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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