There are two subsets of patients that have PCOS. One that falls into the more traditional category with concerns around unwanted hair growth and elevated testosterone. For patients like this, exercising five to even seven days a week, 30 to 60 minutes, will significantly benefit them. The other subset of patients tends to have concerns about stress or the adrenal system, in addition to the traditional PCOS symptoms. Depending on how long they have been untreated or undiagnosed, they may be in a position where more prolonged exercise is almost detrimental. With those patients, initially, we stick with walking and yoga. This beings to help nourish their system and get their adrenal peace back on track. But generally speaking, most patients need more exercise than they are currently doing.

There are a lot of patients that are undiagnosed with PCOS. You might have it, but you’re not 100% sure. We look at androgen levels at the baseline, so testosterone and DHEA. Getting a baseline for your estrogen and progesterone is also helpful. Fasting blood sugar is a very common one that most family doctors will run, but most don’t run a fasting insulin level. If you have not eaten and your insulin is still elevated, it promotes inflammation in the body. Running that fasting insulin is standard. Then, we also look at vitamin D levels. When we look at the research on PCOS, we know about 80% of women are deficient in vitamin D. The other thing is looking at thyroid function. About 20% of patients with PCOS also have an autoimmune condition called Hashimoto’s thyroiditis. With thyroid, the general screen that a practitioner might send you is for a hormone called TSH. But we know that there are a lot of patients whose TSH looks normal, but when we run antibodies to see what’s happening, their antibodies are high. If you want to get pregnant, high antibody levels and conception do not mix well.

The most common thing we’ll see is an irregular menstrual cycle. If you’re going three or four months with no period, that may indicate that you have PCOS. Besides, gaining weight, sugar cravings, excessive hair growth and acne are other typical symptoms. Often, women that come into my office have been diagnosed with PCOS when they were younger and got onto the birth control pill. This gives them a regular cycle. They get off the pill when they’re trying to get pregnant, and that’s when the hormones go haywire. Here is when we need to look into fixing the endocrine issue.

From a diet standpoint, work on reducing refined sugars and carbohydrates. You don’t have to be keto, but you need to be picky with carbohydrates. With PCOS, our ability to manage leptin and Gremlin hormones is often dysregulated. If you’re eating a whole bag of cookies and still not feeling satisfied, that’s a blood sugar piece. A nutrient called Myo-Inositol works really well to minimize sugar cravings by sensitizing your hormone receptors. So now you don’t have as many cravings. Even your estrogen, progesterone and testosterone work more effectively.

There is research on Inositol helping with neurotransmitters as well. So, if you’re on medication for depression, it makes it more effective. It’s quite an interesting nutrient. As for adaptogens that will help support and nourish the nervous system, I really like Ashwagandha because it helps manage stress and supports libido. Low libido becomes a concern for fertility.

From the traditional medical standpoint, a pharmaceutical called Metformin will often get recommended for patients, and it works great for some people. For other people, it causes a lot of digestive upsets, and they don’t tolerate it very well. There was a trial where they compared using Metformin to N-Acetyl-Cysteine for PCOS patients. At the end of the trial, they had equal glycemic control. They saw good embryo or good egg quality from patients. And it tends not to have the side effect profile you can get with Metformin. I would encourage people to talk to their naturopath about it.

We have lots of lectures on IVF, diet, acupuncture and TCM. We have professionals outside the naturopathic field, too—topics ranging from looking at egg donors to potential surrogacy. Depending on where you’re at in your fertility journey, there’s lots of help and support.

The show is held at the International Center near the Toronto Pearson Airport from 10 to 5. There’s a trade show floor with somewhere between 50 and 60 exhibitors. Different IVF clinics, egg donation firms and supportive care centres put up exhibitions. The mental health piece often gets very overlooked when it comes to fertility. We make sure we have those supports available, too, like naturopathic doctors, acupuncturists and the spectrum of people that may be part of your fertility journey. The three lecture rooms run throughout the day with a variety of topics. They will get listed on the show websites. If you go to Canadianfertilityshow.ca, you’ll be able to see the speakers that are coming and their topics and buy tickets.