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Mary-Jo McGuire, owner of MD Nutrition, hosts the Female Health Podcast. She is a nutritional therapist and works with women to address various health concerns. The podcast covers topics such as weight loss, hormonal balance, fertility, and more. Mary-Jo aims to provide educational and empowering information to help women take charge of their health. In this episode, she focuses on struggles related to PCOS, particularly weight loss challenges. She explains that PCOS can make weight loss more difficult due to a lower basal metabolic rate and insulin resistance. Insulin resistance, which affects about 80% of PCOS cases, hinders weight loss and can cause symptoms like irregular periods and high testosterone levels. Mary-Jo emphasizes the importance of targeting insulin resistance through dietary changes, such as regulating blood sugar levels and reducing sugar spikes. She suggests focusing on the quality of food rather than solely counting calories to achieve weight loss and improve PCOS Hi and welcome to the Female Health Podcast. My name is Mary-Jo McGuire, owner of MD Nutrition. I have a degree in Master's in Nutritional Science and I'm studying to be a nutritional therapist also. I work with women every day who want to lose weight, improve their relationship with food, hack their hormones, regulate their cycle, restore their periods, learn about nutrition for hormonal balance, help women come off the pill, and lots more. This podcast will be a place to talk about all things female health related, from periods, to pills, weight loss, diets, fertility, acne, PMS, and lots, lots more. I hope this platform will be educational and empowering, so women can take charge of their health, their hormones, so they can feel and look their best at all stages. Hi and welcome to the Female Health Podcast. My name is Mary-Jo McGuire, owner of MD Nutrition. I have a degree in Master's in Nutritional Science and I'm studying to be a nutritional therapist also. I work with women every day who want to lose weight, improve their relationship with food, hack their hormones, regulate their cycle, restore their periods, learn about nutrition for hormonal balance, help women come off the pill, and lots more. This podcast will be a place to talk about all things female health related, from periods, to pills, weight loss, diets, fertility, acne, PMS, and lots, lots more. I hope this platform will be educational and empowering, so women can take charge of their health, their hormones, so they can feel and look their best at all stages. It's a better time. I've literally just put on the washing machine, so maybe you're going to hear that in the background, so apologies. But this time when I'm doing the podcast, it's going to be more about you and helping you proactively, giving you habits, steps, answering your questions, helping you with the things that you're really struggling with. So I'm going to do some more kind of Q&As. I'm going to just answer questions I'm seeing coming in a lot on Instagram, seeing coming in with my clients, and to help you. So if you're really, really struggling, this is going to be the podcast that you want to listen to, particularly if you've got PCOS, if you've got any sort of hormonal issues, like irregular periods, you've got spotting, you've got bloating, you are maybe worried about your fertility, and maybe you feel like you haven't been fully heard, or maybe you're being dismissed by your doctor at the moment. So I want this to be a place where you can get some information and can do something with the information as well. And so there will be some guest episodes, but I'm going to keep them to more a minimum, and it's going to be more solo episodes that are really focused on a particular topic, or like I said, Q&As and helping you with your struggles. So I'm going to basically get into it, really. I'm going to keep these episodes more short and sweet, so you can listen to them maybe when you're out for a walk or on the way to work in the car, something like that, so that you can get concise messages basically to help you, so you have something to do for the week, basically. You have maybe some homework, if you want to call it that, or action. You can take some action, basically, what I want you to do. So for this episode, I'm going to start with some questions that I've been getting on struggles for PCOS. So what are the biggest struggles, something you suffer with? And I'm seeing like, you know, running themes here, so I'm going to consolidate a few of the themes that I'm seeing. So the first one is the weight, in general, the weight loss, so kind of having to watch calories, what calorie deficit to be in, weight loss in general, just struggling to lose weight. These are the kind of things coming in, losing fat around the tummy area, help me, basically. So all of these are kind of coming in, and so yeah, like basically, we want to kind of give you some actions here. So when it comes to weight loss and PCOS, it can be harder. I'm not going to sugarcoat it and say it's easy, you know, just follow a calorie deficit, because many of you may have been doing this before, you may have done different diets, and your best friend could be doing the exact same calories or exercise plan or diet and not be losing, you may not be losing weight, and they are, they're just making great progress. And this is where it gets so frustrating and so debilitating, because you're doing the exact same as they're doing, but yet you just feel like a failure, like, what am I doing wrong, you're really breaking yourself, you're like, I must have not been counting my calories properly, or maybe not exercising enough, and then we can get into the spiral, a really unhealthy kind of spiral from there. And I suppose, really, when it comes to weight loss and PCOS, it is more challenging due to a number of different issues. But the number one, really, is that we have a lower basal metabolic rate, and we have what's called insulin resistance. Both of them, you know, when basically a lower basal metabolic rate, this is, you've got a slower metabolism or a lower efficiency of burning your calories. So someone with PCOS and someone without PCOS will have a different BM or basal metabolic rate. And the higher your basal metabolic rate, the more efficiently you burn calories, so you can eat more, burn these calories off, and lose weight, where someone with PCOS does not have this. And this is down to a number of different reasons, due to the hormonal imbalances at play, and the insulin resistance, primarily. So I speak a lot about insulin resistance, because it is present in about 80% of the cases of PCOS, which is a huge amount. And insulin resistance, basically, is the reason why it is more difficult to lose weight. So I need to explain, I suppose, what insulin resistance is, to kind of give you an insight into this, and then we can go into what you can do to help this insulin resistance and help to lose weight and reduce other symptoms that are to do with PCOS. So insulin resistance means your cells are less responsive to insulin in the body. So in a normal functioning body, basically, insulin is like the taxi or the shuttle bus that transports sugar into the cells. When the sugar is in the cells, it's broken down and converted into energy, and this is great, this is what we want the sugar to do. We don't want the sugar to be floating around the bloodstream, because this is when it can cause problems. We want it to be in the cells, converged to energy, and we can then burn it off. What happens when we're insulin resistant is that the cells that normally uptake this sugar into the cells via insulin or via the shuttle bus, they are like barricading it, they're blocking it off, they're not letting it come in. So what's happening then, the body is like, why is there so much a buildup of sugar here? Why is there a buildup of insulin? So we start to produce more insulin then, because, well, maybe we need more buses, maybe we need more taxis to help the sugar, to help the passenger, if you want to call it that, get into the cells. And then we get this high insulin level and high glucose levels in the bloodstream. This is when then you might notice, this is where a lot of the symptoms of PCOS come from, such as irregular periods and high testosterone. Insulin has an effect on our ovaries that causes elevated testosterone, and it blocks ovulation as well. So this is why you won't get regular periods and you'll have excess hair growth and acne and things like that because of this high insulin level. But similarly, this is what causes the issues with weight because the high levels of insulin will then eventually have to, the sugar will be stored then as fat and insulin is a bit of a fat storage kind of hormone. Putting it kind of simply, this is what's going on in the body. Now, what happens then is eventually the sugar is going to get transported into the cells eventually, but it's gone up from a really high point to then a big low point. Then you're going to get this sudden crash, and that's where you get these sugar cravings and spikes. You want carbohydrates, you want sugar. And so you're on this kind of roller coaster throughout the day of eating carbohydrate foods and sugar and constantly craving sugar. So you feel like you can't maintain a healthy eating habit because you just crave sugar so, so much. So when we understand one of the reasons why we struggle to lose weight is because of this insulin resistance issue. And also insulin resistance is a big reason for weight gain around the midline. It's a big indicator. If you carry weight around your stomach, it's an indicator that you might be insulin resistant. So when we realize this, we can start to target the insulin resistance rather than just looking at a generic calorie deficit diet. Yes, we will probably need to be in a calorie deficit. I'm not saying that's not important, but what makes up that calorie deficit diet is also really, really important. So when I'm working with my clients, at first, I don't even put them on calorie deficit. I look straight away at what way they're eating, what their breakfast is made up of, how much carbohydrates they're eating throughout the day, what their fiber intake is like, what their protein intake is like. We actually look at this first. And sometimes we don't even need to go on a calorie deficit diet, or count calories, because the changes that we make start to make a difference without doing that. Which is great, because it takes away that pressure of counting calories if they don't want to do that. So what we want to look at, basically, is a diet that regulates your blood sugar levels, so we're not having high spikes in sugars in the bloodstream. Because when we have high sugar levels, we need more insulin to bring the sugar into the cells. So the less sugar spikes that we put into our body, the less insulin that we will need. And therefore, we're not going to get this impact on our hormones, and our testosterone, and the weight gain, etc. So to do this, we want to have a lower carb or more moderate carbohydrate diet, and a higher protein, more fiber diet. And that's in a generic, you know, general kind of way of describing it, but everyone's going to have a different way of eating. But this is kind of the way you need to do it, basically, to regulate your blood sugars. You kind of want to be eating every three or four hours, you want to have protein with every meal, and you want to be eating more fiber and a bit of fats with your meals, and not relying on refined carbohydrates. Because refined carbohydrates, say, from your pastries, your sweets, and your cakes, these are going to spike your blood sugars rapidly. So let's just take, for example, what are you having for breakfast? If you're starting your day with toast and jam, this is a recipe for blood sugar havoc. You are spiking your blood sugar straight away first thing in the day, because toast or bread is basically made of carbohydrates and sugar, and it's broken down to sugar very quickly in the bloodstream. Then if we add jam, which is, you know, a lot of sugar as well, we're just really adding fuel to the fire there, and we're spiking your blood sugar. So it's just like, this is the type of thing we want to kind of stay away from. Instead, maybe we could opt for like a whole wheat, a rye bread, or an oat bread, or sourdough bread even. Maybe a smaller slice of that, instead of having two or three slices, maybe one slice. And instead of, say, sugar or jam, adding something that has like almond butter or peanut butter, or maybe some egg and avocado, something that has a bit more protein or some fats in it. So the egg and the avocados will give you some protein and some fats. The peanut butter would be a fat source. So this is just a little example. I'm not telling you all to go out and have this, that it's the healthiest breakfast ever, because there's definitely different options that you can have. But it's just an improvement on the toast and jam type of breakfast, basically. So this would be just something to help you if you're struggling with weight loss. This is what I would work on straight away. But if you're really struggling with insulin resistance and these kind of symptoms, so insulin resistance symptoms are difficulty losing weight, sugar cravings, and maybe a lot of fatigue. You just feel white during the afternoon, even though you could sleep. You feel like you are getting some sleep. You just still feel really, really tired. Or you could also really, really struggle with sleep as well. Thirst, feeling a lot of thirst. Like I said, the weight gain is one of the issues. And then the irregular periods, the excess hair growth, the acne, they're also signs as well. So this would be one area that's very common, I see, with PCOS. And it takes up a huge majority of the cases that I work with, because, as I said, 80% of people with PCOS have some form of insulin resistance or some degree of it. You don't need to be extremely overweight also to have insulin resistance. And you may not show up on your blood that you're insulin resistant, but you may be developing it. It can take a while for your cells to show that up as well, that you're the high insulin levels and that your cells are not responding to the insulin. So hopefully that helps with the weight management piece. It's a very broad area. I'm not going to be able to answer it specifically for each problem case that comes in, because it's going to be personalized to your set of circumstances. But that is kind of the general management and not to focus just only on calories. You've got to focus also on and the what's making off your calories. That's really, really important. The next area that I was seeing some, I suppose, a theme around was kind of on the theme of irregular cycles. So not being able to track for ovulation or not knowing if you're ovulating, having irregular cycles and long cycles and worrying about trying to conceive. So kind of all falling into this bracket of just you're not having regular cycles. So just to kind of give you a bit of an education here of what cycles should look like again, because again, it's not something everyone is familiar with or everyone knows. So your cycle ideally should be no longer than 35 days. So day one of your cycle is day one. You get your full period lead. So it's when you start having a proper period. That's day one. And then if it goes longer than 35 days, if your next period is longer than 35 days, then there might be something going on there. And it's very typical for PCOS that you would have a cycle longer than 35 days. When I was struggling with PCOS in my early, mid 20s, I didn't, I may not have had a period for months, like there was one or two years, even I might have had two periods in a year if I was lucky, like I went that long without periods. And this is really, again, really, really typical of someone with PCOS. They are not ovulating and they're not getting the periods as a result. So this is the type of cycles that can be seen with PCOS where you're much longer. You could be maybe six weeks, eight weeks, 12 weeks before you get your next lead. And this is essentially due to immature follicles. So we're building up these follicles on the ovaries and they are getting to a certain point of maturation, but they don't fully develop or mature. And therefore, then an egg doesn't get released and you don't ovulate. And you need to ovulate in order to get a period. If you don't ovulate, you're not getting a period. So we want to basically work on supporting the ovaries to fully develop. And we want to really get to the root of why we're not ovulating. And I've already spoken about one of the roots is insulin resistance. If there's high level of insulin, this can stop the eggs from fully maturing and ovulating. So this is one of the things that we really need to get a grip on is supporting regular ovulation and reducing insulin resistance. One of the things that is quite recommended now, if you have irregular cycles and you're not ovulating, is to take myonositol. This is something I recommend to nearly almost all my clients because they have irregular cycles and they have signs of insulin resistance. And myonositol is a kind of sugar type substance that basically helps to, it acts as a messenger for the insulin and helps with insulin sensitivity. So basically it helps our body and our cells become more responsive to insulin. So this is targeting the root of the issue and it helps you to have more irregular cycles. It helps the ovarian cells become more responsive to insulin and it lowers testosterone and helps increase ovulatory cycles. So for me, this is something I take myself and I find it amazing for regulating my cycles. And similarly with my clients, it starts to shorten cycles down when they take this. Now, this isn't to say that you can do what you're currently doing, take this supplement and everything will go back to normal or you'll have a regular cycle. You do need to also make changes to your diet and lifestyle. So again, there's no one size fits all here when it comes to regulating your periods. And it's about identifying the main roots of the issues. Is it insulin resistance? Is it high stress levels? Is it elevated cortisol due to being very, very stressed? Or do you have other testosterone or other androgens being released from your adrenals or your ovaries? So this is something that you need to identify. So there's lots of different reasons why you may not be ovulating. If it's related to PCOS and if you have the elevated androgens and if you have long cycles and maybe you have difficulty losing weight or you've got other symptoms of PCOS, then we want to look at taking myo-inositol supplementation, regulating your blood sugars, eating more leafy greens, eating more greens in general, fruit and vegetables, getting good healthy fats in the diet. And these little changes, while not remarkable, are going to make a little bit of a difference when done consistently and that it should then help you get regular cycles in time. So there's not going to be one thing that's going to fix everything all at once. It is a component of an accumulation of all these little micro-habits, as I like to call them, that makes a difference over time. But we really want to be focusing on regular blood sugars, not eating highly refined carbohydrates, more protein and taking a myo-inositol supplement. And this can really help with regulating and shortening cycles if they are really, really long. Now, when I work with different clients and many of my clients come to me with irregular cycles, it's something that they want to work with. Girls work with me, women work with me for a minimum of three months. If they haven't had cycles in ages, for example, one of the girls who came to work with me, she started with me in August. She didn't have a period since January. So that's what, eight months, she had no period. We got to work straight away on her diet. She also wanted to lose weight and she lost over a stone in, I think it was a month and a half, two months, maybe something like that. It was like very gradual weight loss. She did amazing with her weight loss, but we weren't seeing the period come yet. But she was a bit stressed about this. And I had to tell her, this is extremely normal. We're only getting to work on your hormones now. There's clearly been an issue for the last while. You haven't had a period in eight months. We're kind of basically resetting the system. We're having to basically establish a normal balanced hormone situation. So this can actually take some time. So it was, I think she started in August, like I mentioned. And I'm going to say, yeah, it was in end of September or October, she got her first period. So she was absolutely over the moon. And I was delighted for her. So she got her first period since January. And this was done through a number of dietary changes and lifestyle changes and supplements as well. And then just this week, she has messaged me that she's gotten her second period. And the length of the cycle was 46 days. So this is a indicator of the reduction that is showing. So we went from eight months to 46 days, which is what, maybe five or six weeks. So we're seeing a pattern here that is getting shorter and shorter. But it does take that length of time. It wasn't that she started with me in August and the next month she suddenly got her first period. It did take like two months for that to show up. And then luckily she got it now in November again. So that was in a six-week timeframe. So hopefully her next period will be that or shorter again. And this is the pattern that you want to see is getting shorter and shorter. Like I wouldn't expect for someone to suddenly just start working with me and or with anyone really and suddenly have no cycle for eight months and suddenly get 30 days, 30 days, 30 days. It's not that realistic for the body to respond that rapidly unless you're going through drastic changes. Everything that she did was quite simple and basic for her life, but she was able to lose over a stone. She was able to lose and get her period regulated and have a more regular cycle. I wouldn't say regulated, but she was getting to have a cycle again. She's getting her cycle shortened and she was starting to get her hormones more balanced. So in time, she should be getting an even shorter cycle. She now has the tools to know how to do that. So this is what you kind of want to expect. You're not going to get a cycle straight away. It takes some time. When you know this about hormones, like it takes about your going, the work that you put in like now will probably be seen in effect in three months time. That's kind of how hormones work because it takes an egg like three to four months to fully develop. So the work that you're doing now for that egg will make a difference in three to four months. So that's just important to know for regulating your cycles and for trying to conceive. So like when you want to like try to conceive, you want to be doing the work at least three to four months in advance for that egg quality to be at its best. So they're the two areas that I'm going to focus on and leave it on today. So we talked there about, you know, managing weight loss for PCOS. What way to do it? Do you need to be in a calorie deficit or not? In a nutshell, you can be in a calorie deficit. And yes, you do need to be in a calorie deficit to lose weight. That doesn't necessarily mean you have to count calories rigidly. You can if you wish to. But more so, what's more important is what's making up those calories. What kind of diet you're eating? Are you eating a blood sugar control diet? That's more important. And secondly, with regards to regulating your period, what can you do? Is there hope for you, basically, if you have a regular cycle of PCOS? And 100% there is. I've worked with so many clients and girls who and women who have regulated their periods and it doesn't happen like just within a month or so. It takes some time for this to happen. But this can happen through nutrition and lifestyle and supplement changes as well. So I hope you enjoyed this episode. I hope you enjoyed this style of episode as well. I'm always open to feedback, open to what you would like to hear more of. If you have any questions that you would like me to answer, I can keep them anonymous, of course. Pop me a message on Instagram and I can go through that with you or just reply to, I'll leave a link to my email as well. You can just send me an email and also I'll leave a link to my coaching if you want to sign up to my one to one coaching. The prices are going to be going up in January. So if you want to get on the prices before they go up, sign up now or else if you're thinking of signing up for next year, but you don't want to pay that price, the price that's going up next year, you can also leave a deposit for next year as well. So you'll get the lower price. And so, yeah, thank you so much for listening and I will be back with another episode next week.