When I started on the Paleo diet in 2010, I decided to stop taking the birth control pill at the beginning of December 2010. My periods didn’t start for a few cycles, but I didn’t worry as I am aware that post-pill amenorrhea is fairly common…. but after 6 months, I decided to consult. My doctor ran a few blood work to find out that my testosterone levels (total testosterone, DHEA, free testosterone, sex hormone binding globulin, free androgen index) and other hormones (including LH, FSH and thyroid) were fine. My doctor suggested I wait another 3 months because she considered the stress of moving to another country and my parasite infection possible causes for my amenorrhea… but nothing happened.

My doctor referred me for an ultrasound at the beginning of October after being amenorrhic for 10 months. As the ultrasound was being done, I could see the image on the screen looking like polycystic ovaries… I was told that I had 35 underdeveloped follicules of about 8 mm in length on my left ovary and 25 on my right. The OBGYN doctor told me right away that I had PCOS because of my amenorrhea and polycystic ovaries, even though my androgen hormone levels appear normal and I don’t suffer from hirsutism (abnormal hair growth) or acne.

polycystic ovary

To diagnose PCOS, which stands for polycystic ovarian syndrome, at least 2 of the following criteria need to be met according to the Rotterdam 2003 definition:

  • abnormal or absence of periods
  • polycystic ovaries diagnosed with ultrasound
  • excess androgen levels or clinical signs of excess androgen (hirsutism, male-pattern baldness, acne)
However, I only have PCO (polycystic ovaries) and not PCOS (polycystic ovarian syndrome) according to the Androgen Excess and PCOS Society criteria, which makes it very confusing to understand what is going on. This interesting article discuss the different phenotypes of PCOS created by the Rotterdam definition.
Basically, both PCO and PCOS are the leading cause of infertility and can lead to numerous other health problems. I consider myself very fortunate not having to deal with symptoms of high testosterone levels, but I am quite worried about my ability to conceive, naturally or at all, which is something my partner and I are considering within the next couple of years….
PCOS or PCO are thought to be cause by either high androgens (male hormones), high insulin levels or both (see diagram below). Considering that my androgen levels are normal, I presume that I may be hyperinsulinemic or insulin resistant, although I haven’t been tested for this parameter yet. This would explain why, although I am not terribly overweight, I have always been struggling to stay at my current weight, which is still about 15 to 20 lbs higher than where I would like it to be and where I was before starting on the pill. I was never able to keep my weight stable and at 5’8”, my weight have mostly ranged between 155 and 170 lbs… although I was able to reach my dream weight of 145 lbs on a couple of occasions in the past… but for no more than a week or two though…

Evidence-based guideline for the assessment and management of polycystic ovary syndromeEvidence-based guideline for the assessment and management of polycystic ovary syndrome, The Jean Hailes Foundation for Women’s Health on behalf of the PCOS Australian Alliance 2011

I believe that the Paleo diet is best for correcting the hormonal imbalances associated with PCO/PCOS. I know many women who were able to get their health and fertility back decreasing their carb intake and eliminating grains/gluten, such as Danfredo Rivera and The Primal Parent.

However, I am worried that it is not going to be enough for me. I haven been eating Paleo for a year now, strictly eliminating all grains, legumes and sugar. I have had some dairy, but only good quality grass-fed butter and maybe 3-4 serving of cheese in the last year… I have eliminated plastic and BPA from my life (women with PCOS have higher BPA levels in their blood), my diet is low in carbs and is based on high quality, free-range sources of protein, plenty of vegetables and healthy fats… but I still haven’t had a cycle for 12 months now… 😦

2011 was definitely not a good year health-wise for me. Just as I thought I had it figured out with my parasite infection, newly developed food intolerances, post-infectious IBS, SIBO, I got diagnosed with PCOS… 😦

I am not ready to give up yet but I believe I need the help of a healthcare provider as I honestly believe my diet is close to being perfect! I am also walking on a regular basis and was getting an average of 8-9 hours of sleep (before going on vacations last week, but I intend on going back to my good sleeping habits tonight now that I am back home!).

Maybe my liver needs some help? I probably need some more testing to assess my different hormone levels, determine whether I have hyperinsulinemia or insulin resistance? Maybe some herbs or natural supplements to promote fertility naturally could help? I will be meeting with a naturopathic doctor mid-December when I am back in Ottawa, Canada for the holidays…

…to be continued…

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17 thoughts on “PCO/PCOS

  1. Stick with it – your periods will come back eventually. After 7 years of being off the pill mine have only returned to anything near normal in the last 2 years. In the end it was the Paleo diet and naturopathic supplements that kick started them into action and they have gradually got closer together. So I would have great hope for your consultation with your naturopath.
    When I went travelling for 6 months my periods became very regular which makes me think that sun exposure – or vit D – and reducing stress are also vital to kick starting you periods again.
    I am going back to a naturopath on 14th Dec as I feel like I have slipped back lately and need to get back on the supplements – and the diet!
    Let me know how you get on!

  2. I am pretty much in the same boat. I was taking Yasmin for 5 years when suddenly I got bad cystic acne, painful painful periods (cysts), irregular cycles despite being on birth control and a little weight gain. I quit birth control because I thought “why should I take this if it doesn’t help regulate me anyways?” I had been taking it because I had severely heavy periods from the very first time I had menses. I also had to go to the emergency room for a 4 cm cysts one night around 3AM. I remember crawling up three flights of stairs to my parents thinking I was dying. At that time I am pretty sure I had way way too much estrogen and androgens in my body. I have been sick for the last 6 years. Last year I cut out gluten and it helped somewhat. I cut out grains and went primal (no dairy) about 6 months ago and it has helped alot! I finally got my hormones tested and I had normal androgens, low estrogen and even lower progesterone. My doc put me on bio identical progesterone and cycled it every two weeks. It would help but as soon as I went off for the two weeks it would start my issues all over again. I hadn’t had a period in over 6 months…I was then directed to just take the progesterone continuously at a higher dose of 200MG. This was supposed to stop me from ovulating and help my acne. For some reason it helped me ovulate and have a normal cycle of 28 to 30 days. I have had a normal cycle for 3 months now and can feeling ovulation just around the corner for number 4. I know your hormones may have been ok but one thing I would look at is the ratio of those hormones. If your androgens are normal but are still higher in proportion to the other hormones then you still have high androgens. Same goes with estrogen to progesterone ratios. You can always try a progesterone cream but I have no experience with that. Perhaps have this natropath test your estrogen and progesterone one more time to get an idea. I would try a low dose of progesterone for a month and see what happens. There should be no symptoms from bio identical progesterone except a mimic of estrogen dominance for maybe a few days to a week. Hope you figure it out!

  3. I’m sorry you are being thrown another curve ball.

    I have two friends with PCOS, both are overweight, either diabetic, or insulin resistant, and have all the other symptoms. Both have conceived, with some help…hormone injections.
    One has twin 3 year old fraternal twin girls. One has a one year old little girl.

    Both have had severe medical issues, and both nearly died during pregnancy. The friend with twins, had preeclampsia very badly, and the other’s body shut down. She delivered at 6 mos. If they hadn’t taken the child both would have died. They were very lucky, the child weighed about 2 pounds, but you’d never know it now…she’s strong and healthy.

    I’ve told you this not to scare you, on the contrary. These two women conceived, and have beautiful children, despite the fact that they have very bad diets, did not lose weight, and simply are not taking care of themselves.
    I can only imagine that it would have to be much easier on you (and more responsible..in my opinion only.)

    I’m 48, do not have children, though we had planned to foster to adopt. Alas, Meniere’s disease stepped in, and it doesn’t look like that’s ever going to be possible. there was a time, when I really wanted a child of my own. And occasionally, I’ll still have that twinge, but I think most of that was hormones talking. My body told me I needed a child. I love children, and really would like to be a mom, but I don’t need to have my own biological child. Any child I bring in to my home will be mine, in every since of the word. I would really like to help some of these children who need a stable family and don’t have one. (but this is just my story.)

    I was on birth control for many years. Went, off, back on, had an IUD…didn’t work for me…back on BC…..I was even put on BC continuously for a while to help with my migraines…it didn’t work.
    On the pill, I was skipping periods, having hot flashes, night sweets…all the symptoms of starting menopause, and at my age, I wasn’t surprised. So almost a year ago, I stopped taking the pill. And I started having an extremely heavy period…with mad cramping…and PMDD. I used to have PMS, and other subtle symptoms around ovulation ect. Now I am an irritable cranky bitch with pain 3 weeks of the month. From ovulation to the end of my cycle. So I’m going back on the pill to see if I can get rid of this. Not my first choice. But with everything else going on, Meniere’s, gluten and fructose issues….(I gained close to 50 pounds in the past year!)….I just don’t have the energy to work this out right now. So I’m trying the pill again, at least for a while.

    I hope things work out for you.
    Curve balls are hard to hit out of the park, but it’s not impossible.

  4. I’m so sorry.

    We are strangely on the same path. I’d like to tell you more, but I don’t think I’m ready to share here just yet. I can email you…I think I have your email address..

  5. Hi
    please go see a “functional medicine” doc

    Dr Howard Liebowitz in Santa Monica ( you can look him up) is the absoloute best at this
    he will do a consult with you after looking at all your tests, bloodwork etc
    on skype
    I had the pleasure of hosting his radio show with him
    ( BTW we had the author of the Paleo Diet)
    on the show)
    Dr Liebowitz eats Paleo himself…our closingwords each week were “dont eat bread”
    he’s the real deal..I wish you all the best
    . I know how frustrating this is..believe me I do
    I hope you call Dr Liebowitz
    .Ive seen him work miracles


  6. I just read this & felt as if I were reading about myself!!! Yikes!!!!! 😦 I’d love to talk more about it with you but first I have some exciting news. I’ve nominated you for the Liebster Blog Award!! I recently came across your blog & immediately strongly felt you deserved this recognition! 🙂 Take a quick peek at my blog for the details!!!!

  7. Hi There. Just read through most of your blog and am so glad I stumbled upon it. I am also an RD and am on GAPS and just recently low fodmap! I have the EXACT s/s you have (primarily bloating/distention (I look eternally pregnant) and took the exact route you are taking with healing. Sad to say I have not had any success with my bloating/distention since on GAPS (2.5 months now, started with intro now on full) and think I need to go back and do what you did with the fodmap elimination diet (as I am eating 24 hr fermented dairy, kefir, and sour cream, as well as low sugar fruits and nuts)…so I’m thinking I need to cut all of those things out and stick to meat, low fodmap veggies and fats for a few weeks. Is your digestive system symptom free since doing the elimitation diet that you documented? I’m also thinking I might need to be tested for parasites and SIBO…oh its just all so frustrating!! Did you do any natural supplements for the parasites or just the antibiotics? Also, are you doing the broths on the intro since I see in a previous post you said you were sensitive to the amines in it?
    Again, thanks for your blog. Nice to see another RD out there that isn’t recommending grains, fiber supplements, high sugar fruits and the like : )
    Sorry this isn’t related to your post above…

    • Hi! I am glad you have stumbled upon my blog! 🙂 Before I answer your many questions, I really do think that going a few steps back with the GAPS diet could help you. I have been symptom-free for days, weeks and even months at a time when I am careful. However, I still have some of my symptoms back when I tried having nuts (raw or soaked), nut butter, cheese, maple syrup. I seem to do fine with fruits and coconut flour in small amount. I have also been able to eat dark chocolate and cocoa powder (non-GAPS food) without any problems, but try to eat them only occasionally.

      Good idea for the testing, it could be useful to know because if you are infected, you may need some extra help. I took antibiotics to treat my parasite infection, in addition to talking adp oil of oregano. For my SIBO, I took garlic oil capsules as an antibacterial agent in addition to taking 1-3 tsp of cinnamon a day. I would definitely recommend you work with a naturopathic doctor to make sure nothing else is in your way to a better health.

      Yes I have been doing the broth. I started with meat broths, which are more gentle, and then moved to chicken bone broths after a couple of weeks and haven’t had any problems with them. In fact, I think they have contributed tremendously to my healing.

      Good luck!

      • Thanks for the quick response. Do you think the fodmap elimination diet would be beneficial, or just to stick with GAPS? What are your thoughts on the cultured dairy? Even in the early stages of gaps I was chronically distended…even liquid does it for me so the soups and broths didn’t help. Wish we were in the same country, I don’t have any fellow RDs that follow GAPS or Paleo. : (

      • I would stick with GAPS but choosing low-FODMAPs vegetables at first. I am not sure about culture dairy. I think it is fine if you choose raw milk from grass-fed cows and ferment it for 24 hrs to reduce the lactose content, as long as you tolerate casein. I wanted to reduce the number of variables from the equation so chose to avoid all dairy, with the exception of ghee, at first. I would recommend you choose only 1 or 2 safe vegetable for the first few days of the intro diet and that you cook them thoroughly and make a puree. I chose carrots and ate small amounts of pureed carrots spaced throughout the day, sometimes with cinnamon and coconut oil to switch it up. Try meat broth instead of bone broths if you think you are sensitive to it and make sure you have plenty of animal protein and fat, such as coconut oil, ghee, animal fat. Introduce egg yolks after a few days if you are feeling better and later, egg whites. What country do you live in?

    • Hi!
      I am/was suffering from a lot of the same issues. I have read, studied, researched, asked questions and harassed bloggers.

      I’m finding a unifying issue with hormones. Insulin, yes-and I handled it, but right now am focusing on Estrogen Dominance. Have been reading a LOT of Dr. John R. Lee’s old books and I have changed my diet accordingly. I’m also going to take DIM and Progesterone cream with my next cycle. I do find that the estrogen seems to be a HUGE issue with me still. It causes so many of my problems-and I too have MANY fibroids as a result of estrogen dominance.

      This is such a night mare, but by eating NO starches, NO grains, keeping my carbs under 15g per meal and 7g per snack have helped wonders.

      A sight that might help many is http://www.womentowomen.com/insulinresistance/causesofpcos.aspx

      Will let you know if I get better and will share everything I learn.

      Have fought of anemia once, I am working hard again…tough stuff…fibroids suck.

      • Thanks mcoffeesnob for sharing your findings. I agree with you that insulin resistance is probably the root of these hormonal imbalances and after having slightly more carbs during the Holidays (a bit of fruits, dark chocolate, some honey and coconut flour-based Paleo treats) and gaining 6 lbs. as a result, I strongly believe I am insulin resistant. I did an saliva hormonal panel and am awaiting the results and hopefully, it will help me figure out whether I have estrogen dominance or other imbalances…. 😉 We have to keep going and keep looking for answers!

    • THanks, I am a little familiar with the Perfect Health Diet and believe a higher carb intake is promoted, which I think would not be appropriate for someone with PCOS, insulin resistance and SIBO.

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