at a glance
5 Things I Learned This Week Working with PCOS Fertility Clients
Table of Contents
I’ve been working with clients that have a PCOS diagnosis that are trying to conceive for over 7 years now. There are so many things that stand out to me about women with PCOS. I find this work to be a sacred calling. I took some time off after my last PCOS baby was born so I could focus on other fun goals in my business that would serve larger populations of people. (The PCOS App & a PCOS Supplement Line)
Yet a few weeks ago I had a one-on-one appointment with someone from my courses that needed some additional focused attention and I hopped off that Zoom call and felt a string pulling my heart. I shine in one on one work. I think part of it is that I’ve walked this walk. I have PCOS. I struggled to conceive. I was also brought up by incredibly compassionate humans and taught to love with God’s love.
Pairing my scientific brain, my own human health experience, and a real love for these women and I felt like it was time to ease back into some one on one work. What I didn’t expect was to be reminded of some things and find new things that were common among all the appointments I’ve had in the last week and I felt I needed to share them with you today.
Get ready. This is less about science today and more about human connection and building belief in yourself.
PCOS Doesn’t Discriminate
I remember when I was trying to get pregnant and saw so many different health professionals. I’d start the appointment by saying “I have PCOS so I know this may be an up-hill battle.” Then they’d look at me and say, “you aren’t heavy, it’s probably not PCOS.” Something to that effect.
First of all, it made me feel incredibly frustrated on many levels. Mostly frustrated because I felt like I had been doing everything right, I mean I got a degree in human biology AND nutrition, became a Registered Dietitian, and spent thousands of dollars on doctors, naturopaths, nutritionists, Chinese medicine doctors, supplements, gym memberships, ovulation predictor kits, functional medicine labs, all to have a doctor tell me my weight was why I didn’t have this condition.
Newsflash- I didn’t always look this way. I had been 60 pounds heavier just a few years prior.
The gals I saw in appointments this week had such different backgrounds, different ethnicity, different parts of the country they were from, different family health histories, different goals, different work schedules, and different everything.
You can be “skinny” and have PCOS. You can be a lawyer. You can be Hispanic. You can be a Nurse Practitioner. You can be adopted. You can be a Director of a Health Education Program at a College, or an entrepreneur working completely from home. Honestly, PCOS doesn’t discriminate.
I treated women this week that were tall, short, loved to cook, hated to cook, too busy to cook. Women who worked out, others who didn’t, coffee drinkers, soda lovers, water-only, and everything in between.
No matter your lifestyle, diet, education, or geographical location. PCOS is common. Even women who seemed like they were doing it all “just right” still had labwork that indicated their body was struggling.
Just because your PCOS isn’t well managed yet – doesn’t mean that you aren’t doing everything you can.
2. Sometimes we Focus on the Big Things and Forget the Simple Human Things that We All Need
Every single patient I worked with this past week are incredibly successful in various areas of life. Church involvement, career achievements, supportive family relationships, AND MORE. Yet, the really small things in life are often being overlooked.
I’d venture to bet you are skipping some of these things too. You’d be surprised how much time we focused in appointments creating goals around these items. When I’m talking about the simple things I’m talking about:
meal prep
what one patient called “panic” lunches (more on this later)
evening/bedtime routines
stress management
quiet/downtime
I would venture to guess most of us have an immediate connection to a few of the areas listed above. So let’s talk about some of the goals clients set this week.
Meal Prep for PCOS
This is some of the best low-hanging fruit in PCOS management. Having blood-sugar-friendly breakfasts that are quick if your mornings feel rushed. Cutting up vegetables and washing fruit when you get home from the grocery store so it’s easier to grab one of these items for a snack instead of the chips calling your name in the pantry.
So many of these clients liked fruit and veggies but found they don’t often include them in snacks or breakfasts. Biggest reason why? They aren’t a quick grab. Creating a goal around having them in a ready-to-eat form will make it easier to incorporate more fruit and veggies into meal plans.
Panic Lunches – Have a Back-Up-Plan
This is perhaps a dramatic term, but once I describe it you will know what I mean.
Almost EVERY client described lunches typically being leftovers from the night before. Problems arise here if that’s your only plan.
What happens if there aren’t leftovers?
What happens if you made enough food for leftovers but you can’t find them in the morning (I’m talking to my husband here – my night owl husband sometimes has a second meal before bedtime)?
What happens if you call an audible and eat out and don’t have a doggy bag to bring home for lunch tomorrow?
These are all super common scenarios in day-to-day life. So having a plan for only eating left overs will leave you in a panic sometimes. You know the day I’m talking about. You get to lunch time and realize you have a call in 30 minutes and you need to eat quick, open the fridge and the lunch you planned to eat isn’t there. Panic ensues.
Sometimes you grab a protein bar, sometimes a quick smoothie, or what I heard most often: make a bento-box style lunch: some nuts, fruit, cheese, deli meat, and carrots.
What if you want an actual meal though? This is where having some legit options can come in handy. Here are some of the goals we came up with this week:
Pick one protein and one carb to cook extra of either Sunday or Monday night examples(grilled chicken and rice, steak and sweet potatoes, pork loin, and quinoa). Then on days you need something quick you can throw those in a bowl with prewashed lettuce and throw a sauce or a dressing on top and chow down without the panic.
One weekend per month make a meal you can freeze in single-serve portions (chicken and veggie enchiladas, lasagna, chili, etc).
Grab premade blood sugar friendly frozen meals at the grocery store.
Keep blood sugar-friendly snacks around so you can pair one or two snacks to make lunch: bell pepper and humus, greek yogurt + blueberries + chia seeds + sunflower seeds.
The point of this section is to have a plan. Be prepared because those days will come when you don’t have a solution that you normally rely upon, so having a backup plan is safe and smart.
Evening and Bedtime Routines for PCOS
I get it, I really do. I like to binge Netflix before bed. It’s that time we disconnect, relax, and recline. If it’s not Netflix, it’s probably social media scrolling. My late-night nemesis is working… I get so into something that I look up and I’ve spent two hours on a blog (ahemmmm Caitlin, stop writing and go to bed).
Both of these activities are going to help you create cortisol right before bed and interfere with your natural hormone rhythms. CALM DOWN and don’t stop reading even if you feel called out here (I’m calling myself out too).
I’m not going to tell you to stop completely. God knows I hate cold turkeys…
Nope, I’m going to say, scrolling and Netflix have their place. Let’s create some boundaries around them.
They aren’t the last thing that you do
You wear blue light filtering/blocking glasses and turn screens to warm modes so they have less blue light in them
You set a time limit on the activity (this has been a game changer for me lately as my newest hobby is trying to find the funniest reels and sharing them with friends)
There is a healthy routine between these activities and bed
More on this routine idea. Your body likes safety. It also likes routines. If you create a routine around bedtime you are much more likely to fall asleep quickly. A routine could look like this.
Light a candle and turn the lights down low
Brush teeth, floss, wash face (whatever bathroom things you do before bed)
Head to your candle-lit room and do 3-4 minutes of gentle stretching and breathing
Journal for a minute, and write down any “to-do lists” that are floating in your head
Pray/meditate
Get into cozy bed/ snuggle/ intimacy
Drift to sleep
We make routines for small children because they are really important. Honestly, they are just as important for your hormones. Maybe even more important. If you don’t have a solid bedtime routine and you struggle to fall asleep this goal is a must-focus item SOON.
Also check out this Bedtime Stress Support supplement we created to support lowering evening cortisol levels and helping you have quality sleep.
Stress Management
I’m not about to tell you that you need to do some more self-care AND I am ALL for spa days and pedicures. That won’t get the job done lady, You need honest-to-God help dealing with stress from your nervous systems perspective.
The thing about spa days and pedicures is that they have a shelf limit. The benefits don’t extend far beyond the day you enjoy the treatment.
Come on a journey with me though. What if you could train your heart and mind to see stress differently? What if you could acknowledge it for what it is and help your body process it without as much trauma? What if this were possible?
We’ve all talked about the analogy of the lion chasing you and we don’t really live with those same threats, but your body doesn’t know the difference between a mean email from your boss or a traffic jam. Stress is stress to your body whether it comes from an invading village or an infertility appointment.
When the lion chased you hormones switched on, blood pressure changed, and you ran like hell (or at least your ancestors did). If you outran the lion the stress hormones subsided because the stressor was removed.
We don’t always get that same benefit in modern culture. So we literally need to learn how to turn the stress management processes in our body on to battle this chronic level of stress.
As much as I love a good massage, a good night of sleep will help your stress reserves. Deep breathing is more important than disassociating with Netflix. Time in nature will feed your soul better than binging on Doritos at night.
Here’s the problem. It’s easy to schedule a massage, but changing your bedtime routine is not as easy.
It’s easy to turn on the screen at the end of the day versus journaling, deep breathing, and prayer to reflect on today’s good, hard, and in-between.
Doritos taste great and are just a few steps away in the pantry. Prioritizing a weekly walk in nature may feel like too much of a commitment now.
Therapy, quiet time, setting boundaries, saying “no”. These are the harder things. They pay richer dividends though. We need to focus on stress management that is really going to expand the capacity of the cup, not just skim off the top 10% of the day’s stress.
Quiet Downtime
You need quiet time. You do. We don’t need the podcast on while we drive all the time. You don’t need to listen to music when you take your dog for a walk. When you cook dinner you don’t need to watch a show. When it’s time for bed, it’s time to get peaceful, not binge on the latest thriller.
Over millennia humans have had much less noise, much less distraction, and obviously fewer screens. Our circadian rhythms and hormonal rhythms were much more in tune with nature. The moon played a large role in female hormones. Sleep was easier to obtain because when it was dark, there wasn’t much to do.
When was the last time you actually stopped and watched the sunset start to finish, in nature, no distractions?
Ever noticed what colors are prominent in a sunset? They are those warm tones. Oranges, reds, pinks, creams, purples. You don’t see a lot of blues. Nature turns on the warm tones before bed. We should too.
How do we create calm, quiet, and peace around us?
I’ve said it a million times before and I will say it again: fertility depends on safety.
Music running 70% of the time does not support this. Always needing the TV on doesn’t support this. All of my examples are for myself. Perhaps you don’t struggle with quiet time, but you do struggle with Meal Prep. Take what you need, and leave the rest.
Be honest with yourself though and focus on something this week that will help you!
Okay, ready to get back to the list of 5 things I learned this week working with PCOS Fertility Clients? Yeah, me too.
Supplements Do That, “They Supplement”
3 points here, ready?
they work best when paired with appropriate diet and lifestyle therapies
they work if you take them
it matters that you get the right ones
Taking A Supplement Will Never Work a Miracle – It Has to be Paired With The Right Lifestyle and Dietary Changes
I won’t belabor this point. You get it. It’s pretty self-explanatory.
I found myself quoting this Bible story that honestly my memory is a little fuzzy about. Here is the gist.
A prominent man gets leprosy. He sends for the prophet of God to get instructions on what to do.
The prophet sends the message to go wash in the Jordan River 7 times.
The man is frustrated that this is the message, how could this possibly help? He wanted him to wave hands, perform a miracle, do something special, supernatural.
He wonders why he can’t go to cleaner, better rivers.
The man’s servant asks something along the lines of “If he had asked you to do some great thing, wouldn’t you have done it?” The thing you’ve been asked to do is simple, go wash this many times.
The prominent man decides to heed the instructions, goes, washes and receives healing. Skin as soft as a baby.
This is an imperfect example, but hang in there with me…
Sometimes I think we approach supplements like this prominent man. He wanted a supplement, an ointment, some great thing to do, the miracle different thing. Yet, he was asked to do simple washing.
I just gave you lots of examples of simple things our body needs us to do: eat (meal prep/panic meals), sleep well (circadian rhythm support), stress management, and prioritize quiet time. Those are things you can do and should do.
Yet, many want me to recommend supplements. The supplements can help, sometimes in miraculous seeming ways, but they always do better when you do the ordinary, everyday, simple things for your body.
Supplements Work If You Take Them
Got that drawer or cabinet in your house? Sure you do, me too. Full of all the things. That you NEVER take.
So you put the supplements on the counter where you will see them, and you take them about half the time.
They might work 1/2 as well as intended then.
Often with medications AND supplements, the research points to a really effective dose. Taking half that dose, one-third that dose or even twice that dose may not yield the benefits you expect it to.
If you are recommended by a practitioner to take a specific dose, try to build in routines so that you take that dose.
How this may look practically speaking:
setting the alarm on your phone
keeping two bottles of the supplement (one on the kitchen counter and one at your desk at work)
get a pill organizer like this one to sort your supplements into
ask your partner/room mate/friend to remind you to take them
have an end of day reminder so you can take any supplements you forgot throughout the day
Not Just Any Supplement Will Do
You have PCOS. You are probably trying to get pregnant if you are reading this. Just taking any supplement won’t do. You need to consider what’s safe in preconception and SO MUCH MORE.
Supplements can have drug interactions.
Supplements can seem like they are a good idea for you, yet they may work against you if your labs, symptoms, and goals aren’t taken into consideration.
This week I saw a handful of supplements that were working against these women that we needed to limit or remove completely.
There are some supplements I think almost everyone that has PCOS can benefit from with few drug interactions, side effects, or downsides. Those include:
myoinositol
magnesium
vitamin D
zinc
and berberine (most of the time)
Did you know there are multiple types of magnesium and you should choose one based on your symptom picture and diet?
Get guidance, don’t play whack-a-mole with supplements.
There are also so many other supplements that can be particularly helpful. If you want ideas on what supplements may be appropriate for you check out the quiz on PCOS Formularies. I have created it to analyze your PCOS and goals to make suggest targetted solutions.
It’s Hard to Find an OB/GYN That You Like and Trust
It’s worth trying and trying again until you find a doctor to help you with your PCOS. This can look like an OB/GYN, Naturopathic Doctor, Primary Care Provider, or Endocrinologist. Working with a Dietitian is great (OBVIOUSLY).
My scope of practice is limited. I can’t prescribe medications. I can’t advise on how you personally should take them. I can’t do surgery or procedures or ultrasounds.
At some point in this journey you will need to find a doctor you feel really comfortable with. Someone that treats you with dignity, and respect, takes enough time for you, and is curious about you. A curious doctor (in my humble opinion) is much better than the “most expert.”
Here’s why: The most expert in any area tends to think they know it all and don’t really listen to patients when they are telling their story. They just jump quickly to what they “know” is happening. As if!
While a curious doctor will listen. They may not have all the answers, but they will fight to find them. They will include colleagues when they are feeling like they need someone else to help in a situation or refer out when it is truly something outside of their scope of practice or expertise.
It’s important to do the hard work of compiling your “care team” now.
You do not want to be searching for an OBGYN while you are newly pregnant or in mid-pregnancy. You also don’t want to be trying to build rapport in the midst of a pregnancy loss or when you need an immediate solution.
New doctor wait times are loooooooooong. If you find yourself in a position without a good doctor following you, you’ll end up in an emergency room for something that isn’t an emergency with doctors that are NOT specialized in hormones, pregnancy, etc.
You want to learn to sail in the calm of the sea. You don’t want to learn to sail n the midst of the storm.
On this point, I feel most strongly. Do not settle for a doctor you feel is just “not the right fit.” Fight until you find one that is.
PCOS Women Are Truly The Strongest
You’ve been fat-shamed, I know.
Your provider thought you were lying when you said you have been doing really well on your diet and exercise but the scale just isn’t moving.
You have fought through fatigue, depression, disappointments, self-esteem issues, fear, and hopelessness. And yet, here you are, still fighting. I see you.
You aren’t doing less, typically you are doing more. In fact, doing more with fewer resources.
The medical community has not sufficiently understood the extent to which hormones are impacting symptom manifestation. They typically assume a posture that PCOS women are just lazy. This could not be further from the truth. Will you read that last sentence again and let it synch in.
You do not have willpower issues. You are not a failure. You were put into a track race where everyone got to start on the same line and you were 20 meters back when the shot when off. You are playing with a completely different deck of cards. The hand you were dealt was not only “not fair” it wasn’t even the same game.
Acknowledging this can take a lot of the shame out of where you may be right now. Understanding and believing how strong you truly are will help set up a version of you that is courageous, proud, and ready for the challenging road ahead.
I see you. You ARE strong. You also inherently know exactly what you need to focus on next. Don’t second guess yourself lady. Trust that inner wisdom you have.
I feel really blessed to work with the women I do. I also have a unique perspective.
I’m deep into the biblical analogies today, if you aren’t Christian, just look for the correlation to my point here.
There is a story in the bible when Israel was at war with Syria and the King of the opposing army sent men to capture the prophet of God because he was able to predict the Syrian army’s movements – making victory impossible. They had to “take out” the threat.
There became a situation where the prophet and his servant were surrounded by an overwhelming host of horses, chariots, and strong forces. It was a dire situation with very little room for escape.
The servant panicked wondering what they should do. The prophet said “Don’t be afraid, those who are with us are more than those who are with them.” Then he prayed that God would show the servant and the servant looked up and saw the hills full of horses and chariots of fire all around them.
Sometimes what we see in the physical seems so hard to look beyond. We see the struggle and the immediate. We can’t see the greater context of our situation. Frankly, we weren’t even trained to see it, so how could we?
We look at a square of the quilt that we can see, but we can’t step back and see the entire tapestry, the entire landscape, and how it all works so beautifully together. The context of the square feels wild when it’s all on it’s own. Incomplete even. Yet, when you zoom out and see how it all fits together- it’s a masterpiece.
I have seen miracle after miracle in women with PCOS feeling so much better, conceiving amidst the most amazing obstacles, becoming mothers, enjoying the wonders of what a child is.
This is where the analogy feels a little funny to me, I feel a little like the prophet where I can see the landscape. I see the horses of fire on the hill.
I am no prophet but, I’ve seen miracles before and I’m confident in the process.
Bring your strength. Bring your resilience. Bring your energy. Follow the formula.
I can see the bigger tapestry. Nutrition, supplements, movement, sleep, stress, the right medicine, the right procedure, the right provider and all the things in between.
Follow along for education or consider downloading The PCOS App for more resources and recipes on PCOS and Fertility.
If you are ready for more guided support, ready to take your strength and apply it to the right principles, come hang out in the FIND FERTILITY Course.
I believe in you. I’m cheering for you.
I’M CAITLIN JOHNSON!
You are ready to trust your body again. You are ready to fix your hormones and fall in love with your body. Let me show you the way through comprehensive courses to manage your hormones and boost your fertility with PCOS.
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