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number one cause of female infertility

Shining a spotlight on the number one cause of female infertility 

What is the number one cause of female infertility?

Did you know that 1 in 4 women struggle with infertility that makes it approx 48.5 million couples worldwide (Reproductive Biological Endocrinology, 2015 link here) . So next time you are at a dinner party that is a question you may want to avoid, asking couples when they are planning on having children. If in doubt, always be kind.

There are many known and unknown causes of infertility but the number one cause of female infertility is polycystic ovary syndrome (PCOS) that this article will be shedding a light on.

PCOS is a hormonal disorder that may impact the length of the menstrual cycle (>35 days), absence of regular menstrual cycles, increase in testosterone, and/or cause cysts in the ovaries. This causes unpleasant symptoms like excessive hair growth in some areas on the body, especially the upper lip, chin, chest, abdomen, and low back. Weight gain is also often seen with PCOS. Other symptoms may include dark skin patches, thinning hair, acne, and depression. 

More than 50% of women with PCOS are still undiagnosed as identified in Human Reproduction report by Oxford (read here)! If you experience any of these symptoms it is worth investigating. A very upsetting statistic is that most women with PCOS will see 3 different doctors before getting  diagnosed! So be persistent and insist on getting your blood work done especially if your concerns are not being taken seriously by health care professionals. 

How do we diagnose the number one cause of female infertility?

There are many different ways to diagnose PCOS, but the most common criteria are the Rotterdam criteria, for further reference click here. According to the criteria in order to diagnose PCOS, one must have at least 2 of the following:

1) Lack of ovulation or not ovulating on a regular basis (cycles longer than 35 days)

2) Hyperandrogenism (high levels of male hormones, which could include symptoms like acne, hair loss, increased body or facial hair, and oily skin).

3) Polycystic ovaries (diagnosed by transvaginal ultrasound).

Once your diagnosis is confirmed, the next step will be to determine your root cause or “type” of PCOS. There are 4 main types namely insulin resistance PCOS, inflammatory PCOS, adrenal PCOS, and post-pill PCOS. You can have a combination of two or more types. 

INSULIN RESISTANCE PCOS

This is the “classic” type of PCOS. It is by far the most common – it is estimated that at least 75% of women with PCOS are insulin-resistant. Symptoms include irregular cycles, acne, unwanted hair, sugar cravings, poor energy, mid-section weight gain, and difficulty losing weight. Labs may show elevated insulin & androgen levels. If you suspect you have insulin resistance ask your doctor to do an HBA1c test or oral glucose tolerance test (OGTT).

INFLAMMATORY PCOS

Chronic inflammation causes the ovaries to make excess testosterone, resulting in physical symptoms and issues with ovulation. This will result in irregular cycles, acne, joint pain, headaches, excessive hair, gastric symptoms like irritable bowel syndrome (IBS), fatigue, or other skin symptoms. You can request a C-reactive protein (CRP) test if you suspect you have inflammatory PCOS.

ADRENAL PCOS

This type of PCOS is due to abnormal stress responses and affects around 10% of women with PCOS. High levels of stress will lead to elevated DHEA, which is a hormone produced by the adrenal glands. Signs of high levels of DHEA include irregular cycles, acne, constant stress and worry, mood swings, hair loss, and fatigue. Blood tests to request are DHEA-S and Total DHEA.

POST-PILL PCOS

This type of PCOS is often triggered by androgens produced after coming off hormonal birth control. Symptoms likely begin shortly after coming off birth control but will clear up in time.

Now it is time to treat that underlying cause of the number one cause of female infertility:

Balanced meals, sleep, stress management, supplementation, and exercise are essential in the treatment of all PCOS types. 

If you have insulin resistance PCOS your main focus will be to stabilize your blood sugar levels. You can do so by eating regular meals consisting of whole grains or low GI carbohydrates (brown rice, corn, sweet potato, etc), lean protein like fish or chicken, vegetables or salads, and plant-based fats (avocado and nuts). A daily 30-minute walk and weight training can do wonders. For supplementation, focus on inositol, chromium, magnesium, NAC, and vitamin D. A doctor might prescribe you diabetes medication. 

If you have inflammatory PCOS the main aim will be to reduce chronic inflammation in the body. Identify and eliminate foods you are intolerant or sensitive to, the most common offenders are usually gluten and dairy. Look after your gut with zinc, collagen, l-glutamine, and probiotic-rich foods. Supplement with omega 3 and magnesium to support sleep and help to calm your nervous system.

If you have adrenal PCOS the aim will be to reduce stress. You can do so by making sure you eat enough and do gentle exercises such as walking, stretching, yoga, and Pilates. Make sleep a priority and focus and meditation and relaxation. Supplement with magnesium, to nourish your nervous system and support mind and body relaxation.

I have a free PCOS meal plan for every woman who needs a little inspiration when it comes to PCOS-friendly meals. Here is the link pcos.jacomienel.com/free-meal-plan

*Disclaimer: The intent of this article is not diagnose, treat or cure but rather to create awareness and equip women with the information to seek the appropriate medical treatment. 

 

About the Author:

Jacomie Nel
Jacomie Nel
 
Jacomie Nel is a registered dietitian with a master’s degree and 8 years of experience. Her passion is to help women reduce PCOS symptoms, balance their hormones, improve insulin resistance and manage cravings.


   

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