Does PCOS go away after pregnancy? Is intermittent fasting problematic if you have PCOS and hypoglycemic episodes? And can you still have PCOS after you’ve had a hysterectomy?

Get the answers to these questions in this week’s Q&A with fertility specialist Dr. Fox:

Does PCOS “go away” after pregnancy?


I was diagnosed with PCOS in my 20s, after failing to have a period for over a year after stopping birth control pills (which were prescribed to me for heavy irregular periods in my teen years). I have pretty much always had a normal BMI (in fact, when I was diagnosed with PCOS my BMI was on the low end, around 20).

I was able to get a natural cycle of 35-40 days back with the help of acupuncture and lifestyle changes — cutting sugar, etc. but no strict LCHF. I do think that traditional Chinese medicine had some positive effects on regulating my cycle. Fast forward several years, I had a “surprise” baby at 37 years of age. My cycles post-baby are now 32 days (BMI 23.6).

My question — is it possible for PCOS to resolve itself naturally after having a baby? Or is PCOS lifelong? In one of your talks, you mentioned that 32 days (my current cycle length) is still abnormal — and indicates “mild” PCOS.

Plan is to go keto to improve chances of conceiving… but I was not sure if PCOS is lifelong or can resolve?


Dr. Fox:

Great question. The answer to your question is PCOS and its underlying insulin resistance usually a lifelong issue. The real question in my mind is whether you actually have PCOS or stress-induced ovulation dysfunction.

While lean PCOS is real, I feel most lean PCOS patients really have the stress disorder. Refer to my numerous posts on stress disorder. The differentiating factor for us is the finding on a 3-hour tolerance test of elevation in insulin (PCOS). Many women have a combination of both physiologies.

More likely acupuncture and the introduction of a child in your life reduced physiologic stress and your cycles became more normal. The stress or ‘hypothalamic’ dysfunction is not widely recognized or written about. Search terms are female athletic triad. This is the worst case scenario but there are many women who are not this bad but exhibit the same physiology and it’s not always caused by exercise.

Best of luck. LCHF is still the best nutritional approach either way.


Is intermittent fasting dangerous for someone with PCOS who has hypoglycemic episodes?

My friend has PCOS with “glycemic episodes” of shakiness, feelings of unreality, nervousness sporadically when going a few hours without eating. Is there concern that fasting is contraindicated? Or are these episodes something to push through? We want to help her PCOS and migraines through fasting and ketogenic diet.

Thank you so much for all that you do!

Dr. Fox:

Good question. I am not a fan of intermittent fasting for women in general — see earlier posts. Only in people who are extremely overweight where it works like bariatric surgery. Many don’t understand that for men or women intermittent fasting should not start prior to ketadaptation. I am not a big fan for these reasons. Low blood sugar symptoms should be much less when ketotic.


Can you still suffer with PCOS after you’ve had a hysterectomy?

Can you still suffer with polycystic ovaries after you’ve had a hysterectomy? I still have my ovaries.


Dr. Fox:

Yes, for sure. The insulin resistance does not go away even without ovaries. Some of the skin changes may improve due to changes in the hormonal profile or could worsen due to decreased estrogen. The disease needs to be treated by nutritional change for life.

Good luck!


More questions and answers

Questions and answers about low carb

Read all earlier questions and answers to Dr. Fox – and ask your own! – here:

Ask Dr. Fox about nutrition, low carb and fertility – for members (free trial available)
Videos with Dr. FoxStressing less to get pregnant10:57Stress is a common cause of infertility. But how can you avoid it? Dr. Michael Fox answers.What to eat to get pregnant13:06Can you increase your chances of becoming pregnant by avoiding eating too many carbohydrates? Dr. Fox about food and fertility.Eat LCHF, get pregnant27:22Can you increase your chances of becoming pregnant by avoiding eating too many carbohydrates? Interview with Dr. Michael Fox.Women, hormones and nutrition47:53Presentation by physician and fertility expert Dr. Michael Fox on nutrition as a treatment for infertility, PCOS and menopause.The cure for morning sickness09:57What’s the key to avoiding morning sickness during pregnancy? Fertility-expert Dr. Michael Fox answers.Is coffee bad for you?07:08Can coffee be bad for you? The low-carb friendly fertility specialist Dr. Michael Fox has some pretty controversial ideas on the subject.Exercise less and get pregnant13:35What many people believe is healthful – to run more and eat less – may do more harm than good. Interview with Dr. Michael Fox.
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