The mere idea of fasting, even intermittent fasting, may be a turn off for you. But if you or a loved one suffer from PCOS—hang on. This approach can be a game changer. It certainly has been for me.
After being diagnosed with PCOS (polycystic ovarian syndrome) last winter, I learned that poor gut health and insulin resistance were likely at the root of my hormone imbalances and resultant infertility.
Because of this, I was intrigued to learn about the purported benefits of intermittent fasting, which involves cycling through periods of eating and abstaining from food. Many studies suggest that restricting one’s eating window each day is an effective way to balance blood sugar, fight insulin resistance, and promote cell repair, all of which can have a huge impact on fertility.
I’ve always eaten smaller meals and snacks throughout the day, so I was initially resistant to the idea of fasting. After doing research and consulting with a doctor, however, I decided to give this method a try.
Six months after incorporating intermittent fasting into my lifestyle, my periods regularized, my digestive issues disappeared, and I became pregnant with my first child. Although I certainly don’t attribute all of this progress to intermittent fasting (it was one of several lifestyle changes I made, including committing to an anti-inflammatory diet and taking targeted supplements including myo-inositol), I believe it was a contributing factor.
Today, I’d like to share my positive experience with what I’d call a “gentle” version of intermittent fasting. I’ll also address why women respond differently to time-controlled eating than men.
Why intermittent fasting isn’t for everyone
Before beginning, I want to stress that not everyone should experiment with intermittent fasting. Dr. Steven Gundry notes in The Energy Paradox that fasting is a form of hormesis, or beneficial stress (123). When fasting for health reasons, one is trying to take advantage of the fact that, when exposed to mild stressors, “cells engage in coordinated adaptive measures that stimulate them to clean up, repair, and restore themselves while calming down any inflammation” (125). We might compare this kind of intervention to exercising, where one is exposed to mild oxidative stress that can help protect the body against more severe stressors.
Those whose bodies are already being strained in certain ways, however, should not take on this additional burden. In particular, those who are pregnant or breastfeeding should not attempt to fast. Putting further restrictions on one’s food habits is also ill-advised for women who have suffered from an eating disorder.
In addition, “Bulletproof” brand founder Dave Asprey emphasizes in his recent book Fast This Way that women who choose to fast should do so “in a way that doesn’t overstress your body,” as fasting too much “can create a stress response [in women] more quickly than it would in a man’s body” (200). For women, it’s incredibly important not to overtax the thyroid and adrenal glands, as this would only lead to further hormonal imbalances.
What Is intermittent fasting?
With all that being said, many women can fast in a safe and healthy manner. When learning to do so, I started by researching exactly what “time-controlled eating” means, and what I was trying to accomplish through the approach.
Fasting is not a new idea—it has been part of many cultures for thousands of years. Because of this, Johns Hopkins neuroscientist Mark Mattson, Ph.D. says that “our bodies have evolved to be able to go without food for many hours, or even several days or longer.”
But what does intermittent fasting look like in the modern world? First, it’s important to understand that intermittent fasting does not involve reducing the number of calories you take in. Instead, it means limiting the window of time during which you consume those calories. We already do this naturally when getting a good night’s sleep. Upon waking, we “break” our fast, or have breakfast! When we practice intermittent fasting, however, we intentionally extend the window of time during which we fast.
The health-related reasons for making this intentional choice are manifold. Asprey notes that, when we fast, we are essentially giving our bodies the go-ahead to stop channeling so many resources toward digestion, and to start designating those resources “toward autophagy (cellular cleanup) and rapid fat burning (ketosis)” (203). Mattson suggests that when we go hours without food, our body no longer has sugar stores available and will start burning fat instead—a process known as metabolic switching.
How might intermittent fasting affect women’s hormone levels?
A number of recent studies have shown that fasting lowers insulin levels and improves insulin sensitivity. This makes it a promising course of action for women with PCOS, as the condition has been tied to insulin resistance. In a 2017 study published in Med Hypotheses, for example, researchers proposed that intermittent fasting might improve the fertility of women with PCOS by reducing circulating levels of glucose and insulin. Reducing these levels can help the body learn to stop producing excess androgen hormones (another hallmark of PCOS), thereby significantly improving egg quality and promoting ovarian function.
The takeaway here is that the way the female body processes sugar molecules, particularly glucose, significantly affects our hormone levels. As this article from The Cleveland Clinic explains, high blood sugar levels lead the pancreas to secrete insulin, a hormone that absorbs and uses glucose. But if the flow of insulin is constant and your cells become resistant to it, the pancreas will “pump out more and more insulin” so that cells get the message to lower blood sugar. When circulating levels of insulin remain high constantly, your ovaries respond by making more testosterone and other “male” hormones. And this is a problem for women because elevated levels of androgens hinder ovulation and harm egg quality, which can result in infertility.
My experience with intermittent fasting
My primary goal in practicing intermittent fasting is to help my body learn how to process sugar in a healthy manner, with the secondary goal of balancing my hormones and improving my reproductive health. Below, I’ll share my experience with fasting in the form of four actionable tips. These are strategies I’ve used successfully, and that I believe other women may find helpful.
1. Find the right fasting window by building your endurance slowly
I started simply by not eating any snacks after dinner. Many doctors suggest that this is a good idea for almost everyone, as we sleep better when we aren’t digesting. After a while, I then moved breakfast back an hour each day. By the end of the process, I was fasting from 7 pm (when I finished dinner) to 11 am (when I ate a late breakfast). By doing so, I had accomplished a 16:8 ratio of fasting to eating, a cycle that works well for many people. And, in essence, I wasn’t actually skipping any meals. This was intentional, as I was not looking to lose weight. I simply grouped breakfast, lunch, and dinner much closer together than before and cut out unhealthy snacks as much as possible. Many women also do well and reap benefits from a more conservative fasting window, such as 14:10 or 12:12.
2. Don’t fast every day
It’s best not to fast every day, lest your body think you have limited resources. I usually fast on weekdays, but not on the weekend. You can also try fasting every other day—something Asprey points to as a strategy that works well for many women, so that the body gets the message that it is not in a state of famine or stress.
Throughout the process, it’s important to listen to your body. On mornings when you feel particularly hungry, eat something! Once you’ve been practicing fasting for a while, you’ll understand the difference between cravings for carbs your body doesn’t actually need to function well, and food it needs to combat that day’s unique stressors.
3. Try incorporating fat into your fast
If you’re fasting for health benefits, you’ll be grateful for a hack that makes the experience less uncomfortable from the start. Although some people stick to a strict “water” fast, researchers have determined that the body remains in a “fasting” state as long as we don’t take in any calories from protein and carbs.
In practice, this means that you can add some pure fat, like butter (or ghee or coconut oil, for lactose intolerant folks like me) to your morning tea or coffee during your fast. Then, blend it up to make a creamy latte-like drink. To make it a full “Bulletproof” coffee, you can also add a tablespoon of MCT oil, an oil derived from coconuts, that helps elevate your ketone levels to give you mental clarity and energy.
4. Fuel your body with healthy foods
I’ll never forget a friend telling me how terrible he felt after breaking a fast by eating a huge portion of deep-fried fish and fries. Learn from his pain and try to focus on optimal nutrition when you aren’t fasting.
My experience with the Autoimmune Protocol had already shown me the importance of nutrient density and diversity. I find that I reap the most benefits from fasting when I’m careful to eat plenty of protein, healthy fats, and complex carbs after my fast, and lots of non-starchy veggies.
My takeaways from practicing intermittent fasting
For me, the benefits of gaining metabolic flexibility through fasting didn’t involve weight loss. I wasn’t looking to burn fat by fasting, but instead for a way to get off the sugar rollercoaster and start processing sugar more efficiently.
After fasting intermittently for only a couple of weeks, I found that I no longer desired to keep snacking all day long. I found that I had more energy than before, and that my body was more resilient after nights with less sleep. And though I haven’t been retested for insulin resistance, I can certainly attest that my PCOS symptoms, including anovulation and high androgen levels, have improved greatly.
Want to try intermittent fasting?
As with most dietary protocols, intermittent fasting is not a one-size-fits-all approach, and it’s important to determine what works best for your unique body. If you decide you’d like to give intermittent fasting a try, I encourage you to speak with a doctor or nutritionist before beginning. You can also do your own research by reading this in-depth study, or by reading Dave Asprey’s meticulously-researched book Fast This Way, particularly the chapter on intermittent fasting for women.
Additional reading
The Surprising Connections Between PCOS, Dysbiosis, and Gut Health
How Whole30 Helped Me Manage my PCOS and Overcome Infertility
Insulin Resistance, PCOS, and Fertility Health: Are you at risk?
