Improving Ovulation Naturally, Part II

Ovulation Disorders, Long Cycles and PCOS Part II

In our first article, we discussed a handful of reasons why women fail to ovulate on-time. In this post, we’ll examine the more common implications of long cycles and/or PCOS. When women are completely anovulatory, meaning they aren’t ovulating or cycling at all, this is often due to different causes such as hypothalamic amenorrhea, post-birth control syndrome, or pituitary issues. Primary and Secondary amenorrhea can have a myriad of causes and for that reason  we will discuss in future blog posts. I’ll start with some of the most common reasons our patients experience infrequent ovulation resulting in longer cycles. 

Post-birth control syndrome (PBCS)

Many women are put on hormonal birth control in their teens to correct issues like painful, heavy menses or hormonal acne, while others mostly use it as a contraceptive. The problem with using it to address hormonal problems is that it only acts like a bandaid, masking these issues but not actually addressing the hormonal imbalance or root cause of the problem itself. So when women stop using the pill, these issues are likely to reappear in full-force. 

For women who started hormonal birth control to prevent pregnancy, such as myself (for 14 years…), it can be very effective in doing just that. Unfortunately, what women often aren’t told, is that when you're ready to start trying to conceive, you may run into issues. For some women, stopping hormonal birth control does not bring their period back… or it can take some time. 

According to Jolene Brighten in her book, “Beyond the pill,” 

“Women who stop the pill can experience changes in their menses, including shorter luteal phases, anovulatory cycles, longer cycle lengths for months and sometimes years…”

In our practice, I see so many women who go off of oral birth control, Mirena, Nexplanon, just to name a few-- who months or even years later, never see a return in ovulation/menses. Fortunately, in most of these cases, we’re able to restore their cycles and only wish they would’ve come to us sooner. But I feel their frustration, never having been told (myself) that this is a potential side effect of being on birth control. More importantly, cycle changes women experience coming off birth control can delay ovulation they’re finally ready to start trying. If a women had PCOS or painful periods before birth control, they’ll likely face a similar fate once that bandaid is removed.

Hormonal birth control cuts off communication between the brain (HPO axis) and the ovaries. It can take a while for those connections to re-establish. All forms of hormonal birth control contain Progestins, which inhibit our natural progesterone response often causing issues with fertility and miscarriage later on.

PCOS

Women with PCOS experience long cycles, anovulation, and other irregularities for different reasons. Here I’ll cover some of the more common reasons we see at our clinic. In my experience, I rarely see women who meet all of the criteria for PCOS. I think of it more as a spectrum that many women are on. Some have only a few markers or even only one. Plenty of women have symptoms while others do not. Sometimes PCOS is due to insulin resistance, or estrogen dominance. Other times it’s influenced by elevated androgens or poor estrogen metabolism. If your fasting insulin is over 10 (in bloodwork), insulin resistance is at least one of the factors. If you have issues with facial hair or hormonal acne, there is likely an androgen imbalance. Other common markers are when LH is double FSH early in the cycle (in blood work) or when Antral Follicle count exceeds 15 follicles (guidelines are officially 20) per ovary. A clear sign is the “string of pearls” or polycystic looking (enlarged) ovaries. High AMH levels (due to high follicle count) can inhibit ovulation. Additionally, high estrogen levels can overshoot the LH surge from occurring and inhibit ovulation as well. This is just the tip of the iceberg. All that said, PCOS is fully manageable and with a few lifestyle changes and a tiny bit of supplementation, your cycle can become regular again. An important first step is to cut out processed sugars/carbs and purge use of household cleaning products and personal and cosmetic items containing estrogen mimicking chemicals….and there’s so much more you can do depending on your specific profile.

If you feel like you might have a mild to severe case of PCOS or are questioning a diagnosis based on something you read or were told by a physician, there is one sure way to find out… It's called the DUTCH test. It is the most comprehensive test to measure hormones levels and show how you’re metabolizing them. It covers estrogens, progesterone, androgens, cortisol, melatonin and so much more. We will be posting more information on the DUTCH test this week. You can also look forward to more posts on the causes of irregular cycles and strategies for improving cycle regulation. 

For more info on any of these topics, you can reach out to us personally at the Texas Center for Reproductive Acupuncture. We’d love to help!

Website: www.texasfertilityacupuncture.com

Phone number: 512.302.5600

Email: admin@texasfertilityacupuncture.com