E280: PCOS Doesn't Have To Negatively Affect Your Fertility - With Dr. Angela Potter

You can have zero cysts on your ovaries and still be diagnosed with PCOS. Wild, right? But that's exactly how loose this diagnosis really is.

I sat down for this episode with Dr. Angela Potter, a PCOS and fertility specialist who works with women every day who hear the exact same thing I hear all the time: "Your labs are fine, here's Clomid, good luck."

If you've been told you have PCOS, you've wondered if you might, or you've just been collecting random symptoms for years with nobody connecting the dots, this one's for you.

Here's a glimpse of what we get into:

• Why PCOS can look completely different from one woman to the next, and why "one path for everyone" was never going to work
• The "biological safety" signal your brain sends to your ovaries, and the everyday things that might be quietly sending the opposite signal
• Why "your labs are fine" doesn't mean nothing's going on, and what that conversation usually misses
• Why "just go low carb" is some of the most common PCOS advice out there, and why it can backfire
• What egg quality really has to do with timing, and why that matters before jumping into a medicated cycle

PCOS stands for polycystic ovarian syndrome, and the name is a little misleading. You don't actually need cysts on your ovaries to have it. Doctors look at three things, called the Rotterdam criteria: ovulation issues, elevated androgens like testosterone (which can show up as acne, extra hair growth, or stubborn weight around your belly), and cysts on the ovaries. Two out of three of those, and that's your diagnosis.

Here's where it gets interesting. Because PCOS is a syndrome and not one specific thing, three women can both technically "have PCOS" and look completely different. One might be dealing with insulin issues. Another might have an adrenal driver. Another might be dealing with inflammation. And yet the standard medical playbook treats all of these women the same way: a few rounds of ovulation induction medication, and if that doesn't work, on to IVF.

Dr. Potter put it so well. She said the fertility algorithm for PCOS is linear, basically one path for everyone, and that path doesn't account for the fact that your PCOS and my PCOS could be driven by completely different things. No wonder so many women feel like the system is failing them. Because in a lot of ways, it is.

So we went deeper into something I talk about all the time, which is that your hormones are never the whole story. Your estrogen and testosterone aren't just randomly out of whack for no reason. There's something underneath creating that picture, and a huge piece of it comes down to whether or not your body feels safe.

Your brain is constantly scanning for threats, the same way it would have hundreds of thousands of years ago. If your body senses there isn't enough food coming in, or your blood sugar is all over the place, or your nervous system is stuck in stress mode, your brain's response is to shut down ovulation. Not because it's broken. Because it's trying to protect you.

This is why so many women with PCOS get told to "just go low carb" or "just lose weight," and then feel even worse, or stay completely stuck. If your body is already in a stress response, restricting food sends an even louder signal that things aren't safe. The research doesn't actually back up low carb as the magic fix for PCOS, but it's everywhere, so women try it, it doesn't work, and then they think something is wrong with them. The advice was never built for your specific body in the first place.

We also got into what happens when someone's told to do a medicated cycle without addressing any of this first. Your body might be saying "not safe to ovulate" for a real reason, and a medication can override that signal for one cycle, but it doesn't change the underlying picture. Dr. Potter talked about egg quality and how it takes about 90 days to develop a healthy egg. So if you go into a medicated cycle without those building blocks in place, you're already starting from behind. This isn't an anti-medication conversation. It's about giving your body what it needs first, so that if medication is part of your path, you're working with your body instead of against it.

By the end of this conversation, so many things clicked into place for me, even with everything I already know about hormones. 

Grab your coffee, hit play, and let's get into it together.

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Disclaimer: Nothing in this podcast is to be taken as medical advice, please take informed accountability and speak to your provider before making changes to your health routine.

This podcast is for women and moms to learn how to balance hormones naturally in motherhood, to have pain-free periods, increased fertility, to decrease PMS mood swings, and to increase energy without restrictive diet plans. You'll learn how to balance blood sugar, increase progesterone naturally, understand the root cause of estrogen dominance, irregular periods, PCOS, insulin resistance, hormonal acne, post birth-control syndrome, and conceive naturally. We use a pro-metabolic, whole food, root cause approach to functional women's health and focus on truly holistic health and mind-body connection.

If you listen to any of the following shows, we're sure you'll like ours too! 
Pursuit of Wellness with Mari Llewellyn, Culture Apothecary with Alex Clark, Found My Fitness with Rhonda Patrick, Just Ingredients Podcast, Wellness Mama, The Dr Josh Axe Show, Are You Menstrual Podcast, The Model Health Show, Grounded Wellness By Primally Pure, Be Well By Kelly Leveque, The Freely Rooted Podcast with Kori Meloy, Simple Farmhouse Life with Lisa Bass

Transcript

00:00:00 Leisha
Hey, welcome back to the Happily Hormonal Podcast.
00:00:02 Leisha
I have a special guest today, Dr.
00:00:05 Leisha
Angela Potter, and we are gonna be doing a pretty deep dive into PCOS and fertility, which are things that we haven't talked about a lot recently on the podcast, so I'm really excited for this.
00:00:14 Leisha
Dr.
00:00:15 Leisha
Potter, I would love to have you just give us a little snapshot into who you are, maybe some things that you love, and how you got started in this work.
00:00:23 Angela
Hello, thank you so much for having me.
00:00:26 Angela
And yeah, I work with women who are struggling, feeling like their bodies are broken and not doing the one thing that they're supposed to be able to do as a woman and who want to get pregnant.
00:00:41 Angela
I help them to signal biological safety in their bodies so that they are having regular cycles and ready for
00:00:50 Angela
increasing their family.
00:00:51 Angela
Things I love are food.
00:00:54 Angela
I honestly love going out to eat at restaurants.
00:00:58 Angela
I was a nutritionist before becoming a doctor and food just brings a lot of joy.
00:01:03 Angela
It's a big foundation of the work that I do with my patients and clients.
00:01:07 Angela
And let's see, your question had three parts to it.
00:01:10 Angela
What was the third part?
00:01:12 Leisha
Oh, just how you got started in this work.
00:01:13 Leisha
I also love food, so we're already going to be besties.
00:01:16 Angela
I love that.
00:01:17 Angela
Good.
00:01:18 Angela
I was working in general women's health and more and more women were coming into my practice who had PCOS, were trying to get pregnant, and they were being told from their doctors like, well, you know, your labs look fine.
00:01:34 Angela
I don't really know why these medicated cycles didn't work for you.
00:01:37 Angela
IVF is the only answer.
00:01:39 Angela
Otherwise I can't tell you anything.
00:01:41 Angela
And so they would show up to work with me asking like, is this true or are there
00:01:46 Angela
things I can do.
00:01:47 Angela
And we started working on nutritional foundations and then uncovering what was going on in their labs.
00:01:53 Angela
And these women, they were starting to ovulate.
00:01:55 Angela
They were starting to get regular cycles and get pregnant naturally.
00:01:58 Angela
And so that's just what led me into this work, realizing how many women are struggling with this.
00:02:05 Angela
PCOS is the number one cause of female infertility right now.
00:02:11 Angela
And so many women are, you know, that's hundreds and thousands
00:02:16 Angela
And they're being told that everything's normal and fine in their bodies when it's not.
00:02:22 Angela
They're sitting there in their doctor's office with losing their hair, having acne when they're 33, not being able to lose weight and certainly not being able to get pregnant.
00:02:32 Angela
So how can doctors be telling their patients that everything's fine is beyond me.
00:02:38 Angela
And that's, I just, I can't not be here with these women, honestly.
00:02:44 Angela
And that's why I created the fertile
00:02:46 Angela
PCOS clinical blueprint and why I'm here today.
00:02:49 Leisha
I love that.
00:02:50 Leisha
That's really similar to why I work with women on hormones as well is because I think we've all been there.
00:02:56 Leisha
We've been in that doctor's office where they're like, you're fine.
00:02:58 Leisha
And you're like, but I'm telling you that I'm actually not fine.
00:03:02 Leisha
And we're just being told like, I guess just being a woman is terrible or you're just aging.
00:03:07 Leisha
And it's like, I'm 30, you're just getting older.
00:03:09 Leisha
It's like, well, I'm not 60.
00:03:11 Leisha
I'm not 50.
00:03:13 Leisha
Yes.
00:03:13 Leisha
Maybe some of these things would make sense at that point.
00:03:15 Leisha
But just because I'm
00:03:16 Leisha
not 20 doesn't mean I'm aged out of fertility, right?
00:03:20 Leisha
Yeah, so I love that perspective.
00:03:21 Leisha
I would love to just, for everyone here, honestly, I would love to have an expert really break down what is PCOS.
00:03:28 Leisha
We can talk about clinically, we can talk about symptoms, but for those people who have been diagnosed and they don't really still quite understand what it means for them, but also for the people who are like, I've always wondered.
00:03:39 Angela
Yeah, great question.
00:03:40 Angela
So PCOS, it stands for polycystic ovarian syndrome.
00:03:44 Angela
First thing off the bat is that in kind of layman's terms, that means multiple cysts on the ovaries, but you don't have to have cysts on your ovaries in order to have PCOS.
00:03:56 Angela
So when we diagnose it clinically,
00:03:58 Angela
There are three pillars that we look at as doctors.
00:04:02 Angela
It's the Rotterdam criteria.
00:04:04 Angela
That's the most common criteria that's being used right now.
00:04:08 Angela
And that looks at ovulation issues.
00:04:10 Angela
So whether that's looking at lab work through progesterone or an ultrasound, looking at the ovaries, or just looking at the fact that you're having irregular cycles or no cycles at all.
00:04:23 Angela
Pillar number two would be elevated androgens like testosterone.
00:04:26 Angela
So we look at that on labs or somebody who could be having symptoms.
00:04:31 Angela
Some doctors just diagnose it based off of symptoms, and that would be symptoms like having acne, growing hair where you don't wanna have hair, like on the chin, the upper back, the lower belly, places like that.
00:04:45 Angela
And really holding onto extra weight around the belly area.
00:04:49 Angela
So those are the classic testosterone signs.
00:04:51 Angela
And then of course,
00:04:52 Angela
ovulation because testosterone shuts down ovulation.
00:04:56 Angela
And then that third pillar is having cysts on the ovaries.
00:05:01 Angela
So those are the three diagnostic pillars.
00:05:03 Angela
But as a clinician, what we do is we say, okay, does this person in front of us fall into two out of three of those pillars?
00:05:13 Angela
If yes, then they're diagnosed with PCOS.
00:05:17 Angela
So the top symptoms with PCLS is going to be with the menstrual cycle.
00:05:23 Angela
A lot of women, that's what leads them into going into their doctor.
00:05:27 Angela
So having irregular cycles or absent cycles.
00:05:31 Angela
PCOS doesn't affect just the menstrual cycle, and it's not just affecting the body in this time period of reproduction.
00:05:40 Angela
Women who are in their teens have issues with PCOS.
00:05:45 Angela
Women who are going through perimenopause and menopause have some different considerations that they want to look at with PCOS.
00:05:52 Angela
But I would say the strongest symptoms are really when a woman is trying to get pregnant because she's most into
00:06:01 Angela
what her body is saying.
00:06:02 Angela
And then those other top symptoms are going to be the acne, weight gain, that unexplained weight gain and things like losing hair can happen.
00:06:15 Angela
So that's what it looks like from this clinical perspective and getting a diagnosis.
00:06:21 Leisha
That definitely all makes sense.
00:06:23 Leisha
And I think that because it is a syndrome and because you do have these three pillars, it's like, it feels ambiguous.
00:06:29 Leisha
It's hard to
00:06:31 Leisha
pin it down a lot of the time.
00:06:33 Leisha
And I also think that, in my opinion anyway, it can be a misconception that PCOS is all the same because someone's like, oh, well, I have PCOS, but this is totally different than that girl over there who has PCOS.
00:06:47 Leisha
But sometimes it can be, I think that everyone gets lumped together because it's the syndrome, but then it's like such a broad syndrome that,
00:06:56 Leisha
You can't lump people together.
00:06:57 Angela
You absolutely just nailed that right on the head there because that's exactly what's happening.
00:07:05 Angela
In conventional medicine, we have algorithms for treatments of any condition, any disease process, and the fertility algorithm for PCLS is linear.
00:07:17 Angela
It's just a one path straightforward process, and that includes three to five cycles of medications, so either
00:07:27 Angela
those are the ovulation induction medications.
00:07:30 Angela
And then if those don't work, being moved forward to IVF.
00:07:34 Angela
And that is not taking into consideration that the diagnosis alone tells us that different women with PCOS are going to have different symptoms.
00:07:46 Angela
They're going to have different drivers of what is creating their PCOS symptoms and ultimately their fertility struggles.
00:07:54 Angela
So why in the world would we think
00:07:56 Angela
that one treatment plan would work for all these women, I have no idea.
00:08:03 Angela
And that's ultimately why conventional medicine is dropping these women with PCOS and honestly why the treatment rates are so low and leaving these women just feeling
00:08:17 Angela
unfortunately, leaving them feeling like it's their own body's fault.
00:08:21 Angela
When it's not, it's the system's fault.
00:08:24 Angela
It's the fact that we are looking at them just from this blanket sort of perspective.
00:08:30 Leisha
So this is just what's coming to mind for me.
00:08:32 Leisha
I had some other directions I wanted to go, but I'm gonna start with this.
00:08:36 Leisha
So when you have a diagnosis of PCOS, when we're going deeper into PCOS, like the symptoms that you just mentioned, these are all like the tip of the iceberg, right?
00:08:45 Leisha
It's okay, we have irregular cycles, we're not
00:08:47 Leisha
We have acne.
00:08:48 Leisha
Yes, all of those things can be the case.
00:08:52 Leisha
But something that you talk about and I also talk about a lot is these are signs that the body is not feeling safe on an underlying level.
00:09:00 Leisha
So can you get into more of the metabolic and just safety routes that are causing PCOS symptoms to show up?
00:09:07 Leisha
Because I think that a huge misconception that I talk about all the time is that these hormone issues are their own issue.
00:09:12 Leisha
They're absolutely not.
00:09:14 Leisha
I find that this hormone symptoms are just the
00:09:17 Leisha
way that it's showing up in the body, but it's never just its own thing.
00:09:20 Leisha
It's not like, oh, it's just your estrogen and testosterone.
00:09:23 Leisha
And all we have to do is fix those.
00:09:25 Leisha
But there is a reason that your estrogen and testosterone are a mess.
00:09:29 Angela
Yeah.
00:09:29 Angela
And particularly with PCOS, because it is a syndrome, so it's not just one particular process that's creating ovulation issues.
00:09:38 Angela
No, it could start in the brain, it could be in the adrenals, it could be with insulin levels.
00:09:42 Angela
We just don't know.
00:09:44 Angela
And so what's happening with PCOS first line, you get diagnosed, right?
00:09:48 Angela
Looking at those three clinical pillars that I explained.
00:09:52 Angela
Second line in my work is figuring out the PCOS driver that's essentially driving the symptoms.
00:10:00 Angela
Okay.
00:10:01 Angela
What is that root cause that's creating then the acne?
00:10:06 Angela
What is it that's creating the 95 day cycle?
00:10:10 Angela
And we've got to take that step back to find that driver because the driver, is that an adrenal driver?
00:10:19 Angela
Is that inflammatory?
00:10:21 Angela
Is it
00:10:21 Angela
an insulin based driver, because when in one of those, let's talk about insulin.
00:10:28 Angela
If it's insulin based, meaning someone has insulin sensitivity, they're not able to use the insulin in their body.
00:10:35 Angela
They're in the glucose from the food that they're eating is not being able to go into the cells.
00:10:41 Angela
That ultimately is creating this red alert sign in the brain that's saying alert, alert, there's an issue
00:10:52 Angela
And we know that the brain reacts to stressors the same way now as it did hundreds of thousands of years ago.
00:11:00 Angela
And so even if you had breakfast this morning and you've got your lunch packed in your office,
00:11:08 Angela
you have food in front of you, if your body can't be utilizing the insulin to get that glucose into the cells and to use your stored insulin, then that creates this red alert signal to the brain that's going to shut down ovulation because the brain wants your body to be safe.
00:11:29 Angela
And so it's going to think, oh my gosh, we're in famine mode.
00:11:32 Angela
So I need to shut down ovulation so then I can make sure that the cardiovascular
00:11:37 Angela
system can work properly so that the muscles have enough blood flow to them so this person can run if there is a stressful situation.
00:11:47 Angela
And it says we are a no go for ovulation for now.
00:11:52 Angela
And so it's all about figuring out what that signal is that's sending to the brain that's saying, nope, this is a veto on ovulation and then shifting that person's system
00:12:07 Angela
To create that biological safety.
00:12:10 Angela
So then the signals going to the brain are those that it's like, yeah, we're good.
00:12:16 Angela
We're using our insulin just as we are supposed to be, and we have plenty of food coming in.
00:12:21 Angela
So then that brain goes, okay, green light for ovulation because I've got lots of resources in my body.
00:12:28 Angela
I don't notice any red lights, and so I'm okay to turn on the ovulation green light now, and that's a process.
00:12:38 Angela
And honestly, it takes time.
00:12:41 Angela
And you probably talk about this a lot, but when we're working on fundamentally changing the physiology of the body to create this safety, to create this green light to ovulation naturally, it's not a light switch.
00:12:57 Angela
It's not that we have one
00:12:59 Angela
pill or one lifestyle change that's going to just automatically make these changes.
00:13:07 Angela
And in this world, our medical system puts that into our brains, that one pill is going to solve your one problem.
00:13:18 Angela
And so as a culture, we fall into that trap.
00:13:22 Angela
But when you're looking for not just
00:13:25 Angela
having a baby, when you're also looking for health and vitality and vibrancy, you have to understand that it takes some time for the physiology to shift.
00:13:35 Angela
Is it possible?
00:13:36 Angela
Absolutely.
00:13:38 Leisha
Okay, so that kind of brings me back to, again, this fundamental safety in the body.
00:13:43 Leisha
So let's talk about when someone has PCOS, they're not ovulating because their body's like things are not safe, there's an insulin issue, there's a gut issue, there's inflammation of some sort, there's undereating,
00:13:55 Leisha
whatever it is, under nourishment.
00:13:57 Leisha
And the doctor says, okay, go ahead and do Clomid.
00:13:59 Leisha
So your body is saying it's not safe to ovulate.
00:14:03 Leisha
It's doing that for a reason.
00:14:04 Leisha
And then you take medication to force yourself to ovulate.
00:14:09 Leisha
I love to talk about the metabolic expense of that and even potentially clearly you can do that and still have a pretty healthy pregnancy.
00:14:17 Leisha
I think our...
00:14:19 Leisha
probably our standard as a culture of what a healthy pregnancy is low anyway, but I'd love to just hear your thoughts on that because we're forcing our body to do something, override the safety checkpoint essentially.
00:14:31 Leisha
What do you see there?
00:14:32 Angela
Yeah, I think that's a really good question and something that I talk about a lot.
00:14:37 Angela
I want to preface it by saying that if for the listener, if you're in a position where you've done medicated cycles or you're currently in a medicated cycle, this is not to say you shouldn't be doing it or anything like that.
00:14:52 Angela
I don't come from an anti-medication standpoint.
00:14:56 Angela
Medication is a very
00:14:58 Angela
wonderful tool for many, many families because we do know that it works in some instances and that's great, but the underlying premise of your question is, but what advantage is taking a medication in one cycle when your body's saying no?
00:15:15 Angela
And that is an issue because when you are forcing that ovulation for this one cycle and you haven't had a period in the last, you know, 75
00:15:28 Angela
or maybe six months to two years.
00:15:33 Angela
And the doctor that you're working with is under that assumption that the medicated cycle is the only next step forward.
00:15:41 Angela
What is being forgotten there is egg quality for one.
00:15:46 Angela
We know that egg quality takes at the very least 90 days to develop a high functioning, healthy egg that has the proper amount of chromosomes that are ready to go make a baby.
00:16:02 Angela
So if you're showing up to a medicated cycle without those building blocks to support egg quality, we already know that going into that medicated cycle, your chances are low because you don't have that, literally those building blocks that the egg requires for growth just aren't there.
00:16:25 Angela
Or perhaps there's too much oxidative stress happening in the follicular fluid, and so
00:16:32 Angela
There are too many oxidative markers and not enough antioxidants to support that fluid for the mitochondrial health of that egg.
00:16:42 Angela
So then going into that cycle, you already know that your chances are lower than if you were to first take a step back, understand that, that metabolic driver and understand what is it that's actually leading to the, you not being able to ovulate
00:17:02 Angela
or you not being able to have a full term pregnancy, understanding where that's coming from, supporting that process.
00:17:12 Angela
And at that point, maybe medication is needed because sometimes for PCOS, ovulation, it can be sticky and medication can help just get that last push for the egg to come out of the ovary.
00:17:27 Angela
But imagine how different of a scenario that is when you've done this work to support those building blocks of the body to understand your metabolic driver and to reverse that or to be supporting that and then go into a medication.
00:17:42 Angela
That's a completely different situation than just going in and not having any of that background either assessed or supported.
00:17:53 Leisha
I love that answer.
00:17:54 Leisha
I think that was very, just very well thought out.
00:17:57 Leisha
And I also think of women who would come to a doctor who is more traditional with their PCOS approach.
00:18:05 Leisha
And I say this all the time, I'm not anti-doctor, I'm not anti-medication by any means.
00:18:10 Leisha
What I am anti is women going to a doctor with so much hope and then they just get this like bandaid solution, bandaid response, this one-size-fits-all response that doesn't actually fit most people.
00:18:22 Leisha
Another thing that I hear a lot with women who have PCOS is they go to the doctor and they say, Well, you're stressed and you need to lose weight.
00:18:29 Leisha
Okay, and so these women, most of the women that I work with anyway are moms and they are undernourishing, whether they're under eating or not,
00:18:39 Leisha
Most of them are, to be honest, but they're undernourishing.
00:18:42 Leisha
And it comes from a place of growing up with restriction, wanting to not be overweight.
00:18:48 Leisha
And then a lot of times, if they are at a place where they're not comfortable with their weight, again, it's just so painful to go to the doctor and then be like, oh, it's your fault.
00:18:55 Leisha
You just need to lose weight.
00:18:56 Leisha
And it's like, then they cut calories, then they cut nutrients, whatever those nutrients are, and their metabolism slows even more.
00:19:05 Leisha
It just ramps up the metabolism issues, the thyroid issues, probably the insulin
00:19:09 Leisha
as well.
00:19:10 Leisha
And then the doctor says, do Cloma, do IVF?
00:19:13 Leisha
And it's like they're just hitting the gas on an empty tank.
00:19:17 Leisha
And so I just think that's so important for women to understand that's what's happening in the more traditional.
00:19:24 Leisha
Again, I think there are so many doctors out there who are probably doing way better than this, but this is what I hear a lot.
00:19:29 Leisha
So that traditional care model.
00:19:31 Leisha
And so I hope that if you're listening and you're like, oh wow, that sounds really familiar, you're hearing that there really are ways to restore your safety in your body and your metabolism so that you have the energy and the reserves to be able to accomplish a pregnancy or achieve a pregnancy that's actually healthier.
00:19:50 Leisha
Because exactly what you're saying, you have this foundation of nutrients, you have this foundation of your nervous
00:19:54 Leisha
the system being a little bit more regulated, safety in the body in general, and then maybe you do need medicine to just kick over the can with ovulation, but then you have the foundation for a healthy pregnancy instead of being already in a depleted state, because for pregnancy, your body will take everything it can for that baby, but there may not be enough for both of you and there may not be enough for either one of you, and then we see this baby that you've wanted for so long,
00:20:22 Leisha
then the baby maybe doesn't have, I'm not speaking health issues over any babies by any means, but maybe that's where we get into this picture of like chronic disease in our kiddos where we have tongue ties, we have feeding issues, we have chronic stress in their little bodies because we're carrying this stress in our bodies and just this undernourishment picture that
00:20:43 Leisha
I think can just be changed so much with these foundations in place.
00:20:47 Leisha
So I'm just echoing what you're saying of I know if you've been trying to get pregnant for any amount of time, to be honest, even one month, you want it to happen now and it's really hard to wait and these foundations could get you the result you actually want instead of just this additional cascade of stress.
00:21:08 Angela
And speaking to that nourishment piece, of course, any one of us who brings a baby into this world, we want to set our kids up for the best, right?
00:21:18 Angela
Just from the very beginning.
00:21:20 Angela
So for someone who's in that space of still trying to get pregnant and who has PCOS, not just for PCOS, for any type of fertility, there's so much information out there about diet and fertility.
00:21:34 Angela
And a lot of it is really triggering for people.
00:21:37 Angela
A lot of it is still very much based on that restrictive sort of mentality by cutting calories, focusing on those lower nutrient foods for calories
00:21:50 Angela
like breakfast bars or cereals, what have you.
00:21:53 Angela
And yeah, and that's those kinds of restrictive diets.
00:21:57 Angela
So one actually is that if you want to be seeing these results, it's not your fault that you feel muddled and don't know which direction to go and are feeling like your fertility is still stalled.
00:22:10 Angela
Even if you've tried this amount of different diets that you've heard about, it's that those diets or nutrition changes that you've been making haven't been addressing
00:22:20 Angela
specific PCOS driver.
00:22:23 Angela
And that's the ticket is that you absolutely have to figure out why and what is driving your PCOS to then get that nourishment piece that actually protects the body and nourishes it and sets the body up for having the eggs that are ready to ovulate for having the foundational nutrition pieces together for just basic hormones.
00:22:50 Angela
like progesterone.
00:22:51 Angela
Progesterone is classically low and having that nutritional structure underneath can help push that progesterone to be what it's supposed to be to lead to a successful pregnancy.
00:23:04 Leisha
I know another kind of like across the board bandaid piece of advice that I hear for PCOS is that you need to go either low carb or lower carb.
00:23:15 Leisha
And I would love to just hear your perspective on that because we've already established
00:23:19 Leisha
there's not necessarily always an insulin issue, but even if there is, where do you see that go right or wrong?
00:23:27 Angela
So 2 important points that you just made.
00:23:29 Angela
One, not everyone with PCOS has insulin issues.
00:23:33 Angela
And 2, just the fact that low carb is marketed as the number one way to lower blood sugar levels and to support fertility.
00:23:45 Angela
When the science doesn't back that up, we
00:23:49 Angela
have really good research for far longer about the benefits of things like whole grains, fiber to support that insulin sensitivity, to support blood sugar levels to come down.
00:24:05 Angela
And looking even wider than that, this concept of low carb and restriction that we've had in our culture for a very long time, it creates that biological
00:24:19 Angela
response because it puts your body into that space of not feeling safe in the sense of if you have to restrict some foods, it creates alarm signals, usually in your adrenal glands of extra stress, extra cortisol being released because it's
00:24:40 Angela
the body wants that food, it wants those calories, it needs the sugar to survive.
00:24:46 Angela
And yet when you're taking those foods away, then that's creating this trigger to the brain to say, okay, oh my gosh, this person is restricting food.
00:24:58 Angela
And so there must be a famine around, so I need to shut down ovulation.
00:25:02 Angela
And it just creates this whole other cascade that maybe people don't quite realize because all of the information
00:25:09 Angela
internet or on TV shows, wherever is all about, no, low carb is the best and it's the one way and it's, oh yeah, I'm trying low carb, but it's not working.
00:25:19 Angela
Well, that's because low carb for you is creating these signals to the brain for the brain to say, this is not safe.
00:25:26 Angela
I can't turn on ovulation.
00:25:28 Angela
I am going to restrict it for now.
00:25:31 Angela
And so you've got to then figure out that piece to what kind of nourishment is perfect for your body to create those
00:25:40 Angela
signals to the brain to say, yep, green light, let's go for ovulation.
00:25:44 Leisha
Yeah, I love all of that so much.
00:25:46 Leisha
It just definitely resonates with me and it's exactly how I approach things as well.
00:25:50 Leisha
So I think that the biggest thing that I'm taking away is with all of this PCOS related, that
00:25:59 Leisha
no matter, to be honest, if you have PCOS or just other hormone issues, not that the other hormone issues are just, but like you don't even have PCOS, all of this still applies to you because we still need those foundations of safety.
00:26:13 Leisha
We still need those foundations of nourishment.
00:26:15 Leisha
And I would say the vast majority of women that I work with, and maybe not the vast majority of women, but only the ones with hormone problems, which I still think is a lot of them.
00:26:24 Leisha
come from this place of kind of some misinformation, a lot of misinformation being fed to us and this mindset that restriction is the way to
00:26:35 Leisha
to health essentially, whether that's restricting activities, restricting foods, restricting whatever it is.
00:26:41 Leisha
And I think it comes back to this root of just wanting to have control wherever we can.
00:26:45 Leisha
And that's where all of the eating disorders that many people have gone through come from too, is like this need for control.
00:26:52 Leisha
But when we see this clinical picture of irregular ovulation, not being able to get pregnant,
00:26:59 Leisha
not feeling good.
00:27:00 Leisha
Most of the time PCOS comes along with PMS symptoms, painful periods.
00:27:05 Leisha
There's lots of other things that come along with that.
00:27:07 Leisha
We see all these things and we somehow assume
00:27:12 Leisha
that we need to just have less coming in.
00:27:15 Leisha
We need to make ourselves smaller.
00:27:18 Leisha
And really I think that being able to shift our mindset where it's more expansive, where it's like maybe actually I do deserve to have the nutrients for a full adult woman and not like a 10 year old, right?
00:27:28 Leisha
Or I deserve to have more resources and not just one answer.
00:27:33 Leisha
I think that that kind of mindset shift allows for
00:27:38 Leisha
expansion where your body can start to feel safe and can start to send those signals of safety from your brain to your ovaries and say, hey, actually would be fine if you wanna try ovulating.
00:27:48 Leisha
We've got enough here, I've got your back.
00:27:50 Leisha
The other thing I was just gonna say in that whole picture is when we've had issues with restrictive eating, body image issues, so many women that I work with have been on birth control for a short time to a long time that have turned off these signals with medication over and over again.
00:28:06 Leisha
Again, they are going to take time to shift those things, but they can shift.
00:28:10 Leisha
They were meant to be able to do this.
00:28:12 Leisha
And so even if you haven't quite gotten there yet, there are so many resources and I'm hearing you just go so many other things that I say that you're not telling me you have the fanciest plan in the world with 150 supplements and I'm sure you do supplements, I know you do lab testing, I do those things too, but you have not led with those.
00:28:33 Leisha
You're like, we need to make the foundations firm first.
00:28:37 Leisha
And I just see that work so much more of the time.
00:28:40 Leisha
And so if, again, just for those listening, if you've been even to a functional doctor for PCOS and their answer is myo-inositol, maybe DIM, maybe some sort of testosterone supplement, some supplement for androgens to calm those down.
00:28:56 Leisha
and then like kind of a cut and paste diet, and that hasn't worked for you, there are other options that probably would work a lot better.
00:29:05 Leisha
So if you have anything you wanna speak to there, I'd love to hear it.
00:29:08 Angela
Yeah, I love what you just said.
00:29:10 Angela
And also to the person listening, if you've tried one of those kind of cookie cutter approaches, even if it was with a functional medicine doctor, so you thought, oh, this should be what works.
00:29:21 Angela
With PCOS cookie cutter approaches, they don't work because inherently your body doesn't fit into a box.
00:29:29 Angela
And if you've tried something like that and it hasn't worked, it's not because your body is broken.
00:29:34 Angela
It's not because your body can't work the way it's supposed to.
00:29:39 Angela
It's just that you haven't gotten those missing pieces of your biology figured out yet.
00:29:46 Angela
And it's absolutely possible.
00:29:48 Angela
It's possible to start seeing regular cycles
00:29:51 Angela
ovulation, and to even get pregnant naturally.
00:29:55 Angela
You just have to understand how those pieces go together.
00:29:59 Leisha
Okay, so all of this has been so good.
00:30:02 Leisha
I know if you are listening and you're like, I have PCOS.
00:30:06 Leisha
and or struggling with fertility, you're going to want to find more resources from Dr.
00:30:10 Leisha
Potter.
00:30:10 Leisha
Where's your favorite place for people to find you and start to get into your world more?
00:30:14 Angela
So I have my own podcast, the PCOS lab, and that's where I talk even more about this biological safety and how to turn on that green light for ovulation.
00:30:25 Angela
And if you want to know how, what is, or get the first step to figuring out what your trigger is, what your PCOS driver is, is it
00:30:35 Angela
inflammatory adrenal, insulin.
00:30:38 Angela
I have an assessment, an ovarian assessment that will help you figure out what's your primary driver.
00:30:44 Angela
So you can get started there.
00:30:45 Angela
I'll send you the link to that for the listeners.
00:30:48 Leisha
Perfect.
00:30:48 Leisha
We'll take that.
00:30:50 Leisha
Okay.
00:30:50 Leisha
Thank you so much, Dr.
00:30:51 Leisha
Potter.
00:30:51 Leisha
This has been really good.
00:30:52 Leisha
I've enjoyed it.
00:30:53 Leisha
I hope everyone else has enjoyed it too.
00:30:55 Leisha
And we will talk to you soon.
00:30:57 Angela
Thank you, Alicia.
00:30:58 Angela
It's been a pleasure.