Dear MDs, APRNs, OB/Gyns and anyone providing medical care to women living with PMOS (formerly PCOS):

There are some things you need to know.

Please understand that this comes from my heart and a desire for these women to get the best healthcare, the care they deserve.

My POV comes from the many hours I’ve spent as a registered dietitian sitting face-to- face in nutrition counseling sessions with these women.

I can tell you from the time I have spent listening to their stories, many, if not most, of them leave your office feeling a mix of judged, dismissed, deflated, depressed, hopeless and/or confused.

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I know you are also victims of a broken healthcare system that doesn’t always allow you to provide the comprehensive care you would like to give. I see that and I know it isn’t your fault.

But, I think we can do better. And I want to believe most of you went into medicine truly wanting to make a difference.

These are some things you need to know if you want to make a difference with these patients. And they desperately need your help.

Your weight bias is interfering with their care

We all have biases as humans, but this one is a significant barrier to care.

Women living in larger bodies are judged by everyone- friends, family, partners, strangers, and so often when they come to you for help, they are judged by you too.

They can see it. They feel it. It’s in the tone of your voice.

It’s the “if you would just eat less, and move more” advice you reflexively give out.

It’s in the way you act like they’ve done nothing to help themselves.

In the worst cases, it’s your careless, judgmental comments.

You aren’t showing up for them in the same way you would for someone with a “normal” BMI. Your weight bias is clouding your ability to give them the care they need and deserve.

And what you often don’t see is the undiagnosed eating disorder bubbling under the surface that’s making nutrition extremely complicated.

Or the insatiable sugar cravings they have to white knuckle through every day because of the insulin resistance.

Or the 7 crash diets they’ve tried that’s led to more weight gain and a worse relationship with food.

Or the depression they feel from living in a body they aren’t comfortable in or recognize.

When you tell them to eat less and move more- it isn’t helpful. The equation is not that simple. In fact, this advice often pushes them further into an already disordered relationship with food.

Did you know this population carries a much higher risk for eating disorders, very commonly binge eating disorder that can significantly affect weight?

And this leads me to my next point.

You are under-utilizing your BEST resource

The most recent evidence-based guidelines support lifestyle changes as first line therapy for all women with PMOS.

And we both know, by no fault of your own, you don’t have the time or resources to provide this support in a meaningful way.

We all have a role to play in healthcare, but for the PMOS patient, a registered dietitian is so often the bridge they need to make lifestyle changes a reality.

They need strategies. They need nuance. They need coaching and encouragement. They need evidence-based nutrition care that meets them where they are.

That is what dietitians do- day in, day out. And we are really good at it.

EVERY women with PMOS can benefit from working with a dietitian. Please, make that referral a routine part of your care plan. Together, we can make a huge difference in their health outcomes.

Connect with some exceptional RDs in the your area you feel confident referring to and collaborate with them on patient care.

Your lack of compassion is sabotaging patient relationships

These women deal with some of the most distressing things a woman can face; changes to their body that in many cases rob them of their femininity— facial hair, acne, hair loss, infertility.

The burden on their mental health is great.

They need to hear “I know this feels scary and hard.”

They are worthy of compassion and empathy like any other patient.

These women have a higher risk for mental health disorders which can negatively affect their ability to care for their health. They need you to have that awareness.

They need referrals for mental health support.

They deserve more kindness and collaborative patient/practitioner relationships.

We need you

We need you, desperately. PMOS affects 1 in 8 women.

We need you to be up-to-date on research (here are the latest consensus guidelines to inform your care).

We need you to show up with compassion.

We need you to check your biases.

We need you to screen and refer.

Your role in managing PMOS is critical and you are the first person they will encounter in the healthcare system, and the person that can make all the difference in their health- both mental and physical.

Let’s work together to support these women.

Sincerely,

Tara Noseck, RDN, LD

From my hundreds of hours of time spent in nutrition counseling sessions, I also know the standard advice you’ve received to work on weight loss has been unhelpful, misguided, judgmental and unsustainable.

Here are 8 things I routinely speak about with my clients, that I think can make a world of difference for how you approach and move through a weight loss journey.

1. It’s harder with PMOS

In PMOS, weight is affected by a complex interplay of metabolic, hormonal and environmental factors.

We have to systematically assess each individual, then identify and intervene on the factors relevant to them.

But I believe one of the biggest reasons weight loss is harder is that women with PMOS consistently do not receive the education, resources and support they need.

They get the playbook “eat less and move more” with no context. I have never met a patient whom this advice helped, yet the trope persists. Eating less and eating for PMOS are not the same thing.

I won’t lie to you. Weight loss can be more complicated, but it is possible with the right education, tools and support.

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2. You are allowed to want to lose weight

I grew up in the ‘80s and ‘90s and was a fellow recipient of all the toxic food and body messaging from culture, marketing and media. By the 2010s, women were FED UP.

The anti-diet movement was born as a f-you to all the entities trying to profit off our discontent with our bodies. But somewhere along the way, an extreme version of anti-diet culture became just as toxic as the thing it was rejecting.

You could not talk about weight loss on social media. It was ugly.

My friend, two things can be true:

Diet culture can absolutely go to hell, but it’s your body, and if weight loss is a goal, that’s nobody else’s business but your own.

I will argue, however, the way you go about that weight loss journey is what makes the difference.

You can work on weight loss sustainably, without starving yourself or following some expensive, short-term crash diet. And you can and should do it it in a way that honors yourself as a human.

3. Calories do matter

While there is well-warranted focus on insulin resistance and its influence on weight, it often overshadows the fact that there still has to be a calorie deficit for weight loss to occur.

Simply put, more energy needs to be going out than coming in. The problem is, when most women think about a calorie deficit, it immediately triggers thoughts of crash diets or severe restriction, which is not what I mean.

I mean finding your current baseline maintenance calories and creating a deficit that feels realistic and sustainable for you, while learning how to put foods on your plate that meet your needs (both physical and psychological), balance your blood sugar and keep you full and satisfied.

This is when working with a dietitian can be your lifeline.

4. Tracking nutrition can be a game-changer

Understanding the amount of calories, protein, fat, carbohydrates and fiber in the foods you eat is one of the most helpful tools for weight loss.

You don’t know what you don’t know, and that knowledge can be one of the major factors standing between you and your goal.

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I know many have had negative experiences with this in the past, but how we think about this tool matters a lot for the experience we will have.

Instead of giving these numbers an emotional charge, think of them as just data, like your body temperature. There is no emotion or morality tied to any of it.

These numbers allow you to have confidence in knowing what foods help you meet your needs. They allow you to make informed decisions on your nutrition, like how much protein and fiber your breakfast has. That’s it.

My current favorite nutrition tracking app for weight loss is Carbon. It’s about $12/month, very simple to use and has a built-in guide to recalculate your energy needs based on changes in your body.

Cronometer is also a great free option.

A note: I do not recommend tracking nutrition if you have an active eating disorder. If you are in recovery, I’d encourage you to work closely with a practitioner who can help gauge whether this is an appropriate time for you to introduce this tool.

5. Strength training is a tool you can’t miss

When we’re talking about weight loss, what we actually mean is fat loss. And one of the best ways to support long-term fat loss is by gaining and maintaining muscle tissue.

Muscle increases our metabolic rate, or how much energy (calories) we burn at rest. Not to mention, muscle is one of the most helpful tools for managing insulin resistance, as it increases insulin sensitivity, or how well we uptake glucose from the bloodstream.

If you aren’t taking active steps to preserve or build lean muscle mass while losing weight, you will lose muscle alongside fat tissue, which is not ideal.

This is a huge consequence we are seeing on a large scale with the rise of GLP-1 use. If you are using these medications, the strength training and protein piece becomes even more significant.

With training, you should be focusing on progressive overload, which means over time, you are increasing difficulty in weight, reps or tempo as your muscles adapt.

If you’re looking for resources to get started, some of my and my clients’ favorite programs are:

• Free on YouTube: Caroline Girvan, Sydney Cummings, Kaleigh Cohen Strength

• Subscription apps: Fit with Coco, Ladder, Whitney Simmons, Alex Rice

If you’re a beginner to strength training and feel intimidated about where to start, I highly recommend working with a certified personal trainer for at least a short period of time to understand correct form and gain some confidence around strength exercises.

Side note: one benefit of higher testosterone in PMOS is that building muscle tissue is a little easier!

6. The scale is not always the best measure of progress

Of course, weight is a metric you’re tracking if weight loss is your goal.

But you need to know that a realistic weight loss journey is not going to look like a straight line plummeting indefinitely.

It is completely normal for our weight to fluctuate up and down due to hormones, fluid and electrolyte shifts, higher carbohydrate intake, exercise and other factors.

Not to mention, if you are consistently hitting the weights, you will eventually gain weight that is muscle, which is a good thing!

These fluctuations are often what take a lot of people out. Look at trends over time and don’t let those fluctuations jerk you around.

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I find it helpful to have my clients focus more on changes in how they feel in their body.

Less hunger and sugar cravings? More energy to exercise? Not waking up in the middle of the night? Clothes fitting differently? No more 3pm energy crash? Cycle becoming more regular?

These changes all reflect positive feedback from your body and will ultimately help keep your momentum going so weight loss can happen sustainably.

7. It takes time, consistency and patience

If you aren’t game to embrace these 3 things, you will perpetually stay on a cycle of starting and quitting your weight loss journey.

It takes time to make changes and build the solid habits that support weight loss and maintenance. You have to learn new things and then practice them. You won’t be great at it overnight.

Life will happen and you will have moments. It’s all part of the journey.

Depending on how much weight you have to lose, your timeline may be shorter or longer, but for many of my clients, I need to shift the focus from a few months to what’s possible in a year, minimum.

Healthy fat loss is 1-2 lb per week. So if you have 50 pounds to lose, it will take some time. That is okay.

More on this topic in the article below.

8. Your mindset is critical

During a session with one of my clients, she said, “Tara, I’ve realized I can’t hate my way to health.”

Oof.

What she said has never left me, and I’ve shared it with many others since.

You cannot hope to grow anything healthy or sustainable from the soil of self-hatred and negativity.

You have to fix your inner world first.

You have to truly know and believe in your value as a person.

You have to truly love yourself to do what it takes to show up day after day, even when you don’t want to.

You have to believe you are worthy of the care and time it takes to change your health.

There is no other way if you’re in this for the long haul.

I hope these points helped you reframe weight loss in the context of PMOS, my friend.

It can feel harder, I won’t pretend otherwise, but with the right education, tools and support, it is absolutely possible.

If you’re looking for a guide to provide some clarity on this journey, I’d love to work with you. Visit my website to learn more about me and my approach to PMOS.

Tara 🤍

For decades, millions of women have been diagnosed with a condition named after something that isn’t even accurate. Last week, that finally changed.

Meet PMOS: Polyendocrine Metabolic Ovarian Syndrome.

As a dietitian who has spent years supporting women with PCOS, this is a welcome change, and IMO, long overdue.

The longstanding and well-deserved criticism of “polycystic ovarian syndrome” was always that the name was misleading and that it failed to capture the breadth of what the condition actually is. All of that changes now.

Why this change matters:

Not everyone with PCOS has polycystic ovaries

Although polycystic ovaries is one of the three diagnostic criteria, its presence is not actually required for diagnosis.

A woman can meet the other two qualifiers, elevated androgens and irregular cycles, and still be diagnosed.

This has caused enormous confusion, even within the medical community. Dropping “polycystic ovary” as the defining term was necessary.

The “cysts” of PCOS aren’t actually cysts

Even the characterization itself is misleading. These “cysts” are not technically cysts at all. They are underdeveloped follicles, the fluid-filled sacs that contain immature eggs.

The hormonal chaos of PCOS stalls their maturation, leaving them in a perpetual state of arrested development. They accumulate in the ovary over time, creating the appearance of a string of pearls on ultrasound.

These are fundamentally different from pathologic cysts.

PCOS is more than a reproductive condition

As the leading cause of infertility, PCOS is often mistakenly thought of as a reproductive condition that only matters during the menstruating years.

The truth is, PCOS is lifelong and just as much a metabolic and endocrine disorder as a reproductive one.

The majority of women with PCOS have some degree of insulin resistance, and carry an elevated lifetime risk for type 2 diabetes, cardiovascular disease, and metabolic syndrome.

None of that is implied by “polycystic ovarian syndrome.” PMOS, with “metabolic” right in the name, starts to tell that story before a single conversation is had.

It may improve the speed and rate of diagnosis

PCOS notoriously takes multiple years and multiple practitioners to diagnose correctly.

That is lost time, time that could have been spent on treatments and lifestyle changes that meaningfully improve long-term health, fertility, and quality of life.

A more accurate name may, over time, translate into broader recognition and women getting answers sooner.

People are talking about PCOS, some for the very first time

The rebrand made headlines across every major news outlet. People who had never heard of PCOS are getting exposure for the first time through this story.

For them, it will only ever be PMOS. For a condition that has been historically under-recognized and under-researched, that kind of reach is significant.

My Hope

There have been some voiced concerns on the name change, and I understand it. Advocates have worked hard for years to build the level of public awareness we have today, and it is still nowhere near where it needs to be. The fear that a rebrand could obscure that progress is legitimate.

But I am choosing optimism. A more accurate name gives the medical community better language. It gives newly diagnosed women a term that actually reflects their experience. And if the news coverage this week is any indication, it is already opening doors to conversations that weren’t happening before.

Change is never easy. But this was a band-aid that needed to be ripped off. It might sting for a moment, but I believe it will ultimately catalyze more awareness, more research, and better care for the women who need it.

What do you think? Does the new name feel like a relief, or does it feel like starting over?

Tara 🤍

Yikes. I’ve been away from this page too long. Let’s get back to business- no fuss, compassionate education and support for PCOS.

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✅ Cyst-ems Check: Intro to Androgens

Androgens are considered the “male sex hormones” and are what produce characteristic physical male attributes. Females also produce androgens, but at a much lower level.

Having androgen excess (elevated male hormones) is one of the diagnostic criteria in PCOS and a primary hormone imbalance driving symptoms for many women.

The androgens in increasing level of potency are: DHEA, DHEAS, androstenedione, testosterone and dihydrotestosterone (or DHT)

Weaker androgens like DHEA and androstenedione are precursors and can be turned into the more potent androgens, testosterone and DHT.

Androgens are made in the adrenal glands, ovaries and by conversion in what we call peripheral tissues in the body. For example, in the skin, testosterone can be turned into our most potent androgen, DHT (hello facial hair).

Testosterone and DHT are largely causing the many hallmark physical symptoms of the syndrome, including hirsutism (male-pattern hair growth), acne, androgenic alopecia (male-pattern hair loss), and irregular or absent ovulation.

One important nuance: most testosterone in the blood is bound to a protein called SHBG (sex hormone-binding globulin), which renders it inactive. It's the small free fraction of testosterone that's actually available to act on your tissues and drive symptoms. This is why some women have "normal" total testosterone on labs but are still dealing with significant androgen-related symptoms, and why it’s important to look at free testosterone levels.

🍲Nourish Your PCOS: Chicken Tortilla Soup

I’ve been making this Chicken Tortilla Soup recipe from The Pioneer Woman for probably almost 10 years now. It always hits.

It’s the perfect meal to make on a lazy Sunday afternoon and turn leftovers into easy lunches or dinners for the week ahead.

The only change I make to the recipe is I double the chicken to make the meal higher protein.

Why it’s great for PCOS:

• Black beans provide a steady source of carbohydrate due to their high-fiber content, meaning you stay fuller longer.

• The combo of chicken breast and black beans provides protein for the meal stabilizing blood sugar and naturally shutting down hunger.

• Peppers, onions, tomatoes and the different seasonings are full of antioxidants which helps to balance the oxidative stress that is hallmark to PCOS

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My Tips:

• Although there is nothing “bad” about the toppings of cheese, avocado and sour cream, because they are fats they can add up quickly. My general advice is to pick one fat source as a topping or better yet, swap out sour cream for fat-free Greek yogurt for the same creamy, tangy taste plus some extra protein!

• If you’re trying to keep things lower in carbs, let the beans be the standalone source of carbohydrate or be mindful of the portion of tortilla chips.

✨ Weekly Boost: 1 Month vs. 1 Year

Real talk here today.

If you're measuring your progress with PCOS in weeks, you're setting yourself up for disappointment.

Diet culture has trained us to expect results in 21 days or less.

But PCOS doesn't work that way. It's a complex, hormonal condition that took years to develop. Learning how to manage it well and sustainably takes time, and that is okay.

Here's what I tell almost every single client I work with:

Shift your timeline from one month to one year. Give yourself a real runway to build habits, see your labs move, feel your symptoms change.

Every small, intentional step you take on that timeline is getting you there and you’ll be amazed at the difference.

Keep your head down. Stay consistent. Don’t let bumps in the road stop you.

Small. Intentional. Consistent. That’s how we get there. 🤍

☝🏼ICYMI

TikTok:

• Hot Takes on PCOS I’ll Stand by in 2026

• PCOS & Insulin Resistance 101 (explained in less than 2 minutes)Chicken

• PCOS & Plastics: Don’t Do This

• How to Know If You’re Getting Enough Protein

Substack:

• Before You Start Another PCOS Diet, Read This

• Everything You Need to Know About Supplements

• Diagnosing PCOS

• The Problem Was Never You: My Love Letter to You

🧰 PCOS Toolkit: Open

I love trying all the apps, products and tools, so I have good resources to share with my clients.

The Open app has been one of my favorites this year and something I am personally using.

Simply put: Open makes meditation and breath work uncomplicated and accessible.

Open the app and on the home page and for each day of the week, there is a choice between Meditate, Breathe, Move, or Sound. You choose what you’re in the mood for.

One of the best features is that the sessions change from morning to evening to align with the energy of the day.

⏭ What’s coming up:

• Understanding Insulin Resistance: The PCOS Primer You’ve Been Waiting For

• How to Support a Loved One with PCOS

• The Link Between PCOS & Endometrial Cancer

That’s all for this week!

Tara 🤍

The wisdom I am sharing today is the result of hundreds of hours of counseling with real women living with PCOS and in my general private practice.. These are the mindset shifts I challenge them to make, to support meaningful progress with their health.

Abandon the All-or-Nothing Approach

Does this scenario sound familiar?

You’ve decided it’s time. Tomorrow is the day you are going to change your life. You are going to stick to that rigid diet. You are going to workout 6 days a week. You’re going to take your supplements every day. You’re going to meditate like it’s your job.

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And for the first 2 weeks, you are crushing it. The pendulum is swinging hard to the right.

But then, you get sick. And your dog has to go to the vet. And your family comes to town. And you have to work overtime. And you have a leak in your kitchen.

Slowly, you feel your progress start to slip and you can’t adhere perfectly to the rigid parameters you’ve set for yourself.

Cue the all-or-nothing mindset.

“I ate donuts for breakfast every day this week and I haven’t worked out in 8 days. I might as well just quit and eat whatever I want. ’’ll start again when I’m not so busy.”

The pendulum swings to a hard left.

You abandon yourself and any positive progress you made, because you couldn’t do it all. Your mind tricks you that if it can’t be everything, it may as well be nothing.

The hard truth is, you will stay in a perpetual state of plateau with your health if you continue to see things through this lens.

You will be on the never ending cycle of starting and stopping because the conditions will never be perfect. You will never be perfect.

The reality is, there will be seasons where you can do more and seasons where you can do less.

The trick is to continue to show up in the tough seasons in small, but meaningful ways and not abandon yourself when things get tough.

Incremental, intentional and even perhaps slower changes are the way to sustainable change for health. You do not have to do it all at once, but you DO have to keep showing up!

Don’t let 5 days turn into 5 months. Move on from a tough moment with lightness and don’t let it trick you into quitting.

Expect those hard seasons. They will come as they do for anyone on a journey to learn something or better themselves. Expect it, so when it comes you can recover from it because you know it’s just part of the process.

Elongate Your Time Frame for Change

Our toxic diet culture has trained us to look at health as a transactional process of instant gratification.

Buy this plan and get results in 3 weeks.

Take this supplement and your PCOS will be fixed.

Lies.

Trust me, I hear you. You want to lose this weight. You want to stop losing hair. You want to restore your cycle and get pregnant. You are 100% validated in those goals. But, we are not going to get there overnight.

In an initial consultation with new clients, I invite them to shift their short-term mindset from a few weeks to months, to 6 months to a year.

This is a much more realistic time span to make positive and SUSTAINABLE changes that turn into long-term results.

PCOS is a long game we are playing. We have to intentionally and systematically build a lifestyle around you that supports the condition for your lifetime. This takes time and that is ok.

Each step on this timeline should meet you where you are in that moment and grow with you.

Addition vs. Subtraction

One of the most highly searched PCOS topics on the internet is “foods to avoid with PCOS”.

I get it. Whenever there is a problem with our health, our culture has trained us to immediately begin thinking about what we should restrict.

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It is true there are foods that are going to support PCOS and foods that won’t. But as soon as we start coming from a restrictive mindset, we set ourselves up for failure for the long-term.

Restriction will eventually lead to rebellion. It’s just human psychology, not your own personal failure.

So, instead of focusing on what you want to eat less of– most often refined carbohydrates, sugar and ultra-processed foods–I want you to focus on what you’re adding to your plate.

Because when you add protein, veggies and fiber-rich carbs, you’re going to feel fuller, blood sugar stability will improve, energy will go up, and cravings and hunger for those foods you wanted to restrict are going to go down– naturally.

This is the effect we were going for in the first place, but we got there by shifting our mindset to addition and not subtraction.

This sets you up for success and LONGEVITY.

Mending Your Relationship with Food

I was not taught this in school, but quickly learned on the job a negative relationship with food is one of the greatest barriers to meaningful change.

Inputs from diet culture, childhood experiences, the hormonal chaos of PCOS, relationships, weight bias, years of diets & restriction, negative self-talk, and outside judgement all work to erode this precious relationship for many women.

By the time many of them make their way to me, this relationship is completely broken.

Here’s the thing– there are many things we can avoid in life, but food is not one of them. You have to eat every day for the rest of your life and what you eat has a direct impact on your PCOS and your health.

In order to use nutrition to make a difference with PCOS, this relationship needs healing.

We have to make peace with food and start seeing it as a friend again- like we did when we were young, before all the outside influences derailed this relationship.

And this all starts with your mindset.

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A Tool for Transformation

I believe in the power of the words we use to begin this transformation. I’ll often ask clients to journal one page about how they currently view their relationship with food and another page about how they would like it to feel.

Many of the negative words look like:

• punishment

• control

• toxicity

• shame

• guilt

• anxiety

• fear

• regret

• judgment

• numbing

• restriction

• emotional

• addicting

In opposition, I invite them to spend time writing and reflecting on positive words like:

• nourishing

• sustainable

• healing

• mindful

• flexible

• restorative

• rebuilding

• reclaiming

• satisfying

• connected

• rooted

• embodied

• trust

• freedom

• joy

• balance

• presence

• peace

Another tool we use is writing daily affirmations. These might look like:

• I am restoring the relationship with food I was meant to have.

• I trust myself and I trust my body.

• Food is a way to nurture my PCOS.

• I am learning to be in touch with my body and listen to her.

• Food is a source of life and joy.

These vocabulary shifts are a first step to restoring a healthy relationship with food. One that feels positive, sustainable, nourishing & able to evolve and grow as you do.

Nutrition is one of the most meaningful ways to love yourself and your body and when you start to see it this way, nourishing your body and your PCOS becomes something you get to do, rather than a way to punish yourself.

It changes everything.

When it’s bigger than this

There are certainly times when this is a project bigger than what we can handle alone. Some may need a higher level of care and in those cases I encourage clients to work with a mental health clinician that can support you in this process.

With the high prevalence of eating disorders in PCOS and the low screening rates, we unfortunately have to be our own advocates and know when to seek outside help.

NEDA has a self-screening tool to help understand when you might need to seek that support.

Continuing the Journey

The journey of PCOS management isn’t about perfection, restriction, or quick fixes. It’s about showing up consistently, even when it feels messy. It’s about building a relationship with food that supports your body instead of punishing it. And it’s about trusting that small, intentional steps, repeated over time, are what will create real, sustainable change.

When you approach your health this way, the pendulum slows. You stop swinging between extremes of all-or-nothing. You start to see your body as a partner instead of an opponent, and food becomes a tool for nourishment and empowerment rather than a source of guilt or anxiety.

I hope something here spoke to you today. Keep showing up for yourself. You’ve got this. 🤍

This is my love letter of sorts to you, a woman living with polycystic ovarian syndrome.

One of the initial emotions that led me to work with this population was anger. There was also just as much compassion and empathy, but anger registers very clearly.

In my early work with PCOS clients, woman after woman I counseled, shared their rather heartbreaking, and at times atrocious, experiences navigating the medical system for their diagnosis and care (or lack of it in many cases).

At the start, I thought it was just a coincidence that I was hearing common threads- dismissal, gaslighting, body shaming, blame.

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After several years of working in this space, I’ve come to know this isn’t the exception but the norm of a broken system that is failing 10% of all women (our current estimates of the PCOS population).

The Lies You’ve Been Told

You’ve been led to believe that if you’d just eat a little less and move a little more you wouldn’t have PCOS.

You’ve been led to believe that if you had not gained the weight, this wouldn’t have happened and you would be pregnant.

You’ve been led to believe that your symptoms don’t truly matter unless there is a band-aid or medication we can slap on them.

You’ve been led to believe that you don’t possess autonomy in your healthcare decisions and your voice doesn’t matter.

You’ve been led to believe that having PCOS is your fault.

I’m here to tell you directly and honestly — none of this is true.

None of this is your fault. It never was.

The Problem

The problem is not you. But pull up a chair and I’ll tell you what is:

• The problem is the genes you received from your parents.

• The problem is the insulin resistance that keeps you craving carbs and sugar and your ovaries churning out testosterone.

• The problem is the high male hormones that disrupt your fertility and cause your most distressing physical symptoms.

• The problem is that each abnormal aspect of PCOS influences each other in vicious cycles.

• The problem is a medical system that largely does not understand PCOS, and sometimes, honestly doesn’t seem to care.

• The problem is a patriarchal medical system in which we don’t invest in studies or solutions for women’s health issues (the way we do for men, at least).

• The problem is a government bought by big food companies that promotes their profits over the health of our nation.

• The problem is a food system that is scientifically designed to hook us on ultra-processed, nutrient-devoid foods that wreck our metabolic health.

• The problem is we grew up in a culture that promotes dieting, disordered eating, and body shaming, allowing the people selling “solutions” to profit from our self-hatred.

• The problem is that the above has left us with a completely broken relationship to food and our bodies.

• The problem is our “cupcake culture” where we grew up being rewarded with food; this conditioning has held fast into adulthood.

• The problem is endocrine-disrupting chemicals and environmental pollutants that we’ve been exposed to daily since we were in our mother’s womb.

• The problem is that many aspects of typical modern life are detrimental to our gut microbiome.

• The problem is our demanding work culture in which we are expected to surrender most of our time on earth.

• The problem is our all-or-nothing culture that has never taught us what consistency without perfection actually looks like, leaving us to start and give up on ourselves year after year.

• The problem is that living on 5 hours of sleep is largely considered a badge of honor.

• The problem is our screen-based culture that keeps us in daily worship of our devices.

• The problem is our trauma and over-activated sympathetic nervous systems keeping us in fight or flight more than humans were designed to be.

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• The problem is the separation from our circadian rhythm.

• The problem is our culture’s obsession with convenience and how it’s silently trained us to seek to input minimal effort and balk at physical challenge.

• The problem is that “sitting” has become the “smoking” of our generation.

• The problem is that humans were never meant to be indoors all day, yet our entire world has been built to keep us inside.

I know that list is long (and far from complete), but I hope that was able to bring you a fresh perspective and perhaps some validation and vindication.

Now, let’s get to the good part.

Where Your Power Lives

Here’s a hard truth, offered with love:

This road you are walking is not your fault. But it is 100% up to you to change it.

Change begins when blame falls away and you focus on what’s within your control, reclaiming agency over your health one intentional choice at a time.

Here are your seeds of empowerment:

• The solution is educating yourself about PCOS and your body, so you feel empowered and in ther driver’s seat of your own health.

• The solution is learning what insulin resistance is and the lifelong food and lifestyle strategies to manage it well.

• The solution is learning what foods have protein, fat, carbohydrates, fiber, vitamins, minerals and antioxidants.

• The solution is eating nutrient-dense foods most of the time.

• The solution is learning to prepare meals for yourself.

• The solution is learning to set boundaries with yourself, your time and the people in your life.

• The solution is pursuing mental health support if you need it.

• The solution is to spend some time outdoors every week (especially if there are mental health struggles).

• The solution is knowing that it’s ok to want to lose weight, while rejecting diet culture at the same time.

• The solution is understanding that “unscheduled time” is not free time. Protect it.

• The solution is to stop living our lives on screens.

• The solution is self-love driving every decision you make.

• The solution is learning that you will never be perfect, but that showing up is worth it anyway.

• The solution is working with someone to repair your relationship with food.

• The solution is to speak to yourself with kindness.

• The solution is meaningfully addressing our trauma and stress.

• The solution is learning what is within our control to reduce our exposure to endocrine-disrupting chemicals and environmental toxins.

• The solution is to get good at giving yourself grace when things don’t go as planned.

• The solution is getting ruthless with what gets your attention and time.

• The solution is giving your body the rest it needs to function optimally.

• The solution is curating the media inputs you allow access to you.

• The solution is accepting that moving your body every day is part of managing PCOS.

• The solution is understanding that pursuing ultra-convenience can actually harm us.

• The solution is always meeting yourself where you are and making changes that are realistic for you.

• The solution is daring to choose differently— to choose a path most people won’t.

I’m not saying this is easy.

I’m not saying you won’t have hard days, weeks, or months.

But, it is worth it and I believe with all of my heart that you have the power to transform your health and your life.

Today’s topic is a foundational article and a must-read if you take or are considering taking supplements to support your PCOS.

🌱PCOS and Supplements

Supplements are everywhere in the PCOS space— marketed as quick fixes, miracle cures, or “must-haves” for hormone balance.

In reality, supplements can be incredibly helpful when used appropriately, and equally unhelpful (or even harmful) when misunderstood or misused.

This article breaks down when supplements make sense, what they can and can’t do, how to navigate quality concerns, and my practical approach to using them.

Why use Supplements?

Supplements are one piece of a broader approach to supporting health. In practice, this means they can help fill nutrient gaps, support specific metabolic or hormonal pathways, and gently enhance physiological function.

Key times supplements may be warranted:

• As an alternative when medications are not tolerated

• When patients prefer to explore non-medication approaches

• When nutrients are unable to be obtained from food

• When labs demonstrate a clear clinical need

• During preconception to optimize egg quality & prepare the body for pregnancy

• During pregnancy to supply key nutrients for fetal development & maternal health

• During breastfeeding to support breast milk composition & repletion of the mother during the most “nutritionally expensive” time

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What They Can’t Do

The Oxford English Dictionary defines the word supplement as “something that completes or enhances something else when added to it.”

They cannot compensate for inadequate sleep, unaddressed chronic stress, under-eating, or a diet that lacks overall foundational nourishment.

They also cannot replace medical care or medications in certain situations.

Supplements are most effective when they enhance an existing plan, not when they’re relied on as a quick fix or stand-in for foundational health practices.

When It Comes to PCOS

There are many well-studied compounds that can support things like insulin resistance, high androgens, cycle regularity, egg quality, inflammation, and replete key nutrient deficiencies, positively influencing PCOS outcomes.

Ultimately, the use of any supplement comes down to the desire to improve the way a woman experiences her body and symptoms, supporting it to function as optimally as possible.

How much should I take?

Dosage varies widely depending on the supplement and the individual need. Ideally, this should be guided by a knowledgeable practitioner and based on therapeutic ranges established by scientific research.

While supplements can be powerful tools when used appropriately, some can cause harm when taken in excessive doses for prolonged periods.

For example, long-term high-dose zinc supplementation can promote to copper deficiency, and extended use of high-dose vitamin C may increase the risk of kidney stones.

Supplements can also interact with medications or with each other, making that personalized guidance essential.

How long should I take a supplement?

The duration will depend on the reason and clinical evidence to support it and should be reassessed periodically based on clinical need, labs, and response.

Some supplements are appropriate for long-term use, others are best cycled, and some are intended only for short-term or targeted support.

When repleting a nutrient deficiency

If a supplement is being used to correct a nutrient deficiency, low iron, for example, follow-up labs are typically reassessed within 3–6 months. These results help determine whether supplementation should be continued, adjusted, or discontinued.

Some micronutrients, like iron, can accumulate and become harmful if taken in high doses for too long.

On the other hand, if levels fail to improve, this may point to another issue and warrant further investigation.

When working on a metabolic/hormonal issue

When supplements are used to support a specific PCOS- concern, such as insulin resistance, a 3–6 month trial is often appropriate. During this time, both lab markers and symptoms— like insulin and A1c levels, cravings, energy, weight changes, and menstrual regularity— should be monitored by your provider to assess effectiveness.

When dietary intake will not provide adequate amounts

If a nutrient cannot be reliably obtained through dietary intake, long-term supplementation may be necessary.

For instance, if inflammation markers are elevated and you can’t tolerate or simply do not regularly eat fatty fish, an omega-3 supplement providing EPA and DHA may be an appropriate long-term strategy.

When indicated by the research

Some nutrients and bioactive compounds have strong evidence supporting their role in improving PCOS outcomes.

Vitamin D is a prime example. Research shows it plays an important role in PCOS, and deficiency is common. In these cases, repleting a deficiency and continuing with a maintenance dose, while periodically reassessing labs, may be appropriate.

Quality Matters

With the rise of wellness culture, the supplement industry has grown to a multi-billion dollar industry attracting many people— some that genuinely want to promote health and others that only seek to cash in.

This comes as a surprise for many, but the supplement industry is largely unregulated.

In 2023, the FDA inspected 500-600 supplement production facilities for GMP practices (more on that in a minute). Sounds great right? Well, that is only 5% of the total number of facilities registered! Everyone else got a free pass.

Further, the FDA does not test supplements to verify ingredient accuracy, dosing, or freedom from contaminants like allergens and heavy metals, leaving manufacturers responsible to ensure quality.

These are 4 of the major issues when it comes to supplement quality.

Purity

Supplements can sometimes contain impurities or contaminants not listed on the label, including heavy metals, bacteria, or residual solvents from manufacturing.

They may also include common allergens like gluten, soy, or dairy, which can pose risks for sensitive individuals.

In fact, in 2015, the New York Attorney General’s office tested supplements from four major retailers and found many didn’t contain the ingredients listed—some contained none of the claimed active ingredient at all.

This can impact both safety and effectiveness, making it crucial to choose reputable brands that prioritize testing and transparency.

Potency

When it comes to supplements, potency is critical. To get the intended benefit, a product needs to contain the amount of active ingredient listed on the label.

Unfortunately, many supplements cut corners (cause who’s checking?), delivering less than advertised, which can reduce effectiveness and leave you spending money without results.

Transparency

Many products use proprietary blends, which list a group of ingredients with a total amount but don’t disclose exactly how much of each ingredient is included.

This can make it difficult to know whether you’re getting a therapeutic dose of the nutrients you need.

I see this as more problematic in formulas that have a long list of compounds vs. a shorter list, but an issue nonetheless.

Choosing companies that provide full ingredient amounts and clear labeling ensures you can make informed decisions to get the results you’re looking for.

Bioavailability

Not all forms of a nutrient are absorbed or used by the body equally. Even if a supplement contains the right dose on the label, the body may only be able to access a fraction of it.

The chemical form of the nutrient and the presence of other compounds affect how well a supplement works. Choosing forms that are well-studied and known to be highly bioavailable helps ensure you get the full benefit.

How to Choose a Supplement Brand

Now that you understand the potential quality issues, here are some tips for choosing a reputable supplement company.

GMP (Good Manufacturing Practice)

GMP indicates that a company claims to follow recognized quality and safety standards in how supplements are made, including handling ingredients, processing products, and maintaining consistent batches.

While it’s a positive sign that the company is focused on quality, it’s important to know that GMP compliance is often self-reported and doesn’t guarantee that every product meets the label claims.

GMP is bare minimum, but not enough. Independent third-party testing is the only way to fully verify purity, potency, and safety.

Third-Party Testing

Third-party testing is an independent evaluation of a supplement’s purity, potency, and safety and is the gold standard for quality.

Participation is voluntary, so companies choose to have their products tested and pay for the process themselves, but it provides an objective, external check that what is on the label actually matches what is in the bottle.

The USP and NSF certifications are the most visible.

USP Verified & NSF Certified

Both USP (US Pharmacopeia) and NSF (National Sanitation Foundation) certifications indicate that a supplement has undergone independent third-party testing to confirm purity, potency, and label accuracy.

These certifications verify that the product contains the ingredients and doses listed on the label, is free from harmful contaminants, and is manufactured according to GMP standards.

NSF certification takes it a step further and also includes screening for banned substances, making it especially trusted for athletes.

Consumer Testing

Some organizations, like ConsumerLab, offer independent testing of supplements that is funded by consumers rather than the manufacturer. These groups purchase products off the shelf and test them in their own labs for purity, potency, and contaminants.

Consumers pay for access to detailed reports and rankings, giving them transparency and confidence in which products actually deliver what the label claims.

Red Flags

Some common red flags to look for:

• Missing or unclear ingredient information – Difficulty finding a full ingredient list or nutrition facts, or no listing at all.

• Questionable third-party testing claims – Companies that say they use independent testing but provide no proof or certification on their website. Trust me, if do it, they want you to know.

• Over-the-top or unsubstantiated claims – Grandiose health promises that seem too good to be true

• Opaque “proprietary blends” – When ingredient amounts are hidden, making it impossible to know if you’re getting a therapeutic dose.

• Unverified or sketchy brands – Companies with little transparency about sourcing, manufacturing, or quality control.

Amazon

Amazon get its own section because it is the leading supplement retailer and rife with quality issues including counterfeit/fakes, contamination and safety risks, improper product storage, and mislabeled products.

If you are considering purchasing ANY supplement on Amazon, first go to the company’s website and vet them, then make sure you are purchasing directly from their Amazon storefront.

Of note, many of the professional lines (trusted brands like Metagenics, Designs For Health, Klaire Labs, Thorne etc.) do not allow unauthorized resales on third party websites and some must be sold under a licensed healthcare provider.

Social Media

TikTok, in particular, drives supplement sales by heavy marketing through influencers and TikTok shops, many of which are not licensed healthcare practitioners.

Do not base a purchase solely on the amount of times you’ve seen an ad for it or the celebrity or influencer endorsing it.

Before you purchase anything here, do your research. Go to the company’s website and assess for quality certifications, ingredient lists and transparency.

No matter how effective the marketing sounds or how pretty the packaging is, only base purchases off of quality parameters.

My Beef with the State of Supplement Recommendations

This brings me to one of my biggest concerns with how supplements are often recommended in practice.

Since I myself pivoted from the conventional model to a more functional nutrition approach in 2015, I’ve seen a pattern emerge that is bothersome.

It’s not uncommon for me to see a new client that previously worked with a functional medicine provider and are on 10-20 different supplements.

This angers me for several reasons:

1. The cost. The expense of being on this many things indefinitely is not maintainable from a financial standpoint. I find it absolutely ludicrous to ask this of people, particularly in the financial climate we are in. There is little consideration for what people can sustainably afford.

2. The duration. In many cases, there is no end date given for reassessment. It’s just, “here take these”. ANY supplement you take should have a date for reassessment. If it’s working and you decide to continue and it’s safe- hey, we love that! But, if nothing has changed, why would we continue to spend money on it?

3. The volume. The sheer amount of pills people are asked to swallow every day at some point causes pill fatigue that leads to inconsistency. If you aren’t consistent, you won’t get results. And that is pouring money down the drain.

4. The lack of education. When I ask, most people have no idea why they are taking some or all the products. They were given no benchmarks to assess if they are helping, whether it be lab data or symptom assessment. You should have a general idea of why you are taking something.

5. Lack of follow-up. Of course, at times it is the client that does not follow up, but just as often, the practitioner has not ordered follow up labs or taken a detailed symptom collection to know if things have improved.

My Approach

In general, I try to keep supplements as minimal as possible to get the results I’m looking for— PCOS- focused symptom and lab marker improvements.

To be clear, because I am pro-supplements, it doesn’t mean I am anti-pharmaceutical. Each individual has a unique path to their best health that should be determined in collaboration with their provider.

Pharmaceuticals are not in my scope obviously as an RD, but even if you are using them, nutrition and lifestyle is still the foundation that you need to have, so whichever route you go, that still applies.

My Guidance for Supplement Use

• More is not more- Don’t start with 10 products. Start with 2-3 things, unless you have clear evidence and practitioner guidance to the contrary. It’s hard to know what’s working if you start too many things at once.

• Be consistent- If you are going to spend your hard-earned money, make sure you are in a place where you can be mostly consistent in taking them, so you can correctly gauge if they are moving the needle or not.

• Reassess- Keep track of symptoms and rerun labs periodically to assess efficacy

• Communicate- ALWAYS communicate what you are taking with your entire care team. Medication-supplement interactions are real and everyone needs to be informed.

A Resource For You

As a reader of PCOS Journal, you have access to my Fullscript, the supplement dispensary I use with my clients. It’s an easy way to get safe, professional-grade supplements at a 15% discount. You can sign up for an account here to get started.

Many of the PCOS-focused supplements I recommend are in my Favorites tab for easy access.

Fullscript carefully vets every brand, maintains direct relationships with suppliers, and requires annual third-party cGMP certification. Ongoing testing ensures purity, potency, and transparency, and their Fullscript Quality Program (FQP) keeps products meeting the highest quality standards.

Always check with your practitioner before starting anything new.

Disclosure: I receive a small commission (at no cost to you) when you order through my Fullscript store. This helps support my work on, so I can keep creating thoughtful, evidence-based resources for this community 🤍

A few other articles you might enjoy:

• NAC and PCOS: 5 Evidence-Based Reasons to Consider It

• The Ultimate PCOS Lab Checklist

• 7 Key Hormones Imbalance of PCOS

Yet despite how common it is, many women go undiagnosed and unsupported. With multiple sets of criteria developed over the years and gaps in clinician knowledge, patients often face delays, misdiagnoses, and confusion.

Knowing the current diagnostic standards can make a huge difference in advocating for your own diagnosis and care.

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PCOS As a Syndrome

Before we define the diagnosis, you need to understand what a diagnosis of PCOS means. It is not considered a disease, but instead classified as a syndrome.

A syndrome is a collection of signs and symptoms that occur together, but the exact cause may be unknown or variable. It describes a pattern rather than a single, well-defined disease, of which PCOS is a classic example.

The 2023 International PCOS Guidelines explicitly state that PCOS is a diagnosis of exclusion, meaning doctors must first rule out other conditions that can cause similar symptoms, including:

• Thyroid disorders (too high or too low)

• Hyperprolactinemia (high prolactin levels)

• Non-classic congenital adrenal hyperplasia (CAH)

• Cushing’s syndrome

• Androgen-secreting tumors

This ensures that irregular periods, excess male hormones, or polycystic ovaries are truly due to PCOS, and not another underlying condition. This matters so the right interventions can be applied.

Diagnostic Criteria

Three different sets of criteria have been proposed and used since the 1990’s:

• The NIH Criteria

• The Rotterdam Criteria

• The Androgen Excess Society (AES) Criteria

We’ll take a quick overview of how the criteria have evolved and what is used in practice today.

The NIH Criteria

In 1990, the National Institutes of Health (NIH), reached agreement on the first official guidelines and qualified PCOS diagnosis as the presence of:

• Hyperandrogenism (elevated male hormones) or clinical signs of it (hirsutism)

• Irregular menstrual cycles/ovulation

The finding of polycystic ovaries on ultrasound was considered “suggestive of PCOS”, but not diagnostic.

At the time, this was a contrast to the prevailing thought in the UK and Europe, where polycystic ovaries were considered a “defining feature of PCOS.”

The Rotterdam Criteria

In 2003, a group of PCOS experts met for a conference in the Netherlands and created what is well-known as the Rotterdam criteria.

The criteria require at least 2 of these 3 things to be present:

• Irregular menstrual cycles/ovulation

• Polycystic ovaries on ultrasound

• Hyperandrogenism (elevated male hormones) or clinical signs of it (hirsutism)

The Phenotypes

Based on the Rotterdam, there can be 4 different subtypes, or phenotypes, based on which criteria are present:

• Phenotype A- all three; irregular cycles, polycystic ovaries and hyperandrogenism

• Phenotype B- hyperandrogenism and irregular cycles

• Phenotype C- polycystic ovaries and hyperandrogenism

• Phenotype D- irregular cycles and polycystic ovaries

The key differences in the Rotterdam from the NIH criteria were:

• Hyperandrogenism is not required for diagnosis (Phenotype D)

• Polycystic ovaries are now an official part of the criteria

As a result, these expanded criteria led to increased diagnosis– up to three times reported in some studies.

The AES Criteria

In 2006, the Androgen Excess Society (AES) introduced their own criteria with one stark contrast to the Rotterdam– elevated androgens were a required feature for diagnosis.

The AES criteria defined:

• hyperandrogenism or clinical signs of it (hirsutism)

And at least one of the following:

• Polycystic ovaries on ultrasound

• Irregular menstrual cycles/ovulation

This criteria eliminates the Rotterdam phenotype D— those with only polycystic ovaries and irregular ovulation/menstrual cycles, but no hyperandrogenism.

What Is Currently Used

The existence and use of multiple criteria has been criticized for creating confusion within the medical community and delaying much needed research. Well, duh.

In 2012, the NIH held another meeting of PCOS experts and concluded that the Rotterdam criteria should be used. This sentiment was echoed again in the 2018 International Evidence-Based Guideline for the Assessment and Management of PCOS.

As it stands today, the Rotterdam criteria is what is widely recognized, accepted and used and with what you should be familiar.

A recent change to know

In 2023, an update was made to the International Evidence-Based Guideline for the Assessment and Management of PCOS.

The updated guidelines now allow for anti-Mullerian hormone (AMH), a blood test, to be used in place of ultrasound for assessing polycystic ovaries in adults for the diagnosis of PCOS.

To learn more about AMH, see point number four in 7 Key Hormone Imbalances in PCOS.

Diagnosing in Adolescence

Diagnosing PCOS in adolescents requires caution and care because normal changes in puberty, like irregular periods and mild acne or hirsutism, can mimic PCOS features.

According to the 2023 International Evidence-Based Guidelines, a diagnosis should only be made when both of the following are present:

• Irregular menstrual cycles (adjusted for years post-menarche)

• Clinical or biochemical hyperandrogenism

Polycystic ovaries can a normal finding in puberty, while the menstrual rhythm is establishing, so ultrasound or AMH levels should not be used for diagnosis in this age group.

The expert guidance recommends adolescents presenting with only one feature should be labeled “at risk” and followed up to 8 years post menarche (the first cycle/period) to avoid over diagnosis while guiding early management of metabolic and psychosocial risks.

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Gaps in PCOS Diagnostic Knowledge Among Clinicians

Unfortunately, having clear criteria is not the only issue. Many clinicians are still unaware of or unclear on the recommended criteria, and some continue to associate polycystic ovaries as the primary feature of the syndrome.

A few studies and papers have looked at this with startling results:

• A 2017 survey of 630 North American clinicians found that 27.7% did not know which criteria they used. Over one‑third of clinicians incorrectly associated PCOS primarily with “cysts on ovaries,” and many general Ob/Gyn were less aware of associated psychological conditions (depression/anxiety). Reproductive endocrinology specialists performed much better, highlighting a clear knowledge gap between generalists and experts.

• In 2024, another study in Germany revealed similar gaps. Out of 206 survey taken, 97.9% of specialists correctly identifying the criteria compared to just 51% of non-specialist gynecologists. That means, if you walked into a standard gynecologist office in Germany, you’d have a 50/50 chance of the clinician knowing how to diagnose you.

• In 2018, a US survey study of 347 ob/gyns in-training revealed, only 55% could correctly identify the core PCOS diagnostic criteria, and fewer than 10% recognized all five detailed components— highlighting major gaps in foundational training.

I”m sure it will come as no surprise to many of you that primary care has similar shortcomings.

• A 2022 study of 75 primary care physicians and their PCOS patients found that primary care is often the first stop but rarely where PCOS is diagnosed—53% sought help there first, yet only 22% were diagnosed, 24% treated, and nearly one in four misdiagnosed.

• A 2017 global survey of 1,385 women found that one-third waited over two years and saw three or more clinicians for a PCOS diagnosis, with only 35% satisfied and just 16% happy with the information provided.

What this means for you

If you suspect you have PCOS, there is a chance you may end up in the care of (or have already been in the care of) someone that does not clearly understand how to identify and correctly diagnose PCOS, as well as screen properly for the other conditions associated with it.

This has been the frustrating lived experience for many of my clients and I’m sure for many of you reading.

This means, you need to be very familiar with the diagnostic criteria, so you can appropriately advocate for yourself while navigating the medical system.

Now What?

If you suspect you have PCOS and are seeking help from your doctor, here’s my advice on navigating the diagnostic process and beyond.

Memorize the Rotterdam criteria

Knowledge is empowerment in the medical system. Before your appointment, make sure you are CRYSTAL clear on the diagnostic criteria and how they are measured. Restating here for clarity:

Diagnosis is made by having at least 2 of these 3:

• Irregular menstrual cycles/ovulation

• Polycystic ovaries on ultrasound or elevated AMH on lab work

• Hyperandrogenism (elevated male hormones) or clinical signs of it (hirsutism)

Ask questions

Be vocal. These questions will quickly weed out a practitioner that is not informed on PCOS:

• What criteria are you using for diagnosis?

• What conditions will you be seeking to rule out first?

• What are your goals for my care?

• What are the related conditions and health issues I need to be aware of and monitor if I am diagnosed with PCOS?

Assess for polycystic ovaries

If not ordered, request ultrasound or AMH (blood test) to assess for polycystic ovaries. Seems outrageous I even have to state this here, but I’ve had clients who were never assessed.

Request labs

Having the diagnosis is the first step. Next, we want to know what is driving your PCOS symptoms.

I recommend casting a wide net with labs to assess for androgens, markers of insulin resistance, inflammation and nutrient deficiencies as well as related conditions. I’ve got you fully covered in this post below.

If you don’t get the answers you need, find a new doctor.

Seriously. I know this is not fun, but having a knowledgeable (and compassionate) practitioner is a game changer. You might have to kiss a few frogs, but when you find the right practitioner, it changes everything.

Work with a registered dietitian that specializes in PCOS

Even when patients finally find a clinician who understands PCOS and assigns the correct diagnosis, this is often where care falls apart.

Many of my clients describe the same moment of relief, followed immediately by frustration, when they are then handed a familiar script:

• “Lose weight.”

• “Eat less and move more.”

• “Take birth control and come back when you want to get pregnant.”

• “Start metformin and cut carbs.”

This is where the healthcare system is failing so many of you.

PCOS care requires education, appropriate screening, targeted testing, and individualized follow-up—not generic advice.

“Eat less and move more” is not legitimate medical advice for PCOS and helps no one.

What is helpful, and supported by evidence, is learning and implementing strategic nutrition and lifestyle changes that address your underlying drivers of the syndrome.

What’s even more helpful, is having a kind and compassionate coach that reasonably stretches you, but helps you do it at your pace.

This is the work I do with clients in my private practice. If you’re interested in working with me one-on-one, you can learn more at PCOS Pro. I offer a free, 15-minute, no-pressure call (we are not selling cars here) to see if it’s the right fit.

And because I know individualized care is not accessible to everyone, I am also creating a nutrition/lifestyle-focused digital course on PCOS, planned for launch this spring.

I hope this article gave you some much needed clarity. Let me know if you have any questions in the comments.

I am so looking forward to growing this community here in 2026 and helping you reach your PCOS goals.

Sources

• Christ JP, Cedars MI. Current Guidelines for Diagnosing PCOS. Diagnostics (Basel). 2023;13(6):1113. PMID: 36980421; PMCID: PMC10047373. https://pubmed.ncbi.nlm.nih.gov/36980421/ PMC

• Gaps in knowledge regarding the diagnostic criteria and management of PCOS in Germany: an anonymous web-based survey. PMCID: PMC11617859. https://pmc.ncbi.nlm.nih.gov/articles/PMC11617859/ PMC

• The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. J Clin Endocrinol Metab. 2009; PubMed PMID: 18950759. https://pubmed.ncbi.nlm.nih.gov/18950759/ PubMed

• Dokras A, et al. Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome. Fertil Steril. 2017; PubMed PMID: 28483503. https://pubmed.ncbi.nlm.nih.gov/28483503/ PubMed

• Knowledge of PCOS in physicians-in-training: identifying gaps and educational opportunities. J Grad Med Educ. 2018; PubMed PMID: 32252571. https://pubmed.ncbi.nlm.nih.gov/32252571/ PubMed

• Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2017; PubMed PMID: 27906550. https://pubmed.ncbi.nlm.nih.gov/27906550/ PubMed

• Diagnostic journey of patients with PCOS and obesity and primary care physicians (2022 study). PubMed PMID: 27906550 covers related diagnostic delay experiences; source details above.PubMed

When we only treat symptoms without understanding the underlying hormonal drivers, it can be hard to make meaningful improvements.

In this post, I’m breaking down these 7 key hormone imbalances most commonly seen in PCOS, why they happen, how they show up in the body, and what evidence-based strategies can help support each one:

• high insulin

• high androgens

• high cortisol

• high anti-Mullerian hormone (AMH)

• high luteinizing hormone (LH)

• low progesterone

• low sex hormone binding globulin (SHBG)

Knowing which ones apply to you gives you a clearer roadmap for where to focus, instead of playing whack-a-mole with your symptoms.

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1. High Insulin

Insulin resistance (and the resulting high insulin levels) is one of the main hormonal drivers of PCOS, affecting up to 70% of women with the condition. It also plays a central role in many of the other hormone imbalances you’ll read about below.

After we eat, carbohydrates are broken down into glucose, which enters the bloodstream and raises blood sugar levels. In response, insulin is released to help move glucose into cells and bring blood sugar back to normal.

In PCOS, cells don’t respond as effectively to insulin’s signal, so the body compensates by producing more insulin. Over time, this cycle can worsen insulin resistance and increase the risk of prediabetes and type 2 diabetes if not addressed.

Insulin’s influence on PCOS

• Stimulates the ovaries to overproduce testosterone (this is a key connection!)

• Promotes chronic inflammation

• Drives sugar and refined carbohydrate cravings

• Increases hunger and difficulty feeling satisfied

• Contributes to weight gain, especially in the central region

• Causes skin changes such as acanthosis nigricans (dark velvety patches on skin) and skin tags

• Disrupts ovulation and menstrual regularity

• Impairs fertility

• Contributes to metabolic syndrome (elevated blood pressure, cardiovascular risk)

• Increases risk of type 2 diabetes

• Negatively affects lipid profiles (elevated triglycerides)

• Promotes fatty liver disease

Addressing high insulin

Nutrition

• Balanced meals: Aim for adequate protein, fat, and fiber at each meal to support low and slow blood sugar responses, rather than sharp spikes and crashes.

• Carbohydrate quality and quantity: Managing carbohydrate intake matters. Minimizing refined carbohydrates and added sugars while prioritizing whole-food sources helps reduce insulin demand.

Lifestyle

• Sleep: Inadequate or poor-quality sleep impairs blood glucose regulation and worsens insulin resistance. Improving sleep habits is a foundational step.

• Strength training: Muscle acts as a major sink for glucose. The more lean muscle mass you have, the more efficiently your body can clear glucose from the bloodstream.

• Movement: Regular movement increases glucose uptake by muscles. Daily walks, ,especially after meals, are a simple, effective way to improve blood sugar control.

Medications & Supplements

• Medications like metformin help sensitize the body to insulin

• Supplements like inositols, berberine and NAC have been studied to to improve insulin sensitivity

2. High Androgens

Androgens are often referred to as “male hormones,” but women naturally produce them as well, just at much lower levels. The androgens include:

• DHEAS

• DHEA

• androstenedione

• testosterone

• dihydrotestosterone (DHT)

In PCOS, androgens, particularly the more potent forms, testosterone and DHT, are often elevated. These hormones drive many of the hallmark physical symptoms of the syndrome, including hirsutism, acne, androgenic alopecia (male-pattern hair loss), and irregular or absent ovulation.

High insulin is a key driver of high androgens as it directly stimulates the ovaries to produce testosterone.

High androgen’s influence on PCOS

• Worsens insulin resistance

• Suppresses SHBG, increasing free testosterone

• Disrupts ovulation and menstrual regularity

• Alters follicle development, contributing to polycystic ovaries

• Drives acne, hirsutism, oily skin, and androgenic hair loss

• Shifts fat distribution toward the abdomen

• Promotes inflammation

• Impairs fertility

Addressing High Androgens

Because high insulin directly stimulates ovarian testosterone production, improving insulin resistance is one of the most effective ways to reduce androgen levels at the source (see above section).

• Improve insulin sensitivity: Balanced meals, regular movement, and strength training reduce insulin-driven testosterone production.

• Spearmint tea: Studies show 1–2 cups daily can lower testosterone and improve hirsutism.

• Supplements: Reishi mushroom, white peony, zinc, and saw palmetto may help reduce the conversion of testosterone to DHT.

• Medications: Spironolactone, finasteride, or hormonal contraceptives can lower androgen levels or block their effects.

• Weight management: Even modest weight loss can improve insulin resistance and reduce androgen production.

• Stress management: Chronic stress can indirectly worsen androgens via cortisol; mindfulness, sleep, and restorative movement help.

3. High Cortisol

Cortisol is the body’s primary stress hormone, released by the adrenal glands to help regulate blood sugar, inflammation, immune function, and our response to physical and emotional stress.

In women with PCOS, cortisol levels and stress reactivity are often higher, driven by chronic inflammation, blood sugar instability, poor sleep, and ongoing physiological stress.

Cortisol’s potential influence on PCOS

• Raises blood glucose levels and worsens insulin resistance

• Increases abdominal (central) fat storage

• Disrupts ovulation and menstrual regularity

• Amplifies androgen production and activity

• Promotes chronic inflammation

• Impairs sleep quality and circadian rhythm

• Increases anxiety, irritability, and stress reactivity

• Contributes to fatigue and burnout over time

• Interferes with progesterone production by suppressing ovulation

Addressing high cortisol

• Stabilize blood sugar: Eating regular meals with adequate protein, fat, and fiber helps prevent cortisol spikes driven by low or fluctuating blood glucose.

• Prioritize sleep: Consistent, sufficient sleep supports healthy cortisol rhythm and improves insulin sensitivity.

• Incorporate restorative movement: Walking, yoga, Pilates, and gentle strength training help lower stress hormone output.

• Manage psychological stress: Mindfulness, breathwork, and nervous-system regulation can reduce repeated cortisol surges.

• Support circadian rhythm: Morning light exposure and consistent bedtimes help normalize cortisol’s daily pattern.

• Address inflammation: Chronic inflammation can keep cortisol elevated; anti-inflammatory nutrition plays a supportive role.

• Supplementation: Adaptogens and nutrients such as magnesium, ashwagandha, phosphatidylserine, and omega-3s may support stress response and cortisol regulation. Always use under the care of your provider.

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4. High AMH

AMH (anti-Müllerian hormone) is made by developing follicles in the ovaries and is often used as a marker of ovarian reserve. In PCOS, AMH is commonly higher because there are many small follicles that start to develop but don’t fully mature or ovulate.

So while high AMH can sound like a good thing, in PCOS it usually reflects follicles getting “stuck in development”, not a measure of fertility.

High AMH is less a cause of PCOS and more a signal of disrupted follicle development. Elevated levels are associated with irregular ovulation, longer or absent cycles, and difficulty conceiving—not because of “too much fertility,” but because follicles are not maturing and releasing an egg.

Signs often linked to elevated AMH

• Irregular or absent menstrual cycles

• irregular ovulation or anovulation (not ovulating)

• Follicles that begin developing but don’t fully mature

• Longer time to conceive

• Polycystic ovarian appearance on ultrasound

• Can correlate with higher androgen levels and insulin resistance in some women

Addressing high AMH

High AMH in PCOS isn’t usually the root problem. It’s a signal that follicles aren’t maturing properly, often due to insulin resistance, elevated androgens, or disrupted ovulation signals. Addressing those underlying drivers can help normalize AMH over time.

• Support ovulation: Improving insulin sensitivity through balanced meals, regular movement, and strength training can help follicles mature.

• Manage insulin and androgens: Supplements like inositols, NAC, and lifestyle strategies that lower insulin can indirectly support healthier AMH levels.

• Medical options when needed: For women trying to conceive, medications like letrozole or clomiphene can help stimulate ovulation despite high AMH.

5. High Luteinizing hormone (LH)

Luteinizing hormone (LH) is produced by the pituitary gland in the brain and normally helps trigger ovulation each cycle. LH production is controlled by GnRH (gonadotropin-releasing hormone), which the brain releases to signal the pituitary to make LH and FSH (follicle stimulating hormone).

In many women with PCOS, GnRH is released in faster, more frequent pulses, causing LH levels to be higher than usual or released at the wrong time, disrupting the normal hormonal rhythm needed for a mature egg to release.

LH’s influence on PCOS:

• stimulates testosterone production

• disrupts ovulation

• contributes to formation of polycystic ovaries

• impairs fertility

• can worsen insulin resistance

Addressing high LH

Because LH is primarily controlled by the brain’s pulse signals, we have less ability to directly lower it. Instead, improving upstream factors, like insulin resistance and high androgens, can help bring LH closer to normal and restore ovulation.

6. Low Progesterone

Progesterone is the hormone that regulates the second half of your menstrual cycle and prepares the uterus for a potential pregnancy.

It’s only produced after ovulation, which is why women with PCOS often have low progesterone when ovulation is irregular or doesn’t occur.

Beyond supporting pregnancy, progesterone helps regulate mood, sleep, body temperature, and balances estrogen throughout the menstrual cycle.

Signs of low progesterone

• Irregular, infrequent, or absent menstrual periods

• Heavy or unpredictable bleeding

• Difficulty conceiving or sustaining a pregnancy

• Short luteal phase (time between ovulation and period)

• Mood swings, irritability, or anxiety

• Poor sleep or trouble staying asleep

• Symptoms of estrogen dominance (bloating, breast tenderness, headadches, fibrocystic breasts)

• Low basal body temperature in the second half of the cycle

Addressing low progesterone

Low progesterone in PCOS usually occurs because ovulation is irregular or absent, so the ovaries aren’t producing it as they should. Supporting ovulation is the key to naturally raising progesterone:

• Support ovulation with lifestyle: Balanced meals, regular movement, and strength training can improve insulin sensitivity, which helps regulate ovulation.

• Medications: For women trying to conceive or with very irregular cycles, medications like clomiphene or letrozole can stimulate ovulation and progesterone production.

• Hormone replacement when appropriate: Progesterone supplementation (oral or vaginal) may be used short-term to regulate cycles, support fertility, or address estrogen dominance symptoms.

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7. Low Sex Hormone Binding Globulin

Sex hormone-binding globulin (SHBG) is a protein made by the liver that binds to sex hormones like testosterone, keeping them inactive in the bloodstream.

In PCOS, SHBG levels are often low, which means more free (active) testosterone is available to act on the skin, hair, and other tissues.

Low SHBG’s influence on PCOS

• Increases free (active) testosterone in the bloodstream

• Worsens hirsutism (excess facial/body hair)

• Contributes to acne and oily skin

• Drives androgenic hair thinning or hair loss

• Can exacerbate insulin resistance and metabolic issues

• Linked with fatty liver in some women

Addressing low SHBG

Low SHBG is often a downstream effect of high insulin, high androgens, and liver metabolism issues. The most effective strategies focus on improving these underlying factors:

• Improve insulin sensitivity: Balanced meals, regular movement, strength training, and supplements like inositols or NAC can help raise SHBG indirectly.

• Manage androgens: Lifestyle strategies, spearmint tea, targeted supplements, or medications that lower testosterone can help reduce free androgen levels.

• Support liver health: Anti-inflammatory nutrition, maintaining a healthy weight, and addressing metabolic issues can improve SHBG production.

• Medications when appropriate: Hormonal contraceptives or other therapies may raise SHBG and help reduce free testosterone in some women. Improving insulin resistance through dietary and lifestyle strategies is a primary focus to increase SHBG production in the liver.

Bringing It All Together

PCOS is complex, but understanding your hormone imbalances helps you target lifestyle, nutrition, supplements, and medical strategies where they matter most.

If you’re feeling overwhelmed by all the changes you could make to support your hormones and PCOS, you don’t have to do it alone.

My 1:1 coaching program gives you not only personalized guidance on nutrition, lifestyle, and supplements, but also a compassionate, supportive coach to help you navigate the process.

Together, we’ll break down the science into simple, actionable steps, track your progress, and make adjustments along the way, so you can start seeing real, sustainable results without the guesswork.

Thanks for reading today! If you found this article helpful, please give it a like and a share.

Here are some other related articles you might like:

• Understanding the Menstrual Cycle

• 11 PCOS Myth You Need to Know

• If I Were Diagnosed with PCOS, Here’s What I’d Do

• Ultimate PCOS Lab Checklist

✅ Cyst-ems Check: Meet the Androgens

Androgen excess is a key feature of PCOS, so let’s get to know the basics.

There are 5 androgens, listed here in decreasing order of concentration in the blood:

• DHEA

• DHEA-S

• androstenedione

• testosterone

• dihydrotestosterone (DHT)

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They are made in the ovaries, adrenal glands and peripheral tissues.

DHEA, DHEA-S and androstenedione are considered weak androgens as they have little to no androgenic activity and must be converted.

The stronger androgens, testosterone and and DHT, are the ones really driving signs and symptoms in PCOS.

The androgens made in peripheral tissues like skin and fat take the weaker androgens and turn them into stronger ones. For example, androstenedione can be turned into testosterone in fat tissue and testosterone is turned into DHT in the skin.

🍲Nourish Your PCOS: Warm Winter Vegetable Salad

This Warm Winter Vegetable Salad from Sophie Dahl is case in point, why telling women with PCOS to stop eating carbs is terrible advice.

This nourishing dish provides nutrient-dense carbohydrates that truly use food as medicine to support PCOS.

I’ve made this in years past, but am planning on making it for Christmas dinner with my family. This would also be a great weeknight dinner served alongside grilled salmon, sirloin steak or rotisserie chicken for a solid protein source.

Why it’s great for PCOS:

• The colorful collection of vegetables and herbs give a potent daily dose of antioxidants which help to balance the oxidative stress in PCOS.

• All the veggies in the salad provide high-fiber, blood sugar stabilizing carbohydrates

• Beets provide dense source of folate, as well as potassium, magnesium, copper and iron.

• Celery root packs vitamin K, b vitamins, potassium, manganese and phosphorus

• Sweet potato contain vitamin C, B5, B6, copper and potassium

• olive oil for monounsaturated fats and antioxidants

🧰 PCOS Toolkit: 4-7-8 Breathing

My stress levels always increase around this time of year, mostly just related to the load of things on my plate and less time to do them.

The 4-7-8 breathing exercise is one of my go-to when I feel myself being swallowed up by stress.

Inhale deeply through your nose and into your belly for a count of 4. Hold the breath for a count of 7. Exhale slowly through the nose for a count of 8. Repeat for several rounds or as long as needed to return to a calm state.

The science:

This breathing exercise stimulate the vagus nerve, helping the body return to a calm, restful state, known as the parasympathetic nervous system.

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👩🏽‍💻 PCOS Picks: Three Ships

I was at an event last year and the founder of Three Ships skincare happened to be there and handed me a sample of her de-puffing biodegradable eye masks. I tried the set and felt it noticeably helped with puffiness and left my under eye feeling hydrated and smooth.

I bought a full-size for my best friend, mom and sister (and myself) on Black Friday.

The masks are paraben-free, synthetic-free and EWG Verified, which means safe ingredients for happy hormones. They also completely biodegradable, as they fully dissolve in hot water and can then go right down your sink drain, setting them apart from other masks on the market.

☝🏼ICYMI

Substack

• PCOS Gift Guides one, two & three

• I did a guest live with the lovely Dr. Alycia Lillian at A Black Woman’s Apothecary. God bless her, she allowed me to talk about PCOS for a straight hour. I shared lots of useful pearls and tactical advice in this live, so definitely give it a listen! Here’s a short clip.

On TikTok:

• Things women with PCOS deal with that you will never understand

• How to get 30 grams of protein at breakfast

• Spearmint tea for lowering testosterone

• Recipe: Brussels sprouts with bacon, goat cheese and pomegranate

• Things I wish your doctor said to you about PCOS

⏭ What’s coming up

• Diagnosing PCOS

• A Complete Guide to Inositols

• 7 Key Hormone Imbalances of PCOS

• Meditation and intro to diaphragmatic breathing

That’s all from me this week!

Tara 🤍

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With PCOS, we need to be very mindful of the products we are putting on our bodies. These are some of my favorite non-toxic beauty and skin-care brands.

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1. Biossance- my favorite clean skincare brand. Their Squalane Oil is my die-hard product I can’t live without.

2. Henry Rose fragrance- created by Michelle Pffiefer, this is one of the only clean-fragrance companies on the market.

3. Gua sha stainless steel or jade- If you’re not into botox like me, gua sha is an ancient tradition for sculpting the face.

4. Facial steamer- I do this once a week to deep clean my pores. The steam feels amazing and gives me vibes at home.

5. Primally Pure- best non-toxic dry shampoo in light and dark hair formulations, clean deodorant, facial cupping tools and dry body brush

6. Everyone body lotion unscented- the best clean body lotion I’ve used for years

7. Merit beauty- non-toxic cosmetics; I love their brow gel and flush balm

8. Thrive Beauty mascara- tubing mascara gives the longest lashes and washes off easily with water

9. Ilia cosmetics- I use their multi stick on my cheek and lips daily

10. Esker body planer- exfoliate without harsh scrubs or chemicals

11. Three Ships eye masks- biodegradable masks to firm and depuff undereye

12. Ice roller for depuffing

13. Facial! I love the Hydrafacial technique

Gifts of Support

1. Temp Drop fertility tracker- reliably tracks ovulation an cycle patterns for you. Their Black Friday sale is 30% off + an extra 15% off with my code: AFPCOSPRO to give a total of 45% off the sensor. (**there is a free and premium paid version of the app)

2. Ovasitol- Theralogix is a trusted brand and has the most affordable inositol supplement on the market. Use my practitioner referral code: 689147 to get $12 off a 3 month supply of loose powder, or $14 off a 3 month supply of individual packets.

3. FullWell prenatal- I recommend starting a quality prenatal vitamin and omega 3 supplement at least 3-6 months prior to conception. FullWell is the Cadillac of prenatals, ensuring bioavailable forms of nutrients and the highest choline content in the industry. FullWell applies rigorous testing of their raw materials ensuring safety and potency. They also carry a mercury-free Fish Oil and Fertility Booster supplement.

4. The Fifth Vital Sign- THE book that truly gave me the tools I needed to understand my menstrual cycle. A must read for anyone with a uterus, even if children are not in your plans.

5. Laser hair removal- I think this one speaks for itself.

6. Nutrition consultation with me!

In case you missed it, here are the day 1 and day 2 gift guides.

If you enjoyed these guys, give me a like and comment below what your favorite items were!

Tara 🤍

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Disclosure: Some of these links are affiliate in which I receive a small commission at no cost to you. This allows me to continue providing free education, support and resources at PCOS Journal.

You will ONLY ever see me endorse evidence-based products I have vetted, trust and believe in and use myself and with clients.

Tomorrow, we’re having our Thanksgiving dinner with 30+ people and it got me to thinking about what this time is all about. While a happy time in so many ways, I know for some, being around so much indulgent food can bring about feelings of stress and even shame after we’ve eaten a meal.

I want to give you some perspective today about how to approach this time of year. There is a fine line between being intentional with your choices and negative self-talk and the spiral of self-abandonment that can sometimes come after.

My Best Tips for Navigating the Holidays

Between now and New Year’s there will be many moments and opportunities for you to make choices. Here is my best guidance for moving through this season.

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1. Remember what this time is about

Most of us lead very full, scheduled lives. If you’re like me, you don’t get to spend as much quality time with loved ones that you optimally would want.

Food is nourishment. But, it is also joy, connection, nostalgia and community and those are all worthy things standing alone. Those things all happen around and involve food. Embrace that.

I want you to enjoy the comforting feeling you get when you taste your aunt’s mac and cheese. Let this joy and connection be unapologetically a part of special moments with loved ones.

2. Eat a high-protein, high-fiber breakfast

Many women feel they need to restrict and under-eat as a means to “save” calories.

You do not have to deprive yourself; first of all because you deserve to eat and second, because skipping meals is the most direct road to binge eating later.

Starting the day with a high-protein/high-fiber breakfast sets up your blood sugar stability for the day and is truly one of the most tactical and effective things you can do to prevent overeating later in the day.

A smoothie is a great way to create a breakfast like this that doesn’t feel heavy, but still gives your body and blood sugar what it needs.

Check out my Chocolate Pumpkin Pie Smoothie in The Follicle Files: Issue 5.

3. Walk after meals

Walking after meals for just 10-20 minutes is a science-backed way to regulate blood glucose after eating.

Essentially, it just helps your muscles (the sponge) soak up the glucose (carbs) you just ingested.

It is not a punishment or form or restitution for what you ate.

It is a way to work with your own physiology.

4. Use micro moments for movement

Less activity happens naturally for some as time gets taken up by events, shopping, parties, and increased workload.

Your regular workout ritual may fall off from its normal rhythm. Let’s embrace that less activity may happen, but don’t let it stop you completely.

Shorter spurts of activity are still worth doing to keep your momentum going through the holidays, even though it may be a bit less than usual.

When I’m short on time, I go to YouTube and type in “10 minute no equipment arm workout” and I pick one of the first 3 that come up, or I throw up one of the shorter videos on the Melissa Wood Health platform.

It’s ok if the wheel slows down for a few weeks, just keep it turning.

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5. Set intentions

You will hear me talk often about the power of a pause with yourself. Taking the pause allows you to set intentions for yourself when walking into any situation- food related or not.

Intentions may look like:

• How many drinks will you have?

• What boundaries will you hold with family?

• What commentary on your body will you not tolerate from that one toxic relative?

• How long will you stay at this party?

• How do you want to respond when a triggering subject comes up during dinner?

6. Think about your plate balance

For those that do want to take some structure to a holiday meal, let it be this. No matter what it served, thing about the loose structure of your plate as:

• 1/2 plate veggies

• 1/4 plate protein

• 1/4 carbohydrate

And that’s it. That’s the tip. Enjoy your meal.

7. Move on

If you have a moment of overindulgence, you don’t have to make up for it or punish yourself. Accept it and then move on with your life. Truly.

No beating yourself up. No harsh self-talk.

Instead, ask yourself what is the next supportive action you can take for your health?

8. Don’t abandon yourself

This is the season where the all-or-nothing mindset shows up the strongest.

The truth is, we do have less time for ourselves, longer to-do lists and more opportunities for indulgent meals, so when one thing at a time starts to slip, it’s very easy to fall into the trap of “Well, I _________, so I may as well start next year”.

This all-or-nothing thinking is a hamster wheel and in my experience, one of the biggest barriers to long-term success.

One moment, one meal or even one week does not undo your progress from this year.

Be aware of when this thinking comes up. Don’t abandon yourself.

9. Be present

So many of us routinely eat mindlessly and distracted. No matter what you are eating this holiday season, tune in to the experience. Whether it’s Brussels sprouts of a piece of pumpkin pie, tune in with your senses.

Truly smell the cinnamon and roasted garlic in the kitchen.

Slowly and intentionally chew your food.

Keep the food in your mouth enough to truly taste it.

Find gratitude for the nourishment it is bringing to your body.

During the experience, continually check in with your body to note for mental and physical fullness.

Your presence and attention is one of the most underrated tools for improving your nutrition.

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My Gratitude For You

I want to take a moment to thank you for being a part of my growing community here. I have big plans for where I want to take PCOS Journal and more meaningful ways that I want to serve the PCOS community.

I hope each of you has a special and relaxing day tomorrow.

Tara 🤍

In case you missed it, here are Day 1 and Day 2 of my PCOS-Focused Gift Guides.

If you are interested in investing in the Temp Drop fertility tracker, it is still 45% off through Sunday 11/30. To get the full discount use my code: AFPCOSPRO. **

For more info on Temp Drop see The Follicle Files: Issue 8 and Issue 9 and Understanding the Menstrual Cycle for a deeper understanding of what Temp Drop is tracking.

**Disclosure: I am an affiliate with Temp Drop and receive a small commission at no cost to. You. This allows me to continue providing free education, support and resources at PCOS Journal.

You will ONLY ever see me endorse evidence-based products I have vetted, trust and believe in.

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Movement is another key pillar for taking control of PCOS. Moving regularly and building muscle are two of the most effective strategies for managing insulin resistance.

Here are my favorite tools to elevate your workouts through the year.

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1. Wrist/ankle weights- I take these everywhere with me— on vacation or my kids soccer practice to get in movement when I can and to elevate at home workouts.

2. Ruck sack- A ruck is a weighted pack to combine cardiovascular and strength training at the same time and is a great way to elevate a walk if it’s something you are already doing.

3. Weighted vest- similar concept to a ruck and many women like using these

4. Girlfriend activewear- I love Girlfriend due to their inclusive sizing (up to 6XL) and their featuring of models in all body shapes.

5. Weight set- Strength training is a such a huge part for reversing insulin resistance. This is a nice starter set to add onto as you increase strength.

6. Yoga mat- A yoga mat is a workout staple andManduka makes some of the best, durable mats.

7. Class Pass- if you love mixing it up with group classes, Class Pass gives you access to hundreds of different studios and techniques without having to be a member at a particular studio. Bounce around to new studios to keep it fresh.

8. Fitness platform memberships- a great time to buy a year subscription at a major discount. I love Fit With Coco (pilates/weight mix), MWH (pilates/yoga/weight mix), Ladder (progressive strength training) and Alo Wellness Club (yoga focused, sculpt and pilates, with tons of meditations).

9. Walking pad- a fantastic way to add movement to your day while working, watching tv or if the weather isn’t conducive to walking

10. Simple Modern 32 oz bottle- perfect for a workout

11. Oura ring- The ultimate health tracker monitoring activity levels (steps), sleep, stress resiliency, recovery, heart rate, heart rate variability, temperature, activity levels, and overall readiness. If you like gadgets and all the data this is for you!

12. Fabric non-slip resistance bands- these are on my list this year, because my rubber ones have all snapped!

Gifts of Peace

Mindfulness and breath work practices are key modalities to combat the stress and anxiety that often comes along with PCOS. Cultivating a daily practice just for you is something I encourage all of my clients to do.

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1. The Growth guided journal- “100 deep prompts, 5 life-changing chapters and 10+ interactive pages make the The Growth Guided Journal a great guided journal for mental health and wellness, self-improvement and emotional healing.”

2. Breathe Easy necklace- A breathing tools that shapes your exhale to support calming of the nervous system through your breath

3. Self-care cards- Different decks for of prompts for reflection and self-guided support.

4. Guided meditation/mindfulness apps- A great time to invest in a discounted yearly subscription to apps like Calm, The Way (my fav), Headspace, or Insight Timer.

5. Tibetan singing bowl- Use at home in your own practice to bring peace with calming tones & vibrations.

6. Mindful Affirmation Cards- Flip to a new one each day to bring reassurance in.

7. Calming Drum- another sound tool for relaxation; sounds amazing left outside in the rain!

8. Buddha Breath tool- changing colors guide your breath pattern

9. Sun & Moon Originals meditation pillow- A gift from my mother, this supports a comfortable posture in meditation and is my designated spot.

10. Wellness Journal- daily journal that helps you document your practices and progress over time.

Here is day 1, in case you missed it.

Stay tuned for the last day of gift guides tomorrow- Gifts of Beauty and Gifts of Support.

Tara 🤍

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Disclosure: Some of these links are affiliate in which I receive a small commission at no cost to you. This allows me to continue providing free education, support and resources at PCOS Journal.

You will ONLY ever see me endorse evidence-based products I have vetted, trust and believe in and use myself and with clients.

Whether you need an idea to tell your mother-in-law or you just want to take advantage of all the sales for yourself, you’ll find tons of quality items to support your journey.

Here’s the breakdown of the days:

• Day 1- Gifts to Nourish, Gifts to Restore

• Day 2- Gifts to Move, Gifts of Peace

• Day 3- Gifts of Beauty & Gifts of Support

I hope you love these as much as I loved creating them!

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Gifts to Nourish

Nutrition is such a huge part of managing PCOS and it’s much easier to do when you have the right tools in a cohesive, organized space.

With Black Friday sales, it’s a great time to stock up on hormone-friendly kitchen staples that make being in the kitchen more enjoyable and elevated.

1. Ello glass/silicone food storage- I’ve used these for years! So durable and keeps your food away from plastic

2. Ninja air fryer- PCOS/hormone friendly air fryer that uses glass in place of problematic non-stick surfaces

3. Beast Blender- make creamy smoothies, sauces, dressings and dips

4. Frother- great for mixing Ovasitol in your water

5. Vegetable chopper- I use this to chop perfect cubes in half the time; also makes spirals and ribbons

6. Our Place non-toxic baking set- Our Place brand has pots, pans and bakeware set ensure a toxin-free cook

7. Meal planner/grocery tear off pad- I use one of these every Sunday morning to plan meals for the week

8. Lodge enameled cast iron- a fraction of the price of Le Creuset

9. Knife block- sharp knives are the key to hard-working kitchen

10. Stainless steel cookware set- I received a set as a wedding gift 20 years ago and still used them daily. You only have to buy them once!

11. Lodge cast iron pans- Quite literally cookware you will have for life; creates an amazing crust on searing meats

12. Simple Modern 40 oz tumbler and 24 oz tumbler- Always more reasonably priced than other brands, I’ve used these for my family for the last 6 years. The 24 oz is great for taking iced spearmint tea on the go.

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Gifts to Restore

Sleep and quality rest is a pillar you can’t miss. Here are some of my favorite tools for a good night’s sleep.

1. Hatch alarm- provides a wind down light and sound ritual to help ease you into sleep and wakes you with gentle sound and light that mimics the sunrise. This alarm is key to getting your phone outside of your room to avoid nighttime scrolling

2. Minky blanket- the softest blanket you will ever own

3. Fontana Candle Co.- We all love our candles, but most on the market are not hormone-friendly. Fontana uses only bees wax, coconut oil & essential oils —and are 3rd party certified by Made Safe.

4. Canopy humidifier/diffuser- keep the air in your bedroom moist while sleeping, and diffuse calming aromatherapy scents at the same time.

5. The Five Minute Journal- a daily ritual to help you center for the day and wind down into sleep; keep it on your bedside to keep a gratitude practice top of mind.

6. Auden pajamas- Target has the softest and best priced pajamas for a cozy night of sleep.

7. Loop earplugs- a must if you need silence for sleep are next to a snorer

8. Massage- a perfect gift to give or receive

9. Cymbiotika magnesium spray- Spray onto sore muscles and joints to calm and relax; I love this one because it isn’t oily

10. Silk pillow case- gentle on hair and acne-prone skin

11. Vitruvi essential oil diffuser and Now oil set- Aromatherapy is a science-backed tool for relaxation and mood support. Now brand makes quality essential oils ensure a clean scent and are affordably priced.

12. Archies slides- My favorite cushy sandals with the best arch support. I wear mine around my house on my tile and wood floors for support.

Comment below which items you liked best!

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Stay tuned tomorrow for Gifts to Move and Gifts of Peace!

Tara 🤍

Disclosure: Some of these links are affiliate in which I receive a small commission at no cost to you. This allows me to continue providing free education, support and resources at PCOS Journal.

You will ONLY ever see me endorse evidence-based products I have vetted, trust and believe in and use myself and with clients.

✅ Cyst-ems Check: OPKs vs. BBT

In the last Follicle Files we talked about LH and its role in disrupting the menstrual cycle. Here’s a quick recap.

During a cycle, LH (luteinizing hormone) spikes once around mid—cycle to trigger ovulation within 12-24 hours after.

Ovulation predictor kits (OPKs) measure that LH surge to predict ovulation and are commonly used by women trying to conceive.

One of the primary hormone imbalances of PCOS is LH being pulsed out at excessive amounts at inappropriate times.

I covered this in depth on Tuesday in my video, Understanding the Menstrual Cycle.

Measuring LH to predict ovulation can thus be an unreliable (and frustrating) tool when this hormone imbalance is present.

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🌡 An Alterative

Basal body temperature (BBT) is a more reliable way to track ovulation, particularly in PCOS.

After ovulation occurs, progesterone rises and leads to an increase in body temp.

A sustained body temp of 0.3-0.5 degrees F for ~3 days confirms that ovulation occurred.

LH predicts ovulation. BBT confirms ovulation.

🍲Nourish Your PCOS: Winter Salad

I have brought Ree Drummond’s Winter Salad the last 2 years to my husband’s family Christmas dinner. The first time, his uncle looked at it with a bit of distrust — “Is that kale?”.

By the end of the night, the giant platter I brought it on was nearly empty and he conceded that it was indeed delicious.

It leans into so many of the seasonal nutrient-dense foods I love- butternut squash, pomegranates, and pecans (although I forgo the candied pecans in favor of plain to decrease the sugar content).

Add a grilled chicken breast or rotisserie chicken for a protein source to make this a complete meal.

Why it’s great for PCOS:

• High fiber to slow blood sugar rise > less insulin > less testosterone = better symptoms (over time, of course)

• High antioxidants from kale, Brussels sprouts, carrots, butternut squash, pomegranates (the real superstar) deliver the antioxidants needed to meaningfully combat oxidative stress

• An ounce of goat cheese provides a generous serving of calcium, vitamins A and B2

✨Weekly Boost: Stay on the Boat

As we walk into the holidays, inevitably some of our better habits fall back a bit due to the schedule load— less movement, less sleep, more indulgent food availability at events and parties.

Many of us fall into the thinking trap—"Well, I did/had __________, so I might as well start in January.”

My friends, this mentality is the killer of sustainable change. It does NOT have to be all or nothing.

During this holiday season, I want you to stay on the boat. You may be sailing a bit slower than last month. You may have to adjust your sails. But please, STAY ON THE BOAT.

Don’t abandon yourself and the progress you’ve made this year.

🦋 Little Pearls:

“ The real shift doesn’t happen on the easy days. The ones where mediation, journaling, working out or eating well come effortlessly. It comes when you do it, tired mad, sad, depressed or anxious.

On the days where it requires true unconditional self-love and respect to show up. That’s where your power lives…. In the quiet decision to keep choosing yourself, regardless of circumstance. - The Wellness Process

I hope you’ll continue to choose yourself in small, but intentional ways this holiday season.

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☝🏼ICYMI

• Substack deep dive article— PCOS & Sugar: How Much Is Too Much?

• Substack deep dive video— Understanding the Menstrual Cycle

• Substack audio- A Meditation for Overwhelm

• A PCOS Dietitian’s favorite strength training programs

• 8 Seasonal Foods for PCOS & How to Use Them

• 1 PCOS Dietitian, 10 Obsessions

🧰 PCOS Toolkit:

If you’re on a fertility journey or just trying to get ovulation back on board, Temp Drop’s wearable sensor makes it effortless to track basal body temperature. Wear the sensor on your arm at night while you sleep. The sensor then syncs your data to their app and interprets results, gives you accurate data about your ovulation patterns.

They just increased the discount to now 30% off and an additional 15% off when you use my code AFPCOSPRO for a total of 45% off. Sale ends Dec. 2.

Disclosure: I am an affiliate with Temp Drop and receive a small commission at no cost to. You. This allows me to continue providing free education, support and resources at PCOS Journal.

You will ONLY ever see me endorse evidence-based products I have vetted, trust and believe in.

⏭ What’s coming up:

• PCOS-focused gift guides (so you know what to tell your MIL to get you)

• How to approach food at the holidays

• A complete guide to using inositols

• 7 Key Hormone Imbalances in PCOS

Until next week friends!

Tara 🤍

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Despite this being a key feature of PCOS, most of my clients (and I think women in general), do not have a basic understanding of their reproductive hormones and cycle rhythm. I want to change that.

In 20 minutes, I’m breaking down the cycle in a simple, visual way so you can understand the intended rhythm for your body.

After teaching what should be occurring, I’ll cover the hormone imbalances that contribute to the irregularities in the menstrual cycle.

Although this is for my PCOS audience, this video is for anyone that wants to get to know their cycle better.

Please like and give it a share if you found it helpful!

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Let me know your questions in the comments.

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When it’s all feeling like it’s too much, I invite you to take a pause with this meditation to bring calm and ease back into your mental space.

Your breath is always with you. A more peaceful moment is always just a few deep breaths away.

Tara 🤍

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While I don’t think eliminating sugar completely is a realistic (or necessary) goal, we do need to be mindful of our intake, ESPECIALLY when insulin resistance is part of the picture.

This article will give you some context for sugar and some simple tools to evaluate your intake, so you can start decreasing it in a way that is meaningful for you.

Natural vs. Added Sugar

We are really looking at added sugars today, which the nutrition label now makes the distinction.

Whatever food item this is we see that the total sugars are 25 grams and the added sugars are 23 grams.

So, the naturally occurring sugar in this food is 2 grams, which is very low. The majority of sugar in this was added to the food.

How to Assess Your Sugar Intake

The problem with assessing sugar is that on the nutrition label it is always given in grams. Aside from a baker I worked with, that measurement is not very meaningful to most Americans, myself included.

To give this number more context I like to convert it into teaspoons— something most of us can easily picture. The trick? All you need to remember is to divide by 4.

This will take us roughly to the equivalent in teaspoons.

Let’s walk through an example:

If you look at the label on this 20 oz Gatorade and scroll down to added sugars you’ll see 34 g. Doesn’t mean much right?

Let’s use our trick.

34 grams/4 = 8.5 teaspoons of sugar! Yikes!

Here are some quick breakdowns of a few other popular beverages:

• Grande Starbucks Caramel Frappacino- 54g/4 = 13.5 tsp

• 11.5 oz orange juice- 33g/4 = 8.25 tsp

• Boba Tea drink- 30-60g/4 = 7.5- 15 tsp

• 20 oz Coca Cola- 65g/4= 16.25 tsp

• 10 oz Green Machine- 53g/4= 13.25 tsp

• 24 oz Avocolada smoothie,Tropical Smoothie- 100 grams/4 = 25 tsp of sugar

Did this shock you? When I first learned this I was floored and it was hard to look at these drinks the same through this new lens.

The Serving Size

We also need to be mindful of is the serving size.

In the Gatorade example, 1 bottle was the serving size, but many foods and drinks have more than 1 serving in the container.

Take this barbecue sauce, for example:

When we look at added sugars, we see 14 g, which divided by 4 is 3.5 tsp.

But, hold up. We need to look at the serving size.

Up at the top of the label it says 2 Tbsp is one serving size.

So, if you have 3 servings of this barbecue sauce (6 Tbsp), you have to multiply that 3.5 tsp by 3.

So, the actual serving you had was: 14g/4 = 3.5 tsp x 3 servings = 10.5 tsp of sugar

Ten and a half teaspoons of sugar, just from barbecue sauce.

What about natural sugar?

People often ask about the difference between natural sugars found in milk and fruit and added sugars.

The bulk of the sugar in the Western diet is from sugar that is added to foods, not from having a kiwi with your breakfast.

Milk has protein and fat that helps to support blood sugar stability.

Fruit has a high water content and fiber to help slow down the absorption of the sugar found in it.

Both milk and fruits have great servings of vitamins and minerals and fruit is an excellent source of antioxidants- of which PCOS girlies need a lot!

However, there are a few common fruit-based foods where the sugar intake can be problematic. The top ones that come to mind are juice, dried fruit and smoothies.

Fruit juices

Orange juice, for example, has multiple servings of fruit (way more than you would probably eat in one serving). Depending on the amount, it could be the sugar content of 4-8 servings of oranges vs. the sugar found in one whole fruit.

The second issue with juice is that there is no fiber to slow down absorption, which meaningfully decreases the rise in blood sugar (glucose).

These 2 foods, although from the same origin will have a markedly different effect on blood sugar after consuming due to the quantity and fiber content.

Conclusion: PCOS girlies need to eat their fruit, not drink it.

Dried Fruit

Many dried fruits have a high amount of added sugar. Even if they don’t, dried fruit lacks the water content that would naturally lead to satisfaction and satiety, which can drive you eat eat more than you would than if you were actually just eating a regular serving of mango.

Conclusion: It’s most blood sugar-friendly for PCOS girlies to eat whole fruit.

Smoothies

Store-bought smoothies are typically blood sugar bombs. They often add sugar, juice and/or have way more fruit than you would typically eat in one serving (similar to juice).

If you recall above, the Avocolada from Tropical Smoothie has 25 tsp of sugar coming from a the fruit, but most likely from added sugar. Twenty-five.

Making a blood-sugar friendly smoothie at home is a much better choice. Keep the fruit at a cup or less, don’t add any sugars (agave, syrup, honey, juice) , but do add protein, fat and fiber.

See Follicle Files: Issue 5 for the most amazing Chocolate Pumpkin Pie smoothie to show you how to do this!

Conclusion: It’s probably best for PCOS girlies to avoid most store-bought smoothies, and make and them at home.

An Exercise For You

Often times I will ask clients to do this exercise to get a baseline understanding of their typical sugar intake.

Before they attempt to change anything, I have them record their total sugar intake over a few days or a week to really understand how much they are getting and where it is coming from.

You can record it manually on a piece of paper or note on your phone, or use a nutrition assessment app like Cronometer.

Take this divide by 4 trick and look at all your added sugar intake over the course of a few days and see what it adds up to.

Then, how can you work to decrease it?

How Much Is Too Much?

This is somewhat a tricky question. The American Heart Association’s recommendation is less than 6 grams of added sugar/day for women.

The way I approach it? The less added sugar in the diet, the better for blood sugar control and overall health, but you have to meet yourself where you are.

If after looking at your total intake, you’re having 120 grams of sugar/day (30 tsp), then a good starting goal for you might be to cut that in half and go from there.

The closer you can get to < 6 tsp/day the more results you’re going to see, but you don’t have to get there overnight.

Approach it in a way that meets you where you are.

How To Approach Sugar

Start with the negotiables first

If you’re not ready to ditch the vanilla latte, start with a few things you are willing to forgo and go from there. I bet your non-negotiables list gets smaller when you start to see the positive effects.

Don’t drink sugar

I don’t take many hard lines when it comes to nutrition, but this is one of them. Replace your high sugar drinks (coffee drinks, boba, lemonade, soda, store-bought smoothies, juices) with flavored waters and teas (spearmint tea—IYKYK).

Understand it’s not a moral failing when you eat something with sugar

Guess what? There are going to be days where you have more sugar than you intended.

MOVE ON WITH YOUR LIFE.

Don’t let that moment turn into the all-or-nothing thinking, “Well, I had ________, so I might as well _________.”

Take ownership

It sucks that you have to be more mindful than the average person, but this is the body you live in. The sooner you start working on this, the sooner you start making improvements in PCOS.

Focus on what you are ADDING to your plate

While you are working on decreasing sugar, I want you to be thinking about what you are replacing it with— high protein/high-fiber meals, whole fruits and veggies, healthy fats, home cooked meals.

When you focus on building an eating pattern like this, you naturally decrease sugar cravings which leads you to crave it and consume it less.

This is because you have better blood sugar stability and insulin sensitivity and more satiety from your meals.

I hope this helped give you some clarity on added sugars and PCOS.

Hit me with any of your questions in the comments and like this post if you found it helpful!

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Other articles you might find helpful:

• 11 PCOS Myths You Need to Know

• 💊NAC and PCOS: 5 Evidence-Based Reasons to Consider It

• Are There Actually PCOS Types?

Your weekly roundup of curated PCOS insights, recipes, support, and tips to keep you engaged and inspired. Think of it as your weekly mini coffee chat with me☕

✅ Cyst-ems Check: All About Ovulation

Many mistakenly think that the period is the main event of the menstrual cycle, but it’s not. It’s ovulation.

And I get it, the period is a marked physical change (hello bleeding, moodiness and sore boobs). Ovulation happens with little clues of its presence unless you get the joy of mittleschmerz (Google it!).

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Think of it like this— ovulation is the party and the period is the clean up crew. The menstrual cycle is all about ovulation. The period happens as a consequence.

Around mid-cycle, LH (luteinizing hormone) should take a sharp rise. This triggers the ovaries to release an egg that will end in a pregnancy or a period (if not fertilized).

The disruption in ovulation caused by several different hormone imbalances (one of those being LH being pulsed out at the wrong time) is how infertility shows up in PCOS.

Keep an eye out soon, as I’ll be doing an in-depth video on the menstrual cycle that will be the foundation of some more content to come. I promise you do not want to miss it.

🍲 Nourish Your PCOS: Yogurt bowl

Most flavored yogurt cups are not the best choices for PCOS girlies working on insulin resistance. I’ve seen some better options as of late (love Chobani and Oikos for their 20g protein cups), but most flavored yogurts have the equivalent of 4-7 tsp of sugar per (tiny) cup and ~6 grams of protein and no fiber. This is going to equal low satiety and not a strong combo for blood sugar balance.

The good news is you can build your own high protein, high fiber yogurt bowl as a snack or a meal. This recipe has 37 grams of protein and 11 grams of fiber!

If plain yogurt is not your jam, don’t worry— I cut the sour with a small serving of maple syrup, plus all the toppings make it super yummy and anything but plain.

What you need:

• ~1 cup non-fat plain Greek yogurt (25 gram protein!)

• 1/2 tsp maple syrup.

• 5-10 grams of collagen protein

• 2 Tbsp chia seeds

• 1/2 cup fresh blueberries (I’ve been adding pomegranate seeds as of late for even more antioxidants!)

• 2 Tbsp walnuts

• 2 tsp ground flax seeds

What to do:

Mix the yogurt, maple syrup and collagen well in a bowl. Stir in the chia seeds. Top with blueberries, walnuts and flax.

Why it’s great for PCOS:

• Greek yogurt is highest protein yogurt that helps you easily hit protein needs, while providing a great source of B12 and minerals like calcium, magnesium, potassium, & zinc

• Blueberries provide one the highest amount of antioxidants (PCOS girlies need a lot of these!), plus vitamins C & K

• The high fiber content comes mostly from the chia seeds, with an assist from the blueberries and flax

• Compared to your standard yogurt cup, this blend of protein, fat and fiber will keep blood sugar stable and help to crush sugar cravings. Long term, these types of meals help to improve insulin resistance > which improves symptoms!

• Tip: Cut the portion down to have as a snack

🧰 PCOS Toolkit: Temp Drop

If you are on a fertility journey, Temp Drop is one of my favorite tools for tracking ovulation.

OPKs (ovulation predictor kits) measure the LH surge to predict ovulation, but does not confirm it (another topic for another time, but because LH is dysregulated, OPKs are not reliable for many women).

Basal body temperature however, does. After ovulation occurs, progesterone is released which leads to a rise in body temp of ~0.3-0.5 degrees F for several sustained days. This confirms ovulation occurred.*

Many are averse to recording temps as it is somewhat tedious to do long term, with the timing of collecting temps, recording data and interpretation.

Temp Drop makes ovulation tracking effortless with their wearable arm cuff. The daily data collection syncs with your app, inputs your data into an algorithm, filters out variables that may skew temps and tells you whether ovulation occurred.

💥Big News

Through the month of November, Temp Drop is doing the biggest Black Friday sale they’ve ever had — get 25% off the device, AND you can stack my code AFPCOSPRO for an extra 15% off for a total of 40% off!**

They offer a free or premium paid version ($6/month) of the app, but each new subscription comes with 2 free months of the premium service.

*Temp Drop is NOT a contraception device.

**Disclosure: I receive a small commission at no additional cost to you, when you use my code.

🦋 Little Pearls:

Even miracles take a little time. - Fairy Godmother

There is purpose in your season of waiting. -Megan Smalley

☝🏼ICYMI

• 11 PCOS Myths You Need to Know

• What is a blood sugar spike?

• How much sugar is in your favorite Starbucks drink?

• The cheatsheet for crushing sugar cravings

• 20 ways to start improving insulin resistance RN

Got a Burning PCOS Question?

I want to answer your questions!

I’d love to start a monthly question and answer feature here at PCOS Journal. Please leave your questions either in the comments, private message, or via email at hello@pcosprord.com and I will answer them in a video format.

Have a beautiful weekend lovelies! Thank you for being a part of my growing community.

Tara 🤍