[00:00:00] Welcome to the PCOS Fertility Health Podcast, where you will learn how to boost your chances of getting pregnant. You are in the right place if you have PCOS and you are struggling to get pregnant. You are tired of getting dismissive information like, Just eat better and stay on birth control. And you want fertility answers.

[00:00:23] Join me, your host, Dr. Angela Potter. To learn key steps to optimize fertility with P. C. O. S. I am the creator of the P. C. O. S. Fertility Protocol and have also shared the stage with leaders from companies like Microsoft and Google. So get ready for another powerful episode about boosting fertility with P.

[00:00:43] C. O. S. Let's dive in. As we jump into it today, I just want to say thank you so much for being here. Thank you for showing up every week with me. Thank you for sharing these episodes with your friends and your family. Thank [00:01:00] you for your positive reviews. And it's just really amazing to be here with you.

[00:01:05] And I am incredibly grateful for you being here. One, because I just love having you in this community and two, because then I know that you're getting this really important information in order to help improve your fertility. If you have any specific questions about PCOS fertility, anything that you want me to cover on this podcast, reach out and let me know.

[00:01:31] Okay. I am. open to hearing what you want to be hearing about and what you want to be learning about so that you can optimize your fertility the most. So send me and my team an email, head over to my website and I'll put that email in the show notes because I'm creating this for you, right? I want you to get the most out of this.

[00:01:52] So what do you want to be hearing about? Um, but the very most, thank you so much for being here. So. [00:02:00] We're talking about birth control today, birth control and PCOS. And I am just going to say right off the bat that I am talking about birth control in the situation where it's being used to regulate irregular cycles.

[00:02:15] And irregular cycles are a hallmark symptom of PCOS. It's what leads a lot of people to go in and talk to the doctor and be like, Uh, do I have PCOS because my periods have been all over the place or I've only had one period this past year. And so it's just really common. And unfortunately, the most common recommendation to help regulate irregular periods for PCOS is to just go back on birth control.

[00:02:50] And so we're going to dive into that subject today, but I'm not talking about birth control in the setting of using it for contraception, using it [00:03:00] as birth control and to prevent getting pregnant. All right, that's a different conversation. Totally different scenario than using birth control in. order to get pregnant, in order to balance cycles so that you have this beautiful hormonal picture in order to improve your fertility.

[00:03:19] Okay. That's what we're talking about today. So are you one of those people who gets advice like, Oh, just eat better and get back on birth control? Or how about, you know, you're infertile and the only way to treat your PCOS is to get back on birth control. Doctors are. Giving out this type of fertility advice a lot.

[00:03:42] It's super common. So if you have heard this, you are not alone. If you're confused by why you would get back on birth control in order to help get pregnant, you are not alone. And the issue with what's going on here is that doctors are [00:04:00] just giving out this dismissive information. And this falls into that one size fits all conveyor belt type of fertility approach.

[00:04:10] And right now, if somebody has irregular cycles, That recommendation is to go on birth control, and this birth control recommendation is given in order to help regulate the cycles. That's the intent behind it, but we're going to dive into that today. What's going on with birth control, what the hormones specifically in the pill are doing.

[00:04:39] how that's impacting your fertility and important things that you need to be watching out for if you are taking the pill or if you've recently taken it and you're moving forward trying to get pregnant. Women like you go in and talk to their doctor and they're feeling lost and [00:05:00] broken and every month holding their breath.

[00:05:03] And particularly when Their period is late. And then when it comes, it's just, you cry tears of defeat because your body is not doing the one thing it's supposed to be doing. And it leaves you feeling fed up, failing as a woman. And you go in and talk with your doctor to try to get some hope, to understand what's going on with your hormones.

[00:05:29] what you can be doing to help your body just work right to help get yourself off of the roller coaster of hormones that you're experiencing. And you just, you need answers and doctors are giving out this dismissive fertility advice like, okay, just get back on birth control and this will help balance your hormones.

[00:05:55] But this is that. conveyor belt type of fertility [00:06:00] care with just dismissive information that is not getting to the root cause of your issues. And using birth control in order to regulate periods is really at the heart of that just Band Aid solution. Let's throw something on this just to say that we see some changes with the body, but we're not.

[00:06:25] taking that step to understand, well, what are your hormones doing and how can we optimize them so that your own hormonal picture is just juicy and vibrant and doing exactly what it's supposed to be in order to help make you a baby. But. Before we get into the specifics of the pill and fertility, let's talk a little bit about birth control foundations.

[00:06:52] Okay, what is birth control? Let's get clear on that first. So, birth control is any sort of method [00:07:00] that keeps you from getting pregnant. There's birth control that's specific to female body type types and birth control specific to male body types. Okay, that's the first. Distinguishing factor for birth control, and then there are hormonal birth control types and non hormonal birth control types.

[00:07:24] So, the non hormonal birth control is, you know, really things like barrier methods, condoms are going to be. The most used type of maybe birth control in general, but of the non hormonal birth controls. There's also things like diaphragms and, um, natural family planning would fall into that where your temperature tracking in order to, um, either get pregnant or not get pregnant.

[00:07:52] So those are a few of the non hormonal birth controls. And then there's the hormonal birth controls and hormonal birth controls [00:08:00] right now are just intended for the women, right? The people with female hormones, because they're altering the female hormonal pattern. Uh, there aren't any male pattern hormonal birth controls out there.

[00:08:17] Okay, in the world of hormonal birth control, there's a few different types. There's the implant, which goes into the skin. There's a hormonal IUD, the Mirena, and then there's the pill. Okay. And so, you know, there's a wide variety of birth control out there. When doctors are recommending birth control in order to help regulate your regular periods, then typically it's the pill that's recommended.

[00:08:48] And so what does it mean by an irregular cycle? So, Irregular cycles, again, super common with PCOS, and 28 days is [00:09:00] that, you know, idea of a perfect cycle. You can still have a regular cycle, and it's not 28 days, so there's a few day window there, so it could be 27 days, it could be 32 days, but if every month you are having that 32 day cycle, you're getting positive ovulation signs in mid cycle, then that's a regular cycle for your body.

[00:09:29] If you have consistently long cycles, like 38 days, 45, 60, 80 day cycles. That's still going to be in that realm of an irregular cycle. Your doctor is still going to want to help you to regulate that cycle because that's clear that hormones are not doing what they're supposed to be doing in order to get your cycles to be The 28 days and not just the 28 [00:10:00] days, but you want that healthy hormonal pattern to have ovulation happen so that you're in that window of a regular cycle, meaning your cycle is regular so that the hormones are supportive for your fertility and you could have an irregular cycle that.

[00:10:16] Every single month your period comes at a different time during the month, right? One cycle could be 45 days one cycle could be 80 days one cycle could be 28 days and the next cycle at 60 days It's just all over the place And so that's you know, another really clear sign that hormones are not doing what they're supposed to be every month I'm going to do a full episode on just the menstrual cycle and what hormones are supposed to be doing and what that looks like, what you're, you're trying to achieve.

[00:10:52] But, um, for today's purpose, just knowing that if your cycle is a. different set of days every [00:11:00] month, then that's an irregular cycle. And that's what your doctor is trying to help you with, with the birth control pills. But let's start talking about what's going on with birth control and why it shouldn't be the first step in order to help regulate cycles with PCOS.

[00:11:21] So birth control does contain estrogen and progesterone, those two dominant hormones for our menstrual cycles. And the thing is, the types of estrogen and progesterone in the pill, their job is to shut down your body's own natural hormone production, okay? So they create this feedback loop that tells your body, Hey, we've got enough hormones here.

[00:11:49] You do not have to make anything more. We've got the job done. You can just take a break. And so your body just shuts down. Production of hormones of [00:12:00] estrogen and progesterone mainly, and you can do a hormonal panel. I do this for a lot of patients so that they can see what's going on in their bodies and they can understand.

[00:12:12] But if you were to do a hormonal panel of estrogen and progesterone, they would be really low. Like almost zero because your own body is like, oh, okay, I can just take a step back. No problem. We've got the hormones somehow in the body. Um, so that means that my job is done. And so it just kind of checks out and the hormonal process of estrogen and progesterone is really quite complex on the back end, right?

[00:12:41] It's your brain talking to your ovaries. It's other hormones talking to each other, insulin, testosterone, talking to your ovaries and to the estrogen and progesterone. It's this all complex, but really beautiful rhythm that happens in the body. And so when you're taking the birth control [00:13:00] pills and that shuts down your body's own production for so many women that then.

[00:13:07] disrupts that pattern. So when you get off of the birth control pills, your body's like, what? How am I supposed to be making these hormones? What are we doing? When during the month am I supposed to be putting out what hormone? Your body's still sleeping and isn't waking up to help regulate those hormones.

[00:13:30] And so for many women getting off the pill, that's when hormonal issues start, right? There's post pill PCOS when all of a sudden you get acne and really rapid weight gain and your periods are all over the place. That's because your body is like, I don't know how to do this. I need some help remembering that regular rhythm every month.

[00:13:57] So, you know, the takeaway for [00:14:00] this moment is that the birth control hormones, they actually shut down your body's own production of hormones. And if you're not trying to get pregnant, right, if you're using birth control for that purpose to avoid getting pregnant, that's exactly what you want. Because shutting down those hormones in your body, that shuts down your body's entire fertility Program.

[00:14:25] Okay. So you're saying, yep, I do not want to get pregnant. So let's shut down those hormones. Let's not have that fertility response. I don't want ovulation happening. I don't want hormonal changes that improve my cervical mucus to make it ready for the sperm. You don't want any of that. And so all of that is being shut down with the pill.

[00:14:48] But if you are trying to regulate your cycles, Okay. And you're using the pill in order to do that. That's not what is [00:15:00] happening inside the body, because when you're trying to get pregnant, you want to be supporting your body's own natural production of these hormones. hormones is estrogen and progesterone so that you're enhancing your body's fertility signs, enhancing that cervical mucus, trying to make ovulation happening, happen in your body and, you know, getting all of those things on board in order to make a baby.

[00:15:29] And unfortunately, the birth control, it makes it look like your body is in that really beautiful hormonal state, but it's all just a show. It is that Band Aid approach, it is literally just shutting everything down and putting a picture on the very surface being like, Oh, look, we are balanced and happy and healthy, but you're not.

[00:15:51] It's just the synthetic hormones in the body that are happy and healthy because they're doing what they're supposed to be, but it's shutting down the back [00:16:00] end, the very important back end when you want to be getting pregnant. So, if you're taking the pill, right, you probably experience that monthly bleed.

[00:16:12] That monthly bleed is not a sign of your own hormones becoming in balance. That's a sign of just the drop of hormones in where you're at with the pill. And so it's called a withdrawal bleed. It is well known that we don't call it a period. It is not a true period because it wasn't from your body's own hormones that created this bleed.

[00:16:41] No, it is just the, the drop of hormones creating a very small bleed. The birth control pills, uh, they, because they're keeping hormones very, very low, that keeps your uterine lining thin, which again is keeping you from being able [00:17:00] to implant, right, in conception. And so when your uterine lining is really thin, then, you know, you have a very small bleed because that's what the bleed is, is you're shedding your uterine lining.

[00:17:14] And so, If you're in that place where you're like, okay, my doctor said, the only thing I can do is to get back on birth control. So now I'm on birth control and I've got this monthly bleed. So I must be setting myself up for healthy fertility when unfortunately, no, this is just another 1 of that, you know, bandaid, like, let's just put the picture and cover up the back end.

[00:17:37] Right? Like, how many of us? When we're cleaning up a room, we just shove everything into the closet and close the door. From the outside, the room looks really clean, the door is nice, like everything's tidied. And so that's that withdrawal bleed being like, look, I look so pretty, I'm happening once a month, yay.

[00:17:57] But then you open the door in the [00:18:00] closet, everything falls out. There's just, there's. Trash in there and nothing's in place and it's just shoved in there and it falls out and you're like, oh, that's the problem. And that's what we've got to get to with improving fertility, proving this, these hormonal pictures is to look in that back end and be like, no.

[00:18:20] We've got to clean this up, right? We've got to look at what your hormones are actually doing. But one extra thing I want to share with you before we talk about what needs to happen instead of getting on birth control is the fact that the pill actually depletes your body of nutrients. And there's some sources out there that actually say that the pill is the number one, or it depletes your body of the most nutrients out of any medication, which is huge.

[00:18:54] And unfortunately, it is taking vital fertility [00:19:00] specific nutrients out of the body. So a handful of nutrients that you can get depleted of and move into a deficiency of when you're taking the pill are B vitamins, including the essential folate Vitamin C, Vitamin E, Magnesium, Selenium, Zinc, DHEA, and CoQ10.

[00:19:24] And these are important vitamins and minerals that support hormone balance and egg quality and ovulation. So, let's say You've tried the pill in order to help get your hormones regulated and then you're ready to get pregnant. So you stop the pill and you try to get pregnant, but you're not having any ovulation signs.

[00:19:49] Maybe, you know, you have just jumped straight forward to IVF. And so they're looking at your eggs and they're like, sorry, we can't go through with this cycle because there's [00:20:00] just no. good quality eggs here, the nutrients that were taken from your body while you were taking the pill are pivotal in order to help with egg quality.

[00:20:15] Okay, so if you don't have enough CoQ10, don't have enough selenium and zinc, magnesium, vitamin C, vitamin E, then your eggs as they're developing for that next cycle, they don't know what to do. They can't divide those chromosomes in order to get to a place where you have this happy, mature egg that is ready to ovulate, ready to go out and meet up with the sperm and make that baby.

[00:20:45] And so, you know, let's talk a little bit more just about CoQ10, for instance. CoQ10 is a key part of our body's mitochondria. Mitochondria are tiny, tiny little parts of a [00:21:00] cell, and they're all over the body, okay? Every cell in your body has mitochondria, because those are the energy producers of the cell.

[00:21:09] So the mitochondria inside your cells produce energy for your cell to be able to do what it's supposed to. And this is so fascinating about the body. Your eggs actually hold the highest density of mitochondria in your entire body. One egg. And in one cycle, you might ovulate or not ovulate, but have a thousand eggs that are trying to ovulate.

[00:21:38] But in just one egg, you could have upwards of a hundred million mitochondria in that egg. That is a huge number. And so that shows you how important mitochondria are for egg development. Because they are providing the energy that your egg needs in order to divide [00:22:00] chromosomes, to get to 23 chromosomes, be happy and healthy in order to mature and ovulate.

[00:22:07] Um, real quick, if you need to know more about egg quality, I have an episode on that. I will link it below if you want to hear more about the specifics of that. So as your egg is developing, it relies on that mitochondria in order to get all the energy to be, get to the place where it's mature and healthy.

[00:22:28] If it does not have enough CoQ10, then your mitochondria cannot provide the amount of energy the egg needs in order to mature and get to a place where it's ready to ovulate. So it's really important if you are taking the pill that you replenish the body with these key fertility nutrients. If you have recently been off on the pill, you know, you've recently gotten off of it.

[00:22:56] Then it's super important that your fertility [00:23:00] plan includes these key fertility nutrients to replenish your body, to help with hormone balance and egg quality. So if you are one of the many, many people with PCOS who have irregular cycles, who aren't ovulating and who want to get pregnant, what needs to happen instead?

[00:23:23] Well, you know, really the conversation does not need to be you have irregular cycles. Let's get you on birth control. The conversation needs to be hey, you have irregular cycles. What's going on here? What hormones are out of balance. That's creating your cycles not to be able to be that regular cycle with the hormonal picture needed to improve fertility, right?

[00:23:51] So you want somebody to be asking you, what are your hormones doing? Can I do some lab tests for you to figure out What [00:24:00] your estrogen and your progesterone and your LH and FSH and your testosterone are doing every month so we can understand what that picture is for you. That's the first part of the conversation.

[00:24:14] Then the second part of the conversation needs to be, hey, look at what's going on with your hormones. You have. Basically, no estrogen and basically no progesterone. So how can we be supporting your body in order to raise estrogen levels and also raise progesterone levels? You know, or maybe you're somebody who has really high estrogen.

[00:24:40] Okay, so then your conversation needs to be, well, how can I lower my estrogen levels? Is DIM appropriate for me? What kind of fiber should I be eating in order to help clear excess estrogen and get my body really balanced with the healthy form of estrogen that it [00:25:00] needs in order to help my uterine lining and help prepare my body for fertility?

[00:25:05] You know, if you are one of the. Many, many women who has low progesterone, right? That is the most common hormonal picture that I see is low progesterone. Then, you know, is somebody having that conversation with you of how can we raise your progesterone levels? What's causing your progesterone to be so low?

[00:25:26] You know, what kind of lifestyle factors can we add into your life to enhance progesterone? Is bioidentical progesterone? an important part of your picture. What's your insulin doing? You know, is your insulin impacting your ovulation, which then is causing your progesterone not to rise? Okay. Is the conversation, Oh, you know, you, you have been on birth control and your eggs aren't developing as they're supposed to be, and we're not seeing positive ovulation [00:26:00] signs.

[00:26:00] So let's get some nutrients on board. these are the foods that you can eat in order to help your egg quality and support your mitochondria. And here's, you know, some supplements that help replenish the body right now, because you're in a state of depletion. That's going to help with your egg quality to help you start ovulating.

[00:26:21] And that's going to support. weren't your body's natural fertility hormonal pattern. Okay, those are the kinds of conversations that you should be having that's going to help improve your fertility the most and to get your body into this just juicy and vibrant place where it's got the hormones it needs, the nutrients that it needs to create this beautifully Fertile environment that says, Hey, I am ready to make a baby.

[00:26:52] Okay. So I want you to go out and have those conversations with your doctor and say, this is the information that I want to [00:27:00] know about my body and about my fertility. Okay. Because I want to be in a place where my fertility is at its best. My body is doing what it's supposed to be doing in order to help me get pregnant.

[00:27:13] Okay. So how can you help me? And if your doctor says, well, the only thing I can recommend is birth control pills and get you on some letrozole, then you need another answer. And I'm here for you. If you need that other answer. Okay. So just reach out. Let's schedule a call together. So we can talk about what's been going on with your hormonal picture and how you can be supported.

[00:27:37] supporting your body without this birth control, just suppressing everything going on in your body. So I am here for you. I am your PCOS fertility doctor. Okay? So if you are talking to your doctor and you don't get the answers that you want, Know that there are still options out there and potentially, I'm not your person.

[00:27:58] I would love to be your [00:28:00] person to help you with your P. C. O. S. And your fertility. So I am committed to sharing this information with you so that you know how to optimize your fertility and I ask for you to commit. To finding that doctor, finding that provider that you resonate with, and who can provide these types of conversations and fertility answers for your body.

[00:28:27] Okay, can you commit to that for me? Awesome. Okay, as we wrap up here, I just want to remind you of the beautiful and brilliant light that you are, that you shine in this world and the amazing gifts that you have to share with the people around you and this entire world. Blessings to you today. I hope you have just an absolutely magic filled day and I will see you next week.[00:29:00]

[00:29:00] Thank you so much for being here. It is such an honor to be on this platform with you and to have you in this community. So thank you. As we wrap things up today, I want to share the legal language with you. This podcast is for informational purposes only. It should not replace the medical advice, diagnosis, or treatment given to you by your doctor.

[00:29:22] Take care.