keto meal with salmon and asparagus

I Have PCOS – Should I Try The Keto Diet?

Is the Keto diet right for PCOS?

This is one of the most common questions I get as a Functional Medicine practitioner and person with PCOS myself…

And with good reason! The Keto Diet is often touted as a solution for two of the biggest issues people with PCOS face: blood sugar issues and weight gain.

But as with most things related to PCOS, using the Keto diet for PCOS is not a one-size-fits-all solution. 

Today, let’s take a deeper look at this question - and hopefully, provide you with a customized answer. 


What Is PCOS?

If you’re reading this, you probably either have been diagnosed with or suspect PCOS: polycystic ovarian syndrome. 

But even though it's very common (affecting 1 out of very 10 women), this condition is hugely misunderstood, so I think it’s always good to start with a quick refresher on what exactly it is.

First of all, despite what the name implies, people with PCOS don’t necessarily have cysts on their ovaries. (And equally important - just having cysts on the ovaries doesn’t mean you have PCOS!) Instead, PCOS is about hormone imbalance - specifically, an excess level of androgens. 

Androgens are hormones typically thought of as “male”: primarily testosterone and androstenedione, but also DHT, DHEA and DHEA-S. (But just to confuse things even further, some people with PCOS will never show high testosterone or DHEA levels.)

Along with androgen excess, people with PCOS generally have “ovulatory dysfunction” - meaning they don’t ovulate monthly. They may have irregular periods (long, short, heavy, or absent) - but they can also have normal-appearing periods (they might not even know they aren’t ovulating, or they may ovulate sometimes, and not others).

Lots of other symptoms go along with androgen excess and ovulatory dysfunction - but none of these HAVE to be present. Some people with PCOS have them all, and some have none:

  • Insulin resistance (even if the person is not overweight)
  • Cysts on the ovaries
  • Excess hair growth on the body
  • Weight gain and weight loss resistance
  • Acne
  • Thinning hair on the head
  • Oily skin or hair
  • Infertility


What Is The Keto Diet?

Now that we’ve brushed up on PCOS, let’s do the same for Keto.

Keto is shorthand for the ketogenic diet - this is a pattern of eating where carbs are kept low enough, and fat intake is increased, so that the body shifts from burning glucose (sugar, carbs) for fuel to manufacturing ketones, an alternative source of fuel for your body. The state in which you are using ketones for fuel is called “ketosis.”

It takes a few days of very low carb eating to switch into ketosis - and once you’re there, eating carbs again will bump you back out. That means keto is not a diet you can do halfway or dabble in easily - it's all or nothing.

It varies person to person, but usually carbs need to be kept below 20-50 grams per day to achieve ketosis. That is very low: one banana alone has 27 grams of carbs. This means all starchy foods are out: potatoes, most fruit, oatmeal, rice, bread, etc. Non-starchy foods that are high in sugar - like ice cream - are also out.

But it's not just about cutting carbs - you also have to significantly increase fat intake, with 70% or more of total calories coming from fat - and that’s where this can get a little tricky for some people (more on that to come).

But one REALLY important thing to note before we go any further: keto is not the same as just cutting carbs, and for people with PCOS, it should not involve under-eating. Under-eating calorically can further suppress ovulation, making PCOS symptoms worse. 


How Does Keto Help PCOS?

Keto may help PCOS by addressing one of the biggest symptoms: insulin resistance. And for people with PCOS who have weight loss as a concern, the keto diet may help them shed unwanted weight. 

Research has shown that in small groups of people with PCOS, a keto diet can:

  • Lead to weight loss
  • Normalize insulin levels and reverse insulin resistance
  • And, most importantly: The LH/FSH ratio, LH total and free testosterone, and DHEAS blood levels were also significantly reduced

That suggests that the Keto diet isn’t just treating the symptoms - it may actually help to balance hormone levels. 

It’s not completely understood yet how this happens, but the endocrine system is very complex, and interactions between hormones matter - and don’t forget that insulin is a hormone, too!

I know it sounds great, but before you dive into keto there is a big catch that we need to talk about. 


The Keto Diet for PCOS is NOT One-Size-Fits-All

If you are considering trying a keto diet for PCOS - great! I support you 100%. For my own PCOS, reducing carbohydrate intake was one of the best things I did.

But before you go any further…. I want to give you a quick warning:

Depending on your genetics, you might need to do keto a specific way.

Most people with PCOS need to follow a “Mediterranean keto” diet - in fact, it was this specific diet that led to the amazing results in that 2020 research article I mentioned above.

Mediterranean keto focuses on poly and monounsaturated fats from foods like olive oil, avocados, fatty fish, and nuts and seeds. 

Traditional keto focuses more on quantity than quality - it's all about lowering carbs and increasing fat in any way possible.

That often means LOTS of cheese and red meat - both of which are very high in saturated fat. 

For some people, there is nothing wrong with saturated fat - they are genetically programmed to tolerate high levels of saturated fat well. But for many people - especially those with PCOS - saturated fat is problematic. 


3 Things People with PCOS Need to Know Before Starting Keto

There are two gene variants to look for and one general rule to know about before starting keto. 

First, for people with either the FTO or APOA2 SNP variant, saturated fat can be problematic. People with the FTO variant usually don’t tolerate simple sugars or saturated fats well. This variant also makes you more likely to burn fat slowly and struggle with feeling full. 

The APOA2 gene variant also affects metabolic hormones. Research suggests that people with this variant do best if they eat under 22 grams of saturated fat a day. That’s very hard to do if you’re eating red meat, dairy, and bacon!

Finally, dairy in particular can be a problem for people with PCOS - whether or not they have the FTO or APOA2 variants. Milk (from cows, goats, sheep, and camels) contains the hormone insulin-like growth factor-1 (IGF-1), which mimics insulin in our body. IGF-1 is a growth hormone (which makes sense, as milk is for baby animals!). In most people, a little dairy here and there can be well-tolerated because humans have a binding protein for IGF-1 that inactivates it

But for people with PCOS or hormonal imbalance, who already are likely to be insulin-resistant or have high insulin, the added burden of IGF-1 can be a problem. This is amplified because women with PCOS have LESS of the binding protein for IGF-1 and higher IGF-a levels than other people do, too. And the ovaries of women with PCOS are more sensitive to IGF-1 (and other growth hormones), too. 

IGF-1 can also cause your ovaries to overproduce testosterone (an androgen) - which is something we’re trying to minimize. 

That’s why I recommend most people with PCOS try cutting dairy - and if you’re considering Keto, get some basic genetic testing done to reveal how you tolerate saturated fat (I can help with that). 


Your Genes Can Reveal So Much

Whatever your health struggles are - I think investing in genetic testing is one of the smartest choices you can make. 

Your genes are like your body’s instruction manual. Your genetic variants can give you information about your diet, lifestyle, exercise needs - and even what nutrients you’re likely to struggle getting enough of. 

That’s why I’m making genetic counseling a bigger part of my practice: it helps patients create a truly customized health plan, without wasting time on plans that would never work for you genetically.

Want to learn more? Book a free consult with my team today and we can talk through what we offer. We’d love to support you on the journey to better health.

hormone imbalance after gallbladder removal

Meet Your Gallbladder: The Essential Detox, Hormone, and Digestive Organ Most People Know Nothing About

More than 600,000 people have their gallbladder removed each year in the U.S. 

That’s like if every single person in Las Vegas had their gallbladder removed!

Usually, the gallbladder is removed because of painful gallstones. It’s treated as a totally normal, safe procedure with no side effects.

But that’s just not true... 

Your gallbladder is actually a crucial part of your digestive, detox, and hormonal systems.

And even if you haven’t had your gallbladder removed, gallbladder dysfunction is becoming more and more common, and can cause symptoms like:

  • Digestive issues (pain, bloating, diarrhea)
  • Fatigue 
  • Skin congestion (acne, rashes, eczema, etc.)
  • Weight loss resistance
  • Hormone imbalance (PCOS, estrogen dominance, etc)
  • Fatty liver disease
  • And more

Today, I want to explore the role of the gallbladder, common signs and symptoms of gallbladder dysfunction, and steps you can take to heal and optimize your gallbladder function. Learn about hormone imbalance after gallbladder removal. 

What and Where Is The Gallbladder?

Your gallbladder is a small organ that sits underneath your liver. Your liver makes bile (the digestive liquid needed to break down and absorb fat) and the gallbladder stores it, concentrates it, and then releases it to the stomach on demand. 

The gallbladder plays key roles not just in digestion, but also in detox and hormone balance, as bile is needed both for clearing toxins from the body and for the healthy production of hormones, as well as hormone removal and balance. For that reason, the gallbladder isn’t just a digestive organ - it’s also a hormone and detox organ. 

In Chinese medicine, the gallbladder is also attributed with governing decision making and qualities like inspiration, action, and assertiveness (think of the saying “they have gall!”). A strong gallbladder is associated with a quick return to normal after a physical or emotional shock. On the other hand, a weak gallbladder is associated with timidity or hesitation, and problems making decisions or following through. Finally, the gallbladder is also seen as a pivot, a turning point for new decisions and stages of life. 


What Bile Does 

Although it’s not sexy, the bile created by the liver and then stored, concentrated, and secreted by the gallbladder is one of the most important secretions in your body. Bile consists of ~95% water, in which are dissolved bile salts, bilirubin phospholipid, and cholesterol, primarily.

Here are just some of the many roles of bile:

  • Bile emulsifies fat, increasing fat absorption. Bile is an essential “degreaser” and “emulsifier” of dietary fats. Bile is also essential for the utilization of the fat-soluble vitamins A, D, E and K. Bile deficiency leads to vitamin deficiencies.
  • Bile prepares nutrients for assimilation in the small intestine. Bile takes food that has been acidified in the stomach and alkalizes it, allowing it to be broken down and absorbed. 
  • Bile assists in detoxification. Bile contains the conjugated toxins - carcinogens, xenobiotic chemicals, pharmaceuticals, heavy metals like mercury, aluminium and lead, and deconjugated hormones - from the 2 phases of liver detoxification. 
  • Bile helps modulate the microbiome. It acts as an antimicrobial, keeping the balance of bacteria in check. 
  • Bile transports excess cholesterol out. In doing so, it prevents cholesterol levels from rising too high.
  • Bile lubricates the intestines and plays a regulatory role in motility, allowing food to go through the digestive tract a lot easier and preventing constipation.
  • Bile prevents the formation of gallstones by breaking down fats before crystallization,  and also digests and dissolves gallstones, which are composed mostly of cholesterol and particles. 
  • Bile triggers the release of glutathione, which is considered the “master” antioxidant, and helps eliminate bilirubin.  
  • Bile breaks down fats, and as such, is essential for weight loss!
  • Bile controls the rhythm of the gut - the circadian timing of your gut motility is controlled by the gallbladder. Changes in motility (the time it takes for food to move through the digestive system) can lead to issues like Small Intestine Bacterial Overgrowth (SIBO).


The Gallbladder, Bile, and PCOS

The gallbladder’s role in hormone balance deserves special attention, especially in relation to PCOS (Polycystic Ovarian Syndrome).

Dietary fat and bile (to absorb it) are both necessary for the production of hormones. Even more importantly - bile helps your body excrete excess and used hormones, like estrogen. In addition, estrogen dominance (either as a result of hormone imbalance or due to supplemental estrogen, like birth control pills) are known risk factors for sluggish bile (the precursor to gallstones) and gallstones themselves. This is believed to be because estrogen causes an increase in cholesterol levels in the bile, which can then thicken and form stones. 

Interestingly, research has shown that in PCOS, bile acid levels are actually significantly elevated, and that high levels of bile acids correlated with higher levels of testosterone levels, meaning worse PCOS.

The exact mechanism is not yet known, but it is thought to be related to sluggish bile, which is more commonly seen in those with hormone imbalance and PCOS. The sluggish bile raises levels of bile acids in the blood. There, the bile acids act on the Farnesoid X receptor, which has hormonal actions throughout the body, and can lead to elevated testosterone. 

In addition to increasing testosterone, high levels of bile acids can also contribute to insulin resistance, another major issue in PCOS. 


Bile and Leaky Gut

Bile flow issues or lack of bile can also cause or worsen leaky gut (increased intestinal permeability).

While leaky gut is often attributed to toxins produced in the gut or pathogenic bacteria living there, insufficient bile is another major cause. 

One role of bile is to bind with toxins and help them be safely excreted from the body. But if there is inadequate bile to bind with the toxins, they can damage the intestinal barrier, allowing toxins and undigested food into the bloodstream… creating “leaky gut.”

Leaky gut causes widespread, multi-system issues and may even be a major part of triggering autoimmune disease. It is common in IBS (Irritable Bowel Syndrome), ulcerative colitis, Crohn’s disease, Celiac disease, and more. 


Signs of Gallbladder Dysfunction

The most common type of gallbladder dysfunction is the result of slow or sluggish bile. This can be a result of not enough water (remember, bile is 95% water!), but can also occur when  bile is oversaturated with toxins. The sluggish bile is more like peanut butter than water, and is too thick to flow freely.

In addition, the removal of the gallbladder, as well as other conditions, can lead to reduced levels of bile salts in the bile and weakened bile. 

Symptoms of sluggish or weak bile include:

  • Abdominal tightness
  • Bloating
  • Difficulty digesting fats
  • Diarrhea
  • Constipation (fat can build up in the intestinal wall and cause slow movement in the digestive tract)
  • Trapped gas
  • Bad-smelling gas
  • Stomach cramps
  • Gallstones
  • Fatigue and malaise
  • Fatty stool that floats or is light in color or grayish white
  • Increase in allergies, chemical sensitivities, or food intolerances 
  • worsening PMS/Estrogen dominance… 
  • Hormone imbalances like PCOS
  • Heartburn 
  • Erratic bowel movements
  • Weight loss
  • Signs of Vitamin A deficiency: Dry eyes, night blindness, red or white acne-like bumps (on your cheeks, arms, thighs, and buttocks), and dry skin


Why Are So Many Gallbladders Removed?

Typically, the gallbladder is removed due to gallstones. Gallstones are crystallized masses of bile and cholesterol. Around 20% of females over the age of 40 have gallstones.

When gallstones become stuck in the duct of the gallbladder, they can cause pain and inflammation called cholecystitis. The most common treatment for gallstones is simply having the gallbladder removed. The surgeon then ‘“reroutes” the bile to go straight from the liver to the stomach.

Risk factors for gallstones include:

  • Alcohol
  • Excess reproductive hormones from supplementation or steroids (most commonly estrogen dominance)
  • Oral contraceptive pills (birth control pills)
  • High Endotoxin load causing sludgy bile
  • Hereditary disorders like Gilbert's syndrome
  • Thyroid issues or thyroid supplementation with T4
  • Hepatitis
  • Pregnancy

However, without the gallbladder, bile isn’t concentrated and lacks adequate bile salts - leading to the problems discussed above. That’s why gallbladder removal isn’t something you should just jump into. 


Testing For Gallbladder Issues

If you suspect gallbladder issues, various tests can help pinpoint the problem:

  • Blood test for cholesterol levels - if a person’s cholesterol production is low, bile production is also likely to be low. I look for cholesterol levels lower than 170.
  • Digestive stool analysis - can help identify undigested fat in stool, which is caused by low bile availability. 
  • Bloodwork - to look for changes in serum bilirubin, alkaline phosphatase, serum glutamic oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine transaminase (ALT). In early stages of gallbladder dysfunction, these levels might not change. However, functional medicine practitioners like me also use a more narrow interpretation of what normal is.
  • A HIDA scan - this imaging test uses a radioactive material to measure the emptying function of the gallbladder, and can help diagnose:
  • Gallbladder inflammation (cholecystitis)
  • Gallstones, which can’t be seen, but can contribute to reduced flow or blockage to less bile flow if blocking
  • Bile duct obstruction
  • Congenital abnormalities in the bile ducts, such as biliary atresia

With my own patients, I use the ION panel by Genova (Organic Acids section) to evaluate the various pathways of liver detox and glutathione/antioxidant capacity. These results often illuminate when the liver or gallbladder are overburdened long before we see markers of pathology like elevated liver enzymes in labs. They also give more detail about exactly how the liver or gallbladder are compromised and can best be supported, in each individual. 


Support for a Healthy Gallbladder

If you’re having signs of any gallbladder issues, step one is to get tested and find out exactly what’s going on. 

In addition, here are some of the steps I turn to again and again with my patients:

  • Switching out hormonal birth control (pill, patch, ring, etc.) for non-hormonal to reduce estrogen levels
  • Supplements that support healthy gallbladder function
  • Digestive enzymes and bitters 
  • Dietary changes: avoid excessive fried, fatty and greasy food and increase leafy greens
  • Cut out alcohol
  • Exercise regularly

In addition, addressing the emotional side of gallbladder health can be important. Try to express your emotion freely (journaling is an easy way to get started), address your past traumas (get help from a professional), and forgive. 

And if you’ve already had your gallbladder removed? I can help you with strategies to support your digestion and hormones, even without your GB!

Want to learn more? Book a free 15 minute consult with my team now. It’s a zero-obligation opportunity to get a functional medicine opinion on your gallbladder health (and even if removal is something you should consider!).

P.S. Gallbladder issues are more common in women and those on hormones (like HRT or birth control). But if you catch gallbladder issues early on, you can avoid ever developing painful stones. Book a free 15 minute consult now. 

Woman standing behind white sheet covering face

PCOS 101: Everything You Need to Know About Polycystic Ovarian Syndrome

I’ve been where you are right now… Maybe your doctor just told you, “You have PCOS.” Maybe you’re questioning it yourself… Googling for answers.

Or maybe - and this might be the most frustrating situation of all - you’ve been told for YEARS you had PCOS, only to be told now, you somehow, suddenly don’t.

The fear, overwhelm, frustration, uncertainty - I get it! (I have PCOS, myself.)

Nothing about PCOS is straightforward. (Even the name doesn’t make sense!)

So let me hold your hand for a minute - today I want to explain everything you need to know about PCOS, start to finish. 

What Is PCOS?

PCOS stands for Polycystic Ovarian Syndrome - and it’s an endocrine (AKA hormonal) disorder that affects women of reproductive age. 

PCOS is the most common hormone dysfunction among women and affects 10-20% of all women of reproductive age. 

(That means if you get a group of 10 of your friends together, it’s likely 1-2 of you will have PCOS!)

And despite the name, PCOS really has nothing to do with cysts on your ovaries. Instead, PCOS is a condition marked by elevated levels of androgens (commonly called male hormones.) This is often testosterone, but can include other androgens. 

People with PCOS often also have elevated luteinizing hormone (LH), and prolactin and lower follicle stimulating hormone (FSH).

And while your doctor might not make a big deal out of it, the truth is that PCOS is a lifelong disease with big medical and emotional impacts, and potentially the additional burden of obesity.

What Are The Symptoms of PCOS?

Symptoms of PCOS include:

  • ­Hirsutism
  • Male pattern hair loss or thinning
  • Acne
  • ­Oligo or amenorrhea (chronic anovulation)
  • ­Obesity
  • Sub/­ Infertility
  • Low libido and sexual problems
  • Skin tags or darkened skin in the folds (acanthosis nigricans)
  • GI problems (IBS, leaky gut)
  • Arthritis and tendonitis
  • Depression, anxiety, stress, eating disorders, and body dysmorphia 
  • Increased vaginal infections
  • Sleep dysfunction
  • Increase in certain cancers (uterine and breast)
  • Increased rates of other gyn conditions, like fibroids, endometriosis

PCOS can also lead to:

  • Pregnancy complications
  • High blood pressure
  • Diabetes
  • Dyslipidemia
  • Fatty liver
  • Higher risk of cardiovascular disease

PCOS can present very differently in different women, and there are at least 4 different types (more on that to come). 

One big misconception? That all people with PCOS are overweight. Although overweight/obesity is common in PCOS, it is not a symptom for all people with the condition. 

Another misconception is that PCOS causes painful periods or pain. That’s not true either. If you have pain or painful periods, it is likely caused by something else (though it’s possible you have PCOS, too - it just isn’t the cause of the pain!)

How Do I Know If I Have PCOS?

How PCOS is diagnosed has changed over the years, which is part of why there is so much confusion around who does and doesn’t have PCOS. If you’ve been told you did have PCOS, but don’t now - the changes in diagnostic criteria explain why. 

In the past, PCOS was diagnosed primarily based on missing or irregular periods and the presence of multiple cysts on the ovaries, as seen via ultrasound.

But now we know that there are many reasons cysts can appear on the ovaries - and sometimes, those cysts are entirely normal and not indicative of any disease state. 

That’s why, today, PCOS is diagnosed based on updated guidelines from 2018 for missing or irregular periods AND androgen excess, which is determined as:

1) high androgens (male hormones) measurable on a blood test, 

and/or 2) significant facial hair or jawline acne.

PLUS other reasons for androgen excess have been ruled out.

Ultrasound is no longer required to diagnose PCOS, though many practitioners still do perform one. 

Even if you are missing periods, or have them irregularly, or if you had an ultrasound that featured cysts on your ovaries, if you do not have androgen excess as defined by labs or symptoms mentioned above, then it’s not considered PCOS. (Missing your period, but no androgen excess? There are lots of other reasons for missing periods. Read more here.)

Other signs of PCOS include the following, but these all are not always present, even with PCOS:

  • Bilateral polycystic ovaries 
  • ­Elevated LH and LH to FSH ratio 
  • ­Oligoovulation (irregular or infrequent ovulation)
  • Elevated free testosterone and DHEAS 
  • ­Glucose intolerance and elevated insulin 

When Hormone Levels Are “Normal” But You Still Have PCOS Symptoms

If you have key symptoms of androgen excess - such as severe jawline acne and facial hair growth - but your lab tests are normal, don’t rule PCOS out. 

Some women are extremely sensitive to even “normal” amounts of androgens. This means that even with normal levels, they may have key symptoms like jawline acne and facial hair growth. That’s why the guidelines state that PCOS diagnosis can be based on either elevated androgen levels on a blood test or symptoms of high androgens. 

But, there are also other conditions aside from PCOS that can cause the symptoms of androgen excess, including:

  • Congenital adrenal hyperplasia (an inherited condition that impacts the adrenal glands and sex hormones)
  • High prolactin secretion
  • History of using an oral contraceptive pills that contain progestins, which behave more like testosterone than progesterone in the body

Is It PCOS… Or Something Else?

Other conditions can sometimes be mistaken for the more-common PCOS. These include:

#1 Non-Classic Adrenal Hyperplasia (NCAH)

This condition is similar to congenital adrenal hyperplasia, but comes on later in life (usually around the time of puberty) and is not as severe. For women, symptoms include delayed first period (menarche), male-pattern hair growth and loss, and infertility. It is hard to tell the difference between PCOS and NCAH, but if a person presents with PCOS symptoms and is not insulin resistant, it could be NCAH - though some people with NCAH do have insulin resistance. NCAH is more rare than PCOS. The only way to distinguish PCOS from NCAH with certainty is by measuring 17-hydroxyprogesterone levels

#2 Functional Hypothalamic Amenorrhea

This is the loss of normal menstrual cycles due to overexercise/undereating, and it often occurs in both normal and underweight women. It can be really difficult to distinguish a woman with FHA from a woman with PCOS who is lean. Tell-tale signs that it is FHA include low to normal basal FSH and LH levels and low estrogen (vs. elevated serum LH levels and low to normal FSH levels in women with PCOS). Women with FHA don’t usually have the severe jawline acne or male-pattern hair growth seen in PCOS. On an ultrasound, both women with PCOS and FHA may have cysts, but the ovaries and uterus of a woman with FHA are small or normal, whereas a woman with PCOS typically has increased ovary size. To make it a little more complicated… it is possible to have both PCOS and FHA simultaneously. 

What Causes PCOS?

The exact cause of PCOS is not known, but it is likely a combination of genetic predisposition and environmental effects. Some known risk factors are:

  • Mother had gestational diabetes (it’s thought that the exposure to higher levels of insulin levels in utero could lead to PCOS in adulthood).
  • Exposure to endocrine disrupting chemicals in utero or in life. So far the focus has been of BPA.
  • Diabetes or metabolic syndrome in first degree relatives
  • Gut inflammation, such as IBS, SIBO, or leaky gut (because they cause chronic inflammation)
  • Higher levels of oxidative stress, beginning in utero and continuing through life
  • Vegetarian diet, which may contribute to low levels of zinc and 
  • Autoimmunity
  • Hypothyroidism

It’s also suspected that a genetic mutation of the CYP17 enzyme, which is responsible for forming androgens from DHEA-S, could play a role. 

Beyond these risk factors, it isn’t known exactly why some women develop PCOS and others don’t.

While what starts the initial process of PCOS remains mostly unknown, we do know what happens in the body that leads to PCOS. It’s a hormonal cascade that starts with hypothalamic gonadotropin-releasing hormone (GnRH). 

First up, in a woman without PCOS, here’s what happens: hypothalamic gonadotropin-releasing hormone (GnRH), stimulates the release of LH - luteinizing hormone. The LH tells special cells in the ovaries called theca cells to convert cholesterol (a type of fatty acid in the body) into two androgens: testosterone and androstenedione. The androgens then move into the granulosa cells, where the hormone FSH (follicle stimulating hormone) converts them into estrogen via a process called aromatization. 

But in a woman with PCOS, the process gets stalled out before the androgens can be converted into estrogen. Here’s what happens...

Women with PCOS have increased pulsatile GnRH release, which results in higher levels of LH and lower levels of FSH in most individuals. These higher LH levels cause increased androgen production by follicular theca cells. That means a woman with PCOS has more androgens to convert to estrogen to start - plus a lower FSH level, which is the hormone needed to convert the androgens to estrogen.

All those extra androgens in the ovaries stop the normal growth and maturation of follicles, and prevent ovulation. As a result, the ovaries wind up with lots of small, antral follicles that become cysts on the ovaries. This enlarges the ovaries and can also create an elevated serum estrogen level. 

But that’s not all! In addition, the cells of people with PCOS respond to normal levels of  the “blood sugar hormone” insulin by making increased amounts of testosterone. In a woman without PCOS, these levels of insulin would not result in excess testosterone. 

This is intensified by the fact that women with PCOS also are far more likely than people without PCOS to have insulin resistance and elevated insulin levels. 

PCOS and Insulin Resistance

PCOS and insulin resistance have a complex relationship: insulin resistance is both a symptom and a potential cause of PCOS. 

But before we dig any further, let’s do a quick refresher on what insulin and insulin resistance are. 

Insulin is a hormone secreted by the pancreas in response to blood sugar. When you eat food, it is broken down and absorbed into the bloodstream in the small intestine. This causes a rise in blood sugar. In response to this rise in blood sugar, the body pumps out insulin from the pancreas. The insulin helps shuttle the sugar out of the bloodstream and into the cells, where it can be used as energy. 

Insulin resistance is one way this system can break down. Essentially, the pancreas continues making insulin, but the body stops listening. That can lead to both high levels of insulin (because the pancreas keeps making more) AND high blood sugar levels, since the insulin isn’t doing its job of moving the sugar out of the bloodstream and into the cells. 

Insulin resistance is often the first step on the road to developing Type 2 diabetes and gaining weight, which is harder to lose. 

Insulin resistance is very common in PCOS: even in non-obese women with PCOS are far more likely than other women of the same weight without PCOS to wind up with insulin resistance.

And while we don’t know for sure if the PCOS causes the insulin resistance… or the insulin resistance causes the PCOS… what we do know is that high levels of insulin stimulate the ovaries to make more testosterone. At the same time, high testosterone levels in women lead to insulin resistance and weight gain.

Being overweight with PCOS only intensifies the metabolic problems. Excess fat cells lead to fatty acids spilling into the bloodstream. Combined with the low antioxidant and high oxidative stress seen in PCOS, this leads to increased oxidation of the fats, which damages tissues. This creates yet another cycle where oxidative stress increases testosterone production, which only increases insulin resistance. Once this cycle is set in motion, it’s really difficult to stop. 

PCOS is also inflammatory, and this inflammation further increases insulin resistance and abdominal visceral fat. The inflammation also promotes abnormal adipose function with inappropriate adipokine release. Adipokines include the “hunger and fullness” hormones leptin and ghrelin. 

PCOS and The Microbiome

PCOS doesn’t just affect your hormones, however. It can also have major, negative consequences for the microbiome.

The microbiome is the collective name for all the bacteria that live in your gut and perform vital roles in digestion, metabolism, hormone production, and communication between body systems. 

Stool testing showed the microbiome of people with PCOS was less diverse and had an altered composition compared to healthy controls.

The dysbiosis in the microbiome that PCOS can cause promotes even more inflammation, as well as allergies and autoimmunity. Research has shown that women with PCOS (both those who were lean and those who were overweight) had significantly higher LPS levels, a marker of inflammation and leaky gut, compared to healthy controls.

And, in another example of the way PCOS symptoms can be self-perpetuating, a dysbiotic microbiome as a result of PCOS could contribute to further weight gain and insulin resistance, further fueling excess androgens. Studies have shown that changes in gut microbiome trigger mechanisms that promote obesity, Type 2 diabetes, and metabolic syndrome. And, it’s known that people with Type 2 diabetes also have an altered microbiome. 

Both obesity and dysbiosis, two common results of PCOS, directly increase gut permeability (leaky gut), which promotes insulin resistance, which drives further testosterone production in the ovaries, creating PCOS, which impairs ovulation and promotes further androgen dominance. 

Bottom line: if you’re struggling with weight loss and obesity, and have PCOS, a dysbiotic microbiome could be a reason why. 

What Happens If PCOS Is Ignored

For most people with PCOS, symptoms like unwanted facial hair and jawline acne are enough to make them want to seek treatment. PCOS can really impact quality of life. 

But even if PCOS symptoms aren’t bothersome, leaving this condition untreated long-term has serious consequences.

Of course, PCOS affects fertility: it is more difficult or impossible for those with PCOS to become pregnant due to their irregular/absent ovulation. 

However, even if you never want to become pregnant, PCOS does far more than affect fertility.

The high androgens produced in the ovaries lead to insulin resistance and inhibited ovulation. The insulin resistance puts you at risk for Type 2 diabetes and weight gain. In addition, even if insulin resistance isn’t a feature of your PCOS, the high testosterone levels seen in PCOS also increase the risk of Type 2 diabetes.

The inhibited ovulation leads to low levels of progesterone (because progesterone rises when ovulation occurs). Progesterone should balance estrogen, but when progesterone is low estrogen can become chronically high, and over a lifetime this increases the risk of estrogen-driven cancers like ovarian and breast cancer. Both low progesterone and absence of ovulation have been linked with significantly higher risk of breast cancer. 

And, because another role of progesterone is to block androgens, the absence of progesterone only adds fuel to the fire. In this way, PCOS becomes a self-perpetuating cycle. This means it’s very unlikely to just “go away” on its own. 

Is There Hope for Healing PCOS?

I know that this blog post has been really heavy so far. 

Lots of scary symptoms and confusing hormones… that might leave you feeling like “Is there any hope for healing PCOS??”

So let me reassure you right now: there IS hope for healing PCOS!

I speak from personal experience - I was diagnosed with PCOS in my twenties. In fact, it was this diagnosis that really lit a fire in my soul for natural healing. 

Today, my PCOS is well managed. My weight is stable, I have hair on my head, not my face. I was able to get pregnant and give birth to a beautiful daughter. To be totally transparent, we did use IVF - but I had PCOS, was almost 40, and have only one ovary! With those factors in mind, it went as smoothly and easily as it possibly could have - due in large part to the work I had done to optimize my health and hormones.

 Life is good… and I want these kinds of results for you, too!

The rest of this article will be dedicated to healing PCOS.

Step 1 to actually treating PCOS is determining what type of PCOS you have.

The 4 Types of PCOS

While PCOS is the umbrella term, clinically, I see people with PCOS fall into one of four categories based on their symptoms and presentation. 

Knowing what type of PCOS you have is critical because it guides what treatment plan will be most effective for you. 

Read through all four types and see which one you identify most with. 

Type #1: Insulin Resistance PCOS

Insulin Resistance PCOS is the most common type, and accounts for about 70-75% of all PCOS cases. The defining criteria? If a patient has insulin resistance of any degree and PCOS, they have Insulin Resistance PCOS. In addition, if you have pre-diabetes, you likely also are in the Insulin Resistance PCOS category. 

High insulin levels promote high androgens, creating PCOS. 

What years of working with PCOS patients has taught me is that, usually, there is some level of insulin resistance present in people with PCOS, even if it’s subtle. One tell-tale sign I look for are changes in energy levels after eating. In a healthy person, eating should only make you feel less hungry. If eating makes you feel tired and sluggish, or conversely, clears your head and gives you a major boost of energy, that’s a red flag. 

To know if you have insulin resistance, your blood can be tested for high insulin levels using a fasting insulin test. Fasting glucose and hemoglobin A1c blood tests can also help provide a snapshot of your body’s response to insulin. However, sometimes a person has a normal fasting insulin, but still has a poor glycemic response to carbs. This means their blood sugar spikes above 140 or that their insulin resistance is more exaggerated than it should be. To assess this, an oral glucose tolerance test is used. Glucose tolerance tests are preferred because they can catch insulin resistance at lower levels and in earlier stages.

Another option is at-home glucose monitoring with a glucometer or continuous glucose monitor. I love this option because no doctor’s orders are needed (you can get a glucometer and test strips over the counter) and it can provide a bigger picture of what’s happening to your body when you eat real food over a longer period of time. If you want an exact, step-by-step guide to tracking your glucose measurements over the course of 3 days, click here to download my free At Home Blood Sugar Testing Guide.  

Type #2: Inflammatory PCOS

All types of PCOS feature some inflammation, but in Inflammatory PCOS, inflammation is the hallmark symptom, and insulin resistance isn’t present. 

People with Inflammatory PCOS often have known causes of chronic inflammation or other inflammatory symptoms and conditions, like:

  • Autoimmune disease
  • IBS or SIBO
  • Joint pain or body aches
  • Chronic headaches
  • Chronic fatigue
  • Depression
  • Skin issues like eczema or psoriasis

Sometimes, Inflammatory PCOS is best diagnosed by ruling out the 3 other types. If you’re feeling uncertain if this type describes you, keep reading about the other types. 

Type #3: Post-Pill PCOS

For some people, stopping hormonal birth control pills can lead to the development of PCOS. Stopping the artificial progesterone in the pill (called progestins) can cause a temporary surge in androgens that creates PCOS. This is most common with Yasmin, Yaz, and the Mirena IUD, although it can happen with other pills 

People with this type of PCOS usually report that their periods were normal before starting the pill, and symptoms only began once they stopped. The good news is that, if treated, this type of PCOS is usually more temporary. Detox support and herbs that lower androgens can often reverse this type. (More on treatments to come.)

Type #4: Adrenal PCOS

Adrenal PCOS is largely genetic, but can also be triggered by extreme stress, weight loss diets, overexercise, and lack of sleep, all of which further tax the adrenal system. 

Adrenal PCOS often looks a lot like congenital adrenal hyperplasia (CAH), which was discussed above. However, unlike with CAH, with Adrenal PCOS, 17-OH progesterone won’t be elevated. In addition, women with adrenal PCOS often only have elevated DHEAS, not testosterone or androstenedione. 

For this type of PCOS, the best approach is supporting adrenal hormone function and managing stress, alone with nutrients and botanicals that help normalize androgens. 

My Treatment Goals for PCOS

When you have any goal - but especially a big health goal like treating PCOS, it’s important to break it down into smaller, trackable, manageable goalposts. 

PCOS treatment isn’t a one-pill-and-you’re-done kind of thing… it can take months of consistent work to see changes. Having clear-cut goals in mind helps power you through the process.

(And we also have health coaches on staff who are specially trained in helping you break down goals and achieve them step-by-step!)

My PCOS treatment goals include:

  • Regulating hormone levels (increasing progesterone secretion, LH:FSH, decreasing prolactin)
  • Improving the stress response and HPA (hypothalamus-pituitary-adrenal) function
  • Optimizing the microbiome
  • Optimizing detox pathways and function

What About Standard Treatments?

Two of the most common standard treatments for PCOS are hormonal contraceptives and the drug metformin. 

Metformin is an insulin sensitizing drug that can help with insulin resistance. However, it doesn’t enhance ovulation for many patients. As far as drugs go, I don’t think metformin is a bad one, and it may have some benefit for you. Talk to your doctor about it. But, because metformin tends to displace vitamin B12, be sure to supplement or monitor your levels while using it.

Hormonal contraceptives (aka the birth control pill) are one of the most common “treatments” for PCOS, but aren't one I recommend. That’s because all the pill cna do is further suppress ovulation and hormone production - it does nothing to address the root cause of the imbalance. When you inevitably stop the pill (and all women have to stop the pill at some point, even if only because increased age has made the risk of blood clots too high), PCOS symptoms come roaring back. 

Birth control pills also contain artificial progestins, which actually behave more like testosterone in the body than they do real progesterone. For women with PCOS, this can exacerbate symptoms. 

Furthermore, one of the biggest issues with PCOS is that it suppresses ovulation, and ovulation is necessary for healthy hormone balance, preventing cancer, and maintaining bone integrity. The birth control pill also suppresses ovulation… which means it does nothing to fix the problem. 

Step #1: Testing

Testing is an essential step for my work as a practitioner. But I’m not just talking about the run-of-the-mill tests you’ve likely had before… I use advanced, in-depth testing to get a deep look at what is happening throughout your body.

Here’s some of the tests I commonly use with PCOS patients:

  • Testosterone
  • SHBG
  • DHEA
  • Epi-Testosterone
  • 5a-Androstanediol
  • 5b-Androstanediol
  • DHT
  • Androsterone
  • Etiocholanolone
  • Estradiol
  • Prolactin
  • AMH
  • LH
  • FSH
  • C-RP

I prefer to use the DUTCH Complete test for most of these hormones and metabolites, but they can also be tested via blood serum, as well. Some are only available via serum testing. 

In addition to these, I also run some tests to rule out other conditions and assess overall health:

  • 17-OH progesterone, to rule out CAH
  • Thyroid panel, to rule out amenorrhea due to thyroid issues, and because thyroid issues often co-occur with PCOS
  • Lipid panel, to assess metabolic syndrome and cardiovascular risk

I also sometimes use a month-long cycling panel to assess ovulation, and to look at overall progesterone levels/exposure over the month/cycle, because you can’t assess this with a one day snapshot. To do this, I use the Menstrual Cycle Mapping test from ZRT Labs or the Oova. Oova catches LH surges and can confirm ovulation, even in women with PCOS. This is HUGE because standard ovulation tests can’t detect the LH surge, since LH is already high in women with PCOS. For more on the Oova, read this. The Menstrual Cycle Mapping measures progesterone, LH, and estradiol, which can be really useful in some cases. 

Step #2: Add Lifestyle Changes

The lifestyle changes I have patients implement vary based on their unique case, but there are some general principles that help most people with PCOS.

First, and maybe most importantly: prioritize sleeping 8 hours per night. 

And while I know everyone says this… you also have to find a way to manage stress that works for you. Research has shown people with PCOS actually have a greater stress response than women without PCOS, even when the stressor is the same. It makes women with PCOS more inflamed, and more likely to experience anxiety and depression, too. 

Some of my favorite tools for managing stress:

  • EMDR therapy (with a trained practitioner)
  • The ApolloNeuro wearable - this uses specialized touch therapy against your skin to promote feeling of calm and well-being. There is nothing else like it available!
  •  - a new platform that provides a wide array of therapies to help deal with stress and trauma

In addition, improving diet can help, too. I recommend eating 2-3 meals per day of an organic, plant-heavy diet avoiding gluten, most dairy, artificial sweeteners, trans fat, and alcohol. Eat plenty of healthy fats - like olive, coconut, and avocado oils, plus high quality animal fats, but avoid trans-fats. And if your diet is lower in carbs, be sure you’re including lots of variety of veggies to get the plant fibers your gut microbiome needs to thrive. And, if you’re not overly sensitive to caffeine, add 2-3 cups of green tea daily.

Step #3: Supplement Smart

Most people want to start with supplements, but it’s really the third step, after testing and diet and lifestyle changes. Remember that supplement regimens need to be customized to your needs - so while the ideas here are a great place to start, they can’t replace working one-on-one with a trained practitioner. 

With my own patients, I use the results of their lab testing and the lifestyle changes to create custom, one-of-a-kind supplement protocols, with their specific type of PCOS and symptoms in mind. 

One last thing, more isn’t always better. While all of these supplements have benefits, I usually use no more than 3-5 at any given time. 

Here are some of my go-to supplements:


Magnesium is an essential cofactor for thousands of processes in the body and is especially key for insulin sensitivity. Research has shown people with Type 2 diabetes (which is common with PCOS) may excrete higher-than-normal amounts of magnesium in their urine, and that magnesium deficiency may be associated with the development of insulin resistance - which is another key component of PCOS. 

In addition, magnesium absorption is interfered with by birth control pills, which many women with PCOS have taken or are taking for long periods of time. A good place to start is with this magnesium, 300 mg, twice daily.

Pre and Probiotics

Pre and probiotics promote “good” flora in the gut - prebiotics by acting as food for the gut bacteria, and probiotics by introducing new, beneficial strains. This leads to a greater production of anti-inflammatory Short Chain Fatty Acids (SFCAs), which are a byproduct of bacterial fermentation. SFCAs help improve tight junction function, reducing LPS passing into the bloodstream, which can overstimulate the immune system. 

In an animal study, those with PCOS even showed reversal of PCOS with a microbiome transplant and lactobacillus (a type of beneficial bacteria). In another study, supplementing with probiotics and the mineral selenium reduced excess androgen levels and improved hirsutism.  

My recommended probiotic is MegaSporeBiotic. Be sure to eat plenty of fruits and veggies for pre-biotic plant fibers, or add a prebiotic supplement like MegaPreBiotic


The mineral zinc has been shown to improve ovarian function, lower androgens, raise progesterone,  and promote ovulation. My recommended brand is Designs for Health and the recommended dose is 30 mg daily. 


Vitex is an indirectly progesteronic herb that has been found in some research to benefit PCOS. Vitex can decrease prolactin by stimulating dopamine. Prolactin is often elevated in women with PCOS, and elevated prolactin promotes higher androgen levels. 

While clinically, vitex seems to help many women with PCOS (including me), in theory, it could make PCOS worse. This is because vitex may stimulate LH, and in women with PCOS, LH levels are already too high. However, it is a game-changer for many women with PCOS. If you decide to try it, keep a close eye on your symptoms for signs of improvement or backslide.  Especially consider it if you’ve been diagnosed with elevated levels of prolactin. 

This product is my favorite blend with clinically meaningful levels of Vitex. 


Inositol is a plant compound (often thought of as one of the B-vitamins, but technically a sugar) that has been proven beneficial in those with PCOS. One potential mechanism could be that inositol contains the phosphoglycan that helps mediate insulin, and this phosphoglycan is often deficient in people with PCOS. 

Research has shown inositol:

  • Improves insulin sensitivity
  • ­Improves ovulatory function
  • ­Decreases serum androgens
  • ­Decreases elevated blood pressure
  • ­Decreases elevated plasma triglycerides
  • ­Improves oocyte quality in women with PCOS

There are several forms of inositol: most commonly myo-inositol and d-chiro inositol. Both forms were shown effective in improving ovarian function and metabolism in patients with PCOS, although myo-inositol showed the most marked effect on the metabolic profile (i.e. insulin resistance), whereas d-chiro-inositol was better able to reduce hyperandrogenism. Myo-inositol may also protect against gestational diabetes in women with PCOS.

Most commonly, myo-inositol and d-chiro inositol are used in combination, as there is evidence they balance each other and provide the most benefits together. A standard dose is 4 grams daily. This is my recommended brand

Licorice & Peony

Licorice and peony are often used together in traditional chinese medicine formulas, such as Shao Yao Gan Cao Tang. Research has shown they block the production of testosterone and promote aromatization, which converts testosterone to estrogen. Licorice in particular can help lower testosterone and block androgen receptors. They may also improve low progesterone, and modulate estrogen and prolactin. 


­N-Acetyl Cysteine (NAC) is a powerful antioxidant that works to reduce inflammation and oxidative stress in the body, both of which may be higher in women with PCOS. NAC promotes antioxidant activity by increasing the production of glutathione, which studies have shown women with PCOS have 50% less of than normal. 

NAC can help lower testosterone and improve insulin resistance. One study even showed NAC was more effective at reducing insulin than the drug Metformin (more on this to come). 

For women with PCOS looking to become pregnant, NAC may be especially important. Women with PCOS who took NAC were 3.5 times more likely to become pregnant, had a greater likelihood of a live birth, and reduced risk of preterm delivery. 

In women using the drug Clomid to promote fertility, adding NAC improved ovulation rate, cervical mucus, mature follicles, endometrial thickness, follicular E2 levels, and luteal progesterone levels. 

My recommended brand is Designs for Health, 900 mg, 3 times daily. 


Berberine is an herb that can benefit women with PCOS in many ways. First, berberine can improve insulin resistance in theca cells. It has been shown to be particularly effective against obesity and visceral adipose tissues (hormonally active fat). It also improved ovulation and increased fertility. Berberine was shown to reduce testosterone and improve LH:FSH rations compared to placebo. 

Berberine may also benefit the gut microbiome of women with PCOS by increasing production of Short Chain Fatty Acids (SFCAS - for more on this, see Pre and Probiotics, above). 

I like this brand of berberine


The mushroom reishi blocks 5-alpha reductase, which is the enzyme that converts testosterone into its stronger metabolite, DHT. This can help reduce overall androgen excess in women with PCOS. Reishi is also beneficial for the hypothalamic-pituitary-adrenal axis, as well. 

My favorite reishi supplement is Mushroom Science Reishi, dose is 2 capsules, twice daily.


Gymnema is an herb that has insulin-modulating activity in those with PCOS, and can reduce elevated triglycerides, which are often also associated with PCOS. 

**Important-- Gymnema is not for use during pregnancy or lactation. 


Chromium picolinate is an essential trace element that is particularly beneficial for insulin-resistant types of PCOS. Research has shown chromium had effects comparable with the drug metformin on ovulation and pregnancy rates, and was better tolerated. 

I recommend Thorne Chromium Picolinate, 1000 mcg a day.

­Saw Palmetto 

Saw palmetto is an herb that can block prolactin receptors on ovarian cells, helping to reduce excess androgens. 

Designs for Health Prostate Supreme 2 capsules twice daily. 

Bioidentical Progesterone

Using bioidentical progesterone can lower androgens and LH, leading to less ovarian testosterone production. It also blocks 5-alpha reductase, the metabolite that converts testosterone into the more potent DHT, which is often elevated in PCOS. Bioidentical progesterone also slows the and GnRH pulses that are too rapid in people with PCOS, helping to treat the actual root of PCOS.

This is one of my top choices for every woman with PCOS - but be sure to work with a practitioner on this one, as bioidentical progesterone requires specific dosing to be effective and safe. 

One thing to note is that adding bioidentical progesterone is not the same as starting a hormonal contraceptive (birth control pills). Birth control pills do not contain bioidentical progesterone - instead they contain artificial progestins, which actually behave more like testosterone in the body. 

PCOS Is Complicated, But There Is Hope!

As you can tell by the length of this article, PCOS is incredibly complex. (And I could have written so much more!)

But if you take away only one thing, I hope it’s this: there is hope for effectively treating PCOS.

You don’t just have to suffer through and try to cover up the symptoms. With the right care, you can find and address the root cause.

If you’re ready to start treating your PCOS from the root cause on up, I’d be honored to help guide you there. Having struggled with PCOS myself, helping other women with the condition isn't just my job. It is my passion!

Just click here to book a FREE, no-obligation 15-minute consultation with my team. We use these short calls to get to know you, your health concerns, and see if working together would be a good fit. Think of it like a first date. 

>>> Book a Free Consult <<<


PS - Overwhelmed with all the info on PCOS? I know how that feels, and I’d love to help you find a customized plan (diet, lifestyle, supplements) to help manage PCOS and achieve your health goals. Book a free consultation here so we can chat about a plan for you. (No obligation!)

Woman with clear face with no acne

The REAL Meaning Behind Adult Acne (And How To Get Rid of It For Good)- Part Two

In Part One of this post, I explained the link between PCOS and adult acne. I also explained why PCOS is misunderstood and underdiagnosed. If you haven’t read it yet, make sure you go back and read Part One here. In Part Two, I’ll explain how I help women address adult acne and PCOS in my clinic.

How I Help Women With Adult Acne

Whether or not you have a clinical diagnosis of PCOS, adult acne is almost always related to hormone imbalance. In my clinic, I use a multi-faceted approach to treating hormone imbalances.

Step 1 is always proper testing to determine exactly what type of hormone imbalance you’re dealing with - there is no “one size fits all” treatment, so proper testing is critical to healing. Every woman I work with recieves a customized plan for healing based on her test results, symptoms, and lifestyle - but there are some general recommendations I start with for many women:


  • Optimize Your Diet For Hormone Health
  • Nurture Your Microbiome
  • Lower Stress
  • Promote Ovulation
  • The Right Skin Care Routine


Optimize Your Diet For Hormone Health

You don’t need to go on a no-carb diet or severely restrict to optimize your diet for healthy hormones (in fact, that is probably the worst thing you can do!). Start with balancing your blood sugar and insulin. Almost all women with PCOS (regardless of weight) show some signs of insulin resistance.

You can counteract this and get back to healthy blood sugar by:

  • Optimizing the amounts and types of carbs you eat. (It’s not about cutting carbs completely. Instead, eat more whole-food carbs, fewer processed carbs.)
  • Moving more! It doesn’t have to be in the gym - walk more, hike, dance, swim, just stay active throughout the day.
  • Using key supplements. The exact supplements and doses matter, so work with a pro to add in things like inositols, d-pinitol, curcumin, chromium, and berberine - if they are right for you.

Key nutrients for healing acne are:

  • Vitamin A - natural sources are cod liver oil, liver, pastured egg yolks.
  • Zinc - zinc has been shown to clear acne as effectively as antibiotics! It also interacts positively with Vitamin A. Dietary sources are organ meats, beef and lamb, oysters and scallops.
  • Omega-3 fats - These fats are anti-inflammatory and reduce your skin’s reactivity to UV light, too. EPA and DHA are the best sources - find them in fatty fish or a high-quality supplement.

You should also consider cutting dairy from your diet. I don’t like to make blanket dietary suggestions, but for women with acne and PCOS, cutting dairy is almost always helpful.

Here’s why: there is a hormone in milk (from cows, goats, sheep, and camels) called insulin-like growth factor-1 (IGF-1) which mimics insulin in our body. IGF-1 is a growth hormone (which makes sense, as milk is for baby animals!).

In most people, a little dairy here and there can be well-tolerated -  humans have a binding protein for IGF-1 that inactivates it. But for women with PCOS or hormonal imbalance who already are likely to be insulin-resistant or have high insulin, the added burden of IGF-1 can be a problem. This is amplified because women with PCOS have LESS of the binding protein for IGF-1 and higher IGF-a levels than other people do, too. And the ovaries of women with PCOS are more sensitive to IGF-1 (and other growth hormones), too.

IGF-1 can also cause your ovaries to overproduce testosterone (an androgen) - which is something we’re trying to minimize.

Not only all of that - but IGF-1 also increases sebum production and inflammation in the skin - sebum is oil on your skin - and encourages new cell growth. As new cells grow, old ones die and are shed.This means more oil and old skin cells potentially clogging pores and causing acne.

For all of these reasons I do recommend you try cutting out dairy if you’re dealing with PCOS or acne. Grass-fed butter and ghee are OK to keep in, as they are almost entirely fat and don’t contain much, if any, IGF-1.

Nurture Your Microbiome

A healthy microbiome is critical for both hormone health and lowering overall inflammation to help calm your skin.

The right gut flora is a main player in regulating your hormones, especially your estrogen levels. If you have too much of the wrong bacteria, the result can be increased estrogens in circulation.

Eating a whole-foods-based diet and taking probiotics are obvious ways to care for your microbiome - but if you’re already doing that and still having gut issues, I highly recommend advanced stool testing. Common gut infections like Blastocystis hominis, H. pylori, candida, and staph or strep overgrowth in the gut correlate to acne in patients. There is also a huge connection between Small Intestine Bacterial Overgrowth (SIBO), candida, and acne - especially rosacea.

Endotoxins released into the bloodstream by a leaky gut (aka increased intestinal permeability) are also a major cause of inflammation in the body and can impact the skin, too.

Lower Stress

This is the advice everyone hates - but it is the MOST important step toward achieving long-term health.

The reason people hate the advice to lower their stress is because they feel like most of their stressors are outside their control (bills, deadlines, work, family drama!) - but the truth is that there are many small steps you CAN control that can help reduce the burden of stress on your body.

Some simple but powerful things you can start doing right now:

  • Get quality sleep - that means going to bed with 7-8 hours before you have to wake
  • Avoid blue light after sunset  - get the glasses, change the settings on your phone, and dim the lights inside
  • Start a daily meditation/gratitude practice - just 5-10 minutes can set the tone for your entire day

Promote Ovulation

Supplementation should always be done only after proper testing and consulting with a practitioner. That being said, there are supplements that can support and promote ovulation that I use with my patients:

  • Flaxseed and DIM to address excess estrogen
  • Saw palmetto, reishi, pygeum, zinc, white peony/licorice, and green tea to slow the conversion of estrogen to testosterone
  • Vitex (aka chasteberry)  to support Hypothalamic-Pituitary-Ovarian signalling and progesterone production.
  • Adrenal and thyroid support, as needed (this is why you need proper testing!)

The Right Skin Care Routine

A pimple here or there  - or a bad breakout after you use a new face wash - is potentially a topical issue. That means it has to do with what you’re putting on to your skin from the outside, externally. But most cases of adult acne are more a result of internal imbalances (like we’ve been talking about in this article).


That being said, what you put on your skin still matters. Don’t use harsh products externally on your skin. Instead, try more simple options. I love:

  • Mother Dirt spray (promotes a healthy skin bacteria)
  • NERD skincare system
  • Homemade masks with Manuka honey, tea tree oil, turmeric powder, and apple cider vinegar 

This Is A Whole-Body Issue

I hope you take away this key point from this article: acne is a whole-body issue, not just a skin thing!

Whether you have PCOS or not, if you have adult acne, it is a sign that something isn’t working right in your body. From gut issues to hormone imbalances, there are multiple overlapping, underlying causes that could be causing your skin troubles.


But, I also hope you now understand that PCOS is underdiagnosed and misunderstood - and it could be affecting you.


Once I discovered that truth, I was finally on my way to #clearskineveryday (not to mention better moods, healthy monthly cycles, & healthier hair and nails!).


I’m passionate about helping women uncover the root causes of their health problems and address them naturally. If you’re dealing with adult acne, I’d love for you to book a free 20-minute root cause symptom analysis  consultation with my team. These appointments are TOTALLY free, and there’s no obligation to book any further appointments. See what time slots we have open here.


Woman with clear skin and no acne

The REAL Meaning Behind Adult Acne (And How To Get Rid of It For Good)- Part One

You wake up on the day of your dream-job interview, look in the mirror… and there it is, a big pimple on your chin.

You wish you could blame it on nerves, but the truth is that lately your skin is more broken out than it was when you were a teenager. You don’t know what else to try...

  • You’re already spending tons of cash on facials and trips to the dermatologist
  • You’ve tried every “miracle” regimen at Sephora
  • You even tried cutting back on nights out with your girlfriends!

But here’s what you don’t know… what you think is just “annoying adult acne” might actually be more than that. It could be a sign you have Polycystic Ovarian Syndrome.

I know what you’re thinking - you’ve heard of PCOS and you couldn’t possibly have it! You have normal cycles (well, at least your birth control pill makes them seem normal), you’re not overweight (although you do feel like you carry a bit more weight than you should, given how active you are), and you don’t have any other symptoms (except the acne… and your hair is thinning a bit… and the need to wax your lip every month…).

Listen girl, I get it! When I found out I had PCOS, I was shocked. But it turns out, I actually had a pretty atypical case. And you might too.

Misinformation about what PCOS is and the symptoms it can cause let many women slip through the cracks and never get the diagnosis or treatment they deserve.

Adult acne isn’t normal, and it isn’t something you should have to deal with. Finding the root cause of your acne and addressing it can mean clear skin and better health (because acne is always a sign of a bigger problem). And even if you’re certain you don’t have PCOS, keep reading anyways - you may be surprised by what you learn!

What PCOS Is (And Isn’t)

The #1 misconception about PCOS is that it is simply a condition where cysts develop on the ovaries. So wrong. In fact, some women with PCOS don’t even have cystic ovaries!

PCOS is actually the most common type of hormone and metabolism imbalance. It affects 1 out of 10 women. (Yes, that number is the same as 10% - a huge amount.)

Based on the Rotterdam Criteria from 2003, there are 3 diagnostic criteria for PCOS - and to be formally diagnosed, you have to have at least 2:

  1. Confirmed androgen excess on labs or androgen excess symptoms
  2. Ovulatory dysfunction
  3. Multiple cysts on ovaries (PCOM) diagnosed via imaging ultrasound

If you have at least 2 of the 3 criteria above, your doctor can diagnose you with PCOS.

In 2018 PCOS diagnosis guidelines were updated by a combined counsel of the Australian National Health and Medical Research Council, European Society of Human Reproduction and Embryology, and American Society for Reproductive Medicine.

It was a HUGE step forward in the treatment and diagnosis of PCOS, since the new guidelines (finally!) took into account how different PCOS can be in different women.

Here are their new recommendations:

  1. Androgen excess can be diagnosed by measuring free testosterone or bioavailable total testosterone. However, elevations in the hormones Androstenedione and DHEAS can also indicate PCOS, even without elevated testosterone.
  2. When irregular menstrual cycles are present, a PCOS diagnosis should be considered. Irregular is defined as cycles less than 21 days, greater than 35 days, or less than 8 cycles per year. However, ovulatory dysfunction can still occur with regular cycles - this can be confirmed or ruled out with serum progesterone levels taken in the second half of the cycle.
  3. Ultrasound should not be used for the diagnosis of PCOS in those less than 8 years out from their first period, because many younger women have multifollicular ovaries, even without having PCOS.

The new diagnostic criteria don’t mention weight  - and that’s because your weight is not part of the diagnosis for PCOS. Only 30% of people with PCOS are overweight or obese. And pain is not a symptom of PCOS, either.

What Does PCOS Do To You?

The hormone imbalance in PCOS creates problems with how the ovaries function, so the egg that should develop each month may not, or may not be released during ovulation (aka anovulation).

Some women think that if they aren’t actively trying to get pregnant, anovulation is no big deal - but regular ovulation is a sign your body is humming. Many women with PCOS also experience irregular cycles. Again  - this is more than just a fertility problem (though it is that too!) A healthy period is a sign your overall health (physical & mental) is good

(Side note - if your doctor prescribed the pill to regulate your cycle, this is still a problem! More on that later, so keep reading).

But PCOS is about way more than just ovulation.

Excess Androgens Are The Real Cause of Adult Acne

Women with PCOS tend to have an excess of androgens. Androgens are male hormones, and an  excess can mean high testosterone, high DHEA, or high metabolites of either.

Excess androgens are responsible for some of the most dreaded PCOS symptoms like:

  • Acne (especially on the chin, jaw, and back)
  • Male pattern hair loss/thinning
  • Hirsutism (male-pattern hair growth, like on the face)
  • Anger, irritability, mood swings
  • Poor stress response
  • Increased anxiety and depression

Not every woman with excess androgens has all of the above symptoms  - and sometimes one symptom can be severe (like acne!) while other can be more mild (maybe just a bit more hair on your upper lip).

But pay attention here - hormones levels are complex! Many women with PCOS also have symptoms of high estrogen. It commonly happens like this: DHEA is high, but progesterone is low relative to estrogen levels. On top of that, many women have poor estrogen detox because their liver is overburdened.

How PCOS Presents in Real Women

Remember, every woman is unique - but there’s a common scenario I see in my clinic with women with PCOS. And - full disclosure - I was one of these women too!

Here’s a story I hear from a typical PCOS patient with acne in my clinic about her teenage years/early 20s:

  • Her period came in her later teens (or never started naturally)….or started “on time” but then had irregular long windows between
  • Acne started to develop and so did hair in places she didn’t want it --(like nipples, lip, chin, stomach)
  • She may have been put on oral birth control pills to “regulate” her  period and help deal with the acne
  • And she might have been put on antibiotics like tetracycline or Accutane to further help control the acne

Sound familiar to you?

Then, as she aged into her 20s and 30s:

  • As other women’s acne clears up, hers is getting worse than ever
  • She may start to gain weight around her middle (even if she remains thin), or struggle to control her weight despite a healthy lifestyle
  • Her hair might lose its luster and start to thin
  • She may notice more anxiety and depression, trouble recovering from stress

And if she decides to stop taking the pill, here’s what usually happens:

  • Her period takes a long time to return after stopping the pill - or it NEVER comes back
  • Can’t conceive easily or without intervention

Not all of these symptoms are drastic (although some women do have very dramatic symptoms as a result of PCOS) - they can be subtle annoyances that hint at a bigger underlying problem.

What Not To Do If You Have PCOS & Acne

Most doctors - be they GPs, gynecologists, or dermatologists - only think of acne as a cosmetic issue. They often don’t make the link between acne and bigger issues like PCOS or hormone imbalance - especially if your other symptoms are mild or masked by the artificial hormones in the pill.

So, if you go see your doctor complaining about acne, you’ll probably be given one of these 3 things:

  • Oral contraceptives (birth control pills)
  • Antibiotics like tetracycline
  • Medications like Accutane

While these meds might help short-term for some women, in the long-run they only make PCOS symptoms worse. Research has shown women with PCOS already have a less diverse microbiome than women without PCOS (and, that increasing microbiome diversity may be an essential part of treatment). The pill, Accutane, and antibiotics all only further damage the microbiome (especially when you’re taking them long term!)

Our microbiome (aka all the bacteria living in our gut) are critical for hormone biotransformation - that means they help produce and then clear out hormones. To have healthy hormones, (and clear skin) you’ve got to have a healthy gut - and taking any of these common acne meds can wreck your gut!

(It always comes back to the gut!)

Don’t Panic!

If you’re reading this and thinking you may have PCOS - or are nodding along because you were prescribed the Pill and antibiotics to treat your acne  - please don’t panic!

Our bodies are so resilient, and there is a lot you can do to balance your hormones. In Part Two of this article, I’ll explain exactly what you CAN do and how I help women with acne, hormone imbalances, and PCOS in my clinic. Check out Part Two here.

Woman using fertility app on smartphone

The Truth About Fertility Apps (And the Exact Ones I Use and Recommend)

In college, I tracked my periods on my wall calendar. A red dot (so subtle!) marked day 1 of my period. It wasn’t very advanced, but it was when I first started paying attention to my not-so-monthly cycle. Back then I also read paperbacks and kept a grocery list on a magnetic notepad on my fridge. 

I don’t do any of those things anymore though because - hey, there’s an app for that! 

If you’re like me, you keep everything on your phone now, and there are even some amazing fertility tracking apps you can get, too. These apps don’t just help you remember when you last got your period - the best ones can accurately predict when you'll ovulate each month. You can use that information to help you get (or not get) pregnant. 

But not every fertility tracking app you can download is actually useful. Some really can help you predict when you’re ovulating, but others are no more sophisticated than my old red-dot method. 

Let me explain how and what fertility trackers can and can’t do - and I’ll tell you which ones I use and recommend (even if you have PCOS or irregular periods!). 


Why Should I Track My Cycle?

I recommend cycle tracking for all women. Your period is one of the biggest indicators of your overall health - but it’s also really sensitive to changes. Little changes in your cycle can be a clue of a bigger problem, even before any other symptoms show up. 

Plus, being aware of your cycle gives you powerful information about your body. As you get more in tune with your cycle, you may even start basing some other patterns around it (like how you eat or your exercise throughout the month). 

And of course, the obvious reason to track your cycle is to track your fertility (by knowing when you ovulate). This is not just for women who are trying to get pregnant - you can use this information to help you get pregnant more easily OR to avoid pregnancy without having to use hormonal birth control methods. 

Yes - the right fertility tracking app can replace hormonal birth control if it is used correctly! 

But if you’re going to rely on cycle tracking to predict your fertility, it’s critical that you use a reliable app - and they aren’t all created equal.


Calendar-Only Apps Can’t Tell You Enough

Unless you are simply trying to get a better sense of cycle length and variations, regular calendar based apps are useless for fertility detection. These are apps like “Period Tracker” that just ask you to track when your period begins and ends. 

These apps base their estimation of your fertility on data from your prior cycles, assuming you have a 28-day cycle and Cycle-Day 14 ovulation. But the truth is that fewer than 10% of women actually do. Your cycle length can also vary from month to month. Because most women don’t have this cycle pattern, these apps cannot accurately tell you when you can and can’t conceive.


Which App Should I Use?

If you really want accurate results (and when it comes to getting pregnant or not, accuracy is key) you need a fertility tracker that does more than just count days. 

After testing and trying them all, both myself and with my patients, there are three  I recommend - one for people whose goal is avoiding pregnancy, and another two for  those who are looking to conceive OR who have very irregular cycles (my PCOS sisters, this one is for you!)

Let me break them all down for you.


If You’re Trying To Avoid Pregnancy (And Or Get Pregnant & Have Regular Cycles)

If you want to track your cycle, get a better understanding of your fertile window and monthly rhythms, and/or avoid pregnancy, I think the Kindara Fertility Tracker is the simplest to use and has a great track record. 

Kindara  is an app that you use along with a basal thermometer (which gives temperature to the second decimal).All you need to do is remember to take your temperature using the thermometer every morning, right when you wake up, and enter that data into the app. You’ll also track changes in your cervical mucus. 

Research by  the CDC has shown that, when used perfectly, this method of birth control is 99.6% effective! 

Kindara reports days to you as either fertile or not fertile, based on your temperature, past cycles, and cervical mucus. If you’re avoiding pregnancy, abstain or use a non-hormonal birth control method when you’re fertile.

At only $4.99/month (and with a free basic version, as well), the Kindara app is a great alternative to hormonal birth control and is a useful tool for tracking your fertility. 


If You’re Trying to Get Pregnant  - Or You Have Long or Irregular Cycles

If your goal is to get pregnant, or if you have PCOS or irregular cycles (whether you want to get pregnant or avoid pregnancy) I recommend both Oova and the new Priya

Priya  is a vaginal sensor that monitors temperature all day long. It’s a silicone ring that you can wear continuously for up to 29 days - or remove for up to three hours daily - that takes regular temperature readings. 

Because it measures core temperature, and because it takes readings all day long, every 6 minutes, the resulting temperature data is much more accurate than taking a single, oral reading. 

Priya is able to predict ovulation up to 2.5 days in advance of a LH surge on an ovulation urine test and data in trials suggests it is just as accurate as an ultrasound, which is the gold standard for ovulation testing! 

If you have PCOS, or unexplained fertility, using Priya can unlock a huge piece of the puzzle. The same holds true if you have irregular cycles or irregular ovulation from any cause, and are either trying to conceive, or trying to avoid it. It also works if a woman is taking fertility treatments in the form of herbs or medications to promote ovulation. 

And if you’re wondering if it’s safe to wear, I have you covered! My first question was about the potential for EMF exposure. What makes Priya cool is that it only connects to the device once an hour for a few minutes, and it’s at a very low power. You can also change the setting and have it connect even less often, 1-2x daily is all that’s needed, and you can remove it before connecting. It will still read and store your temperature, even when disconnected. 

I also asked about the potential for biofilm buildup and vaginal microbiome disruption (which is a major issue with other vaginal rings, like Nuvaring). Priya is different because it's made from washable silicone. You can take it out every day and wash it, and it can be removed up to 3 hours per day and still be effective. 

Priya is not yet available to the public, but I am testing it with my clients and loving the results. Sign up for pre-orders here. 


Another Amazing Option - Especially for PCOS! 

Along with Priya, I recommend Oova, which uses urine tests (think pee-on-a-stick pregnancy tests) to track fertility throughout the month instead of temperature. You order a kit with 15 tests, and enter test results into the app for lab-quality results. 

Honestly, I love Oova. The technology was developed by a doctor who struggled with fertility herself, and it’s unlike anything else you can buy. 

You’ve probably heard of LH tests (AKA Ovulation Predictor Kits) before: you can buy them at the drugstore, and until now they were the best option for at-home ovulation prediction. But the big problem is that LH - luteinizing hormone - is present in your urine all month, and it surges just before ovulation. All an LH test can tell you is that ovulation is coming in the 24 hours or so  - and that depends on you taking it at the right time (too early or too late and you’ll miss the tell-tale surge). Plus, interpretation can be confusing: is today the strongest pink line? Was it yesterday? Will it be tomorrow?

If you’re trying to get pregnant, LH tests alone aren’t very helpful because your fertile window is actually 5 days up until you ovulate, and an LH test misses most of that. And, an LH surge doesn’t always mean that an egg has actually been released, as some women don’t release an egg every cycle.

Oova uses super-sensitive, nanotechnology LH tests along with progesterone tests to solve this problem. Progesterone levels rise when an egg is released from the follicle in the ovary where it has been growing. High progesterone levels are also necessary for the vascular development of endometrial lining, and to prevent shedding of the endometrial lining if you are pregnant. By tracking progesterone levels with LH, Oova gets a complete look at your cycle. 

You’ll use the Oova tests - which are read by the app, so you don’t have to do any interpretation - to establish your hormonal baseline and then see the changes that indicate your fertile window. It can uncover your exact, unique cycle length, and confirm that ovulation has in fact occurred - so it’s ideal for women with irregular cycles or PCOS!

I love to pair Oova with Priya or Kindara data, too - especially for tricky, irregular cycles who are trying to conceive!

Learn more and get Oova here. Use code BWIH1 for 15% off your Oova order!


Can A Fertility Tracker Really Replace Other Forms of Birth Control?

Like I said before, I recommend tracking your cycle to all women - even if it’s just a simple calendar app for right now.

But the right fertility tracking app CAN replace other forms of birth control as long as you’re doing it the right way. Just like with the pill or condoms, user error is the biggest problem with using fertility tracking as a birth control method.

Before you get started, read all the instructions included with your fertility tracking app  - and when in doubt, use a backup method like a condom. My favorite condoms are Sustain Natural Latex Condoms, which are nitrosomine-free (nitrosomine is is a carcinogen that is formed when latex is heated and formed). The rubber they use for manufacturing their latex is also non-GMO and fair trade, which is really significant with condoms, as child labor and harsh working conditions are a big issue in many rubber plantations world-wide.


Do You Track Your Fertility?

If you have experience with the Kindara, Priya, or Oova, I’d love to hear how it worked for you! Got another fertility tracking app you love? Leave a comment and let me know. 

And if you’re not yet tracking your fertility but want to give it a try using one of the apps I recommend, save 15% on the Oova kit with code BWIH1

brie the pcos whisperer

10 Common Signs & Symptoms of Polycystic Ovarian Syndrome

If you've ever struggled with infertility, irregular menstrual cycles, or other reproductive problems, please know that you're not alone. Thousands of women out there are striving for help and healing in the face of such frustrating health issues.

One relatively unknown yet common cause of reproductive health problems is a condition known as Polycystic OvarianSyndrome, or PCOS for short. PCOS is so common that it affects as many as 1 in 10 women of child-bearing age, although even girls as young as 11 can be affected. Considered a hormonal and metabolic imbalance, PCOS is the leading cause of infertility worldwide.

10 Top Signs & Symptoms of PCOS

By definition, PCOS is a syndrome, not a specific disease. This means there is no one test or procedure that can confirm a diagnosis. Instead, clinicians must rely on a thorough evaluation of each individual woman's signs, symptoms, lab markers, and patient history in order to determine if PCOS is the cause of her symptoms.

Effectively, PCOS is a diagnosis of exclusion. That is, a woman may receive a diagnosis only if and when other diseases that could explain her symptoms have been ruled out. As the most common hormonal disorder in women of reproductive age, PCOS impacts over 100 million women around the world, and has impacts on health that extend beyond the reproductive system to cardiovascular health, metabolic and immune health.

So, what are the indicators of this syndrome? Could you or someone you know be affected? Take a look at the following 10 signs and symptoms. They could suggest the presence of PCOS:

1. Irregular ovulation and/or menstrual cycles.

Women with PCOS may experience long or irregularly timed menstrual cycles, sporadic or missing ovulation (oligo-ovulation or anovulation, respectively) amenorrhea (absence of a period), or dysfunctional uterine bleeding (spotting). Additionally, a pelvic ultrasound may show increased thickening of the endometrial lining of the uterus. Ultrasound imaging can also show enlarged ovaries covered with a series of cyst-like formations which often resemble a "string of pearls."

2. Infertility.

This may be one of the most stressful and troubling symptoms for many women with PCOS who are otherwise trying or would like to become pregnant.

3. Hirsutism. (Excess hair growth)

This is a medical term that refers to male-patterned hair growth in women, including excessive hair on the upper lip, chin, chest, abdomen, and/or back—exactly where most women don’t want it.

4. Hair loss.

A bit of a double-edged sword, isn't it? In addition to excessive hair growth in unwanted places, PCOS can also cause thinning of hair on the scalp and in some cases male-pattern baldness. It’s just not fair.

5. Acne.

Breakouts can be moderate to severe, or newly developing in adulthood, when everyone else’s teenage-acne is ancient history.

6. Obesity and overweight.

Weight gain is common, as is the increased likelihood of related metabolic disturbances including pre-diabetes and diabetes. Interestingly, not every woman with PCOS will be overweight—in fact up to 50% of women affected by this syndrome may be normal weight or even underweight.

7. Darkening of skin.

This hyperpigmentation, called acanthosis nigricans, is usually the most obvious around the groin, underneath the breasts, and in the creases of the neck.

8. Skin tags.

These small flaps of excess skin typically grow around the axilla (armpits) and/or neck area.

9. Depression.

The distress caused by other symptoms can lead many women with PCOS to feel depressed, although depression or anxiety can be symptoms in and of themselves. Additionally, women with PCOS often experience a low or absent sex drive, and a lower stress tolerance.

10. Abnormal lab tests.

Blood work and other tests may indicate elevated levels of male hormones such as Testosterone (also known as androgens), and a ratio greater than 2:1 between two hormones known as the lutenizing hormone, or LH, and follicle stimulating hormone, FSH (a normal ratio is around 1:1). There are other lab markers that can further characterize PCOS, and I will discuss these in the next article in this series.

Recognize any of these symptoms in yourself or another woman in your life?

If so, be sure to consider requesting screening with labs and ultrasound. If you're looking for a holistic, effective, and individually-tailored approach, I invite you to consult with myself (PCOS whisperer) and the rest of my integrative team. We're here to help you heal, and it's my honor to join you on your journey toward better reproductive health.

To learn more about the role of Functional Medicine in the treatment and management of PCOS,  schedule your initial consultation or a FREE 15-minute Consultation today.