at a glance
How Does Caffeine Affect PCOS?
PCOS and Caffeine: should you break up with caffeine if you have PCOS?
If you rely on caffeine to keep you going throughout the day, you aren’t alone. Millions of women across the globe share the same beloved relationship with caffeine.
Every relationship has its ups and downs. Caffeine has a reputation for increased risk for health problems in women with polycystic ovary syndrome (PCOS). Often healthy compromises are made in relationships, but sometimes love is severed. You may be wondering: should you make up or break up with your darling, Leonardo de Venti?
What is Caffeine?
Caffeine is a “Drug”
Caffeine is a stimulant and is classified as a (legal) psychoactive drug. It’s related to LSD, alcohol, and marijuana. However, it doesn’t behave exactly like them. Caffeine expedites messages between your brain and body – altering how you think and feel. Caffeine is notorious for its short-term effects: increasing energy levels and alertness.
For a variety of reasons, caffeine may be your knight in shining armor – swooping in and giving you a wave of energy in the morning or enchanting you to power through long workdays.
Caffeine is Found in Food and Drinks
You may find caffeine in everyday beverages like coffee, teas, sodas, and energy drinks. Some foods, such as chocolate, also have caffeine. For example, Cliff bars with chocolate have about 49 mg of caffeine in them. You may also find caffeine in pre-workout powders. These are typically high doses of caffeine, many of which are 200 mg or more.
Coffee, PCOS, Caffeine
How Much Caffeine is Okay to Have?
So many of us drink caffeinated beverages – men, women (pre-conception and in pregnancy), and even children. It’s important to understand where you are getting caffeine from and how much you are consuming.
Amounts of Caffeine in Drinks
The FDA requires companies to list “caffeine” in the ingredients on product labels, but there’s no requirement on listing the precise amount. Meaning, you’re on your own to figure this out.
Panera’s lemonade is going viral for its 260 mg of caffeine that is infused into the drink. For reference, that’s more than a quadruple shot of espresso!
The actual caffeine content in drinks can vary depending on:
How its brewed (french press, espresso, steep time)
Light roast vs. dark roast (hint the darker the roast, the less caffeine)
Processing (soda, energy drinks)
Type of tea
This guide gives you a picture of the amounts of caffeine in beverages.
What is a Safe Amount of Caffeine?
The FDA has cited that 400 mg of caffeine per day is generally safe for most healthy adults. There’s a caveat to that statement. Caffeine sensitivity varies from person to person. Your ability to metabolize caffeine is unique to you.
What Does Caffeine do to Your Body?
The effects of caffeine are felt differently in each person. Not everyone metabolizes caffeine at the same rate. How your body processes caffeine can depend on:
genetics
age
sex
body weight
lifestyle
physical activity
tolerance
health conditions
Are you a fast metabolizer – you can drink coffee and fall asleep an hour later? Are you a slow metabolizer – at 10 pm are you still buzzing from your 8 am cup?
It Depends on Your Genetics
Caffeine’s strongest effects are usually felt in the first hour after consumption. Caffeine has a half-life of 4-6 hours, meaning its effects could be lingering around later in the day.
Fifty percent of humans don’t make very much of the enzyme that metabolizes caffeine. That means 1 out of every 2 people will be more sensitive to caffeine and feel the effects for longer.
Medications Affect Caffeine Metabolism
Women who take birth control metabolize caffeine slower than those who do not. It may take between 7-9 hours (compared to 4-6 hours) for caffeine to exit your system (2). Meaning that 2 pm coffee can still be lingering at 11 pm – contributing to disturbances in sleep and circadian rhythm.
Sleep is Disrupted
Caffeine impacts the time it takes to fall asleep and stay asleep. Evidence supports that anyone consuming caffeine will take on average twice as long to fall asleep compared to those who do not consume caffeine. This is true no matter what time of day the caffeine is consumed.
Caffeine or Sleep?
It’s not just falling asleep you should care about; research suggests sleep patterns are affected across the board in those who consume caffeine. If you have trouble sleeping, pulling back on the caffeine may be beneficial to you.
Sleep quality is impactful for so many things. Immune health, stress levels, insulin resistance, even healthy menstrual cycles. If you struggle with being sick all the time, feel like you are drowning in stress, or irregular periods and haven’t seen your menstrual cycle return like you’d like to – consider cutting back on caffeine levels.
Caffeine and Hormones
Adenosine
When you are awake, there is a chemical called adenosine floating around in your brain. As it binds to receptors in your brain, you begin to feel more tired. The longer you are awake, the more tired you feel. When you are asleep, adenosine decreases. This gradually wakes you up (10).
Caffeine is actually very similar in structure to adenosine. When caffeine binds to those adenosine receptors, the (anticipated) feeling of tiredness is not felt. This is great because you will feel more awake, but over time your brain adapts. More caffeine is required to produce that same “alert” effect of caffeine. When you skip a day of caffeine, you may end up feeling more tired than you normally would (10).
Adrenaline
Caffeine also stimulates the production of adrenaline, our “fight or flight” stress hormone, much like cortisol. This increases your heart rate, blood pressure and opens your airways. This gives you a temporary boost but may cause fatigue later.
Dopamine
Dopamine is your “happy hormone.” Caffeine affects your dopamine levels, improving your mood at the time. The downside, it may lead to a decrease in mood after it wears off. This actually makes caffeine moderately addictive (10).
Cortisol
Cortisol is a stress hormone secreted by the adrenal glands. It regulates energy balance and is important for circadian rhythm.
It works by increasing blood sugar (4). Cortisol is naturally highest in the morning and lowest during early sleep. Caffeine increases cortisol secretion, which can disrupt your natural cortisol pattern (3).
If cortisol levels increase later in the day, you are more likely to experience sleep disturbances. Cortisol has a partner in crime named melatonin. When one is high, the other is low. They compete for effect on your brain.
If you are consuming caffeine late in the day it is likely you are impacting how your body will make melatonin at bedtime.
Over time, consistently high levels of cortisol can impact your whole body.
In PCOS, women experience cortisol imbalances. The adrenal glands tend to overproduce stress hormones, like cortisol. If you are already stressed, then it may be best to avoid an additional spike in cortisol by consuming caffeine.
If you aren’t convinced yet, consider that your body makes DHEA-S to protect your brain from the negative side effects of cortisol. So if you are consuming something that increases cortisol you can bet that it is also increasing your androgen levels. Which is something in PCOS we are constantly battling against.
Is Caffeine Bad for PCOS?
I am presenting this information so you can make your own informed decisions. I’m not your evil stepmother taking away all your favorite things. I am your nerdy-science-PCOS-bestie here to educate you so you can make the best choice for your body and PCOS.
What works for you today, may not be the thing that works for you this time next year. So stay flexible and listen to your body and what it needs.
Caffeine and PCOS Symptom Management
Can Caffeine affect my hormones?
Reducing stress, improving sleep, and supporting good nutrition all play a role in hormonal health. Too much caffeine can impact all of these.
Research suggests that caffeine is impactful to menstrual periods, luteal phase, and hormone levels (2).
Caffeine and Fertility
Is caffeine bad for fertility in PCOS?
The tie between caffeine and fertility has been disputed. Caffeine may impact luteinizing hormone and other reproductive hormone levels. Consuming high amounts of caffeine may impact the length of the menstrual cycle and luteal phase, causing delays in conception. One study found that women who consumed 300 mg of caffeine per day were 27% less likely to conceive (7). For comparison, a Starbucks venti blonde roast has over 400 mg of caffeine!
The source of caffeine matters: is this caffeine from a soda, Starbucks sweet drink, or from an 8 oz black coffee? High sugar intake (especially on an empty stomach or alone) can trigger inflammation – impacting female fertility.
Green tea may be beneficial for conception. One study looked at women trying to get pregnant. Caffeinated tea was the only caffeinated beverage that doubled the odds of conceptions per menstrual cycle. Soda actually reduced the odds of conception (8). If you’re drinking a lot of coffee or soda, then switching to green tea might benefit you.
Caffeine and Pregnancy
Can you have caffeine while pregnant?
If you are pregnant, not everything you eat or drink crosses the placenta. However, caffeine DOES cross the placenta. Many women that are pregnant metabolize caffeine slower than they did pre-pregnancy. Caffeine is floating around in the blood for a longer period of time.
Caffeine in Pregnancy
In the first trimester – the ability to metabolize is similar to pre-pregnancy
In the second trimester – the ability to metabolize is 1/2 of what it was pre-pregnancy
In the third trimester – the ability to metabolize is 1/3 of what it was pre-pregnancy
After pregnancy, you get back to baseline
Babies in utero don’t have the same ability to metabolize caffeine that gets into their blood supply. Slowly weaning yourself off the amount of caffeine you are having may be a good place to start if you are trying to conceive or pregnant.
Caffeine and Miscarriages
Could caffeine intake cause a miscarriage?
In the 80s, there was a study where rats were given caffeine (9). In this study, they found fetal abnormalities – leading the FDA to come out with the recommendation that pregnant women should pull back on the amount of caffeine. No definitive statement has been made. The research is evolving, yet almost every big name in reproductive medicine quotes 200 mg as a safe upper limit.
The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women limit their caffeine consumption to less than 200 mg (about two, six-ounce cups) per day. Not Venti 16 oz coffee. Similarly, the European Food Safety Authority (EFSA) states that maternal consumption of caffeine up to 200 mg per day does not give rise to safety concerns for the fetus. This is probably what your healthcare provider will tell you.
I can not find one ounce of research that supports those recommendations. This 200 mg seems to be from mystery and wonder.
It is hard to point to the exact cause of a miscarriage. Associations between caffeine and miscarriages have been found in a dose-dependent relationship. Higher intake of caffeine may increase risk of miscarriage. Given the variation in caffeine content of beverages and some foods – many women decide to give up caffeine during pregnancy. You have to do what it realistic for you.
Benefits of Caffeine Intake
Coffee has been studied for its potential benefits, specifically for the heart. Coffee contains many biological compounds that reduce oxidative stress and inflammation in the body, suggesting it may be heart protective.
The American College of Cardiology suggests moderate coffee intake (2-3 cups per day) is associated with a lower risk of heart disease (5). These studies did not consider participants’ diet – so it is uncertain if coffee alone is the exact cause.
Side Effects of Caffeine Intake
Caffeine is something that your body gets used to. Over time, the more you consume, the higher your tolerance becomes. Other adverse effects of caffeine are (1):
Nervousness, restlessness, irritability, increased anxiety
Insomnia
Upset stomach
Increased urination
Heart palpitations
Irregular menstrual periods
I found for myself personally, coffee gives me anxiety.
Caffeine or No Caffeine: What Are Your Options?
Consider what place you are in.
Are you:
trying to manage PCOS symptoms?
Pre-conception or pregnant?
Childbearing age and trying to improve your overall health?
Consider the Alternatives:
Introduce Herbs
So maybe you don’t want to break up with your darling Joe for good, but you need a break and want to see other people like Joe- but nicer to you.
L-theanine
L-theanine is a nervine. A nervine is a herb that can benefit your central nervous system. L-theanine can give a sense of calm instead of agitation. It is found in green tea, black tea, and some mushrooms. It provides benefits like:
support alertness
reduce stress and anxiety
provide mental clarity
improve quality of sleep
Green tea (decaf)
Decaffeinated green tea has many of the benefits that regular caffeinated green tea has. Most of the caffeine has been removed (like 98% of it), so you can enjoy its antioxidant and L-theanine benefits and avoid the jitters.
Spearmint tea
Spearmint tea does not contain caffeine. It is known in the PCOS community to help with hormone imbalances. Spearmint tea can help lower androgen levels in women with PCOS, as well as increase other hormones like luteinizing hormone and follicle stimulating hormone that are important for ovulation.
Roasted dandelion root
Roasted dandelion root has an earthy flavor similar to coffee, but is totally caffeine-free. It is also helpful for women with PCOS because of its liver benefits. The liver’s job is to filter and balance hormones. Dandelion root can help the liver dump out excess hormones. This regulates hormone production in other parts of the body, which many women with PCOS need help with.
Decaf Coffee
Switching to a decaf coffee is an easy way to enjoy the aroma and flavors of regular coffee, but without the high amount of caffeine. One thing to consider when shopping for a decaf blend is how the coffee was decaffeinated.
Swiss water vs. chemical treatment
The decaffeination process of a coffee bean can be done a couple of ways.
1. Swiss Water is a process where the caffeine is removed from the coffee bean. Swiss Water:
uses zero chemicals
removes 99.9% of caffeine
the beans still retain health benefits like antioxidants
2. Chemically treated coffee beans are decaffinated by:
using solvents methylene chloride (MC) or ethyl acetate (most common)
a most-cost effective method to decaffeinate
the beans may lose some antioxidants with this method
Chemically treated coffee beans have raised some concerns in the coffee community because trace amounts of MC were showing up in the coffee. Though amounts are within the safe limit the FDA set for MC, California added MC to its list of carcinogens and reproductive toxicants. They noted it should be avoided during pregnancy – it can pass through the placenta.
This group did research into specific brands of decaf coffee and tested for levels of MC, making a list of “best” and “worst” brands for chemically treated decaf coffee.
Break-up with caffeine
If you are considering breaking-up with caffeine, slowly ripping the band-aid off(over 2-3 weeks) is the way to go. Even though Joe has been bitter, completely ghosting caffeine may lead to higher risk of caffeine withdrawal symptoms – making you reconsider what could have been!
This may look like:
Start by keeping tabs on how much caffeine you’re getting from drinks and foods
Ask for half-caf
Replace your 3 pm coffee with a cup of tea, or decaf coffee
“Friend-zone” caffeine
If you are at a point where you need a boost, caffeine may help you. You may find that after some time apart, reuniting with your old, bitter Joe one morning has rekindled an old flame. Are you better together?
Statistically, only 50% of separated couples get back together. -but a “one morning stand” might be just what the doctor ordered. (have we taken this example too far?)
When to Enjoy?
The best time for coffee? Not first thing in the morning. A good practice would be to have your first cup of coffee 1-2 hours after you wake up AND after you have had your first meal of the day. This can help with your natural rhythm and may shunt the afternoon crash.
Podcast:
Listen to our podcast on caffeine:
https://www.foodfreedomfertility.com/podcasts/research-brief-on-caffiene-while-ttc-and-pregnancy/
I’M CAITLIN JOHNSON!
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