Now what?
I kept asking myself this as the months passed after my diagnosis with Polycystic Ovarian Syndrome. I was not interested in taking medication to lose weight, control my testosterone, force a period, and force ovulation. It seemed there had to be a different answer.
By working to remove simple carbohydrates like white flour and potatoes from my diet, I had shortened the length of my long, anovulatory periods. By introducing weightlifting into the equation, I had begun to ovulate occasionally. My lifestyle clearly influenced my menstrual cycle. This we knew before having a name for my problems.
But why did they have that affect?
As we dove into what PCOS was, how it all worked, the answer became clear. The root of the condition is not in the ovaries. The problem is insulin resistance. At its heart, PCOS is a metabolic condition (meaning it relates to how food is processed). For most people, eating a meal with a lot of carbohydrates or sugar signals the pancreas to secrete insulin. The insulin signals the liver to turn the sugar into usable glucose, as well as signaling the muscles to store it. In an insulin resistant person, the body requires extra insulin to get the cells to respond in their proper way. That extra insulin doesn't get used up, and instead it floats around until it gets to the ovaries. The insulin signals the ovaries to produce extra testosterone. This throws off the menstrual cycle and affects a host of other things in the body.
The problem, then, was the extra insulin. How could we keep the insulin from spiking too often, triggering extra testosterone? Eliminating the simple and processed carbohydrates were a clear solution. That was why it had worked, to a certain extent, in the past. Fewer carbs equaled less testosterone.
We also discovered that dairy naturally triggered the body to produce testosterone due to the growth hormone IGF-1 it contains. Cutting our dairy seemed like a natural next step.
The weightlifting not only gave the testosterone something to do, it also made room for more glucose. The larger the muscle, the more glucose it can hold..
All of the these things were wins. It seemed that I was moving in the right direction. But I was not ovulating every month. Even on the months I was ovulating, I was not getting pregnant (that was getting old, let me tell you). Something more drastic needed to be done.
While doing his own research, my husband discovered a study. Twenty-two women with PCOS were put on a ketogenic diet. At the end of the the sixth month trial period, 17 had dropped out or been disqualified. Of the five that were left, however, two were pregnant. All of the women had seen an improvement in their blood sugar levels and other markers of PCOS. It was an encouraging study. Perhaps this diet would be the answer we were looking for!
What is a ketogenic diet, you may be asking. I did when I first heard about it. The ketogenic diet is basically a low carb-high fat diet. When done properly, the liver produces ketones from fat to fuel the brain because there is no glucose. The carbohydrates have to be low enough to trigger this ketone production.The body is running and burning fat for fuel, so fat becomes the key nutrient. Because of the focus on fats, which do not spike insulin, a ketogenic diet seemed to be the perfect solution to PCOS.
As a diet, it is very difficult to stick with! The human body prefers carbohydrates as fuel. If it is given enough of them, it will switch out of fat-burning mode and burn only the sugars. A single slice of bread, a piece of fruit, or even too many nuts could knock a person out of ketosis. My favorite desserts and french fries were clearly off the table.
The difficulty of sticking with a ketogenic diet likely accounted for why 75 percent of the women in the study dropped out. But the success, in my mind, outweighed the difficulty. This might be my chance to finally conceive a child! My husband and I decided I would try the ketogenic diet for six months. Our hope was this period with reduced carbohydrate would re-sensitize my body to insulin and reduce the amount of testosterone I was producing.
I started the diet in April of 2017. It was hard, but I was determined to make it work. Transitioning from burning carbohydrates for fuel to burning fats for fuel can be a difficult, uncomfortable process, known as the "keto flu." Removing cold turkey the French fries, ice cream, and peanut butter and jelly sandwiches I still loved and craved was also difficult. I had two weeks of consistent keto, but then other foods began to slip in on occasion. I definitely did not do keto as strictly as it is intended to be. There were weeks that were more compliant and weeks that were much less than compliant. However, it was still effective.
After 6 months, I had lost the 20 pounds I had gained when I first got married. More importantly, I was ovulating regularly. Every month, consistently. No more long, anovulatory spotting. Things were looking up at long last.
**Disclaimer: The information in this post is not intended to diagnose or treat any condition. If you have questions or concerns about what you are experiencing, please discuss them with your healthcare provider.
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