PCOS Q&A: TTC, Environmental Factors, Ovulation, Birth Control, Weight Loss and more!

Double board certified fertility doctor, Natalie Crawford MD answers your PCOS questions!
Questions answered:
What is PCOS?
What are the options for trying to get pregnant with PCOS?
Should you start with Clomid or metformin before using gonadotropins?
Clomid or Letrozole?
What are the risks of using gonadotropins?
Has PCOS always been around?
Are there environmental factors for PCOS?
Is the combined birth control pill suggested for PCOS?
Is the progesterone only pill suggested for PCOS?
When is it important for you to have a period?
What is the most effective way to lose weight with PCOS?
How can you decrease cortisol levels?
*This is medical education not medical advice, please ask your doctor for your own medical care and medical questions.
Join the Enhance Your Natural Fertility Program
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Fertility doctor, Natalie Crawford, MD is a double board certified OBGYN and REI, and co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas.
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715 W 34th Street, Austin, TX 78705
To become a patient: email [e-mail] or call 512-956-5006
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Sharing fertility facts to educate women about trying to conceive, getting pregnant, ovulation, fertility treatments, IUI, IVF, becoming a doctor, life as a woman in medicine, and more.

[@melindashrum2136]

These videos are so awesome for people needing this information. I'm turning 42 this year and I think was around 24 when I was diagnosed. I started trying to conceive after getting married almost 10yrs ago, 2 miscarriages later, we realized we will never be parents. I wish the best of luck to all of you!!

[@miakalifa116]

Within 21 day's I contacted DR RORPOPOR HERBAL ON KZbin my wife's PCOS problem cured totally.🤱

[@angiemartinez2325]

I'm 50 and never was able to get pregnant with fertility treatments. Best of luck with other women trying to get pregnant.

[@AshleyJones-cq7cr]

I’m so happy you answered my question! This video was so helpful, thanks Dr. Crawford!

[@thereallockerelf]

Thank you so much for science based information. I’m struggling to find actual medical information online. So many people are unqualified or outside of the scope of their practice. Thank you for real answers.

[@jazzysmovies]

Omg...the way you explained this..even just 3 mins in, was so clear. THANK YOU! I have never heard exactly what is going on with me like this before.

[@NatalieCrawfordMD]

I'm so glad!

[@hafsashahid]

Thank you. This was very helpful. Can you please do a video on pcos diet.

[@MiVidaBellisima]

This video is so underrated!!! I learned so much, thank you!

[@NatalieCrawfordMD]

I'm so glad!

[@akosuam2892]

Thank you for your video! 😊 I just found out I have PCOS in my right ovary. I definitely need to do blood work to see what my androgen levels are. But I have normal periods (never missed a period). Like you said in the video PCOS can be a broad and confusing thing.

[@1lost_sheep]

This was super helpful, thank you.

[@NatalieCrawfordMD]

So glad!

[@nataliejones1385]

Hi Natalie, firstly I love your channel. I've learned more about my PCOS from you and mama Dr Jones then my own Drs, so thank you for informing our community. One thing I'd like to stress though. Please don't encourage people to seek out ozempic, I don't know about other countries supply but here in Australia is critically low and my diabetic friend just got out of hospital due to issues that arose when he was unable to get enough doses for himself. 😢

[@NatalieCrawfordMD]

Omg that’s terrible! Here in the US I have a lot of patients on it and haven’t heard of issues (I don’t prescribe it though so appreciate this feedback, just had insulin resistance patients have success)

[@LikeTheVik]

this is by far the best channel for PCOS patients. you are amazing (and super pretty too:))

[@NatalieCrawfordMD]

Thank you!!

[@daynatorres3619]

Hi! Ive been diagnosed since 2019 I have irregular cycles but I have them sometime every two weeks for 7 or more day or sometimes more regular but really big flow. I’ve heard of Ovasitol, any insite on that? Thank you so much

[@ShraddhaA]

I was diagnosed with PCOS in early 2021. My ultrasound did show the ring of pearls in my ovaries. Since March 2021, I've not missed a single cycle. They haven't been super regular i.e. fluctuate 28-33 days. We are planning to start TTC next year. I've improved my lifestyle, lost 10 lbs and I eat healthy and get good amount of sleep. Should I be doing anything else to improve my chances? and should I get another set of bloodwork done to check my hormones? Thanks for these super helpful videos!!

[@caseymintzer]

Dr. Crawford. I've never had or seen a youtube doctor never fully address my type of PCOS. Every video I've seen talks about "irregular periods". But, I have never had a natural period. Not once. As a young teenager, I was so embarrassed so I lied and said I did. When I was 19 I finally went to doctor about it, and finally got put on birth control to help regulate the entire situation. It took a while since I was not overweight at all, doctors were hesitant to diagnose anything- this was 2009. My ovaries were covered in cysts, obviously. But, I've never been overweight or underweight. My hormone levels were pretty normal. Luckily I got pregnant when I went on Letrozole. I needed a HIGH DOSE to create ONE follicle. That one follicle became my now amazing 2 year old son. I am thankful. But, I still want to understand what never having a natural cycle means. Every doctor just says, now that you are on birth control it doesn't matter, but i still feel forever uneasy about what is going on in my body that I don't ovulate or get a period.

[@michellerendel9852]

Thank you! I am so grateful for my NP OB/GYN to recommend you and your channel for education. I was diagnosed with PCOS. You explaining that weight gain is mainly in the mid area. I cried because it explains a lot on why that’s one of the hardest areas to lose and easiest to gain. It’s just a symptom. I thought I wasn’t using the right exercises . I appreciate the knowledge and thank you again! ❤

[@NatalieCrawfordMD]

Of course!! Glad it was helpful!

[@ragavendrapanakarajupally9062]

Could you do a video on Bicornuate Uterus please

[@jessicakelley-nd1rs]

Pcos is so weird never been so bad until couple years ago been on birth control for long time now then couple years ago I still at times skip a period at times n hairs in areas so annoying I was told to look u up learn so much on it

[@CourtneyHuval-ne5kr]

What form of inositol do you recommend? Myo-innositol alone or this + D-chiro? And what dose? Is this something you recommend indefinitely?

[@marinaherrm6862]

What's the difference between Ovasitol and metformin?

[@joterry123]

Please can you’d Q&A On PCOS AFTER the menopause ?

[@emmamarshall2156]

I have recently found your channel and oh my god, I feel so empowered to take control of my PCOS symptoms that I’ve had for about 8 years. Could anyone give any advice on how I should raise this subject with my doctor?

[@nazhopkins5825]

As someone that lives in the UK where there is no PCOS support, I appreciate these videos. I know you covered weight loss in this one, but I have been doing all of those things for a few years now, macros, low fat, no sugar, cardio and strength training and the weight is not shifting. The Drs in the UK do not give any support unless you are trying to get pregnant which I am not. When I went to see the dr recently she was honest and advised they are not to provide any support unless the patient asks specifically for a treatment. The only treatment they offer openly is some form of bariatric surgery and only then if your BMI is 40 or above, which I am not. I am however nearing 40 and at a loss as to how to lose the weight. Are there any medications other than Ozempic I can ask my dr to prescribe to help with the insulin resistance and weight loss?

[@Puggleatlaw]

For your next Q&A, can you talk about PCOS and miscarriage? Multiple losses my REI thinks it’s just my age (36-37), but I am skeptical PCOS/androgens or insulin sensitivity are not a factor.

[@LisaFromTheNorth]

Thank you! So helpful! I was just diagnosed with Lean PCOS. At around the 14min mark you mention that you recommend 30 days of no Dairy, gluten, sugar & processed food. Would really love to hear an expanded explanation of this - i.e what is the intention with doing this for 30 days, and what do we do after 30 days? Is it a recommendation to primarily help lose weight, or what is the intention with this 30 day period? Thank you!!

[@jevhonrivers5149]

I was wondering the same thing! Hopefully she'll get a chance to expand on that but I think she's referring to an elimination diet. In an elimination diet, one eliminates groups of foods (dairy, gluten, sugar, etc) that sometimes lead to issues like inflammation for a set period of time, at least a month, and then reintroduce them one by one to see how you react to them and make more conscious decisions about your diet (eg reintroduce gluten and try to observe your energy levels , how bloated you feel, etc. The Whole 30 is an elimination diet that follows that kind of process.

[@kenziekae]

Around the 9 minute mark you said there are certain things your mom could have done while pregnant to increase your chances of getting PCOS. What are some examples of those things?

[@riyasahota6101]

what are your thoughts on inositol?

[@kiarelireynoso6488]

Are there any natural ways to help our body ovulate?

[@tinyteacher620]

PCOS and LOW SPERM COUNT and motility, is ivf my only option? I did 5 months on Femara and ovitrelle shot, one failed iui. Hubs count was 38m/ml and washed 8m/ml

[@amberjackson2017]

Thanks for the video. I love your channel! Started my fertility treatment journey a year ago with PCOS at age 33. I've been through 8 cycles of letrozole and ovulate on the dot every time...feeling a little exhausted emotionally. Next cycle we are going for an IUI. Is there any other factors such as a cervical mucus test that would be useful? Husband's semen analysis came back normal.

[@daynatorres3619]

Hi! Ive been diagnosed since 2019 I have irregular cycles but I have them sometime every two weeks for 7 or more day or sometimes more regular but really big flow. I’ve heard of Ovasitol, any insite on that? Thank you so much

[@paulmuresan8889]

Would a estrogen inhibitor work for woman (PCOS) with normal estrogen levels?

[@spiderWOMAN]

Q: with a very thick lining/pre cancerous situation, would metformin be enough to avoid cancer from developing? Would you suggest a D&C as well as ovarian drilling at the same time to get to the root of the problem?

[@NatalieCrawfordMD]

metformin is not enough - need to have regular bleeds or prevent with a progesterone, a D&C is helpful because you can evaluate the tissue and make sure it isn't precancerous or cancer.

[@amandawiemken]

I froze 31 mature eggs at age 34. Is this enough? Should I freeze more?

[@jasminepeteetarocha9764]

Hello I have PCOS ovravian cyst and just got last month and am trying to get 🤰 and am new to PCOS ovravian cyst. My Dr gave me birth control pills.

[@miakalifa116]

Within 21 day's I contacted DR RORPOPOR HERBAL ON KZbin my wife's PCOS problem cured totally.🤱

[@gulianabiasetto8672]

I’ve been reading about supplements that help with PCOS symptoms. Does this actually work/help? Especially for weight loss.

[@Miss.Krystle]

Specifically which

[@muhammadhadi4030]

Hello mam I m patient of azoospermia any tablet or medicine 😢😢😢tell me plz please

[@annarose161]

Doctor how to gain with lean PCOS?

[@theosimm9925]

What could be the cause If I used to ovulated every month and after a pregnancy loss I don't ovulate at all? I don't understand what happened. I have pcos. Thanks!

[@kenu78]

I have PCOS , estrogen dominant, will POP help? Also I notice no breaks or sugar pills like COP, do I not bleed monthly?? When do I bleed?? And lastly , you mention no ovulation with POP, is there not ovulation with COP ?? And how does no ovulation help mY PCOS… do I need to have a period with PCOS, I read about low FHS hormone… please advise

[@manikdevnath624]

I am 19 yrs old diagnosed with pcos for one yr.I got mens delay,acne,hair fall,lot of stress.I am not taking any medication.What should i do ?

[@sabrinabaldi6178]

THANK YOU , but my questions is i want to test how body reacts without hormones and i would like to try the Copper DIU... i´ve been taking birth control pills for almost 10 years on and off. I am sexually active with my partner but dont want to get pregnant now ( yes in a couple of years). Any advice , much appreciated

[@MaeveMcMullen-kz7xu]

My ultrasound looks fine blood work doesn’t and I was still diagnosed

[@britneylewis7244]

I’ve been on bc for ivf since January 2023. Each time I go for my baseline my estradiol levels are to high for follicle stimulation. This has happened twice. Should I continue taking the birth control that contains estradiol. I have pcos. I have never had any issue with estradiol levels before this pill.

[@NatalieCrawfordMD]

the estrogen in the birth control is not one that shows up on a blood test - so if your estrogen is high it means you are 'breaking through" the pill and starting to grow a follicle - talk to your doctor to see if a higher dose or another suppressive option will be better for you (I see this a lot with lo estrin or lo lo estrin)

[@evangelineb3404]

As you get older and have fewer eggs over time (35+) if you have PCOS, is it more likely you'll release fewer eggs and have a more natural cycle?

[@Miss.Krystle]

I've had pcos since teenage years, I'm now 37 and no, age hasn't made my cycles more regular . In my mid 30s my cycles actually became more absent

[@safoorakhan1821]

What about the teenages diagnosed with pcos? I'm 18 yrs old

[@miakalifa116]

Within 21 day's I contacted DR RORPOPOR HERBAL ON KZbin my wife's PCOS problem cured totally.🤱

[@pandora11211983]

Hi doctor I have PCOS, hypothyroidism and diabetes. My doctor has prescribed the depo shot in order to start getting my period. I do hope to get prego when I'm a little more ready. I'm scared I might have made the wrong choice of getting the depo shot. Do you have a recommendation as to getting my body to start ovulating? I haven't gotten my period since 1/2021😢 the most I get is cramps and maybe very lite spotting

[@pandora11211983]

Mind I'm turning 40 years old in November. Am I being unrealistic?

[@csmith5436]

I often have an anovulatory cycles and I know that from temping and using strips. If I were to not ovulate one cycle and then ovulate the next cycle would I only have one period at the end of both? Example: I didn’t ovulate until cycle day 45 and my period started cycle day 60. Did that mean I didn’t ovulate for the first cycle Thus no bleeding and the second cycle started at day 31?

[@NatalieCrawfordMD]

correct, my thought - likely did not ovulate the first cycle and those eggs "died" and then another group was released and you ovulated at that time

[@csmith5436]

@@NatalieCrawfordMD thank you! How long of a cycle would you say that would happen. This cycle I ovulated on cycle day 27. Most likely would those be old or new eggs? I also got diagnosed with pcos this week so trying to navigate it all.

[@jeanetjohnson8112]

I am diagnosed with PCOS and it been 1yrs 2months I have not seen my period. What is the best medication to take to get my period back 😊. Need helps from anyone 🙏🏾

[@lavanyagandham6293]

Heyya i will suggest you to try namhya pcos tea its a tea from india its an ayurvedic medicine give it a try no side effects! I have used it personally and its great

[@Blessedfamilymama]

All pcos women should give up wheat! I went gluten free and lost 40 lbs in a year without changing my lifestyle. I didn’t deprive myself but once I cut wheat even my sugar cravings reduced! Highly recommend people with endocrine and hormonal issues to try it for a few months and see if you improve. It didn’t change my cycle at all, but I’m a normal BMI and feel great now.

[@Butterflyinyourgarden]

What's the alternative to wheat??

[@Blessedfamilymama]

@@Butterflyinyourgarden just go “gluten free” there are tons of options these days. Gluten free bread, pasta, tortillas. I will say though the less that I eat of all of those refined carbs, the better.

[@sherrydedell9732]

Is there a higher rate of miscarriage with pcos? Thx

[@Miss.Krystle]

I've read it's 3x higher with pcos. I've only been able to get pregnant once but it ended in an early loss

[@salmafaheem7600]

Please help me ,I recently have been digonsed with pcos ,, I have just one cyst on one ovary and I'm married for 10 months ,and I have regular periods but periods are so odd , just dark brown spots for 3 days,,, and I'm not over weight but doctors are not giving me ovlution medicine and I also have good diet ...Im from Pakistan, here doctors don't guide a patient properly, I want to get pregnant...For now I have been using Diabe 35 medicine for 3 months .... And one more thing what did you say I the video ??? No dairy ,no gluten, no sugar for 30 days.. you mean JUST FOR 30 days we have to cut out these things??? I use multi grain flour and just in dinner I eat wheat flour loaf .. Is it OK to eat wheat flour loaf just one time in a day??

[@veronicafravola7145]

This comments are discouraging 😢

[@uriah9100]

Could it be caused by a non binary tumor on my pituitary gland??

[@bykristenelaine]

Hyperinsulinisma. Lower the insulin and stabilize the blood sugar, everything else falls into place for PCOS.

[@shian_thee_rapper]

With some of these comments lm seeing l might get a heart attack 🤦🏽‍♂️🤦🏽‍♂️

[@phanipriya9005]

Weight loss doctors?uh mean bariatricians mam?

[@Veenaali786]

I'm not over weight but i have PCOS since 2018. I got married in 2022 and concieved after a month but i lost my baby in 9th week of pregnancy 😢. Now it's August 2023 and I'm on my TTC journey. My periods i irregular not really irregular. I bleed on 35 to 40th day of last period that's why I'm struggling to concieve. 🥹 Doctor prescribed me OCP but I'm feeling uncomfortable while taking these pills like fast heartbeat during sleep, spitting blood out of mouth, irregular bleeding in the mid of cycle, acne, weight gain 😭

[@oceanskye33]

Never take anything not prescribed from your doctor. But I do encourage those with low progesterone to speak with a professional from RaenaHealth here on KZbin. Hope it helps someone relieve some of their symptoms.

[@CourtneyHuval-ne5kr]

What form of inositol do you recommend? Myo-innositol alone or this + D-chiro? And what dose? Is this something you recommend indefinitely?

[@angelinachemeris6733]

I am not a doctor, but due to the info from open sources D-chiro form is used to decrease higher level of testosterone.