Polycystic ovarian syndrome and fertility
(Co-authored with Ann-Maree Bortoli)

Polycystic ovarian syndrome is a complex endocrine and metabolic condition commonly associated with failure to ovulate regularly. 90-95% of women, whom attend fertility clinics for failure to ovulate, have PCOS. Insulin resistance, being overweight or obese and metabolic syndrome are also common features of the condition.

As ovulation is vital to pregnancy, and PCOS is often associated with failure to ovulate regularly, women who are diagnosed with PCOS can be concerned that the condition may make it very difficult or impossible for them to have children. Whilst PCOS can make conceiving more difficult, it should be noted that not all women with PCOS have difficulty becoming pregnant. More than half of women with PCOS are fertile and are able to conceive without any medical intervention, depending on how severe their PCOS is.

Some women with PCOS are not overweight, but for many who are overweight or obese, this increases the likelihood of them having infertility problems. 90% of women with PCOS who have difficulty falling pregnant are obese. Obesity also increasing the likelihood of complications during pregnancy. Age can also be a complicating factor - having a baby earlier in reproductive can be advantageous.

Women with PCOS often seek the help of a naturopath, such as Sandra, s if they have been trying to conceive unsuccessfully for some time. Sometimes women come with a diagnosis of PCOS and want assistance to conceive naturally.

After taking a careful personal health history, and examination of any tests a woman may have, Sandra may suggest specific diet modifications and exercise aimed at reducing weight and regularizing ovulation and therefore menstruation. Herbs and supplements may also be prescribed to assist in this process. 

Sandra’s treatment principles reflect those of the new Australian guidelines for the management of PCOS, which recommends diet and lifestyle modifications over pharmaceutical drug therapy for improving fertility more effectively. These guidelines recommend that women who are obese (BMI≥30g/m²) should first have 3-6 months of diet and lifestyle interventions, aimed at achieving weight loss, to see if ovulation is established. Ovulation induction with pharmaceutical drugs is not recommended for women whom are more obese until appropriate weight loss has occurred. Sandra is aware of the difficulty of losing weight for women with PCOS, and is sensitive to emotional woes that are associated with the ongoing battle. She individualizes her dietary and exercise recommendations to optimize successful results. Sandra aim’s for an initial small and achievable weight loss of 5-10%, which regulates the menstrual cycle, establishes ovulation and improves fertility. Diet and lifestyle interventions are continued for promoting weight loss and preventing weight gain for sustained and further improved outcomes.