Polycystic Ovary Syndrome and Breastfeeding

There is some evidence to suggest that women with PCOS may have trouble when it comes to breastfeeding due to low milk supply.

Before we look at the reasons and what the evidence says, I want to reassure you that not all mothers with PCOS struggle to breastfeed, and in the studies looking at the relationship between PCOS and breastfeeding there are still large numbers of women who manage to successfully breastfeed. There are a limited amounts of studies looking at breastfeeding and PCOS, so still a lot of work to be done in this area. But I wanted to write this blog post and share the evidence because I believe that arming yourself with knowledge around how PCOS may (or may not) impact your breastfeeding journey may increase your chances of successfully being able to breastfeed – should this be how you wish to feed your baby.

Studies have shown that the main issue when it comes to breastfeeding with PCOS is undersupply. This seems to be caused by the underdevelopment of breast tissue either during puberty, pregnancy or both. Breastfeeding involves interactions between multiple different hormones, many of which can be elevated or slightly lower than normal in women with PCOS. It is thought that it is these hormonal imbalances which have a negative impact on the development of breast tissue (mammogenesis), the production of milk (lactogenesis) and being able to maintain lactation once it’s been established (galactopoesis). The three main hormones at play are progesterone, androgens (testosterone) and insulin.

Progesterone:

Throughout puberty and pregnancy estrogen and progesterone stimulate the development of breast tissue. In early pregnancy progesterone and prolactin facilitate alveolar growth. In late pregnancy and after birth there is a drop in progesterone levels which stimulates the secretion of milk by breast tissue. It’s common for women with PCOS to have lower levels of progesterone which may interfere with the alveolar growth in early pregnancy and therefore impact milk supply.

Androgens:

High androgen levels during pregnancy may interfere with the development of the breast in to the lactating state. Postpartum androgen levels that are slight elevated may inhibit lactation. Third, may be the psychological effects of elevated androgen levels that make women less dedicated to breastfeeding. Possibly, a combination of all of the above is to blame.

Insulin:

Insulin resistance which affects women with PCOS may have a role to play. Receptors in the breast must be sensitive to insulin to work effectively with other lactation hormones, should they lose that sensitivity it will be harder to produce a good supply of milk.

Studies have shown that women with insulin resistance have a more sluggish response in milk supply to a nursing infant.

If you are currently pregnant, or thinking about conceiving and preparing yourself then the good news is that there is a lot you can do to help increase your chances of being able to successfully breastfeed.

  1. Keep moving

Exercising throughout pregnancy or with a newborn is not always easy, however, we know that exercise increases insulin sensitivity so if you are able to move then go for it. This could be anything from walking, a light stretching routine, swimming to something slightly more intense. Make sure you are exercising safely when pregnant or newly post-partum.

 

  1. Balance meals with protein

We want to keep those insulin levels down and adding protein to meals helps slow down the release of glucose. Aim to have some source of protein with each of your meals, even snacks.

 

  1. Take your inositol supplements

Inositol is an insulin sensitizer and is safe to take throughout your pregnancy. Continuing to take your inositol supplements will help keep insulin levels down and prevent androgen levels from increasing.

 

  1. Avoid stress

Easier said than done when pregnant right? But if stress is avoidable remember to take time for some stress reducing activities like yoga, light stretching, relaxing bubble baths. If our cortisol levels stay up for long periods of time, then insulin and testosterone levels increase too.

 

  1. Eat plenty fibre, for the same reason we add protein, we want to have lots of fibre in our diet too. Fruits and vegetables are high in fibre and consuming wholegrain, unrefined carbohydrates will help you reach your daily fibre target. Lots of fibre will help keep constipation at bay which is a common pregnancy symptom.

 

You probably already know that PCOS increases the risk for developing type 2 diabetes. And babies born to mothers with PCOS are genetically more likely to develop type 2 diabetes later in life. Research shows that breastfeeding helps reduce this risk which is great if you are able to breastfeed your baby.

The most important thing to remember is that a fed baby is best, regardless of how you choose to feed them.

If you are currently breastfeeding and feel that you’re struggling with low milk supply, then the above recommendations can still be helpful. You can also reach out to la leche who have great advice on how to increase milk supply, and follow @milkmakingmama on Instagram for great breastfeeding advice.

You can be fat and fertile

Using an individual’s body mass index (BMI) as a measure of their general health is antiquated and inaccurate. We know that athletes who train every day and have very strict diets can have a BMI that states they are overweight or obese. And that many whose BMI categorises them as overweight or obese have an excellent bill of health and live an incredibly healthy lifestyle. So why then are we still using BMI cut offs to decide who is worthy of receiving fertility treatment?

Our reproductive system is controlled by a series of hormones. If there is an imbalance in these hormones we may face challenges with menstruation, ovulation, and our ability to conceive. Women in larger bodies (a BMI of over 30) are thought to be less fertile than women in smaller bodies due to the amount of fatty tissue present in larger bodies which may negatively impact the balance of hormones. There are also greater risks associated with being ‘fat’ and pregnant to both the mother and the baby (so previous research has claimed).

However, more and more articles are being written to challenge this school of thought and the supporting research. And, more importantly, questioning the moral principle of refusing a woman fertility support based on her BMI.

In the UK, fertility clinics have a cut off a BMI between 30-35kg/m2, meaning that you will not receive treatment until your BMI is below this level. A women’s general health is not taken into consideration, nor is her age. Which seems ridiculous because we know that the one thing that definitely affects fertility is a women’s age; the older we get, the more difficult it becomes to conceive.

The result of this unfair discrimination is that it leaves many women feeling unworthy of becoming a mother, women are delaying conceiving because they believe they need to be a certain weight before they can.

There is nothing quite like the desire to conceive and have children. Believe me when I say that many women will do whatever it takes to have the opportunity to carry and birth a child. So, when a woman is told that she needs to lose weight before she’s able to conceive you can bet your bottom dollar she will adopt any strategy to do so. This often means that women will severely restrict their calorie intake or eliminate whole food groups to drop the numbers on the scale. And do you know what happens when we don’t provide our body with enough nutrients and energy? It starts downregulating the systems that aren’t essential for survival – and yes, you guessed it, reproduction is one of these systems. So, by telling a woman she needs to lose weight, experts are potentially decreasing the chances of conceiving.

Let’s look at what the studies say – or don’t say:

If we look at the studies which have concluded that women with higher BMI’s are less fertile you will notice that these studies have not accounted for age. They’ve lumped women of all ages into the same group. This is going to skew the results as the older we get the less fertile we become. We should be comparing women of similar ages as well as BMI.

Studies looking at how weight loss improves fertility are flawed for many reasons.

  • They cannot separate whether these women saw improvements in fertility because of the weight they lost or because of the lifestyle changes they made. It is not possible for us to see whether if they had made the lifestyle changes but remained the same weight, they would still see improvements in fertility.
  • As part of these weight loss programmes women often receive support that is unheard of in most weight management programmes, such as a weekly 3-hour session with healthcare professionals. Most women who are turned away from fertility clinics are left to their own devices and receive little or no support to help them lose weight. And as rates of overweight and obesity are higher in more deprived communities, these women usually don’t have the funding to seek support to lose weight safely.

Although these studies conclude that losing 5-10% of total body weight positively effects the ability to conceive and carry, for many this equates to only a few BMI points and it would not be enough to gain access to fertility treatments – despite studies telling us they would have improved their chances. That gets a mega eye roll from me!

Studies looking at the effectiveness of certain medications to help improve fertility such as Clomid (used to stimulate ovulation) indicate that these medications are less effective in women with a higher BMI. However, the doses given to all groups are often the same, regardless of weight or BMI. We know that certain medications need to be given in higher doses to those in larger bodies. We don’t give children and adults the same doses and any anesthetist will tell you that dosage is based on size.

In fact, a study where anovulatory women were treated with gonadotrophin to induce ovulation found that whilst women with a high BMI required higher doses of gonadotrophin, “there was no difference in the rates of ovulation and clinical pregnancy in relation to body weight.

A randomised control trial in the Netherlands (Mutsaerts et al., 2016) looked at the effect of lifestyle interventions prior to assisted reproductive technology (ART) versus immediate ART on the chances of live birth in obese sub fertile women. The lifestyle intervention did not result in more live born children than starting ART immediately, it actually decreased the number of vaginally delivered babies beyond 37 weeks. There were also no differences in pregnancy complications between the two groups.

There is in fact no evidence to support the BMI cut offs presented by fertility clinics. These cut offs are arbitrary numbers, potentially created to lighten the load on fertility clinics and save money in countries where fertility treatments are funded by the government.

Whilst no one is claiming that there is no risk during pregnancy and birth for women in larger bodies, it’s important to note that it’s not only women in larger bodies who carry these risks. Women with diabetes, similar to women in larger bodies, are at an increased risk for developing hypertension, congenital abnormalities, and premature labour, however they are not excluded from receiving fertility treatment.

Whilst I’m not saying that the risks should be ignored, patient centred care is about looking at the individual patient and not classifying/grouping them based on their BMI. It means taking a woman’s age into consideration as well as the damage that pursuing weight loss may have on her chances to conceive.

 

 

 

 

 

 

 

 

References:

Balen, A., Platteau, P., Andersen, A., Devroey, P., Sørensen, P., Helmgaard, L. and Arce, J-C. (2006). The influence of body weight on response to ovulation induction with gonadotrophins in 335 women with World Health Organization group II anovulatory infertility. BJOG: An International Journal of Obstetrics & Gynaecology, 113(10), pp.1195–1202. doi:10.1111/j.1471-0528.2006.01034.x.

 

‌Banker, M., Sorathiya, D. and Shah, S. (2017). Effect of Body Mass Index on the Outcome of In-Vitro Fertilization/Intracytoplasmic Sperm Injection in Women. Journal of human reproductive sciences, [online] 10(1), pp.37–43. doi:10.4103/jhrs.JHRS_75_16.

 

Brown, R.C.H. (2019). Irresponsibly Infertile? Obesity, Efficiency, and Exclusion from Treatment. Health Care Analysis, 27(2), pp.61–76. doi:10.1007/s10728-019-00366-w.

 

Koning, A., Mol, B.W. and Dondorp, W. (2017). It is not justified to reject fertility treatment based on obesity. Human Reproduction Open, [online] 2017(2). doi:10.1093/hropen/hox009.

 

Mutsaerts, M. A., van Oers, A. M., Groen, H., Burggraaff, J. M., Kuchenbecker, W. K., Perquin, D. A., Koks, C. A., van Golde, R., Kaaijk, E. M., Schierbeek, J. M., Oosterhuis, G. J., Broekmans, F. J., Bemelmans, W. J., Lambalk, C. B., Verberg, M. F., van der Veen, F., Klijn, N. F., Mercelina, P. E., van Kasteren, Y. M., Nap, A. W., … Hoek, A. (2016). Randomized Trial of a Lifestyle Program in Obese Infertile Women. The New England journal of medicine, 374(20), 1942–1953. https://doi.org/10.1056/NEJMoa1505297

 

‌Sathya, A., Balasubramanyam, S., Gupta, S. and Verma, T. (2010). Effect of body mass index on in vitro fertilization outcomes in women. Journal of Human Reproductive Sciences, 3(3), p.135. doi:10.4103/0974-1208.74155.

 

‌Slocum, B., Shami, A. and Schon, S.B. (2022). Body Size, Fertility, and Reproductive Justice: Examining the Complex Interplay between BMI, Reproductive Health, and Access to Care. Women, 2(2), pp.93–101. doi:10.3390/women2020011.

PCOS and Hair loss – how can you manage it

Why is my hair falling out?

PCOS related hair loss is one of the most frustrating symptoms of PCOS and one that has a really negative impact on my self-confidence. Seeing that clump of hair in the shower leaves me feeling frustrated, upset and reminds me how Sh*t PCOS can be.

Like all other PCOS symptoms, it’s easy to be annoyed and let it get you down. Whilst I would always encourage you to take the time to feel all the feels and process what’s happening, I’d also encourage you to get curious – what is this symptom telling you and why has it shown up?

Let’s take a look at some of the facts:

Does PCOS cause hair loss?

Yes, PCOS causes an increase in male hormones, mainly testosterone which often results in acne, excess facial hair, anovulation and hair loss, also referred to as female pattern baldness.

What are the symptoms of PCOS related hair loss

Clumps of hair in the shower after washing

Excess hair in your brush

Hair on clothing and pillowcases

Once you’ve noticed these symptoms there’s a possibility that you’re experiencing an imbalance in your hormones. Most likely that your testosterone levels are too high.

What causes elevated testosterone levels?

One of the most common causes of elevated testosterone levels is elevated insulin levels. Around 70% of women with PCOS experience insulin resistance which leaves them with elevated insulin levels. This increase in insulin stimulates the ovaries to produce more testosterone. This means that the key to lowering your testosterone levels is working on insulin resistance.

Once I’d got over mourning another clump of hair lost to the drain, I started reflecting on what’s been going on and this is what I discovered:

  1. I’ve been really stressed and busy with work, trying to cram in everything and saying no to nothing. Whilst a day or two of being stressed is okay, when it goes on for a while and we expose our body to high levels of cortisol (our stress hormone) for long periods of time, insulin levels increase and our ovaries produce more testosterone

 

 

  1. I haven’t prioritized exercise. When we’re busy exercise is often one of the first things to fly out the window, this is certainly the case for me. Exercise causes our cells to become more sensitive to insulin which helps keep insulin levels down. It’s also really good for managing stress and keeping cortisol levels down.

 

  1. My supplements have fallen out of my routine. I try to keep my supplements where I see them every morning and evening but when I’m constantly rushing around, I keep looking at them and saying, ‘I’ll come back for those’ and never do. Inositol and Omega 3 are part of my everyday routine, and I can really notice when I stop taking them. Inositol helps improve insulin sensitivity and keeps my cycle regular due to its effects on ovulation. Omega 3 helps reduce inflammation. Did you know that low grade chronic inflammation is common in women with PCOS, and it contributes to increased insulin levels?

 

  1. I definitely haven’t had my 8 hours of sleep every night, welcome to mum life and hello 15-month sleep regression. Lack of sleep over a long period of time worsens insulin resistance which is why focusing on sleep hygiene and prioritizing sleep is important in managing PCOS.

 

  1. There’ve been a lot of snacks that are low in nutrients (oh hi easter eggs) and while I’m all for having everything in moderation, when we consume too many snacks of low nutritional value (chocolates, crisps, biscuits) we leave less room for snacks with a higher nutritional value (fruits, vegetables, protein, and healthy fats). The sugars in chocolates and biscuits can increase inflammation, whereas fruits and vegetables have an antioxidant effect helping to reduce inflammation. You can quickly see why we need to have a balance of the two.

 

  1. I’ve recently had my hair coloured. It was such a great idea at the time, and I really needed something to make me feel a little brighter, but peroxide can weaken hair and encourage hair loss. Exposing your hair to high temperatures can also impact the strength of your hair which is why I try and use a hair dryer and straightener as little as possible.

 

Getting curious has made me realise I’ve let life get in the way and have not focused enough on me over the last couple of weeks. My curiosity has helped me understand what’s going on and what I need to change to start managing my PCOS a bit better.

It feels so silly because PCOS is my thing – I help women manage their PCOS every day. But at the end of the day, I’m human too and juggling a business, being a mum, a fiancé, trying to have a social life and run a household gets a little crazy. And that’s the thing about PCOS, you don’t simply fix it and it’s gone – you need to keep working on it or your symptoms come back.

8 Ways to cope with stress with PCOS

Studies have shown that women with PCOS are more inclined to suffer from stress, anxiety, and depression. It could be due to their diagnosis and the features of PCOS, underlying hormonal imbalances (already high cortisol levels), as well as the stress we put our bodies under by following strict diet and exercise regimes in an attempt to control our symptoms.

Managing stress is often one of those things that are a lot easier said than done. In an ideal world we would be able to think about what it is that’s causing the stress in the first place and then remove that cause, however, when that cause is work, family, relationships it’s not quite as simple as removing them.

 

For this reason, it’s important to find other ways to help you cope with the stressors in life because unfortunately, they will also be there in some shape or form.

 

I’ve pulled together a list of some of the things that I have found most helpful when it comes to dealing with stress because like you, I’ve had my fair share and have suffered for it too. I hope this list will give you some ideas and inspiration to carve out some time for yourself.

 

  1. Schedule time for you – it’s so easy to rush into another busy week with a jam-packed schedule and get to the end feeling exhausted. YOU need to break this cycle by spending some time at the beginning of the week to protect some ‘me time’. This may mean turning down an invite for a social event, it might mean not letting your boss put that after hours or early morning meeting in, perhaps it’s having a chat with your partner so that they can prepare dinner or do the bed/bath routine one evening for you to have some alone time. Remember that it’s okay and important to sometimes say no. You can’t pour from an empty cup; you need to recharge your batteries too.

 

  1. Meditate/Breath – I have such a busy mind that even the thought of sitting still for as little as five minutes stresses me out because I know my mind will fill with all the thoughts I’ve been trying to avoid. This is why I found the calm app so great, it’s five minutes of your day and it gradually introduces you to the concept of quietening your mind. Doing this every morning grounds me for the day ahead. For a free month’s trial of calm visit: https://www.calm.com/calmhealthtrial

 

  1. Yoga – Once again this is something, I was so sceptical of, but wow does it make a difference. Often, I find that my brain is so occupied with figuring out the pose and pushing through any discomfort I feel during the class that there is no headspace for the things that are stressing me out. And weirdly pushing through those uncomfortable poses kind of feels like you’re pushing through the uncomfortable situations/emotions that you’re experiencing. Sounds weird I know, but you should give this one a go! Sarah is one of my favourite Yoga instructors and is now offering online classes.

 

  1. Journaling – My mind races with everything that I need to do, that I didn’t do, of situations or confrontations that need to or could happen along with a full analysis of how they could play out – often the worst-case scenario. Sometimes when this happens, I find it so helpful to do a mind dump and write all of these thoughts down on paper to get them out my head and be able to either move on with the day or get to sleep that night. It doesn’t have to be a fancy ‘dear diary’, a simple list of things that pop into your head does the trick.

 

  1. Nourish your body – through wholesome food and movement. When I’ve eaten well and made some time to move my body (whether with a walk or a gym session) I feel so much better and more confident that I can face whatever the day throws my way. If I give in to my emotions and have a meal that makes me feel heavy and sluggish I find it impacts my mood and how I tackle the challenges that the day throws my way.

 

  1. SLEEP!!! I can’t emphasise this one enough, when we’re busy and have so much to do it’s easy to feel like we need to wake up at the crack of dawn or stay up past midnight trying to get everything done. We do not function at our best when we’re tired, and sleep deprivation wreaks havoc with our mood, food choices, and how we respond to stressful situations. So please make sleep a priority!

 

  1. Laugh and have fun, when last did you allow yourself the time to let your hair down, enjoy a good old rom-com, or go to a comedy show? It feels so indulgent to take time out for yourself when things feel a little stressful and busy, equally when it’s emotional stress that’s getting us down it just doesn’t feel right to ‘have fun’. But it’s one of the best things you can do, a little bit of optimism sprinkled over your stress and you might see things in a different light and feel a little better equipped to deal with the thing’s life throws your way.

 

  1. Acupuncture – There is growing evidence showing the effectiveness of acupuncture for PCOS and stress. How it works is still not yet completely clear, but it has been shown to help with ovulation and to regulate androgen levels. I went to the lovely Hannah and couldn’t recommend her enough. Click here to find out more about Hannah and her amazing work.

 

It’s important to remember that what works for one person will not necessarily work for everyone. These are merely suggestions to give you some ideas of things you could try, if you try something and it just doesn’t feel like you’re benefiting then there’s nothing wrong with scratching it off the list and moving on to the next thing.

What blood tests should you have for PCOS?

What blood tests should you have for PCOS?

Although blood tests are not required for the diagnosis of PCOS (read about diagnosing PCOS here), they can help rule out any other hormonal conditions which could be causing your symptoms.

The difficulty can be getting your GP to send you off for blood tests and ensuring they send you for the right blood tests. Unfortunately, many GP’s don’t know a lot about PCOS and how to manage the condition or what to look for. I hope that this article arms you with the correct information to enable you to have an informed conversation with your GP about what blood tests would be most beneficial for you.

This is by no means an extensive list, there are many other things we can test for with PCOS, however anything more specific will be linked to your symptoms and would need to be discussed with a PCOS specialist or your GP.

Tests to exclude other conditions which have similar symptoms

Prolactin

Thyroid stimulating hormone

17-hydroxy-progesterone

Other tests to confirm the diagnosis and any hormonal imbalances:

Testosterone

The most accurate way to check testosterone levels is to test DHEA-Sulphate, testosterone levels fluctuate throughout the day therefore not giving you an accurate reading. DHEA-S remains the same for a few days and will therefore provide a more accurate reading. Elevated testosterone levels are often the cause of excessive hair growth, acne, and irregular menstrual cycles as it can prevent the maturation of follicles in the ovaries.

LH & FSH

These are both involved in ovulation and your ability to fall pregnant. FSH can be low in PCOS and LH can be high, often due to increased insulin and testosterone levels which stimulate the pituitary gland to produce more LH than FSH. High LH levels can prevent regular ovulation. The ratio of these hormones is important, ideally, we are aiming for a ratio of 1:1, we often see ratios of 2:1 or 3:1 (LH to FSH) in women with PCOS.

Liver Function test

If insulin resistance is present and not managed damage can be caused to the cells of the liver. It is important to check for any damage and help identify whether lifestyle changes need to be made to better manage insulin and glucose levels to prevent further damage to the liver.

White blood cell count

Our white blood cell count can help us identify inflammation which we often see in women with PCOS. This can indicate that might benefit from supplementing with things like Omega 3 to help reduce inflammation and make lifestyle changes that help reduce inflammation.

Glucose metabolism

Here we are looking for insulin resistance as well as prediabetes or diabetes. PCOS increases your risk of developing diabetes so it’s important to pick this up as early as possible to ensure you get the right treatment and manage your lifestyle accordingly to prevent developing diabetes in the future. Most GP’s will send you for an HbA1c test (this looks at your glucose levels over 3 months) which is great for identifying prediabetes or diabetes, but it does not always show us where there is insulin resistance. Glucose tolerance tests are slightly more accurate but not routinely checked as they involve drinking a glucose solution and then having blood tests at regular intervals for 2-3 hours afterward. Ask your GP about both tests, you might get lucky and be able to get both done.

Lipid profile

This includes things like triglyceride levels and cholesterol levels. With PCOS there is an increased risk of developing heart disease which is why your GP needs to check these indicators to ensure you make the correct lifestyle changes to keep your heart healthy.

When it comes to interpreting your results, it’s important to note that most GP’s use reference ranges when looking at the results of your blood tests. Reference ranges are not based on what is considered normal or optimal, instead they are the levels that 95% of the normal population fall in to – this includes women of all ages and stages of life including postmenopausal. It is for this reason that women who are clearly showing signs of elevated testosterone levels (excess facial hair, acne) get a ‘normal’ testosterone reading. Be sure to take your results to someone who specialises in PCOS and will be able to interpret your results correctly.

If you are not getting anywhere with your GP you can request to see another GP, alternatively it might be worth working with a health care professional (preferably one that specialises in PCOS) who can communicate with your GP on your behalf and request these blood tests. 

11 Things we tried that helped us conceive with PCOS

When I was diagnosed with PCOS in my early twenties I was told very little about it, like most others I found myself consulting Dr. Google and the results were pretty devastating. “May have difficulty conceiving”, is what I remember reading before I burst into floods of tears. I knew I wasn’t ready to have children right then, but I was 100% sure that it was something I wanted in the future.

 

I was told that going on a hormonal contraceptive, for now, would help with all my symptoms and that I had nothing else to worry about until was in a position where I was ready to start trying for a baby.

 

After about 5 years on oral contraceptive, I decided I’d had enough of simply putting a plaster over my ‘wounds’ and wanted confirmation that my body could function on its own, if it couldn’t I needed to learn how to help it because being on the pill was not going to help me fall pregnant one day.

 

Armed with my degree in dietetics I started doing loads of research about what I could do to improve my symptoms without medication or the pill. And oh boy was this insightful! There is so much nonsense and nutribollocks out there about what you should/shouldn’t do to help overcome your PCOS symptoms. It took a lot of sifting, but I got there eventually – I finally got to a place where my acne had cleared, and I went from never having periods to having a regular monthly cycle. Wooo Hooo!

 

Roughly 3 years after this my partner and I decided we wanted to try for a baby, we knew that the sooner we started the better because it may take a little longer than others due to my PCOS.

 

I won’t go into the details on our journey here as I covered this in a previous blog post which you can find here.

 

This post is about what we used that we believe helped us conceive, hopefully it will help others on their journey too. So here it is:

 

Sleep – We forget how important sleep is. Research has proven that when we are even just a little sleep deprived we make poorer food choices and are more susceptible to the effects of stress. I’m an 8 hours a night kind of girl so I tried my best to get my full 8 hours. Sure, this isn’t always possible but when it is take it! Avoiding any screens an hour before bed and creating a calming night-time routine can help you fall asleep a bit quicker. A bath filled with Epsom salts and lavender oil became a frequent indulgence for me.

 

Stress management – Over the years I have come to realise that stress is one of the biggest contributors to my PCOS. When I’m stressed my symptoms flare including my cycles going wonky. So, finding a way to manage my stress levels was incredibly important for me. I used the calm app for daily meditation, and I was by no means consistent – I skipped days now and then but tried to do it as often as possible. I also learnt to say no which is so hard when you’re running your own business, but the benefits of creating boundaries quickly became clear.

 

Acupuncture – this is linked to stress management, but the benefits of acupuncture extend far beyond stress management. The evidence for acupuncture in PCOS is growing and shows that somehow (they’re still figuring out exactly how) it helps with ovulation and to regulate androgen levels. I used the lovely Hannah Pearn who specialises in acupuncture for fertility and can’t recommend her highly enough.

 

Inositol – Inositol improves ovarian function and metabolism of women with PCOS. It does this by decreasing insulin resistance, reducing testosterone levels, regulating menstrual cycles, and promoting ovulation in women. Inositol also supports normal lipid (blood fat) levels and improves egg quality in women trying to conceive.

 

Vitamin D – We started trying in summer, so I originally wasn’t worried about vitamin D however as we moved into winter, I started taking a vitamin D supplement as I do every winter. The months then got warmer, however, I continued with Vitamin D as we were in lockdown and weren’t getting out and about as much as we usually would.

 

Fertilily conception cup – A friend had shared an article with me about using a moon cup to help with conception which I thought was a really interesting concept but wasn’t quite ready for that step. Inserting a cup inside your ‘foof’ felt like a pretty big step to take and something I just couldn’t quite get my head around yet. Then as if by fate, I saw a competition on Instagram, by the fertility help hub (an amazing site with lots of great resources), for a cup that is similar to a moon cup but that has been designed specifically to help women conceive. I figured what the hell, entered the competition, won and it arrived the week that I was allegedly ovulating (I say allegedly because although I used the CLUE app to track my cycles these things are never 100% accurate, especially for those of us with PCOS). We started using it straight away and that was the month we fell pregnant! Go figure.

 

It starts with an egg – A client of mine recommended this book and whilst some of the information and evidence in there is great it’s important to remember that some of the studies referenced include very small groups of people and are not necessarily robust enough to make solid recommendations. I took from this book what I wanted and what I felt I could change. The biggest change we probably made was to continue to keep our use of plastics low and I bought some glass storage containers for foods and tried to use these as much as possible over plastic (NOTE: I did not throw out our plastic containers as that would be wasteful).

 

I stopped tracking – Whilst I will always recommend using an app like Clue to keep track of your cycles and help you notice any patterns; these are not always accurate when it comes to letting you know when you ovulate. At the very beginning, I bought myself a thermometer and did my daily temperature, but this soon became an unhealthy obsession and one that added to my stress when I couldn’t see any patterns or dips or spikes in all the right places. I kept an eye on cervical mucus but to be honest with you I never experienced that oh so fertile stretchy, egg white mucus (not even the month I fell pregnant). It’s easier said that done but try not to get caught up in all the science and what every else experiences – no one has your exact genetic make up and body, what your body does and how it behaves is truly unique.

 

And because it takes two people to make a baby my fiancé also took the following supplements:

 

Inositol – I did some research that showed that inositol helped with improving sperm motility (their sense of direction) and morphology (their shape) as previous tests had shown these were slightly lower than average.

 

Wellman Conception – These contain vitamin B12, zinc, and selenium which are known to help improve the health of sperm.

 

Alcohol – This is not one he added to his list but removed. He wasn’t drinking a lot, but he decided to give up alcohol completely until we conceived. Lucky for him this only lasted around 5 weeks (3 weeks in we conceived) and it was lockdown so there was no social pressure to drink.

 

Now I’m not saying that the above list is the answer for everyone, and it’s hard to know which of the things listed did the trick or perhaps it was a combination of everything we were doing that helped us on our journey? We’ll never truly know.

 

What I hope you’ll notice is there are no extremes in the list above, I did not eliminate certain foods from my diet, or follow any crazy diet or exercise regime. I was gentle with my body and put more focus on sleep and stress management than I did on food and exercise. It’s so easy to feel like you have to do everything to take control of the situation but often that can do more damage than good.

 

Be gentle with yourself and make small changes over time that you feel comfortable with and try and enjoy the process, baby making is meant to be fun after all.

Our infertility journey with PCOS

The irony isn’t lost on me that you spend a huge portion of your life trying not to fall pregnant and then when you want it to happen it doesn’t; turns out falling pregnant isn’t as easy as what it’s made out to be. That small window of opportunity (24 – 48 hours every 28 days) is so easily missed, add PCOS on top of this and that window is suddenly more like a tiny crack in the wall.

You won’t be able to conceive naturally”. I will NEVER forget hearing those words over the phone from the GP. I have never for a second doubted that I want to have children, hearing those words felt like my world has collapsed around me.

 

I knew that having PCOS would make conceiving slightly more challenging than normal but never in a million years did I think that this was how my journey to being a mum would begin or worse yet, end.

For the last three years, I have had my PCOS under control. Through changing my diet, understanding my PCOS root cause, exercising for enjoyment not punishment, managing my stress levels and prioritising sleep, I have managed to regulate my cycle to roughly 31 days. My skin was acne-free, my energy levels were great and insomnia was not something I had struggled with for a long time.

Until a few months prior to this conversation with the GP.

As a business owner my schedule was ridiculous, for three months I was insanely busy and constantly felt like I was running around like a headless chicken seldom pausing for breath. Suddenly my hair was falling out, my energy levels were at rock bottom, my periods were only lasting 2 days, my weight was dropping even though I was constantly eating and craving all the carbohydrates.

In hindsight, it’s so easy to see what was going on, but at the time I kept telling myself that I just needed to get through to the end of the year and once we broke for Christmas things would calm down and come January my load would be more manageable. It was just 3-4 months of go, go, go, and then I’d be through the thick of it.

What I chose to overlook was the fact that as someone with PCOS I am more prone to the effects of stress. I also know that for me stress is a huge contributor to my PCOS symptoms flaring. My body was so busy trying to survive and just get through every day without breaking down that there was no chance in hell it would allow me to conceive – my body was not in a state to grow and nourish myself let alone another human. This was confirmed by blood tests which indicated that I was not ovulating, which meant we were referred to the fertility clinic at guys hospital.

So, I slowed down. I made some changes to my schedule that gave me the chance to pause and breathe. I had to learn to say no and create boundaries between business and my personal life because this line had become so blurred. Basically, I chilled the F*@k out and prioritised managing my PCOS, regulating my cycles, and trying to get my body ready to grow a human.

December was a month of rest and recuperation, followed by a 3-week holiday in February. These came with the promise of ‘I bet it happens on holiday because you’ll be nice and relaxed’. It didn’t and the disappointment simply seems to escalate.

On the day we came back from our holiday we had our first appointment at Guy’s fertility centre – it was a little glimmer of hope that they would be able to find out what was going wrong and fix it. The fertility team was incredible, and I will be forever grateful for how kind, compassionate, and caring they were. I was immediately whipped off to a room to have an internal scan and some blood tests. Both of which confirmed that I was ovulating and nothing abnormal was picked up. On one hand, this was great – maybe all that rest and sunshine did do the trick and I was on the road to recovery, but I also had Negative Nancy on the other shoulder thinking what if there’s something else wrong that they just haven’t picked up on yet.

We left the clinic with an appointment booked for my partner to have a sperm test (it takes two to tango after all) and for myself to have follicular monitoring once my next period had started.

And then lockdown happened, I received the email I’d been dreading to say that due to COVID-19 all non-essential (fertility) appointments were cancelled. Our journey was now on hold and there was nothing we could do about it. I felt more helpless than ever.

Just before we went into lockdown my fiancé managed to send off his semen sample, after weeks of waiting for the results we finally got them back with confirmation that all was normal – a relief, but it didn’t give us any answers. Then a week later we found out that the results he was given were not his (angry doesn’t begin to describe how we felt) –  his actual results were slightly abnormal. Although his sperm count was high, his swimmers had little sense of direction and weren’t quite the right shape (in more medical terms their progressive motility and morphology were slightly below normal).

Although we now had a possible reason for our infertility it didn’t feel like a huge relief, instead it felt like another obstacle that we had to contend with, and our dreams of parenthood felt more impossible than ever before.

What’s more, there was no advice given. We were just told that if we could (dependent on the COVID situation) my fiancé should have another test done in 2-3 months. Helpful!

We did our own research and my fiancé decided to give up alcohol for a while and started taking some multi-vitamins which claimed to help.

In some weird way, I’d resigned myself to the fact that it would take at least three months for his lifestyle changes to take effect and that I would just need to dig deep and find some patience and not lose all hope the next time my period arrived.

And then two months later my period was one day late, I knew it, my fiancé knew it but neither of us dared say anything in case we got one another’s hopes up. In my mind, it was too soon to test but I could not resist the urge, I popped into Superdrug and bought a pack of three tests, that way if the first one was negative and my period still hadn’t arrived a week later I could test again.

I snuck into the bathroom with my tests (the last thing I wanted was my fiancé to know I was doing a test because I didn’t want him to experience that same drop of all hope when the test was negative).

That first minute of waiting for the results felt like a lifetime, instead of being filled with the thrill of the possibility of seeing two lines I was filled with dread. I’ve been here so many times before; the sight of that single line confirming another month of a failed attempt followed by spending the rest of the day beating myself up for allowing myself to feel the slightest bit of hope that this time we might have got it right.

And then there were two lines, I did not know whether to laugh or cry, so I think I went for something in the middle and immediately did a second test. Just in case.

I couldn’t believe it, after almost a year of trying to conceive we had finally made a baby, naturally too.

I know how lucky we are, I know some women have struggled for years and they continue to struggle. But I wanted to share our story to give you some hope, that even when you are told it will never happen that is not necessarily true, even when it feels like everything is working against you it can still happen. I want this to be a reminder that if you have PCOS this does not mean you will never fall pregnant; it simply means you may have to work a little harder. I want this to remind you that male infertility is a thing too, it’s more common than you think and it’s okay.

I want every woman who has struggled to conceive to know that this is not your fault, you are not any less of a woman because of this. I am so grateful that we did not have to go down the road of drugs and IVF, but if this is where your journey has led you then know that this is ok too and I have everything crossed for your rainbow baby to happen soon.

What is mindfulness?

Hearing the word mindfulness often conjures up images of someone sitting peacefully on a yoga mat, surrounded by candles, the sound of calming music, eyes shut and breathing rhythmically as they shut out the outside world. Whilst this isa form of mindfulness (more mindful meditation), mindfulness is the every day practice of being in the present moment. It’s the practice of focusing all your attention and senses on one moment and acknowledging the feelings and emotions that arouse from it.

 Why is mindfulness important?

We live in a fast-paced world in which we are constantly multi-tasking and thinking about the next thing on our to-do-list. Have you ever gotten to work and not really remembered the journey? Watched a television programme and not been able to recall what happened, or eaten a meal and not paid attention to the flavours and textures? For many of us we spend our free time scrolling through our phones; browsing the internet or social media, catching up on emails or texting friends or loved ones – our minds are never still, and we are constantly stimulating our brains. Whilst we are thinking and doing our brains do not have the time and space to process everything that is going on around us, which manifests in many different forms, such as stress, a feeling of being overwhelmed, anxiety, depression, insomnia etc.

What are the benefits of practicing mindfulness?

  1. Better stress management – if we can focus on the present and not allow ourselves to get lost in thoughts about what could happen in the future, or has happened in the past, the opportunities for worrying and feeling overwhelmed suddenly become fewer.
  2. Our relationships improve – being mindful around people means that we listen to what they say, notice how they look and feel, respond to their body language and make true connections through quality conversations. We’re all guilty of pretending to listen whilst our mind wanders to a totally different place.
  3. Productivity increases – focusing on one task at a time and not allowing yourself to be distracted by roaming thoughts, the constant flow of messages on your phone or reliving a conversation you had earlier, means you will work better and faster creating so much time for yourself.
  4. It improves your relationship with your body – there is no doubt that there is a strong connection between our brain and our body. Ever eat too much and suddenly feel fatigued and unable to concentrate? Ever feel uncomfortable in your clothes and feel a bit low all day? That’s the connection right there. Being mindful about the foods we eat and the impact they have on our body can do wonders for our confidence and energy levels.
  5. It improves sleep – if we allow ourselves enough time in the day to process our thoughts and emotions and provide our mind with some space without being overstimulated, then when it comes to going to bed at night our brain is not still running at a million miles an hour, making it impossible to get some quality sleep.

It’s easy to see how mindfulness does not just impact your mind but your overall health and wellbeing. Make sure you are giving yourself the time and space to be more mindful. And remember; it’s a process – you won’t master it straight away, but practice makes perfect! Click here for ways to incorporate mindfulness in to your daily routine.

 

Seven ways to be more mindful every day

7 ways to be more mindful

Mindfulness can sound overwhelming and technical, but it doesn’t have to be. It’s important to remember that getting good at practicing mindfulness takes time; start with small changes and build on them as you get better. Here are seven simple ways that you can start incorporating mindfulness into your everyday life:

1. Mindful mornings

So many of us reach for our phones as soon as we open our eyes. We don’t even give our brains the opportunity to acknowledge how we feel when we wake up, what our concerns are about the day ahead or what we’re excited about – whatever we see on our phones dictates this to us. Spend the first five minutes of your morning checking in with yourself; how does your body feel, what thoughts enter your mind, acknowledge them and let them pass. Sometimes it can help to write things down, not as a to do list but just as a way of acknowledging the way we feel.

2. Put your phone away

Do you reach for your phone as soon as you sit down, stand in a queue or have time to kill? Put it away and let your mind be still for that time instead, check in with your mind and your body and how you’re feeling.

3. Practice mindful eating

How often do you eat in front of a screen, whether it’s a computer, a TV or a phone? We’re all guilty. This draws your attention away from your food, the flavours you’re tasting, the smells and textures as well as your body’s natural signals which let you know when you’ve had enough. Practice eating away from a screen

4. Mindful listening

The next time you have a conversation with someone, listen. Don’t allow your mind to wander, pass judgement on what is being said or think about what you are going to say back. Don’t just hear what they are saying, listen to their words.

5. Check in

So often we rush from one task or event to another and do so with a list of things rattling through our head. We’re never fully present when we arrive as our mind continues to rattle through and add to that list. The next time you arrive somewhere, take a deep breath, acknowledge where you are and what you’ve come to do and leave every other thought at the door.

6. Schedule time for nothing

It may feel like a weird thing to do, many of us feel uncomfortable and guilty even just sitting down and doing nothing. You’ll be amazed at how much difference even just five minutes of stillness can make. Whether you flop on your bed, sit in your favourite chair or find a sunny spot in the garden, take time to just be alone with your thoughts.

7. Exercise

Many of us don’t realise just how mindful we become when we exercise. You’re often left concentrating so hard on doing a certain exercise or just making it through the class that your mind has no space to think about anything else – that is mindfulness at it’s best. It’s one of the reasons exercise is so good for stress management and linked to making us happier people.

Try adding one or two of these to your daily routine and gradually add more as you get better.

Five tips for workplace wellness

Workplace wellness blog image

One-third of your adult life is spent at work. That’s a pretty big chunk of your life which is why it’s important to make sure that your work place is having a positive impact on your health and wellness and not a negative one.

Whilst more businesses are offering a spectrum of ‘wellness’ benefits to employees there is still a long way to go for some, and we can still take ownership of ensuring we are looking after our own health. I’ve created a list of the five things I think are most important when it comes to looking after yourself in the office:

Stay hydrated

We often get to the end of the day and realise that we’ve been sipping on tea and coffee all day and only had the occasional glass of water. Up to 60% of the human body is made up of water which helps the body function on a daily basis by aiding digestion, flushing waste, delivering oxygen to different parts of the body, and the list goes on. Keeping a bottle of water on your desk helps as a constant reminder to keep drinking. Drinking herbal teas also counts towards your daily fluid intake. It’s recommended that we aim for 2 litres of water per day, if you’ve participated in exercise where your daily losses (sweat) would be higher then you may need a little more to replace this.

Keep moving

Many of us have a job which involves siting at a desk for 6-8 hours a day, followed by relaxing in front of the tv or with a book (in a seated position). Inbetween all this we are commuting – mostly seated. When we are siting we are using very little energy and not a lot of muscle movement is happening, which is not great for our health and wellbeing. Where possible, try to get up and walk around, use your lunch time as an opportunity to go for a walk (even 10 minutes is better than nothing) and on your way to and from work find ways to walk a little more – whether that’s getting off the bus one stop earlier or parking a street or two away. All of these little batches of steps add up and can make a big difference. Going for a walk and some fresh air at lunch time can also do wonders for your energy levels and productivity.

Be aware of non-hunger snacking

Snacking can often be caused by emotion; we snack when we’re stressed, upset, frustrated or even bored. All common workplaces are full of emotions, so it’s no wonder we find ourselves reaching for a little pick-me-up, not to mention all the treats that get brought in by the office star bakers which make it near impossible to choose an apple over a gooey chocolate brownie. Whilst the occasional treat is most certainly allowed, avoid getting into the habit of reaching for a sugary snack. Go to work armed with healthy options, as having these to hand makes it easier to make a better snack choice. Nuts, fresh fruit and vegetables, wholegrain crackers with peanut butter, air popped pop-corn, yoghurt are all great options.

Be conscious of your caffeine intake

Although there are benefits to drinking caffeine, such as increased concentration and alertness, having too much can have a negative impact. Consuming more than the recommended amount of 400mg per day can cause headaches, irritability, nervousness, upset stomach and sleeplessness. Coffee, tea, soft drinks and energy drinks are all sources of caffeine so try and be aware of how much your consuming. For more information on the caffeine content in certain drinks click here. If you’re struggling to sleep at night, try and avoid caffeine in the afternoon as it can stay in your system for 5-10 hours.

Practice being mindful

It’s so easy to get stuck in a rut of going to work, charging through the day and heading home again. When last did you stop and take the time to think – think about how that healthy lunch gave you energy to be productive in the afternoon or how that walk you went for at lunch time gave you perspective after a challenging meeting? How did it feel to take five minutes out of your day to catch up with a colleague and share a few lol’s? What about spending a few minutes after each meeting thinking about what you learnt, what could have been done differently, what didn’t work well? Giving yourself time to reflect on your day and different elements of your day helps you to identify things you do and do not enjoy as well as, areas of strength or gaps in skill/knowledge that you can develop further. It can also help you to become aware of tasks that energise or drain you and by learning more about yourself you can improve your overall wellness.

Always remember that you’re not only at work to do a job and earn a pay cheque – you’re there to grow and develop, improve your skills and knowledge and stimulate yourself. In order to do these things well we have to be well so looking after yourself should be your top priority.