PCOS, the Pill, and the Epiphany
Stop me if you’ve heard this story: a young woman gets put on birth control to treat her irregular menstrual cycle, and stays on it for a decade with reinforcement and encouragement from her gynecologist.
I’ve heard this story from many women, though I’d wish I’d heard it earlier. Maybe I could have avoided experiencing it firsthand.
My name is Nicole and I’m a clinical psychologist and Nutritional Therapy Consultant. I was put on the birth control pill at age 18 and stayed on it for nine years to treat my irregular menstrual cycles and symptoms associated with Polycystic Ovarian Syndrome (PCOS), only later learning I had other options. Now, I’m contributing to this community to raise awareness of issues like this one—women’s health challenges that are widely experienced, but not widely understood or discussed
I was diagnosed with PCOS at age 25, but I had been reporting a variety of symptoms to my gynecologist since I was 22: I was experiencing rapid facial hair growth and even more sporadic periods than usual. I barely had acne has a teenager, but suddenly around age 23 I was getting persistent cystic acne breakouts.
At the time when I was explaining these symptoms, I was told that I didn’t match the phenotype for a PCOS diagnosis—in other words, I didn’t look like I was suffering from PCOS. I was thin, while most women with PCOS were overweight; my arms weren’t “that hairy” compared to most women with PCOS; my acne was “normal” and would go away with time (though I had tried various acne treatments with no luck).
After persistently reporting these symptoms for almost three years, my gynecologist finally decided to order a sonogram of my ovaries to check for cysts on the surface of my ovaries. Maybe I did have PCOS after all. My appointment revealed obvious cysts and based on that, my doctor made the official diagnosis.
But even then, I was told the birth control pill was my the only way to manage. There was no cure for PCOS, but it was supposed to alleviate my symptoms—never mind that I’d been taking it for years already. I felt stuck.
I had always felt the pill somewhat blunted my mood, but I was a “good patient” so I kept taking it diligently. None of my symptoms ever went away while I was on the pill. My unwanted facial hair growth continued, spreading to other areas of my face and ultimately requiring laser hair removal. My acne worsened to the point where I resorted to accutane, and my periods became even more infrequent.
Then, in 2017, everything changed. I was 29 years old, and had been “managing” my PCOS with the pill for 10 years. That year, I spontaneously decided to participate in a 21-day diet elimination challenge to remove processed foods, sugar, gluten, dairy, soy, and alcohol from my diet. Instead, I was to focus on eating whole foods with more balanced macronutrients (proteins, carbs and fats). At the time, I hadn’t gotten my period for almost nine months, my longest stretch without it. I wanted to figure out why, but I never thought this challenge would lead me to discovering how to heal.
I felt awful for the first few days on the elimination diet. Up until that point, I’d been eating essentially whatever I wanted. My diet regularly consisted of pizza, pasta, all the bread, and maybe one or two vegetables a day. I had to re-learn how to eat again, and how to cook.
After about a week, I started feeling really good. My energy was high, I slept better, and my brain fog went away, along with my between-meal crashes. I was impressed. I stuck with it for the entire 21 days. At the very end of the 21st day, at a concert at Jones Beach NY, I got my period.
I was ecstatic. I will never forget that day or that feeling. It changed the trajectory of my life forever. I knew this was no coincidence so I started researching all I could about the connection between diet and PCOS. I was astonished by how much information I found about the importance of food as a way to manage PCOS.
After that, I stopped taking my birth control pill and focused on my new way of eating for several more weeks to see what would happen. What happened was that I got my period again after five or six weeks. Again, I was astonished. I kept at it and after another five or six weeks, another period. I hadn’t had regular menstrual cycles since I was 16, and now I was menstruating like clockwork after simply changing my diet. I was hooked, and became obsessed with learning everything I could to help my body heal from PCOS. A whole world of possibilities opened up.
I had been told that I had to take the pill to manage my PCOS because there was nothing else I could do, nothing else in my control that would help my symptoms or affect the trajectory of my diagnosis. And I blamed my gynecologist for a long time after that. Why didn’t she listen to me earlier, when I was reporting the same exact symptoms for three years? Why did I only get a test confirming my suspicions after complaining repetitively and consistently?
I know now that it wasn’t her fault. Medical school does not include nutrition science or other lifestyle practices that affect a person’s biology. It’s simply absent from their training.
I had to learn on my own that I could moderate PCOS and manage symptoms with food and lifestyle. But I’m glad I had to learn.
I had to learn so now I can educate other women about the power of food and how it helps balance our hormonal health. I had to learn so I could realize my mission: educating individuals on how food and lifestyle create mental, emotional, and physical wellness.
I want you to know that there are evidence-based ways to manage and heal beyond what we learn from our doctors. This is what I’m going to explore with you in the next few articles. We’ll talk about how to connect with your body and mind, how wellness is different than simply the absence of disease, and how to use food and lifestyle as tools. Perhaps most importantly, we’ll talk about how to trust our bodies, and how treating ourselves with compassion and curiosity is the best pathway to health and empowerment.
Dr. Nicole Barile is a licensed clinical psychologist and certified Nutritional Therapy Consultant practicing in New York, and her mission is to educate people on the power of food and lifestyle practices on the path to mental and emotional wellness. Dr. Barile received her Ph.D from Hofsta University, and you can learn more about her practice at FeedYourMental.com.