility Consultation. Learn more and book a Fertility Consultation here…

  12. Hi there,

    I was diagnosed with pcos 8 months ago. My doctor told me to go all veggie and to take this supplement Furocyst. I am getting good results but I want to eat something else then veggie as well. Can you suggest me some items that can be eaten and won’t affect My PCOS levels and is not veggie.


  13. Hi there,
    I was diagnosed with PCOS around 3 years ago although many doctors dismissed it, on all the scans and blood tests I have had it is evident that I have PCOS, although I do not have the syndrome, so no facial hair, acne, etc. I weigh 50 Kg and exercise twice a week, I consider myself to be healthy. I am trying to get pregnant and have been for a while now, I have taken a lot of clomid which did not produce any pregnancies although strangely enough when I was not taking anything I fell pregnant but miscarried after 5 weeks. I am now considering treatment along with metformin, I also struggle to eat enough protein during the day, could you recommend some protein dishes that I can have?

    • Dear Olivia,

      There are many faces of PCOS, so many different ways it presents itself. Not all women with PCOS are overweight, in fact many are lean. Here are the most important natural health tips for women with lean PCOS.

      Below are some foods and their protein content in grams (per 3 ounce serving unless noted otherwise). Get creative with your protein, add foods to smoothies to get a lot of protein in one delicious meal. Snack on high protein foods throughout the day. The chart below should help you to see what food have the highest amount of protein. Variety is great! It is important to eat small meals throughout the day that have balanced portions of protein and carbohydrates. One way is to balance this ratio is by supplementing once daily with FertiliWhey Protein Powder.

      Animal Proteins in Grams:
      Steak, sirloin 26
      Ground meat 20
      FertiliWhey Protein (1 scoop) 16
      Venison 26
      Buffalo 13
      Bacon (1 slice) 21
      Turkey breast 26
      Roast beef 21
      Chicken, light 26
      Salmon 18
      Scallops 14
      Crab 13
      Cottage cheese (½ cup) 14
      Cheeses (many types) and milk are 7-8
      Low-fat plain yogurt (1 cup) 10
      Egg (1) 6

      Vegetable Proteins in Grams:
      Peanuts (1 oz.) 7
      Peanut butter (2 T.) 8
      Sesame seeds (1 oz.) 5
      Sunflower seeds (1 oz.) 6
      Flax Seeds (1 oz.) 6
      Tofu (6 oz.) 12
      Kidney beans (½ cup) 8
      Lentils (½ cup) 9
      Chickpeas (½ cup) 10
      Split peas (½ cup) 8
      Pinto Beans (1/2 cup) 7
      Oatmeal (1 cup) 6
      Almonds (1/4 cup) 6
      Quinoa (1/4 cup) 6
      Millet (1/4 cup) 7
      Brown Rice (1 cup) 5
      Black Beans (1 cup) 14
      Spirulina (1 Tbsp) 4

      I hope this is helpful!

  14. I was diagnosed with PCOS about 3-4 years ago. My husband and I have been trying to conceive for about a year. I’ve been following the diet, lost about 20 pounds (I now weigh about 150), completed the fertility cleanse, and I’ve also been taking vitex before and after the cleanse. I recently started having pains and my cycle disappeared. I am now approaching day 53 with no cycle in sight. I went to the gyno only to learn that I have a cyst the size of a golf ball on my right side and numerous others on the left side. I’m so disappointed and frustrated at this point and I have no idea on how to proceed. Any suggestions would be very much appreciated.

    • Dear Lesha,

      I am sorry to hear of what you are going through! So many positive changes to have a set-back… I can imagine you are disappointed.

      Consider along with the PCOS Diet, reducing exposure to excess estrogen, which is one of the most common types of hormonal imbalance that can cause the disruption of ovulation. One of the best ways to rid the body of excess estrogens is to stop exposing yourself to xenohormones (ways to do so shared below) and to start taking a supplement called DIM (diindolylmethane).

      Avoid exposure to estrogens and xenoestrogens
      -Stop eating soy foods
      -Eat only organic meats and dairy
      -Do not microwave foods in plastic
      -Stop drinking water from plastic bottles
      -Avoid mineral oil and parabens in skin care products
      -Use natural detergents

      Consider learning more about Systemic Enzyme Therapy, Castor Oil Packs and naturally supporting progesterone levels as well.

      What may be most helpful is to consider a one on one Fertility Consultation. One of our Fertility Herbalists will review your fertility health history and then create, layout and explain each step of your natural fertility program for you.

      I hope this is all helpful!

  15. Hi, I just got diagnosed with pcos. I have been taking the herbs from my fertility consult and seen a lot improvement. However, my husband is studying naturopathy and he keeps insisting I should take adrenal glands. I wanted to know if I need it and if it’s safe to combine it with my treatment. I am taking vitex, dim, maca, saw palmetto, thyrofem, cod liver oil and antioxidants. Thanks!

    • Hi Mich,

      I think this question would be best to ask your fertility consultant. I know our team of herbalists don’t like to use any type of glandular supplements. If you are working with one of our fertility consultants, please contact her via email. Thanks!

  16. Hi there. Great info! I am 40 and was diagnosed with PCOS several years ago. No one wanted to treat it, since I didn’t want to get pregnant. I work out regularly and eat clean, organic foods, (No dairy no gluten). I lost 30 lbs since last year and I am stuck. I have much more weight to go. Recently I went to an endocrinologist. She put me on Metformin ER 1000mgs and Saxenda (injection).I can tolerate the Metformin fine but its not helping me lose weight. The Saxenda has made me very sick, vomiting, etc and I can’t eat much throughout the day because I have no appetite. Im often afraid to eat because of the vomiting. I saw a “natural cure” on amazon called Inositol. Have you heard of this?TY

    • Hi Jenny,

      Thank you for sharing your story and I don’t think it is okay for doctors to say they didn’t want to treat you for PCOS because you don’t want to have kids. That is unacceptable, especially since PCOS can lead to type 2 diabetes, which you definitely want to prevent! It sounds like what you are doing so far is good, except for the fact Saxenda is making you sick. If you aren’t eating, your blood sugar levels will be impacted negatively.

      I would be wary of purchasing any product that says it is a “natural cure”. For one, it is illegal for nutritional supplement manufacturers to state this. I have heard of inositol and research shows it can be very helpful in the management of PCOS. We have a couple articles about inositol that will explain how it is helpful for PCOS:
      Studies Show Benefits of Myo-Inositol & D-Chiro-Inositol for Women with PCOS
      Promising Alternative Therapy for Women with PCOS

      I hope this helps answer your question!

  17. Thank You for such good info! I was diagnosed with PCOS 3-4 years back. I am on PCOS diet from past 3 years and use to exercise 3-4 days a week. My periods got regular since then. Last 6 months i got off track, but now getting back to it. Me and my husband a planning for our firs child from past 4 months. Last two months i got my periods back every 15 days as soon as we try for baby. This has never happened before. I am 32 years old. I have been taking D Chiro for PCOS. Also i use Ovulation Kit to check if i am ovulating. But my gynae said that with PCOS LH level is high so the test is not accurate. What is the most accurate way to check ovulation for me? Please advise. Thanks!!

  18. Thank you so much for this information!!! I’m 35 and just three months ago found out I had PCOS but looking back I can see all the symptoms I had for years!!! Took metformin but my body doesn’t like it and I’m so looking forward to doing things naturally now. My question is…in the example daily meal plan above it mentions protein balance and shows several instances of animal protein. Is there any way to substitute some or a lot of the animal protein with any plant proteins?! Thanks!!!

    • Hi Stephanie,

      Great question! I would say nuts, seeds, nut butters, seed butters, hemp hearts, hemp protein powder, beans in limited amounts, as they can be starchy, and sprouted whole grains like quinoa, buckwheat, amaranth, etc, oh and spirulina.

  19. Hi I’m 30 and my husband and I would like to start a family. I’ve just been diagnosed with PCOS and I just wanted to say that the information on this website is great so many random issues I’ve had all make sense now. I’m going to stick to the PCOS diet for the next 6 months and hopefully prepare my body before starting to try for a baby. Even without wanting to be pregnant I think this change of diet will give me a healthier prognosis for later on in life and will hopefully prevent further complications. Thank you for practical recommendations that I can actually use everyday! I feel much more positive. Clare

  20. I’m interested in royal jelly but I’m hearing mixed things about its estrogenic effect. Since us PCOS women are most likely more estrogen dominant, how can this supplement be helpful if it acts as a natural estrogen booster?

  21. Hi, Is there any supplement for suppressing the appetite? With PCOS i have experienced a lot of cravings. Sweets more than ever. I am taking Metformin but i feel that is not doing anything in my body, i am overweight and i had 2 miscarriages. Can you advise what should be beneficial for me? i would like to substitute metformin for another supplement. I feel i am gaining more weight since i started taking it. I feel bloated and tired. Please help. Thanks 🙂

    • Dear Caro,

      While we can not suggest replacing a medication with an herb without guidance from your, or a natural healthcare provider, consider learning more about the herb Gymnema. This may be helpful along with dietary changes, herbs, nutritional supplements and natural therapies.

      Cravings can be viscous! I know. One more trick… try not buying sweets, not having them around! As a place to start, replace conventional sweets with dried fruits (and then slowing cut back on them as cravings wane), or dark chocolate (at least 60% cacao or more as your tastes acclimate). Consider PCOS Fertility Smoothies too.

      Take care!