Lean PCOS - in need of help, and a hug

(((((HUG)))))

Sorry you've had such a rough go of it for such a long time! But, you've named the beast now and can really get started about taming it!

Have you asked your doc for diet advice? Or maybe a referral to an RD? Here are a couple links that may provide some helpful info:

http://www.mckinley.illinois.edu/handouts/pcos.htm

http://www.eatright.org/Public/content.aspx?id=11182

http://texashealthmoms.blogspot.com/2012/07/best-eating-plan-for-women-with-pcos.html

http://www.drnandunne.com/?p=1808

https://www.pcosdiva.com/category/blog/supplements/

http://www.webmd.com/vitamins-supplements/condition-1956-PCOS.aspx?diseaseid=1956&diseasename=PCOS

As for the settling down and having kids, please try and focus on yourself and your health and not on the "deadline" you've been given. Eight years is a long time! I find there's peace in knowing you can't control everything. You do what you can with what you've got and let things fall into place. Hang in there!

(((HUGS)))
There is a PCOS group on here that you might find helpful.
I am also a lean PCOS with the characteristic PCOS belly. I got down to my initial goal weight and lost another 8 lbs below that but still have a really disproprotionately flabby belly even though I've gotten fairly slim elsewhere. It's frustrating.
I'm sorry you're having a hard time getting the medical care you need. That's also a bit crappy IMO that pregnancy care is only covered through age 35. No pressure or anything.
I haven't really done anything to treat my PCOS other than going lower carb and exercising. I also went off the pill and the ring since I didn't like the side effects. (I use FAM to avoid, which has a high effectiveness rate if you follow it correctly.) I know a lot of people who are on Metformin but haven't tried it myself. I know a lot of people take cinnamon or other supplements but again, haven't researched them myself. A number of the ladies on the PCOSis group here do follow a low carb/moderate protein/high fat diet. Mine is more moderate across the board but I've thought about trying it their way to see.

I can't help with you the diet thing... but I just want to say, that yes, it can be harder to conceive a child, it's not impossible. Please don't put a time limit on it.

I have PCOS, didn't meet my husband until I was 33, got married 18 months later and didn't have my first child until I was 38, my 2nd at 39.5. I did need help to get pregnant, but I did.

I have a few questions.

I do have a couple clients with PCOS but each is different BTW.
Also a wife with extreme endometriosis.

How is your sleep cycles?
How is your stress management?
How is your libido?
Do you lift weights or mostly cardio?
What type of diet are you following and how much are you eating per day?

Thanks Mich,
The time limit is really set by the NHS. I would have to go private to get the drugs after 35 years old.
x

NHS help is limited (and time limited), but private care is a possibility too. It's not cheap, I know, but 8 years is a long way away. Things could be very different for you by then, both with regards to settling down, and your finances. Basically, you can't predict what will happen between now and then. But.....if you are worried about it, you could start a small savings pot, put a small amount in each month, and have it as your 'plan b' pot. If you need it for fertility treatment, you'll have it ready. If you don't, you can use it on home improvements, or a holiday etc etc.

Also, big ((HUGS)) x

Firstly, to comment on the having kids side of it, I'm 31, still single so that leaves me a lot less time to have a child than you. But the way I see it is that if nature has decided we're not meant to have kids then we should just accept that instead of taking unnatural measures to have one. There's nothing to say that we CAN'T conceive after the age of 35, just that the NHS won't help with IVF after this point. So don't let yourself freak out about finding someone before you're 35, you just have to let nature take its course.

That's pretty extreme that your periods never came back, but I find when I go off the pill it takes my body some time to get back to more regular cycles. I have been on and off the pills since I was a teen too, and even though periods disappearing altogether is quite drastic perhaps your body has not been able to get back into a regular cycle because you haven't ever given it the ability to get into a menstrual rhythm without synthetic hormones. This may be something you want to ask your GP about though, it just seems to make sense to me seeing how my periods take so long to get back to normal after I stop the pill. This last time it took me 2 months to get a period and I only take the pill periodically to try and help the acne side that I still struggle with!

Also, metformin doesn't help for everyone with PCOS. I tried it and it did nothing for me and many people don't experience any improvement in weight loss on it. It's mainly used in type 2 diabetes to increase insulin sensitivity, but this doesn't mean it will have any bearing on weight loss. You have to remember that IR doesn't automatically mean you can't lose weight because insulin is not the only factor in weight loss. People with type 1 diabetes can't produce insulin, yet being overweight isn't a main problem of that form of diabetes. Rather, overeating and being overweight causes IR and not the other way around. So becoming more sensitive to insulin (while very important to health) does not automatically mean you will have an easy time losing weight. However, studies have shown that women with PCOS have lower BMRs than women without PCOS and women with PCOS and who are insulin resistant have lower BMRs than women with PCOS but don't have IR.

My question would be; are you currently trying to lose weight or maintain? I don't know what your BMI is so I can't tell whether you are within a healthy weight range or not.

I currently have a BMI of just under 26 and believe me it has not been easy getting here. I don't have a ton of weight to lose (another 7 and I will be within a healthy BMI). I found low carb to be the most helpful for me, but not very low carb so I don't recommend that. Our bodies preferentially store carbs as fat which is why we need to workout a lot of we're eating starches regularly but I keep my carbs to about 100g or under.

As far as protein and fat goes, you don't want to be low fat and high protein for too long. Protein is great for keeping blood sugar stable and keeping you feeling fuller longer and it also uses more energy to digest than fat and carbs, but it is not an efficient source of fuel for the body as its primary use is for growth and repair. So unless you are working out a lot, I would say you don't need to be going over 100g a day. Then the rest should come from fat. Fat is a very efficient fuel source for the body. When it comes to low intensity and longer periods of activity, fat is the body's preferred fuel source. And yes, most definitely healthy fats. This includes saturated fats such as grass fed butter, coconut oil, animal fats as well as avocadoes, olives and olive oil, nuts and omega 3 fats as found in oily fish. You want to ensure you are getting enough omega 3s in your diet and limit intake of omega 6 fats as found in conventionally raised meat and poultry and processed seed oils like sunflower oil and canola oil. Also only use saturated fats for cooking as other fats are unstable at high heat temps and cause oxidative damage in the body (not good for cancer!). You also want to avoid overcooking or charring food - try steaming, light frying, boiling as much as possible.

As far as vitamins and supplements go, there are SO many that have the potential to help with PCOS. there is a company called Insulite Labs who produce a specific range of supplements to help reverse PCOS. It's very expensive and they are based in the US so you'd have to pay shipping and customs charges but if you have the cash then it might be worth a try. Unfortunately they don't offer a money back guarantee as far as I know and I have tried the product but I'm afraid I wasn't at a stage in my life where I was prepared to change my diet and it was a complete waste of money and I saw no change which is no surprise considering I was eating so much sugar and junk on a daily basis. You are in a much better position than I was. So that is an option, but only if you can afford it.

You might also want to try a supplement with chromium and cinnamon extract as these things have been found to help with blood sugar regulation and carb cravings that come with PCOS. You could also try adding a teaspoon of cinnamon to your tea or coffee every day or to yoghurt. I don't really suggest a fish oil supplement as they don't seem to be as effective as the whole food sources of omega 3s, but these type of fats are believed to help with insulin sensitivity so as mentioned above try eating more oily fish at least twice a week.

Those are all the suggestions I can come up with at the moment. But you say you have low estrogen which is actually a good thing as far as cancer goes. Maybe have your thyroid checked out as if you've been dieting for a while your thyroid levels tend to plummet as well as leptin levels, making weight loss or maintenance even harder and a break with eating at maintenance and upping your carbs a bit to over 100g may really help you.

The last thing I would say is that if you're within a healthy weight range but just want to lose weight to look better, it might be a bit unrealistic to expect your body to maintain at a weight that is not natural for your body. I find that I can lose weight but my body fights back very hard and I can rarely maintain at a healthy weight, so I think it would be wise to set up some realistic expectations of your body.

(((( BIG hugs ))))

If you're just trying to maintain then you should definitely increase fats. These don't need to be limited as long as you are not going overboard with them as with all foods. But with protein, the RDA is 0.8g per kg of bodyweight. I don't know how much you're eating, but I'm estimating that your RDA is around 50g. If you work out that can be increased slightly. But as I said, it's not an efficient source of fuel for the body and so too much isn't really warranted. Fats however, help a lot with hormonal balance and with absorption of vitamins and general health and as I said, is the body's preferred source of fuel hence why we have the ability to store so much of it! Whereas carbs in the form of glycogen can only be stored to provide enough energy for one day.

And speaking of carbs, I wouldn't go too low. Very low intakes over long periods tend to increase cortisol production which will signal the body to store fat (especially around the belly). If you're fairly active up to 150g of carbs is fine. Less active people need less. Also, if you have been avoiding starches for a long time, if you incorporate them back in your body will need time to adjust again so don't be alarmed if you suddenly have stomach upsets or blood sugar issues. Just make sure you eat them with protein and fat to slow absorption.

I do feel really bad for you though, as one of those people at a healthy weight but still have many PCOS symptoms. The only things doctors can suggest to help with symptoms aside from medication is to lose weight. If you don't need to lose weight then it really seems there's no way to improve your symptoms and to be perfectly honest, my symptoms aren't any better now than they were when I was 2 stone heavier. So the best way is to try balance out hormones with diet and exercise. If you have issues with high blood sugar then eating large amounts of starch may not be a good idea, so I'd start really small.

I don't know if you eat organic or not, but I would highly recommend going organic with animal products at the very least as the non-organic ones are pumped full of hormones which you then assimilate when you eat them and would make sense that this would then upset your hormonal balance further.

Oh, also, if you're not already you could try things that naturally lower testosterone which affects your period. Some examples are flaxseeds, inositol, Vitamin D, spearmint tea and again omega 3s which you're already on top of . Good luck! I really hope it works out for you

Honestly regarding the 35 thing, that's just your GP, and I'm sure it's different depending on all sorts of circumstances, and I honestly think that's very irresponsible of them to say that to you, because it's not the GP that has the final say with fertility, it's the fertility specialist. I would pretend that I hadn't heard that and live life normally and cross that bridge if and when you come to it. You might have no problems conceiving, you just can't predict the future, so try not to worry about it.

Regarding your macros, if you are lifting weight try and get a minimum of 0.8 grams of protein per lb of bodyweight. And for fat 0.35-0.45 grams of fat per lb of bodyweight. And the carbs get the rest. Though personally I try and get much more protein than that as I do a lot of strength training. So basically the standard recommendations lol. In terms of losing fat, you need to create a calorie deficit to get rid of it.

Also exercise in general is great for PCOS, hormone stability and insulin resistance, especially HIIT, so that might be something to look into.

You should try and find out if you are insulin resistant or not though, that could help you get some specific dietary recommendations. In your position, with the periods being absent etc, I would push your GP into sending you to a specialist.