In the BOMA-USA pamphlet entitled “Unraveling the mystery of PCOS”, Dr. Mary Martin speaks to natural ways of treating this increasingly common condition. As Billings user may already be more natural-minded than the average woman, this is a great question to know how to address with ready-to-go tips.  

Besides drugs such as metformin, bromocriptine or dexamethasone, Dr. Martin has some good advice for managing PCOS naturally. This advice can be organized into two categories:  

1. Improving insulin sensitivity 
2. Eliminating foods that trigger an inflammatory immune response 

First, improving insulin sensitivity. Here are some proven therapeutic lifestyle changes: 

Exercise – works by activating the Glut 4 alternate pathway for glucose entry into the cell. Three 10-minute session per day (ie a brisk walk after every meal) only 5 days per week will give you the CDC recommended 150 minutes per week. Doesn’t that sound doable? 

Calorie shifting (or caloric cycling) – works by improving fasting insulin concentrations as well as subcutaneous and visceral fat. There are many variations of the calorie shifting approach, all involve eating a regular amount of food for a set number of days, then significantly reducing caloric intake for another set time frame. Some variations also include specific intervals between meals. (Using a food tracker like the MyFitnessPal app helps a lot with this technique.)  
 
Limit sugars and starches – works by reducing the carbohydrate/glucose load in your bloodstream, thereby reducing the insulin spike. Sugars include refined sugars from processed “treat” items as well as natural sugars found in fruit, dairy, grains and starchy vegetables like potatoes and corn. Ask your client to start by picking one sugary/starchy item they can do without. 

Emphasize fat, fiber and protein – works by slowing the digestion of food, resulting in a slower rise in insulin. Choose unprocessed plant-based fats like nuts, seeds, avocado, and coconut more often than animal-based fats like cheese, butter or bacon. Many of the whole foods listed as plant-based fats are also sources of fiber and protein. Bonus! 

In some cases, PCOS has an autoimmune component in addition to endocrine and reproductive effects. A physician can determine the presence or absence of antibodies that indicate autoimmunity.  

What’s going on with your client’s digestion? Protein components (ie gluten, casein) from foods containing wheat and dairy are some only partially digested, creating macromolecules the immune system does not recognize and therefore attacks. This is the food-digestion-autoimmunity connection.   

An Elimination Challenge is the best way to determine if improving autoimmune PCOS is as simple as cutting out gluten, dairy or another possible food offender. Per Precision Nutrition’s infographic guide, here’s a synopsis of an Elimination Challenge: 

1. Decide which food you like to test (ie wheat/gluten, dairy/casein/lactose). 
2.  Get into the habit of checking food labels for “May contain trace..” or “Contains...” 
3. Avoid all foods that contain the food you are testing for 3 weeks. (Keeping a food record is very handy for tracing back any symptoms to possible ingestion of the test food) 
4. After 3 weeks, re-assess signs and symptoms. Have things improved? 
5. Slowly re-introduce the test food, once per day, every 3-5 days. Note if symptoms reappear.

 
(N.B. When eliminating gluten, be mindful of the tips to improve insulin sensitivity and stay away from highly refined carbohydrates like gluten free cookies, pretzels, crackers, etc.)   

According to the U.S. Department of Health and Human Services, PCOS affects 1 in 10 women of childbearing age worldwide. Lifestyle changes are hard work but have the potential to cut medication costs and restore reproductive and endocrine function naturally. If your client is motivated, consider referring them to an experienced health coach who can help them stay on track with their wellness goals.  

As Billings Ovulation Method® teachers we cannot be seen to advise in areas where we do not have the expertise or training. However, this article may be a good resource for you to give to women you are helping who have PCOS, so they can decide if they would like to follow up and get help with their diet and lifestyle changes.

References: 
1. “Unraveling the mystery of PCOS (Polycystic Ovarian Syndrome): Q&A with Mary Martin, MD, FACOG. BOMA-USA pamplet available at www.boma-usa.org  
2.Davoodi, Sayed Hossein et al. “Calorie shifting diet versus calorie restriction diet: a comparative clinical trial study” International journal of preventive medicine vol. 5,4 (2014): 447-56.  
3. Mobeen, Hifsa et al. “Polycystic Ovary Syndrome May Be an Autoimmune Disorder” Scientifica vol. 2016 (2016): 4071735.  

As part of our continued series that features our board members, Sue Ek interviewed John Worden, MD, who is finishing his last term on the board.

Photo L-R: John V, Cecilia, Dr. John , Dr. Rebecca, Rachel and Patrick

​Q. Years ago, I remember meeting you at the first Teacher Training we hosted with trainers from WOOMB in Australia. One of your comments remains vivid even to this day. You had just returned from medical training for another NFP method in Omaha and, you told me you got more science in our weekend training than you did in two sessions there. Tell us about the differences.

John - I think I was impressed with the Billings Method™ because we were able to learn a huge amount in just a few days whereas with the training in Omaha it took two one-week sessions.

Q. As a family practice physician, how has the use of Billings impacted your practice of medicine?

John - Knowing the Billings Method™ allows me to be able to be much more comfortable diagnosing and treating women with various menstrual or other issues. It also gives me something to offer them that will help them understand themselves.

Q. Do you utilize www.nfpcharting.com to view patients’ charts?

John - I have used NFP charting.com to look at charts. It is very useful and easy to navigate and use.

Q. Am I remembering correctly that you and your wife, Becky Worden, MD own a family medicine practice? Tell us about that and, your children.

John - We practice medicine in Gardner, MA at Mercy Family Practice which is owned by my myself and my wife who is also a family practice physician. We have two nurse practitioners and several nurses and staff. They are all excellent people. We take care of the full range of family practice from conception to natural death. We also take care of obstetrical patients as well as pediatrics and adults. We heard we are some of the few remaining doctors in our hospital who still admit our own patients to the hospital.
Rebecca and I have four children, two boys and two girls. The oldest boy is a senior in high school. The youngest is a girl who is in fourth grade. They all have their activities and are interested in different things. We are very happy to have such lovely children.
We belong to Saint Martin’s Parish here. We have a vibrant group of Catholic friends with whom we share much time together.

Q. Speaking directly to physicians, what would you tell them to encourage them to learn the Billings Method™?
​
John - I would think that every physician should be aware of The Billings Method™. I would think it would be even better if every physician knew The Billings Method™. It should be a required part of every medical school education. I teach all my medical students who come through my office about the Method.