Polycystic ovary syndrome (PCOS) is one of the most common causes of fertility challenges, affecting millions of women worldwide. Characterized by hormonal imbalances, irregular periods, and ovarian cysts, PCOS can make it challenging to conceive. However, I want you to know that it’s entirely possible to restore hormonal balance and improve fertility naturally. I’ve seen this firsthand in my clinical practice—when we support the body with the right nutrition, mindset, and self-care, healing happens.
Understanding PCOS: Diagnosis, Types, and Natural Strategies for Restoring Fertility
Polycystic Ovary Syndrome (PCOS) is one of the most common causes of irregular cycles and ovulatory fertility challenges. But PCOS is often misunderstood, misdiagnosed, and oversimplified. Many women are told they have PCOS simply because of irregular periods or because an ultrasound shows ovarian cysts. In reality, PCOS is a spectrum condition, and proper diagnosis matters.
How PCOS Is Diagnosed Today (Rotterdam Criteria)
A PCOS diagnosis should be based on the Rotterdam criteria, which requires at least two of the following:
- Irregular or absent ovulation (long, inconsistent, or missing cycles).
- Elevated androgens (on bloodwork or symptoms like acne, chin/jawline hair growth, hair thinning).
- Polycystic ovarian morphology on ultrasound (noting that this is more common in younger women and does not automatically equal PCOS).
It is also important to rule out other conditions that mimic PCOS, such as hypothyroidism, elevated prolactin, functional hypothalamic amenorrhea, or adrenal hormone imbalance.
The Different Types of PCOS
There is no one-size-fits-all PCOS. Understanding the underlying pattern helps determine the right treatment approach.
- Insulin-Resistant PCOS
The most common type. High insulin levels drive elevated androgens, irregular cycles, and inflammation.
Key clues: fatigue after meals, cravings, weight held around the belly, fasting insulin above 6. - Non–Insulin-Resistant / Inflammatory PCOS
In this type, the main driver is chronic inflammation, gut imbalance, stress chemistry, or environmental triggers.
Key clues: normal blood sugar labs, digestive symptoms, food sensitivities, skin inflammation. - Post-Pill or Hypothalamic PCOS
Cycle disruptions after coming off hormonal birth control. The ovaries can take months to regain communication with the brain.
Key clue: history of long-term pill use and temporary irregular cycles.
Understanding which pattern is at play helps target treatment more effectively.
Helpful Lab Markers to Request
These labs help clarify whether PCOS is insulin-driven, inflammatory, or hormonal signaling–based:
- Fasting glucose and fasting insulin (goal fasting insulin under 6; leptin between 4-7)
- HOMA-IR score (insulin resistance index)
- Leptin (connected to appetite, metabolism, ovarian signaling)
- Total testosterone, free testosterone, DHEA-S
- SHBG (sex hormone binding globulin, often low in insulin resistance)
- LH:FSH ratio (a ratio above 2:1 can suggest PCOS)
- Lipid panel and hs-CRP (inflammation indicators)
- Thyroid panel including antibodies
- Vitamin D (supports ovulation and hormone regulation)
Natural Strategies to Support PCOS and Restore Ovulation
1. A PCOS-Supportive Nutrition Approach
Food can stabilize hormones or contribute to inflammation. Aim for meals that keep blood sugar steady and support liver detoxification.
- Focus on whole-food proteins (fish, eggs, pasture-raised meat). My best-selling fertility book, The Egg Quality Diet is a great place to start.
- Include healthy fats (avocado, nuts, ghee, olive oil)
- Increase fiber-rich vegetables to support hormone metabolism
- Choose slow-digesting carbohydrates (squashes, sweet potatoes, quinoa, berries)
- Avoid refined sugar, processed snacks, and artificial sweeteners
For personalized meal plans and support, my Natural Fertility Coaching Program guides you step-by-step in stabilizing cycles and supporting ovulation.
2. Exercise for Hormonal Balance
Exercise is beneficial, but over-exercising can increase cortisol and worsen PCOS symptoms.
Supportive options include:
- Strength training to improve insulin sensitivity
- Walking, Pilates, and yoga to regulate the nervous system
- Gentle cycling or swimming for metabolism without stress overload
- Consistency matters more than intensity.
3. Supplements That May Support PCOS
Supplementation should be tailored to your labs and symptoms, but commonly helpful options include:
- Myo + D-Chiro Inositol for insulin sensitivity and ovulation support
- Spearmint tea for reducing elevated androgens
- Vitex for menstrual cycle regulation (used carefully and only in the right PCOS pattern)
- Cinnamon to support healthy blood sugar metabolism
Always work with a practitioner when adding supplements while trying to conceive.
4. Stress and Nervous System Support
Stress hormones directly impact reproductive hormones. Supporting your emotional and nervous system health is essential.
- Breathwork, meditation, journaling
- Restorative yoga or yoga nidra
- Acupuncture to support hormonal signaling and ovulation
5. Supportive Weight and Metabolic Care
If insulin resistance is present, even a 5–10% shift in body composition can improve ovulation. Focus on nourishment rather than restriction: stable meals, protein in the morning, restful sleep, and daily movement. If you want one on one support from a seasoned team of fertility experts, explore my coaching options.
PCOS does not mean your body is broken. With the right diagnosis and a targeted approach that addresses your underlying pattern—whether insulin-driven, inflammatory, or post-pill—your cycles can regulate, ovulation can return, and fertility can improve.
You are not alone in this, and your body is capable of healing.