TTC Flow Chart - Back On The Metformin Wagon

I am fervently against the long-term use of drugs to control PCOS because I believe the best, safest, long-term way to manage it is through permanent positive lifestyle choices. Drugs work by chemically inducing the body into some semblance of normality, but they do not cure the underlying causes of the hormonal disruptions in the first place and so are not a cure for the condition.

That being said, a lot of women with PCOS need help with ovulation, myself included. I am not a metformin nazi. I am not saying women who take it should be lined up and shot for doing so. Under certain circumstances taking met can improve the chances of successful ovulation. In fact, taking metformin in conjunction with Clomid has been proven to increase the chances of ovulation while undergoing IUI treatment and that's fine with me. 

I am already doing a low GI diet, and ever since I started taking Met again, I've had to increase my carbohydrate intake because of the headaches (caused by low blood sugar). My met belly has also been mitigated somewhat by the fact that I forced it upon myself last year but had to stop after a few weeks because of the severe headaches, shakes, fatigue and weight gain. 

For the sake of doing everything within my power to conceive, and not having to go through 6 months of IUI in futility, I've decided to foist it upon myself again. 

The above flow chart has guided my decisions in my TTC journey. So far I've made the appropriate life style modifications. I may be ovulating but not releasing an egg (shocking contradiction there) because I know every month I get ovulation pains and exactly 14 days later, I get a period. My periods also come like clock work, with not so much as a 2ww delay-scare-fright-joy type glitch. I also know that I have one fully functioning tube. And that for the last two months I've been ovulation on my blocked side, arrrrgh!!!!

I also suspect that I may have mild endometreosis, although this has not been officially diagnosed. I believe it's sabotaging my body's attempts to ovulate. I believe it's what gives me an intense anal pain when I'm ovulating; so much so that I can't sit down and have to lie on my belly until it subsides. 

I didn't seriously consider remaining Metformin for ovulation because I was already doing the low GI diet diet/exercise which, for all intent and purpose, is equivalent to Met. In addition, the adverse reactions put me off. I thought to myself; if its about insulin resistance there are pain-free ways to forcing a particular drug on myself. This time around I know what to do while taking Met, how to maintain my blood sugar without any of the intestine-ripping effects. As a result it's so much better this time around. I can tolerate it with just a few extra teaspoons of sugar in my tea, which I'm gradually phasing out. 

My aim is to get my body used to it so that when I start my IUI in a couple of months hopefully, together with clomid I can ovulate and hopefully, conceive. 

Things I've Been Doing To Improve My PCOS Naturally

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If you've been following this blog you'll know that I'm more into natural ways of controlling PCOS than relying on pharmaceuticals like metformin and birth control pills. For me personally, my symptoms began to manifest after I'd decidedly taken on a lifestyle of ingesting large amounts of carbs and refined sugar with very little exercise (even though I was eating lots of fruits and veggies!).

It's been 1year since I started blogging about my journey through PCOS and infertility and I'd like to say there has been a great improvement in my condition. Just thought I'd share a list of things I have been doing consistently for almost  a year now.

1. Oats for breakfast. I have organic oats every morning for breakfast. To this I add 2 tablespoons of wheat bran, 2 tablespoons of wheat germ, 1 tablespoon of oat bran and I finish it off by sprinkling sunflower seeds or mixed seeds and muscovado sugar. I know I complained about oats but I've grown to love it so much so that if I don't have it for breakfast, I don't feel like I've eaten breakfast.

2. Flaxseed (linseed). Two table spoons per day. I will happily rant and rave about this because I noticed almost immediately when I started taking it that my PMS symptoms reduced dramatically. A lot of websites talk about linseed oil, but I personally prefer the whole seed to the powder or oil. To maximise the benefit  from eating it whole I first soften it by soaking in a glass of boiling water for about 1 hour without stirring, then drink the water and chew the seed which are by now crunchy and slimey... Yum!

3. Whole foods. That is foods that have not been processed or refined; foods that aren't pre cooked and packaged with use by dates. If I have to eat bread, it must be whole meal; if it's rice it has to be brown; etc. I also eat lots of plant protein (at least every other day).

4. Glass of warm lemon juice first thing in the morning. Or two tablespoons of vinegar diluted in a glass of water. I alternate between the two for variety's sake (sipped through a straw to avoid enamel corrosion).

5. I cook everything I eat. Except for maybe once a month when I treat myself to my favourite burger; lamb burger, Yum!! Even so I usually substitute the top bun for loads of salad.

6. Tea. Lots of tea... I guzzle it up by the cupfuls daily... I have them all, green tea, ginger tea, camomile tea, rooibus tea, assam tea, black tea, peppermint tea, spearmint tea, fenugreek tea. I've developed into a tea enthusiast and as I write this I have some new flavours in mind that I can't wait to try.

7. I'm not a full vegetarian and I will never be. But I eat lots of veggies and my primary source of aminal protein is mostly fish and prawns. I have meat once in a while.

8 Exercise. 30 mins to 1 hour every other day. I walk a lot too in-between, on days when I don't workout. AND I would like to attempt a 5K marathon this summer. Still plucking up the knowledge and training for that. (actually started training, sprained my ankle, limped around for a whole week and haven't started again)

9. I'm not into low fat diet. I personally don't believe in low fat diets for two reasons. Firstly, when I go low fat it makes me crave fatty foods even more, and secondly, I noticed that when I introduced healthy fats in my diet I began to lose weight again. Those oils are mostly sunflower, olive, coconut oil, palm oil and organic butter.

10. Yoghurt. Full fat yoghurt with my oats every morning, did this for several months. Initially I was afraid because of the hormones in milk and also the glycemic effect of milk but I've been doing it for a while now and there have been no untoward effects. However, these days I've switched from yoghurt to skimmed milk. Even more, I only take a couple of teaspoons with my tea daily.

11. I used to do expensive multi vitamins, but, having realized that with a healthy diet and more balanced hormones I could do without, I haven't bothered replacing the last batch that ran out. I would still recommend for those starting out. As time goes and you are more informed about what the body needs, you'll be able to acquire all the nutrients you need from food.

12. Cut out exposure to hormone/endocrine disrupters. These includes creams and any cosmetics with paraben, warming foods in plastics inside the microwave, canned foods, prepared foods in plastic covers, and non-stick cookware. Research has shown that exposure to PCB's commonly found in non-stick cook wares can lead to premature menopause. The use of BPA has been banned in baby bottles in several countries. Better to be safe than sorry I'd say. Besides, with PCOS our systems are already highly sensitive to the slightest hormonal changes, I think it's better to severely cut down or avoid these things entirely.

All these tips are a starting point, there are plenty more online, with a bit of research. What's most important is to find what works for you. Whenever you cut something out of your diet, or introduce something new, it's very important to monitor the effects it has on your body so you can eliminate foods that worsen your symptoms and know those that are 'good' for you.

After all said and done, I have started taking Metformin to improve my chances of success when I start my IUI in a couple of months. I am not taking it to manage my symptoms, and I've said numerous times on my blog that I don't recommend taking it on a long term basis to manage PCOS symptoms. Since it has been scientifically proven to improve the chances of ovulation in conjunction with Clomid (I'll explain in my next post) I figured I would do everything I can to boost my chances. But I do get preggers, it and I would immediately part ways again.

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The Doctors Don't Get It!

I watch Embarassing Bodies on Channel4 and in the last two weeks they've featured women with PCOS. Both of whom in addition to the classic symptoms suffered from extreme hirsutism. As usual the doctors told them the classical ways of dealing with their condition was putting them on Birth Control Pills (BCP) or prescribing Glucophage (the anti-diabetic drug also known as Metformin, commonly prescribed for women with Insulin Resistance related PCOS).

I was disappointed that there was not a single mention of lifestyle changes. Both of these women were obviously overweight. Yet the good doctors, after telling them there was no cure for PCOS, believed pumping them with drugs is the solution.

Neither BCP's or Metformin help PCOS by eliminating the cause of it. What they do is chemically suppress the symptoms. For instance, if you were having irregular periods taking BCPs makes you bleed every month but it hasn't really resolved the fact that you're getting irregular periods on your own due to hormonal imbalance. In other words, it doesn't correct the inherent hormonal imbalance that's causing irregular periods, hirsuitism, and all the other symptoms.

I just find it incredible that the medical profession overlooks the fact that permanent lifestyle changes have been proven to be the best way to tackle PCOS. By cutting out refined carbohydrates, sugar, eating fruits and vegetables and water and taking regular exercise can not only reverse ones symptoms but enable ovulation, conception and staves off long term complications that come with untreated PCOS such as type 2 diabetes, miscarriage, high blood pressure and heart disease.

If you have PCOS, you don't need to rely on drugs for the rest of your life. I've met women who have been taking Metformin for almost 20 years who are tired of taking it and are considering natural ways of dealing with the condition. Similarly, I have a type 2 diabetic friend who was taken off Metformin and started up on insulin injections because she refused to modify her lifetyle the Metformin was ineffective in suppressing her symptoms. Similarly, there are people out there who have cured themselves of type 1 and 2 diabetes.

I'm sick of the medical profession telling people there is no cure for things that clearly have a genesis. You don't develop these conditions overnight, there must be a precipitant. There must be something you are doing or not doing excessively that caused sufficient strain on your body for it to give up and let a condition manifest.

My advice to women with PCOS is this: if you are over weight lose the excess by adopting a healthy lifestyle. Never mind if you lose as little as a pound a month, don't give up. Losing small amounts of weight over a long period of time is more likely to be maintained than losing large amounts over a short period of time.

If you're trying to conceive, losing as little as 7% to 10% of your current weight is enough to kick start ovulation. Research the low Glycemic Index diet or the Insulin Resistance diet and try to exercise at least 30 minutes everyday, even if it's just to walk around your neighbourhood.

If you are not overweight (if you are a thin cyster) it's possible your body is severely lacking in certain micro nutrients. There are women who've improved their symptoms by taking vitamin D supplements. Research food supplements that are connected to infertility/fertility or see a good naturopath or nutritionist who can do a through check up to see what deficiencies you may have.

Women with PCOS should try not to consume genetically modified foods and endocrine disrupter's. Eat organic as much as you can afford. Steer clear of or severely reduce consumption of dairy products and red meat (although some can tolerate it, it's up to you as an individual to see how your body reacts).

A lot of women with PCOS moan about food they absolutely cannot stop eating. The truth is if you understand WHY something is bad for you, and you truly want to improve your health, you won't hesitate to cut it out of your life. Likewise if you know something is good for you, you'd try to do as much of it as you can.

It really is that simple, don't let anyone tell you there is no cure or that you have to 'suffer' with it for the rest of your life or pop pills for the rest of your life. It can be done naturally, and more and more women are choosing the natural/drug-free approach.

Ye Olde Blog

I haven’t abandoned my blog. For the last few months my life has been one non-event after the other, so there’s been nothing new to report. Still trying to not be broke, lol… I’m getting there. Still keeping up with my healthy lifestyle and still being relatively symptom free, ‘xcept for the still lingering infertility bit.

A few months ago I was wondering if I wanted to go ahead with IUI. According to the information sheet I got from the fertility centre the success rate was 15%. Meaning there’s just about a 1 in 10 chance of conception. Meaning out of every ten couples that undergo IUI only one of them will conceive. The statistics seem too low to be considered; but when it comes to TTC all procedures are considered, especially if they're relatively cheaper than IVF.

With my just-one-tube I was considering if it was worth putting myself through the procedure for 6 months. Do I have the strength for the emotional ups and downs; the inevitable and emotionally nerve wrecking 2ww? The expectations that come after you’ve been through so much and you believe you deserve to get some reward afterward and the disappointment that comes with it too.

Hubby decided we should give it a shot. Even he was not impressed by the success rate but we figure we might give it a shot. He is more hopeful than I am though. I am going into this realistically.

For now I’m still waiting to book an information session with the nurse and commence treatment. It should be within the next 30 – 60 days. You need a shitload of patience when you are battling infertility. I’ve had 4 years to perfect mine.

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