How To Be WellnStrong

60: Acne, Weight Gain, Facial Hair, & Infertility: Is PCOS the Cause? | Cory Ruth, MS, RDN

August 06, 2024 • Jacqueline Genova • Episode 60

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In this episode, I’m exploring a complex and often misunderstood condition that impacts millions of women worldwide – Polycystic Ovarian Syndrome, or PCOS. PCOS is one of the most common hormonal endocrine disorders in women and is closely associated with infertility. It can create a heavy emotional burden on those who suffer from it and its related physical problems (like weight gain, facial hair, acne, & infertility). That's why I’m very excited to welcome Cory Ruth to the show today. She is a Registered Dietitian, Nutritionist, women’s health expert and the founder of The Women’s Dietitian, a digital platform that helps women seek nutritional support for hormone balance, PCOS, fertility, and weight management. She specializes in PCOS and nutrition therapy for infertility and assisted reproductive technology. Cory and I discuss how women can put their PCOS symptoms into remission by addressing the root causes of their symptoms.

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*Unedited Transcript*
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Jacqueline: [00:00:00] Corey, I'm again, I'm so excited to connect with you and see your beautiful face. We've been Instagram friends for, I don't know, several months now, and I look forward to your posts every single day.

Um, for listeners, Corey is an expert in PCOS, which is the topic of our episode today. But honestly, Corey, I wish I knew about you. Well over a decade ago when I struggled with PCOS in high school because, and I'm sure that, you know, sentiment also resonates with you, but again, we learn as we go through life, right?

And we share our knowledge with others. But had I known you back in high school, I feel like things could have been a lot different.

Cory: Totally. I always say, yeah, I, I want, I aim to be the person that I wish that I had, you know, that, that I was able to look towards, you know, for better answers 

Jacqueline: Yeah. 

Cory: Yeah. Yeah.

Jacqueline: Well, with that, Corey, just to kick it off, I'd love if you could just share a little bit about your background, how you found yourself in this space with listeners. you've amassed such an incredible, following on [00:01:00] Instagram, and I know you have courses and recipes and all the good stuff, which we'll get into later, but yeah, how did you find yourself in the space?

Cory: Yeah. So I, I have PCOS shocker there. Um, and I remember Way back in high school, you know, we got like one sex ed class in high school. I think it was taught by our like high school football coach. So that went, um, basically, you know, we learned that we get a period every 28 days. We ovulate on day 14, um, so that was the gist. Feeling in like, you know, listening to my girlfriend's talk in the locker rooms and oh my period's coming on Friday Oh my it's coming Saturday, and I just remember thinking how do you know that like that is knowledge that I Have never had the pleasure of just having And it made me feel like I was so different.

It made me feel like I was I don't know, like a freak of nature, you know, like, why wasn't I getting a period [00:02:00] happening on a regular schedule? Why was it so random? Why would it show up and stay for, you know, weeks, months, or just be totally gone for months? So, um, it may be, yeah, it may definitely make me feel like just very different and I didn't understand it.

And, um, you know, as I got older and I learned a little bit more about Like, I learned what PCOS was and I started hearing about some of the symptoms. I was like, wow, I think that's me, you know? And I finally had an answer to the weird wacky period problems. sort of. I didn't still, I still didn't know how to fix them.

Um, but at least I knew that there was some, something driving that. So when I, I became a dietitian, um, and I thought, okay, I'm going to, I want to open up my own private practice. The one thing I'm never going to go into is PCOS. It's way, way, way too complicated. Way too much going on there. Like, no. Um, but then the more I realized, you know, what a huge role diet and nutrition and blood sugar regulation plays [00:03:00] in our hormones, you know, in that whole connection in our weight.

And I've been through my whole weight. Journey. Um, I realized, okay, here I am, you know, a dietitian with a master of science degree and I have PCOS too. Maybe I am the perfect person to step into this space and, you know, really, really try to make a difference. And that's what I aim to do. And I've had the pleasure of doing, um, now for gosh, almost five years.

and then some. So yeah, it's, it's been an amazing opportunity to learn and to teach others and, you know, along the way, be able to really heal myself in ways that I never imagined I could. So it's just

Jacqueline: I love that.

Cory: yeah.

Jacqueline: Yeah, I couldn't agree more. Again, that's why I love being in the wellness space, because I feel like everyone who specializes in something either has A, experienced it themselves, or B, has a really close family or a friend who's experienced it. And again, that just drives your passion, and I'm very similar to you in that regard.

But you touched on it before, Corey. So for the [00:04:00] listeners out there who are like, what is PCOS? I've never heard of it, but I might have it. What is it, and what are some symptoms of it? 

Cory: Yes. Yeah. So PCOS stands for polycystic ovary syndrome, and we estimate about 10 to 15 percent of menstruating women have it. It is the most common endocrine, aka hormone, um, issue, but it's also got metabolic components and all of this stuff, um, in the world. And it is the leading cause of infertility as well.

So, um, it impacts a lot more women than we think. And it's so complicated because it can really look different on everyone. And in order to be diagnosed, you have to meet only two out of three criteria, which means that allows for that variability of symptoms, right? So the first one is if you go to the doctor, you get a pelvic ultrasound done, which means they're looking at your ovaries, your uterus, you know, all that stuff.

And they see polycystic [00:05:00] ovaries, meaning they basically see a ton of little tiny follicles on your ovaries. These are actually not cysts. You know, it's, it's an interesting misnomer. Um, these are not the same types of cysts that can rupture and cause pain. And a lot of women think, oh, I have painful periods.

Or I have, I struggle with, you know, um, big cysts that get enlarged and burst. You know, I have to go to the er. Do I have PCOS? You could have both of those going on for sure, but the tiny little follicles that we see on an ultrasound that can diagnose PCOS are not actually painful. We can't feel them.

What they are are little follicles, which grow our eggs basically. And what is happening, the way I describe it is that they're all competing to ovulate, which, you know, we basically release an egg and that then turns into either a baby or a period. Um, and none of them are winning. That's how I describe it.

So, um, that's one way. That's one of the criteria. The second one [00:06:00] is to have elevated androgens, which are like the most famous one, testosterone. So all women have testosterone. Did you know all men make estrogen? We just typically make these things in smaller amounts, right? Men make less estrogen than women.

Women make less testosterone. So in women with PCOS for a myriad of reasons, we have, we make more testosterone and that can cause symptoms like facial hair, hair loss on the head, body hair growth, acne. It can contribute to irregular periods and weight gain. So you can, you could either have elevated testosterone or another androgen in your blood work, and you could ask your doctor to run that test, or you could have Like I just described of those.

Um, and then the third one is to have irregular periods. So what does that mean? Basically, your period is not coming on a regular schedule. So typically a period will come roughly every 21 to 35 days. That's kind of the normal range. So if it's coming, you [00:07:00] know, 17 days and then 85 days and then 100 and then 12.

That would be an irregular period. If it's not coming at all. Would be in a regular period, or if you feel like you're always constantly bleeding, that's an irregular period. All three of those things means that you're not ovulating regularly. And that is the problem when we're talking about fertility.

That's why PCOS is the leading positive infertility, because a lot of us are ovulating, irregularly, irregularly, uh, or not at all. So yeah, so you meet two outta three of those and you could have A-P-C-O-S diagnosis.

Jacqueline: Is LHFSH considered as, um, well, I'm curious why it's not necessarily considered as one of those three, because I remember that's something that I had tested too.

Cory: Yeah. Yeah. Um, so typically our, our LH to FSH, FSH ratio is off. Um, it's like double. So it, it, it's not necessarily one of the diagnostic criteria, but it's very common just like, [00:08:00] um, AMH is if you, if you get your anti malarian hormone tested and it's high, that can be an indicator of PCOS, but those haven't quite formally made it into the diagnostic criteria just yet.

Jacqueline: Gotcha. Interesting. And you mentioned that 15 percent of women have this. I know there's been a lot of, uh, you know, new research, right? As to how does PCOS even happen, right? And a lot of people have identified it as a metabolic issue versus a genetic issue. But is there a genetic component to it? And what are some of the primary risk factors for developing it?

Cory: Yeah, so there, we do think there is a genetic link. We have research that shows daughters of women who have PCOS are eight times likelier to have PCOS too. So, um, as far as other genetic links, we haven't identified those clearly, but that alone can show there's potentially a big genetic component. Um, risk factors.

Really, I don't, I [00:09:00] can't say for sure because, um, you know, we're, we're typically, we typically get. Or not get diagnosed, but we typically start to understand things are off, you know, right around puberty and beyond. Um, so there's not one thing that you have done to cause your PCOS or increased your risk.

We don't really understand why some women have it and some don't, especially there's no genetic component going on. It's like, well, why me? We just don't know, unfortunately yet. And that's where we definitely need more research.

Jacqueline: and also too, Corey, I mean, we hear about these rising rates of infertility, especially among, you know, women in their late 30s. Is PCOS a primary contributor to that, would you say? Has there been research on that?

Cory: You know, um, not that I know of, and the, the fertility decline debate is messy, right? Because women are also waiting longer to have children. What's the primary indicator of infertility? It's your [00:10:00] age, right? So we lose eggs every year. Um, and that's just the way biology is right now. Uh, who knows if it'll ever catch up to our lifestyle, but, um, and then there's, you know, there's also talk of, you know, endocrine disruptors and how that can potentially impact fertility.

So it's hard to say. But, um, you know, I did ask that question before several times to other people that I've had different podcasts with, um, you know, are we seeing higher rates of PCOS? Maybe it's again, it's hard to say because we're getting diagnosed more, which is a good thing. Now, because we're starting to understand, Ooh, Hey, this is an issue.

Um, there's also potentially some kind of link to body weight. We have lots of research that shows when warranted, some weight loss can help restore ovulation in women who have PCOS. So, um, you know, as we tend to be in larger body sizes now than we were, you know, 50 years [00:11:00] ago, are we potentially seeing ramifications of that?

Maybe, yes. So it's hard to say. It's really hard to say

Jacqueline: So speaking of more diagnoses, obviously, there's probably going to be more focus on treatment and For me personally, Corey, I was, I want to say a sophomore or a junior in high school when I started to have more irregular cycles, and I think for me it was more exercise induced, like oligomenorrhea, that female, like the female triad syndrome, is that what they call it? so essentially, I think I was just over exercising, but sophomore year of college, I remember experiencing a lot of the symptoms that you mentioned and did have a pelvic ultrasound, had a bunch of blood work done, saw my androgens were very elevated, including my testosterone, um, I had two of those three, um, markers for PCOS and didn't know any better again, which is why I wish I knew about you 15 or so years ago, but didn't, didn't really know any better.

And I went the conventional route, right? Which is basically birth control. [00:12:00] Um, I tried, I tried metformin for a week. It was horrible. I got off of it. Um, never quite tried spironolactone cause I didn't really want to take medication if I didn't absolutely have to, but I was put on birth control for four years, before I just, Realized it was a band aid solution and opted to get off of it and was actually able to reverse, my symptoms on my own and kind of keep it into remission up to this point, which is awesome.

But, um with that, I mean, could you just dive into, I guess, like, what is the major difference between that conventional approach to PCOS, which again is often a band aid solution, if you want to call it that, versus a more holistic and integrative approach?

Cory: Yes, yeah, thank you for for wanting to dive into that because it is, you know, it's the main thing that we learn when we go to the doctor with our, we come to them with our concerns right and by no fault of, we have incredible doctors. We. PCOS is so poorly misunderstood and they're not taught a lot about it.

And so typically kind of the first line of defense [00:13:00] is to help the symptoms, right? That makes sense. Um, but no, it does not dive into and help us uncover what's driving those symptoms. So birth control, metformin, Spiro are typically kind of first line defenses. So, you know, if you're having irregular periods, let's have you take birth control, let's regulate your period with birth control, which we, we know, you know, it doesn't truly do that.

Um, what it does is it gives us a regularly timed bleed, but it does not help our bodies ovulate on its own, which is fine, you know, but if you are wanting to explore other options, you could absolutely make a choice. changes in your diet and your lifestyle because of that huge blood sugar regulation component.

So, um, there is a very strong connection and we have so much good solid research about how dietary and lifestyle interventions can be effective for women with PCOS. And so that comes down to working on, so a lot of women with PCOS have this insulin resistance [00:14:00] component. We estimate about 70 to 80 percent of women, um, are struggling with this, uh, you know, which can definitely put us at a higher risk for type 2 diabetes and other health complications as we get older.

older. Um, but you know, it all comes down to blood sugar balance and understanding how to regulate that. It comes down to how to lower inflammation, how to work on your adrenals. There's a big adrenal component. So if, you know, someone's listening to this and they're like, well, I don't have insulin resistance.

I'm not in a larger body size. I actually want to gain weight or, you know, something like that. you could either be, you know, working on lowering your androgens like your testosterone, or you could be working on your adrenal health, which is basically, um, you know, how, how our body is responding and adapting to stressors and, and working on that because we're kind of, we're a type a perfectionist, a lot of us, and we're go getters and we want everything to be perfect.

Um, and then it drives us crazy really. [00:15:00] So, um, it sounds simple, but it really can be powerful because our, our period can actually come back on a regular. more consistent schedule just by working on our stress. So there's a lot of different moving parts. And again, it looks so different on everyone, but I just, you know, if you're listening to this and you're like, well, you know, birth control is the only thing I've been offered or I've, I've only heard about that.

You know, that's not the only route that you can go. There's lots that you can do on the other side of things, aside from pharmaceutical medication, which definitely has its time and place for sure. But if you want to explore other routes, you definitely can. Transcript.

Jacqueline: And quick note on the birth control too. I mean, you know more than I do on this, but there's a lot of research too that's shown how birth control can harm, um, metabolic health, which obviously is a very important component for women with PCOS, um, as well as contribute to chronic inflammation. And I've, I've even seen literature, Corey, and I'm curious what your take on this is that.

The pill can actually worsen PCOS, [00:16:00] um, symptoms, like once you get off of it, they can kind of come back like with a vengeance if you're not, I guess, careful and ensuring that like your internal environment is prepped for when you do transition off the pill. Um, Dr. Jolene Brighton has a great pill, a great book, Beyond the Pill, which I read prior to getting off birth control, which was so, so helpful.

Cory: Yes. Yeah. She's great. Yeah. Yeah. Um, I, I think PCOS or not, you know, your body can go a little bit wacky when you come off birth control, just as a result of you've been, your sex hormones are kind of put to sleep, right. Um, on birth control. And so your ovulation is essentially shut down. So your hormones kind of have to, they got to wake up again.

They got to, you know, figure themselves out and that can take some time. So I see that across the board in, you know, PCOS or not, but I think a lot of us. We get on birth control when we're really young and then we, you know, we're in our early thirties. We get married. We're like, okay, we're ready to start our family.

I'm going to come off birth control. And then all of a sudden, yeah, [00:17:00] symptoms because they've been put to sleep, just Blair, right? And they come, they come back with a vengeance and someone is, you know, totally missing a period. Well, how do I get pregnant if I haven't had a period? Eight months, you know, so that can definitely happen.

Um, and that's where I really love to work with women to show them here are some steps that you can take, you know, to, to, to make that transition a lot smoother. Nothing is guaranteed and Hey, you might not even have any issues when you come off of it, but for those that do, um, it can be kind of shocking.

And I always tell women who are coming off of birth control to expect the unexpected because you just don't know, especially if you've been on it a long time, bodies change. Hormones change. We change so much. You know, if you've been on birth control for 10 years, think about how, how things have changed in your own life so much.

Your body's changed a lot. So who knows, you know, what's going to come back? What new thing will pop up? Um, what old thing will come flaring back? Or, you know, maybe what will [00:18:00] continue to stay away? It's hard to 

Jacqueline: Yeah, that's so true. No, I was fortunate that I didn't really have, again, too many issues as soon as I came off of it. And it's so funny, Cori, I'll never forget when I visited my endocrinologist after coming off the pill, um, she was very, you know, she wasn't a fan of me coming off of it. She's like, I don't understand why you're doing this and I basically shared with her my stance.

But when I went to see her about a month or so after getting off of it, we did some hormone tests. labs and everything appeared within normal range. And then we repeated that blood work, you know, several months later. And she's like, I don't understand. You don't present as a patient with PCOS, like everything's back in range.

What have you been doing? And she was so curious and I basically was just like. Oh, you know, just some diet and lifestyle changes. But I mean, I'd love to get in, you know, into that section with you in terms of what are steps that you advocate for in terms of a more natural approach to PCOS. I can tell you what I did.

Um, it was very, you know, [00:19:00] Not as a complex as I feel like many women make it out to be but obviously focused on nutrition So I really kind of abided by a more Mediterranean style diet I completely cut out alcohol not that I was ever really a big drinker I introduced some fun supplements Uh, like peony and licorice, inositol, which I know you're familiar with to kind of, again, help manage your blood sugar spikes. Um, there's also some research or literature on peony and licorice serving as like an anti-androgen, So, yeah, I'm just, I'm curious to hear what your protocol is.

Cory: totally. Um, yeah. So starting with diet is, you know, if we always talk about it, if you were looking at, you know, PCOS as like a pyramid, right? Like the food pyramid, we go back to school, think about the food pyramid at the bottom, at the base, the very core, the foundation is the food. What and how you're eating and that can be the hardest one to tackle, right?

I mean by no fault of our own our food society has changed so much We've got [00:20:00] Uber convenience convenience convenience And we're going out to lunch and we're going to happy hours and that's just our light So it can be the hardest one to tackle But if you can make some changes without driving yourself crazy, and you don't have to you know, eliminate all these, this and that you really can make really good headway in this, in this area.

And it comes down to, I talk about my, my PFF formula, protein, fiber, and fat. We're really highlighting those. We're emphasizing those macros and we're, eating less of carbs and sugars. Not that you have to can't, you know, completely eliminate those. We still need carbs and sugar is going to be around. It's good.

It's here to stay. So it's figuring out how to incorporate those foods in, um, in a way that still keeps your blood sugar nice and happy. So, um, that's, that's first and foremost. And that's really the most important thing that I help women to, to learn and to

Jacqueline: Yeah. On that note too, Cori, I love how you said we need [00:21:00] carbs, right? Can you touch on why carbs are so important, especially for women? Because again, I feel like there was this whole keto train for a while. People advocating that, you know, keto improves metabolic flexibility and reduces insulin resistance, which it does, right?

But it's not necessarily something you want to be on in the long run. So can you just touch on why we should not be avoiding carbs?

Cory: Yeah. Yeah. We actually have some, you know, research on key on the keto diet and PCOS and how amazing it can be, which is really cool. But here's the problem. Most of those studies, the attrition rate, which in research is basically how many people drop out of a particular study are, are low. Yes, so high, like sky high because this type of diet is so hard to maintain.

What do we want to do as dietitians? We want to help people figure out how to eat and to keep [00:22:00] eating that way because you know, you can hop on and off diet train XYZ, hop on another one, get off of it. It's a vicious cycle and it's exhausting. So we want to find something that people can. you know, work with for life and incorporate it and continue to benefit from.

So the keto diet, yes, we have cool research. I mean, it can do some cool stuff, but it is so restrictive. So carbohydrates are our main energy source. Um, so we really want to focus on carbs that give us what I say, like, more bang for our buck, which is more nutrients, right? So out of the car, you know, if we're looking at a bunch of different carbohydrates, we want to pick the ones that have more benefits.

And those are the more fiber containing carbohydrates. So, you know, if you're looking at, okay, I want to do, uh, you know, burritos or a wrap, or, you know, and we're looking at different tortillas, We find the ones that have more protein and fiber in them. Um, that will help to negate a blood sugar spike that otherwise maybe a white flour product would give us.

[00:23:00] So fiber containing carbs are important. Um, and we want to eat them along with some protein. Um, so carbs should be eaten with protein and fiber because that really helps to keep blood sugars happy. Um, while still absorbing the benefits of that particular carbohydrate, you know, and especially when we're talking about energy levels.

We need them. We really do need them. And we want to pick the ones that are most helpful for us. So, you know, looking at looking at the PCOS diet, um, in a way that says, okay, I'm going to try eliminating all gluten, dairy, soy, and sugar. Good luck because that's, it's not, it's very, that's an unrealistic way to look at how I'm going to be eating for the rest of my life.

So we want to pick something that's more sustainable. 

Jacqueline: Yeah. Who is it? Someone said if you can't follow a diet for 10 days, or, yeah, if you can't follow a diet for 10 days, don't expect to follow it for 10 years, and I think that's a really great proxy to live by.[00:24:00] 

Cory: Yeah, definitely. Yeah. So, so diet is first and foremost, um, that's number one. And then the second little block on that pyramid up above from the dietary changes are, is movement. You know, I, I find a lot of, there's so much fear mongering about workouts for PCOS,

you know, what, what can we not do? And what it does is it terrifies women into thinking that.

They don't, they can't move their bodies and they think they're going to spike their cortisol too high. And so they end up being sedentary. There's a nice balance, right? I don't need someone to go be, nor do I really want them to go be an Olympic athlete just because you have PCOS, but don't be completely sedentary either.

Humans are meant to move. You know, we're not meant to be doing what we're doing right now, sitting behind the screen. So even if you're just walking, you know, even if you're, um, anyways, pick something that you like. keep consistent with it. Exercise is always going to be beneficial as long as you're not overdoing it for your metabolic health, which yes, [00:25:00] we are at an increased risk for, you know, heart disease, stroke.

Um, of course, type two diabetes exercise can help regulate blood sugar. So find something that you enjoy and do it as regularly as you can. Um, so exercise is important. Stress management is the other one. You're in your adrenals. We have certain androgens that we make mostly in our adrenal glands, not our ovaries like DHEA.

So we really want to be paying attention to the state of our, how we are handling stress, right? And really paying attention to our stress response system, self care, all that woo woo stuff is so real because we're just the way that our society is set up right now. It's so, you know, so, So busy, so hectic, so stressful, and paying attention to your stress levels is only going to benefit your hormones and especially PCOS, especially if you've got that elevated DHEAS that you get, you know, back 

Jacqueline: Yeah, so true. My body is [00:26:00] very sensitive to stress and there's been times where I went through a stressful event and lost my cycle for like six or seven months. So again, everyone is different, but I've realized that I'm very sensitive to stress. And speaking of stress, stress sensitivity, going back to exercise, um, you made a great point.

I think a lot of women get paralyzed in terms of thinking what is the most optimal exercise to do and then doing exercise at all. But with that said, Corey. Ideally, what is like the best type of exercise for women with PCOS? I mean, I know strength training improves insulin resistance and metabolic flexibility.

Um, I used to be one of those, I'm going to run six miles on the treadmill back in college every day and burn my adrenals out, which hindsight's 2020, but that probably wasn't the best for someone with PCOS, but what is like the quote unquote, exercise we should be striving for.

Cory: The best exercise for PCOS is the one that you enjoy. It's the one that you're going to get your butt to go do because you like it and [00:27:00] it feels good and it's good for your mental health and it doesn't burn you out. Um, you can do strength training, you can do cardio, you can do more restorative workouts, which would be like Hiking, slow biking, yoga, walking, gentle Pilates, um, you can do all of these.

I love a combo. I love a combo of all three. Get some strength training in there a couple of days a week, get some cardio in there a couple of days a week, especially if you're working on weight loss, cardio and strength training are excellent tools for that. Um, and then get that restorative workout in too, because that's going to benefit your mental health and your adrenals.

And yes, if you are someone who is prone to hypothalamic amenorrhea, which is what you Basically you're talking about when we are kind of overdoing it in the exercise department, underdoing it in the fuel food eating department, um, or, you know, either both of those are one of those. You definitely want to pay attention to how much you're exercising and your stress levels because your body is just more sensitive.

And I speak from personal experience [00:28:00] with that too. You can have both PCOS and hypothalamic amenorrhea,

which is basically lose your because your body is kind of in this super stress state.

Jacqueline: Yeah, that was me for quite a while. Um, speaking of stress, We obviously, in this age of biohacking, right, we hear a lot about hormetic stressors, which, for listeners, are basically things that cause short term stress on the body, right, but that can often have long term benefits, things like fasting, um, cold showers, things like that.

For a woman with PCOS, who already kind of has a lower stress level, Threshold. What are your thoughts on, on participating in some of those types of practices? 

Cory: Yeah. Um, I mean, if they're, they're helpful for you, do them. Um, I don't, I can't tell you, I can cite, you know, 10 different scientific pieces of, you know, different literature that will tell you that, you know, you must do this if you have PCOS, because it's going to be an absolute game changer. I think everyone's different.

We all have to, you know, Twirl around different ideas and figure [00:29:00] out what works best for us. But if that's helpful for you, awesome. I remember meeting with, um, a coach who was, she was all about, you know, um, anxiety and lowering anxiety. And, um, one of the things she said that was great for getting yourself out of an anxious state, um, she was actually a guest on my podcast a while ago, was to do a really cold shower.

That doesn't work for me. I hate being cold. It makes me anxious thinking about getting in a cold shower. So it's awesome that it works with people. That's not going to work for me. So I think we just have to fiddle around with what, what resonates most with us. You don't have to go do all of the things, but test things out in what works best for you.

Jacqueline: Yeah, that makes sense. I'm sure you might have a similar response, but what about time restricted eating? 

Cory: Yeah. So I know there are some people who it works great for. If you are prone to blood sugar dysregulation, if you are working on fertility, if you're, you know, someone who's [00:30:00] insulin resistant, I don't recommend it because we really Our sex hormones want to feel safe enough to flow and if they don't know when their next meal is coming from and our blood sugar drops significantly and then it spikes when we eat a ton of food and 

then it drops, the goal is to really keep our blood sugar steady.

We want that stability. That's what makes our hormones happy, especially when it comes to androgens. When our blood sugar is all over the map, we for PCOS, it sends messages down to our ovaries to pump out more testosterone. That's exactly what we don't want. So I always recommend to get in regular meals and snacks, high protein snacks, keep your blood sugar stable as possible to avoid those big kind of peaks and valleys.

Um, you know, we have people who are like, I have done intermittent fasting and nothing else works for Am I going to tell you that that's wrong? Absolutely not like do that. But the majority of research that we have [00:31:00] and from my experience doing this for many, many years, I see the best results when we actually do the opposite.

When we're focusing on regular meals and snack times 

Jacqueline: Yeah. 

Cory: standpoint.

Jacqueline: And what does that look like to Corey? Like, 'cause I know there's some people who might be eating every like hour on the dot, which also isn't good. So what's a proper, like, allotted amount of time between 

Cory: Yeah. Yeah. I typically recommend three meals and two high protein snacks a day. So if you want to do, you know, breakfast and then lunch and then dinner and have your like afternoon snack and then after dinner snack, or you could do a, you know, a. m. and a p. m. snack, there's, there's not one time that, you As far as duration and I'm like do not go over but typically we want to be having something You know at least every yeah, four to five hours We don't want to go these like big long like six seven eight hour time chunks, which I see all the time When women are just [00:32:00] we're too busy to eat.

I don't even know what that's like I have to eat all the time, but um I'm always thinking about food, but, um,

Jacqueline: Mm-Hmm.

Cory: like I forgot to eat. I'm like, what? Um, no, but we don't, we don't want, we don't want to go that long. We want to keep our blood sugar stable. So, um, there's not one clear, you know, number I can toss out there, but just don't go all day without eating, come home and have a gigantic meal, go to bed stuffed, have it interrupt your sleep, wake up hungry as a result and start the cycle all over again 



Jacqueline: Used to be me.

Cory: Oh yeah. You're not alone. I see that all the time. And it's so funny. Even when I work with clients one on one for months, it's like the hardest cycle to break. So if that's you, that is one thing that you can change to really set your blood sugar off on the right foot is get up in the morning, have a breakfast that includes protein.

And here's the magical one that everybody [00:33:00] forgets. fiber. Both of those in the morning are going to put your blood sugar in a happy state all day long. You're going to have better energy. You're going to have better mood. You're not going to have that afternoon crash. You can still have your coffee or your caffeine, but wait a little bit until you eat after you eat.

Um, if you make that change and stop making dinner, your most gigantic meal, you're going to wake up hungry. Cause a lot of people say, well, I wake up and I'm not hungry. You know, I don't want to or I'm nauseous or something like well, what's your big? How much did you eat dinner or a dinnertime? Right if we pare that down and wake up hungry We want to wake up hungry.

That's a 

Jacqueline: so true. Yeah, honestly, you're gonna laugh I like look forward now to waking up in 

the morning like rather than wanting to hit snooze because I am hungry and I do Want to eat breakfast, right? Because again, I used to be in this cycle of you know Not eating until like 11 11 30 in the morning. I'd have like Coffee on an empty stomach, which is the worst [00:34:00] thing to do.

It spikes your blood sugar. And then, yeah, I'd be thinking, Oh, I'm intermittent fasting. I'm going to have my first meal at 12 o'clock. And then when four o'clock rolls around, it's like, you're also starving. And then you just binge eat and you feel horrible about yourself. And it's just this really vicious cycle.

So again, that's a really simple hack that a lot of women can make that I'm sure makes a really big difference. But what are some other, I guess, like resources you give to women who are in that? Repetitive cycle, and you alluded to it before, but I feel like a lot of women with PCOS do have that perfectionist type A personality, and it might be more challenging, right, to get out of those cycles that are so ingrained, so how do they do that?

Cory: Yeah. Well, I, I want to, I want to go back quickly and just, you know, revisit this binge, you know, restricting binging kind of cycle because I really want to eliminate the shame from that because we can feel so shameful over [00:35:00] that, but it really is a natural physiological cycle. response. If you're not giving your body regular fuel and you're starving, but you've kind of muted that feeling because you're not paying attention by no fault of your own, you haven't trained your brain to do that yet to your hunger signals.

And then you go completely overboard. And then we feel this intense guilt and shame around that. And then we're like, well, why can't I lose weight? Or why can't I, you know, feel and look the way that I want to look? Let's strip all the guilt and shame from that? Because. The problem is not you or your willpower.

That's false. The problem is that your body needs fuel and it's overcompensating, right? So by giving your body those regular, that regular fuel source, even if it feels like you're eating more often, you will train your body. You will not have such intense cravings or urges to go overboard because your body doesn't need it.

feel like it needs it anymore. [00:36:00] So it, it, it's a training, you know, I train my clients and my program members to really get into this new zone. And that's where the magic happens because all of a sudden we realize, okay, wow, I'm in much more in control than I thought. And also when we have this power, blood sugar dysregulation component, which going long stretches of time without eating exacerbates, it intensifies our cravings.

We talk about fatigue. Women with PCOS, we talk a lot about cravings and fatigue, and that's because of that insulin piece, that blood sugar piece. So by tackling that, you can help to mitigate your cravings. Turn down the volume knob. And, and also boost your energy levels, your mood, your libido. So you don't, you feel like a totally different person.

So if you're incorporating these things in, you know, if this is, if you're listening to this and you're like, well, that's me, you're not stuck there forever. We just have to tweak how your blood sugar is behaving. And that's the key. That is the key to unlocking [00:37:00] that. So, um, yeah, you know, there's, there's a lot of, I think PCOS plays mind games with us.

You know, we, we feel like we're so powerless. We feel like we're not in control of these urges and these thoughts and these feelings that we're having, but we really, we're a lot more in control than we think. We just have to get the tools to climb into the driver's seat and say, I'm the boss now, and 

here's how it's going to go. And you know, that's where I love to help women to understand what tools to give them, what do they need to know, um, in order to tackle that and regain that power. 

Jacqueline: And I mean we know Cory that symptoms can go obviously into remission Like I'm exhibit a but could you say that I mean? PCOS is also kind of classified as it's a metabolic disorder and it's like a chronic disease in some cases so could you say that someone could actually completely heal from PCOS or is it more of like this underlying thing that We're always going to have, but we can manage symptoms, you know, through diet and lifestyle and everything we've been [00:38:00] discussing.

Cory: This second. So you'll see, you know, there's a big red flag if you see an influencer on social media claiming, I cured my PCOS, you know, it's gone. I'll cure yours too. Well, think about what they've done to get there and what they continuously do, right? That social media influencer is not, you know, sitting on the couch, eating, you know, pirates booty, watching, Island all day long, right?

They're exercising. They're making their protein packed smoothies. They're doing all the things they're managing their PCOS really well. And so you PCOS, there is no cure, but don't let that frustrate you. Right. Or, you know, doom and gloom cause doom and gloom. It just means that it's something we have to continuously manage, but it's a lot easier to manage once you have tackled those initial fronts.

diet movement. We didn't get into supplements, but taking the right supplements and understanding what your body needs, you [00:39:00] can keep your symptoms in remission and that might look like it's cured. But if you were to stop doing those things, right, if you were to go back to eating, skipping breakfast, having coffee, nothing until 4 p.

m. binging, going to sleep, getting crappy sleep, waking up stressed about it, totally falling off your supplement routine, what's going to happen? PCOS symptoms are going to come rolling right back. So there is no cure but as long as we can stay on top of these things and I'll tell you now for you know having PCOS since puberty basically and now being in such a good place with it, there, it's not so overwhelming now as it was initially, there are little things that I do still but it's not this life changing thing as it once was when it first when I first started to Tackle it so let that you know give hope to women who are like, oh my gosh, but I'm so overwhelmed It's normal to feel overwhelmed at first But once you have those tools and you understand your unique PCOS [00:40:00] and your body and what it needs It's so much easier to manage

Jacqueline: Yeah. I am curious to Corey, do you know what the average age of women who are diagnosed officially diagnosed with PCOS is?

Cory: I don't, that's a good question. I would think it's not right at puberty, right? Because these are kind of crazy for even women who don't have PCOS periods can be wacky the first couple of years, which is why I don't have a PCOS diagnosis at age 13. I don't love that. Um, I would say mostly in early mid twenties, I would say.

And also as women, you know, start to think about. family, you know, get having a family getting off birth control. We see that a lot. We get off birth control, you know, in our late twenties, early thirties, and then boom, we get a PCOS diagnosis because, oh my gosh, like all of this stuff that I totally forgot was happening has come back as I've come off birth, not because of the birth control, but because birth control has been masking it.

Mm hmm.

Jacqueline: yeah, that makes complete sense. You touched on it before. I did want to get into [00:41:00] supplements with you because, again, I, that, those are really helpful for me in, in my healing journey, but what are the top supplements that you like to have clients use?

Cory: Totally. Um, so I would say a huge one and the most, the, the, I have my own line and the top seller, the one that flies off the shelves every single time is a blend that helps to support lower androgen levels. 

Right. So like. Because that's so crucial for so many of us, and it can cause so many of our symptoms, taking something that can help lower that, those androgens and support that process.

Spearmint tea is

not a pill, but it is actually, we have a ton of great research about spearmint tea, two to three cups a day, not peppermint. Y'all experiment, uh, to, or drinking that a couple of times a day. You can have it hot. You can have it iced in the summer. Um, along with an androgen blocker supplement, like the one that I make that there's different [00:42:00] blends out there, but can be really helpful and help to attack things like, you know, get down that facial hair growth, acne, um, help regulate your period.

So that's a big one. And there's a reason why it's constantly flying off the shelves. Um, in my own. business and for others. Um, inositol is one of probably the best known PCOS supplement. Um, you want to find it in the correct ratio, which is 40 to one ratio of myo to D chiro inositol. And that is so great for blood sugar regulation.

It's great for helping to support lower androgens. And if you're trying to conceive or thinking about babies in the future, it's actually really great for egg quality. And 

Jacqueline: Interesting. I didn't know that. What are your thoughts on like inositol versus berberine? Because that's another one we hear a lot about. And is there a benefit to one over the other?

Cory: Berberine is great too. Berberine and inositol both kind of do the same thing in terms of [00:43:00] the, um, blood sugar balance. I have seen in my clinical practice much better results with inositol than berberine. But if someone doesn't react well to inositol, some people can have some digestive complaints. Um, it's not as much as metformin, most certainly not.

But some people can still have some complaints, and that's when I would switch them to berberine. Um, so I had some better results with inositol, which is why I recommend it, why I make it, but um, yeah, both, both can be good.

Jacqueline: Another thing I included was saw palmetto. I have to look at your line and see which different herbs you, um, use because I'm really curious about your mixes. But yeah. Yeah. saw palmetto, uh, peony licorice, spearmint tea. Chase Barry, like, and there was an element where I was just experimenting with things on my own because I wasn't necessarily working with someone, which I do encourage patients to work with someone.

Um, so it's more of like a test and trial run for me, but I learned a lot through that. And yeah, it is very frustrating. I remember just being in college thinking, why is my face [00:44:00] breaking out so much? You know, I'm not 13 or 14 years old anymore, but you have to realize what's going on underneath. And the dermatologist can only do so much, but they're.

Steroid recommendations, which also it's a whole other story, but not really good for you. Um, accutane. Yeah. Exactly. I know. And it's, and it's just really crazy because again, it's just all, all Band Aid solutions while not really addressing the root of what's going on, but yeah, spearmint tea, eating breakfast in the morning, like simple, simple steps that women can take that really do have, have huge effects.

Cory: Yes. Yeah. And I think with supplements too, you know, I get asked all the time, what supplement can I take for X, Y, Z, right? And supplements, if you think about that pyramid that I mentioned earlier, diet at the bottom, the foundation, the biggest part movement, stress, gut health, and supplements is at the very top of the little triangle.

Women want to reach them up and get the supplement and, and ignore all the other steps of the pyramid. You've [00:45:00] got to build on the others. And supplements are at the top. Supplements are supportive of dietary and lifestyle changes for PCOS. So if all you want to do is take a supplement, that is not going to fix all of your problems.

You need to incorporate the other steps too. So don't start with supplements, start with other changes, and then add supplements in that are supportive and helpful.

Jacqueline: Yeah, I love that. And one other thing too, Corey, I wanted you to touch on because it is so important because they're so prevalent today 

is endocrine disruptors, right? So things that are found, and we know, I forget, there was a stat, it was like women Put over like a hundred different things on their bodies every single day from makeup to deodorant to the like the shampoo they use and it was just so overwhelming and I understand right that like people like you know you can follow some health influencer and they're basically saying you can't put anything on your skin and I think there's a fine line right but can you just elaborate on maybe what are some like [00:46:00] Top things we should really be actively avoiding in, again, skincare products, deodorant, etc.

Yeah.

Cory: is, um, such a huge wide world, and I will be the first to say that it's something that you can easily drive yourself nuts over, right? Because we live in, I mean, we sleep in plastic, literally our sheets are polyester, we're sleeping in plastic. So to try to make changes is so difficult unless you're like, Living off the grid making your own shoes, you know, that's not most of us So I think we have to be realistic about what and and when we all have our own comfort levels Right, like I'm okay with adding in blank blank blank in my food My best friend is not we have to figure out what is important to us and just do the best we can You know, we can't be perfect.

We can't [00:47:00] eliminate every single synthetic thing that we hear about on the news or social media that this is toxic and, and it's sad because, you know, who, I don't know, we see cancer rates rising in younger people and we wonder why. I don't know exactly, but we theorize that, you know, endocrine disruptors and our food, it could potentially be key players, but it's like, okay, what do we do with that information?

So that was long winded, but, um, it's hard. It's a big can of worms. You know, I don't want to open it up and go into all these different areas. But I think it's about number one, figuring out what are our comfort levels, right? Like where do we fall on the spectrum? We're all on a spectrum as far as what we're willing to accept and use in our everyday lives and what we're not.

Get clear on what that means for you and be okay with that and understand that you're not going to be perfect. Um, What we really talk about and I talk about in my [00:48:00] programs are like when it comes to personal care products like, uh, fragrance, you know, phthalates, parabens, sulfates. These are things that you can avoid and are becoming easier to avoid because brands are being more transparent about when they're adding them when they're not.

So if you, you know, look at the bottle of, shampoo that you're using, right? And it says no, no sulfates, no parabens. The, uh, the phthalates and the parabens are basically two fragrances, um, that are added into a lot of stuff. We can at least feel comfortable there. So you're not having to, you know, look every single thing up.

Um, there's other, there's apps that can help you think dirty is one, um, that, A lot of people use that you can, you know, check different ingredient lists, check different brands. Where do they fall on that? Like clean beauty spectrum. So I would recommend using that just as you're shopping around. Like if you go to Target without your phone and you know, if you're looking at

Jacqueline: I love that. I haven't heard of that one. I've heard of 

the EWG [00:49:00] app, but I haven't heard of the Think

Cory: Yeah. 

Jacqueline: check that out.

Cory: EWG has the skin deep, um, system that you can use, type in an ingredient, type in a brand. It basically gives it a grade. So you can definitely be a conscious shopper, um, you know, and a lot of that work has been done for you by people that have, you So that's mostly what we talk about in terms of food.

It's so controversial. It's so conflicting, like 

seed oils and, you 

know, 

and it's just really hard. And I always say, you know, You don't need to go and say, I will never have another, you know, diet Coke and the rest of my life, you know, fine. If you, if you want to do that, but you know, don't drink it every day, you know, figure out a balance to where you can feel comfortable, but still once in a while indulge in that thing, 

Jacqueline: That's so true. Honestly, Cori, I feel like the common theme in this whole conversation is do what's best for you. And that's really so important because I was chatting with my [00:50:00] mom the other day and I was like, I just feel like the more immersed you become in the wellness space and like you and I are on it every day with Instagram friends and everything, you It's so overwhelming because there's constantly new research and new things coming out.

People are saying, do this or do that and like dietary changes. And like, honestly, it's just, it's overwhelming. And I think the stress it creates is worse than the thing itself. And it's so funny. Are you familiar with, um, Emily Morrow? She has this Instagram account called really very crunchy.

Cory: No, I don't think

Jacqueline: You have to check her out.

You would really appreciate her account. It's hysterical. But she basically, like, she uses satire and creates all of these really funny videos on, like, the quintessential crunchy mom. And, and some of them, and some of them are just, like, so spot on. Like, there's one video where she's outside walking with her two kids, and all of a sudden she smells, like, fabric softener from the lady next door.

And she's like, kids, like, pull up your [00:51:00] shirts! It's just so funny, but it's so true because like, that's, that would be my reaction too. But again, the stress over whatever it is you're worrying about is worse than the thing itself. But she was telling me, I think it was her husband, Jason's. Grandma is like in her mid 90s and she literally microwaves like styrofoam. Emily would go over and be like, you know, you've really, yeah, like you really shouldn't be doing this, but she's like, who's yeah. And she's like, who's 95. But like, the point is that You know, there's people who live to like their hundreds not ever knowing about organic food or all these things that you and I are sitting here talking about and they live long and healthy lives, you know, so like I think there's a balance and again, the more I get into this space, the more I realize like it's not all about doing what everyone says is right to do.

It's about doing what's intuitive and what you think is [00:52:00] best for you, right? And having that balance.

Cory: I so agree. I so agree. And I, the older I get and now that I'm a mom, I find that it's, yeah, it's definitely a balance. Do what you can. Don't drive yourself crazy. Genes, genetics are a lot stronger than we think. Um, but there's still room to change and make improvements. But, um, yeah, there's, you know, there's so much to say in that whole discussion and it's, it's a big wide world.

And there are people that are much more well versed in it than I am. You know, I'm more on the food side of things, obviously, but, um, yeah, you know, make sure who you're getting advice from on social media is somebody, you know, who is a credible source, who has. a degree, a license, um, you know, who's qualified to speak on that issue because there are a lot of people operating on social media who have great, fancy, beautiful accounts and they're beautiful and, um, but do they have the [00:53:00] qualifications to really be speaking, you know, behind this?

This really comes down to science. It always comes down to science with anything in the wellness space. So make sure that they're legitimate, qualified providers. And, you know, they're giving correct advice because otherwise you're going to be led down 85 different rabbit holes just before 9am about, you know, glide, whatever it, anyways, there's a lot of different things.

So, um, yeah, just make sure you're, whoever you're following and you're listening to, when you're actually absorbing information from is. Legitimate because that matters, you know, people, people are like, well, just because you have a degree, it's like, well, I mean, yeah, I wouldn't want a plumber performing my open heart surgery.

People are going to get qualifications for a reason. So, you know, let us do our jobs. And, you know, anyway, yeah, a lot out

Jacqueline: Love that. Speaking of following, where can listeners find you on social, um, your courses, your website, all of that fun stuff?

Cory: [00:54:00] Um, so I, my Instagram, TikTok, YouTube handle is all the same. So is my website. It's the women's dietician. So I'm probably most active on Instagram. Um, and then I have my two programs. I have, um, the PCOS boss Academy, and then I have get pregnant with PCOS. I run both of those several times a year. I love them.

They're so fun. They're so informative. They're so so popular. Um, they sell out very fast, but I love to run them and that's really where I'm able to work with women to give them, you know, the foundation and the tool set to really tackle this diagnosis. Well, um, and then I have my supplement line, which is by the PCOS and I have my, You know, androgen blocker, I make an inositol.

I have a cortisol calmer, um, all kinds of stuff for healthy periods. It's a, it's a cool line of thought. Yeah. I have a book on PCOS coming out next year and I'm very excited about it. Never really talked [00:55:00] much about it because it's just entering like finding the right publisher phase. This is a huge process.

Writing a book is a Um, even after it's written, it's like, you know, a year and some change before you even can get it out there. But I'm excited about that. Um, and then I am going to be opening up a multi practitioner practice where I can basically, um, provide one on one services again under people working underneath me.

So they 

will my brain on and can help, you know, women in a one on one setting, which is very, very cool. And then I have another program now, but I won't talk about it yet, but it's very exciting. And I can't wait to launch that. So yeah. 

And 

Jacqueline: gosh.

Cory: so I have my third baby due in two and a half weeks. So

Jacqueline: I didn't know that!

Cory: yes. Yeah.

Yes.

I'm you're a super mom doing all of these things.

there.[00:56:00] 

Jacqueline: Oh my gosh, congratulations on, on all of that and yeah, super exciting about your book as well. I'll have to have you back on right before that goes live,

Cory: Yes. It's going to be awesome. It's so needed. It's so needed out

Jacqueline: I'm sure. Corey, this has been so much fun. I'm so glad I finally got to actually meet you. Um, I look forward to having you back on, but my last question for you, and this is my favorite one to ask, and that is, what does being well and strong mean to you?

Cory: Hmm. That's a good question. Of course it goes along with the theme. What is well and strong? I think, I think, um, In my early 20s, I would have answered this very differently than I will in my mid 30s. I think Well and Strong to me now is more about mental health than physical strength. Um, and that mental health, You know, being able to govern whether or not you can go on to work [00:57:00] on your physical self, work on your physical health goals.

If you feel well enough, capable enough, strong enough, mentally, you know, your, your anxiety, depression, um, whatever it is, is, you know, in check and in a really good place. You have the capacity and the bandwidth to be able to work on other pieces of your health. So I think that mental health part is just so key and, um, something that I have prioritized more as I have gotten older.

And now that I'm a mom of almost three, you know, and, and really prioritizing that and putting that at the focus of making sure I'm good there so that I can take care of everything else, my family, you know, my relationships, my business. probably 

Jacqueline: I

love that. Beautiful. Yeah, I couldn't agree more. It'll be interesting to see how that changes for you 10 years from now too.

Cory: Yeah, totally. I 

Jacqueline: Awesome. 

Cory: We'll see. Time will tell.

Jacqueline: We'll see. Have to have you back on. Well, Cori, [00:58:00] thank you so much again. Super excited to share this with listeners. And yeah, I hope to have you on again at some point soon.

Cory: Awesome. That sounds great.


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Jacqueline Genova

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