PCOS: How Lifestyle Changes Can Improve Fertility Naturally

Polycystic ovary syndrome (PCOS) affects up to 10–13% of women of reproductive age and can impact everything from hormonal balance to fertility and metabolism. While the condition is complex, growing evidence shows that women can take meaningful steps to manage their symptoms and improve their quality of life. From smart nutrition and targeted exercise to supplements and natural therapies, a personalised lifestyle approach can make a powerful difference—especially when fertility is a goal.

Recognizing the Signs of PCOS

PCOS is a complex endocrine disorder with a wide spectrum of symptoms, including:

• Irregular or absent periods
• Excess androgen levels, leading to acne, oily skin, and excessive hair growth (hirsutism)
• Polycystic ovaries, seen on ultrasound
• Weight gain or difficulty losing weight
• Thinning scalp hair
• Fertility problems, due to irregular ovulation or anovulation

Because symptoms vary greatly, PCOS is often missed or misdiagnosed. Early detection is essential, especially for women trying to conceive.

PCOS and Fertility: A Difficult Journey

Infertility is one of the most distressing complications of PCOS. Many women struggle to conceive due to irregular or absent ovulation. The hormonal imbalances typical of PCOS—such as elevated insulin and androgens—interfere with the natural menstrual cycle, making pregnancy more difficult.

While fertility challenges can feel overwhelming, there is encouraging news: even small, sustainable changes—particularly in weight management—can significantly improve reproductive outcomes. Emerging research is shedding light on just how impactful these changes can be.

Why Weight Matters: New Data on Weight Loss and Fertility

The link between PCOS and weight is bidirectional: excess weight can worsen PCOS symptoms, while PCOS itself can make weight loss more difficult. However, recent research offers hope.

A large cohort study published in July 2025 in Human Reproduction (Verfürden et al.) examined data from over 246,000 women with overweight or obesity. Women who lost 10–25% of their body weight (median 14%) experienced a 5.2% increased chance of pregnancy within three years compared to those who maintained their weight.

Importantly, weight loss also significantly reduced the risk of gestational diabetes and emergency caesarean section. While the study included all women with elevated BMI, not only those with PCOS, the implications for women with PCOS are particularly encouraging: losing weight can directly impact fertility outcomes.

Effective Weight Loss Strategies for PCOS

So what works best when it comes to weight loss in PCOS? A comprehensive June 2025 review in Current Obesity Reports (Yang et al.) evaluated multiple approaches:

• High-Intensity Interval Training (HIIT): Short bursts of intense exercise improved insulin resistance and metabolic health.
• Time-Restricted Feeding (TRF): Limiting eating windows helped regulate menstrual cycles and androgen levels.
• Ketogenic Diet (KD): Low-carb, high-fat diets improved both metabolic and reproductive parameters.
• GLP-1 receptor agonists (e.g., semaglutide): These medications mimic a natural gut hormone that helps regulate blood sugar, reduce appetite, and slow stomach emptying. Especially when combined with metformin (or the natural alternative inositol), they have been shown to support weight loss and improve menstrual regularity in women with PCOS.
• Bariatric surgery: Showed the most dramatic improvements, though it is typically reserved for severe obesity.

While there is no “one-size-fits-all” approach, combining lifestyle changes with medical guidance yields the best results.

The Role of Nutritional Supplements

Beyond diet and exercise, supplements can support metabolic and hormonal balance in PCOS.

• A 2022 meta-analysis found that carnitine supplementation led to reductions in body weight, BMI, and lipid levels in women with PCOS. Carnitine may also improve insulin sensitivity and reduce waist circumference.
• A 2020 clinical trial reported that chromium combined with carnitine significantly improved insulin resistance, lowered blood sugar and cholesterol levels, and supported weight loss over 12 weeks.

While more research is needed, these findings suggest that targeted supplementation may enhance the effects of lifestyle changes, especially in women struggling with insulin resistance.

What Do Women with PCOS Think About Their Treatments?

Scientific studies provide valuable insights—but they don’t tell the whole story. To truly understand what works in everyday life, it’s essential to listen to the voices of women living with PCOS and learn from their real-world experiences.

A 2025 machine learning analysis of user sentiment in a PCOS online forum (Phys Eng Sci Med, Emanuel et al.) evaluated posts from over 100,000 women and found clear trends:

• Lifestyle changes and supplements were associated with the most positive sentiment.
• Intermittent fasting showed the strongest positive association with weight loss (RR 33.50).
• Inositol was linked to improvements not only in physical symptoms but also mental health, including depression, anxiety, and mood disorders.
• Combined oral contraceptive pills, particularly those without anti-androgenic progestins, were associated with negative sentiment, especially regarding depression, anxiety, fatigue, and libido.

These findings validate the importance of personalizing treatment and listening to women’s lived experiences when managing PCOS.

Frequently Asked Questions (FAQs) on Self-Management of PCOS

1. Can lifestyle changes really improve fertility with PCOS?
   Yes. Research shows that diet, exercise, and weight loss—even as little as 5–10%—can restore ovulation and improve chances of conception.
2. What diet is best for PCOS and fertility?
   Low-carb, intermittent fasting and anti-inflammatory diets, such as the Mediterranean diet, can support hormonal balance and insulin sensitivity.
3. Is weight loss necessary to get pregnant with PCOS?
   Not always, but for women who are overweight, modest weight loss may significantly boost fertility and reduce complications during pregnancy.
4. Are supplements like inositol and carnitine effective?
   Studies show promising results for inositol and carnitine in improving insulin resistance, cycle regularity, and even mood in women with PCOS. Fertilovit for PCOS combines these nutrients together with chromium in a comprehensive micronutrient care that is ideal for women with PCOS, especially when planning for pregnancy.

Final Thoughts: Hope Through Action

PCOS can feel overwhelming, but the science is clear: small, sustainable changes can have a powerful impact. Whether you’re trying to conceive or simply aiming to feel better in your body, a combination of weight loss, targeted nutrition, physical activity, and targeted supplements can help rebalance hormones and restore fertility.

For medical advice tailored to your personal situation, consult your healthcare provider. This article is for informational purposes only.

Sources

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Hu R, Zhang L, Zhu J, Zhao S, Yin L, Hu J. Weight loss effects of non-pharmacological interventions in women with polycystic ovary syndrome: a systematic review and network meta-analysis. PeerJ. 2025 Apr 16;13:e19238. doi: 10.7717/peerj.19238. PMID: 40256727; PMCID: PMC12009027.

Jamilian M, Foroozanfard F, Kavossian E, Kia M, Aghadavod E, Amirani E, Asemi Z. Effects of Chromium and Carnitine Co-supplementation on Body Weight and Metabolic Profiles in Overweight and Obese Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res. 2020 Feb;193(2):334-341. doi: 10.1007/s12011-019-01720-8. Epub 2019 Apr 11. PMID: 30977089.

Liao D, Liu X, Yuan X, Feng P, Ouyang Z, Liu Y, Li C. Clinical evidence of the effects of carnitine supplementation on body weight, glycemic control and serum lipids in women with polycystic ovary syndrome: a systematic review and meta-analysis. Gynecol Endocrinol. 2022 Feb;38(2):110-115. doi: 10.1080/09513590.2021.1988559. Epub 2021 Oct 11. PMID: 34633275.

Verfürden ML, Schnecke V, Winning Lehmann E, Rendón Guillén A, Balen AH. Association between weight loss and reproductive outcomes among women with overweight or obesity: a cohort study using UK real-world data. Hum Reprod. 2025 Jul 6:deaf122. doi: 10.1093/humrep/deaf122. Epub ahead of print. PMID: 40618200.

Yang S, Pan X, Yang R, Wang Y, Zhang Z, Chen G, Li Z, Qiu G, Li L, Jing C, Tian F. The Efficacy of Various Weight Loss Strategies in Alleviating Polycystic Ovary Syndrome. Curr Obes Rep. 2025 Jun 28;14(1):57. doi: 10.1007/s13679-025-00649-5. PMID: 40580384.