How PCOS Affects Fertility and Natural Ways to Support Your Hormones for Conception
Starting Your Fertility Journey with PCOS
If you’ve been diagnosed with Polycystic Ovarian Syndrome (PCOS), or suspect you might have it, you’re likely feeling the weight of what that means for your fertility. PCOS is one of the most common reasons women struggle to conceive, affecting roughly 1 in 10 women of reproductive age. But here’s the truth I share with every patient: PCOS doesn’t have to keep you from getting pregnant.
I don’t often share personal stories, but when I was 20, I received a voicemail from my OB-GYN’s office telling me that I had PCOS and that I’d likely have a difficult time getting pregnant. I carried that message with me for years. It was heavy, and honestly, terrifying. If you’ve heard something similar, I want you to know: that isn’t the whole story.
Many women with PCOS go on to conceive naturally by addressing the underlying hormone imbalances and making a few targeted, sustainable changes to support their body.
Because PCOS is so much more than irregular periods or cysts on the ovaries. It’s a complex hormonal condition that affects how your body manages ovulation, insulin, and androgens (male hormones). Understanding what’s driving those imbalances is key to reclaiming your hormonal health and optimizing your fertility.
In this post, we’ll break down what PCOS really is, how it impacts your hormones and fertility, and the natural ways you can support your body on your journey to conception.
Understanding PCOS and Its Impact on Fertility
What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is a hormonal condition that affects how your ovaries function, specifically, how (and if) they release an egg each cycle. It’s one of the most common endocrine disorders in women of reproductive age, and also one of the most misunderstood.
The diagnosis of PCOS is based on the Rotterdam criteria, which means a woman must have at least two of the following three features:
Irregular or absent ovulation (leading to irregular or missing periods)
Elevated androgens, either seen on lab work or visible as symptoms like acne, excess facial/body hair, or hair thinning on the scalp
Polycystic ovarian appearance on ultrasound (ovaries with multiple small follicles, often described as a “string of pearls”)
Let’s be clear: you do not need to have cysts on your ovaries to be diagnosed with PCOS and having cysts alone doesn’t mean you have it. That’s why PCOS is considered a syndrome—it presents differently from one woman to the next.
What ties it all together is a pattern of hormonal imbalance that interferes with ovulation. And in many cases, there’s also insulin resistance, which drives excess androgen production and worsens symptoms. While not part of the official diagnostic criteria, insulin resistance is a key piece of the puzzle for many women and it can directly impact fertility.
Understanding your specific presentation of PCOS is essential. With the right support, it's absolutely possible to restore hormone balance, regulate cycles, and improve your chances of natural conception.
How PCOS Disrupts Ovulation
For ovulation to occur, your brain and ovaries need to communicate clearly. The brain sends signals via hormones like FSH (follicle-stimulating hormone) and LH (luteinizing hormone) to help an egg mature and eventually release each cycle. In PCOS, this communication gets scrambled. LH is often too high, FSH too low, and as a result, the ovary may not release an egg. This is why many women with PCOS experience irregular cycles.
And without consistent ovulation, pregnancy becomes more difficult (though not impossible), because if you’re not ovulating, there’s simply no egg present to be fertilized.
The good news? Regular ovulation can often be restored by identifying and addressing the underlying imbalances contributing to your PCOS picture.
The Missing Link: Insulin Resistance
One of the most overlooked pieces of the PCOS puzzle is insulin resistance. Insulin resistance means that your cells don’t respond efficiently to insulin, so your body produces more of it to compensate. Excess insulin can stimulate the ovaries to make more androgens, like testosterone, which in turn interferes with ovulation and worsens symptoms like acne and unwanted hair growth.
Not everyone with PCOS has insulin resistance, but for many, it’s a key driver of their symptoms and fertility struggles. But here’s the hopeful part: insulin sensitivity can improve significantly with targeted nutrition and lifestyle support.
Natural Ways to Support Hormonal Health with PCOS
If you’ve been told that managing PCOS requires medication or that fertility treatments are your only option, I want to offer a more hopeful message: your body has the capacity to heal, especially with the right foundations in place. Below are the five key areas I focus on with my PCOS clients to improve ovulation, reduce symptoms, and support natural conception.
1. Use Nutrition to Support Blood Sugar & Insulin
At the root of many PCOS symptoms like irregular cycles, acne, hair growth, weight changes, is insulin resistance.
Here’s how it works: when you eat, your body breaks down carbohydrates into glucose (blood sugar), which fuels your cells. Insulin is the hormone that helps your cells absorb that glucose for energy. But when your cells become less responsive to insulin, your pancreas produces even more to try to keep blood sugar balanced. This excess insulin can disrupt your hormone balance, leading to many of the symptoms associated with PCOS.
Supporting your blood sugar is key to managing insulin resistance and balancing your hormones. Here are some simple habits to try:
Prioritize protein, fiber, and healthy fats at every meal. This will help slow glucose absorption and prevent insulin spikes.
Limit added sugars and highly processed foods, which can cause rapid blood sugar swings and worsen insulin resistance.
Avoid skipping meals, especially breakfast. Consistent eating helps keep your blood sugar stable throughout the day.
Don’t think of this as restrictive dieting. Instead, it’s about giving your body steady, balanced fuel that supports balanced blood sugar levels.
2. Lean into PCOS Supportive Nutrients
Certain nutrients play a crucial role in restoring balance when managing PCOS and many women with PCOS are often deficient in these key players.
Inositol: This is a true game-changer for improving insulin sensitivity and supporting regular ovulation. The combination of myo-inositol and D-chiro-inositol (in a 40:1 ratio) works by mimicking insulin’s action, making it especially effective for women with PCOS who are trying to conceive.
Omega-3 Fatty Acids: Found in flaxseeds, walnuts, chia, and algae or fish oil, these anti-inflammatory fats support healthy hormone production and help reduce the chronic inflammation often seen with PCOS.
Vitamin D: This vitamin is essential for regulating menstrual cycles, improving egg quality, and enhancing insulin sensitivity. Since vitamin D deficiency is common in PCOS, optimizing your levels can have a significant impact on your fertility.
3. Manage Stress to Support Your Cycle
While PCOS is primarily a hormonal condition, it’s closely tied to your nervous system. Chronic stress elevates cortisol, which can worsen insulin resistance and disrupt ovulation — which is why supporting your nervous system is a non-negotiable.
Here’s how to support stress recovery:
Create gentle daily rituals that ground you, like walks in nature, breathwork, prayer, journaling, or a calming cup of tea before bedtime. It doesn’t need to be complicated. It just needs to work for you.
Prioritize 7 to 9 hours of truly restorative sleep, not just time in bed, but deep, nourishing rest.
If stress feels overwhelming, magnesium supplementation or calming herbs may be helpful—but always under professional guidance.
While stress may not cause PCOS, it can definitely amplify symptoms and make balancing hormones more difficult.
4. Consider Strategic Supplements & Herbal Support
There’s no magic pill for PCOS, but targeted supplementation can be a powerful tool when used thoughtfully alongside lifestyle changes.
Vitex (Chaste Tree Berry): Known for supporting progesterone production and promoting cycle regularity, Vitex can be especially helpful for women with long or irregular cycles.
Maca Root: An adaptogen that enhances hormonal resilience, boosts energy, and supports libido, offering broad support for your cycle and nervous system.
Berberine: A plant-based compound shown to improve insulin sensitivity, similar in effect to metformin. Berberine can be particularly helpful for those experiencing the metabolic symptoms of PCOS.
5. Move Your Body (But Don’t Overdo It)
Exercise is critical for improving insulin sensitivity, supporting ovulation, and regulating cycles; but when it comes to PCOS, more isn’t always better. Excessive high-intensity workouts, especially without adequate rest, can increase cortisol and add stress to your already strained system.
Here’s what I suggest:
Aim for consistent, moderate movement such as walking, cycling, strength training or Pilates.
Prioritize consistency over intensity. Even 20 minutes of gentle daily movement can support your hormones in meaningful ways.
Listen to your body. If you’re feeling wiped out, anxious, or notice your cycles worsening with intense exercise, it’s okay—actually, it’s important—to slow down and focus on recovery.
When to Seek Professional Help for PCOS and Fertility
Lifestyle changes are powerful, but they’re not always enough on their own—and you shouldn’t have to guess your way through this journey. If you’ve already cleaned up your diet, supported your sleep and stress, and added in targeted supplements, but still aren’t seeing the symptom improvements or fertility outcomes you’re hoping for, it may be time to go deeper.
Here are some signs it’s worth reaching out for more personalized support:
You’ve been trying to conceive for over 12 months (or over 6 months if you’re 35+)
Your cycles are irregular, painful, or unpredictable
You’ve been diagnosed with (or suspect) PCOS, hypothyroidism, endometriosis, or another hormone-related condition
You’re overwhelmed by conflicting advice and just want a clear, targeted plan
The bottom line is that a PCOS diagnosis does not equal infertility. If you take anything from this article, I hope it’s the knowledge that with the right approach, it’s entirely possible to restore hormonal balance and conceive naturally.
And if you’re thinking, “That sounds great, but … complicated.” Let me help you. Schedule a free discovery call to get started.
