PCOS Fertility Diet: Best Supplements to Boost Fertility Naturally | Cory Ruth

Cory Ruth: [00:00:00] I've literally heard a doctor and MD call PCOS a fat, lazy girl condition.

Dr. Brighten: Oh!

Cory Ruth: Yeah. Yeah. 

We have a three times higher risk of anxiety and depression. 

Here is a really staggering statistic. Over 50 percent of women with PCOS will develop type two diabetes by age 40. 

Dr. Brighten: Can you talk about what fiber sources should people be looking for? 

Cory Ruth: you can add that in and you get five grams of fiber just in one tablespoon. So that's a very large amount of fiber for a very small amount of food.

Dr. Brighten: What are the red flags with PCOS that people shouldn't ignore? 

Cory Ruth: if you are noticing, increased Thirst and increased urination skin tags darkening of the skin like dark skin patches Really intense fatigue and cravings that could be a sign of 

Dr. Brighten: What are steps that someone can take to improve their mood if they're struggling with anxiety or depression?

Cory Ruth: The first one is working on

Dr. Brighten: Corey Ruth, welcome to the Dr. Brighton show. I am [00:01:00] looking forward to today's conversation.

Cory Ruth: Oh, me too. Thank you for having me.

Dr. Brighten: Absolutely. And we're going to get into best foods for your hormones and PCOS, PCOS pregnancy, a lot of mood stuff. But I first have to say congratulations on baby number three, and thank you for taking a break in your postpartum recovery to have this conversation with us and share this information with everyone.

Cory Ruth: Absolutely. My pleasure. Yeah. You know, it's a, it's a crazy time. It's a chaotic time, but it does feel good to kind of take breaks. And this is my break. Just, you know, getting some work in doing what I love. So yeah. Yeah. 

Dr. Brighten: when You know, my last postpartum, uh, period, I was writing a book and people were like, that's wild. I mean, I was on a treadmill desk with a baby strapped in front of me, like writing. And I'm like, you don't understand. Like I was breastfeeding and icing my vulva. And then I was like, Oh, I can write a book. Like the writing, the book was like the break. So just so people [00:02:00] know, like, we're not sadistic. It's just sometimes. Especially I think any mom who has done the extensive hours of breastfeeding and being with an infant knows that like getting Getting to take a break from that and use your brain a little bit other than like what was the last time?

I changed your diaper. It's it's nice. 

Cory Ruth: it does feel good. It's exactly the way you described too. It's, you know, having to use my brain in a little bit different capacity. It feels refreshing. It feels good. Even though I'm very sleep deprived. It's okay. We'll push through. 

Dr. Brighten: I have to say I didn't want to comment on your appearance and yet I was like, wow She looks so refreshed and like what is her secret because I remember postpartum just thinking will these bags under my eyes ever go away?

Cory Ruth: You know, you have good nights and bad nights. Last night was really good. The night before, the night before that, though, was awful. So I feel like I made up for it. So you caught me on a good day. That's honestly the only reason why I look like this.

Dr. Brighten: And here's what I want to say. If people in the podcast are like, why are you guys talking about sleep and, and all of this stuff? Because if any of the tips are like sleep or do certain things and you're like, [00:03:00] I'm a mom and this is so hard, I want you to know, we're not judging you. We've been there.

We've been in the thick of it. And I often hear this from people whenever I'm like, one of the best things you can do for your hormones is sleep. And they're like, yeah, I got it. Two month old, I hate you so

Cory Ruth: Yeah. Yeah.

Dr. Brighten: much too. Um, and I think that's so much about what I like about your content.

It's really relatable. It's it's honest It isn't this like highlight reel happening and something that I I really like about your content that I think you do so well is that You create these awesome grocery store hauls on your social media, , and you are like, here's Trader Joe's and here's Costco and, and you also have this way of looking at it not from the perspective of just like, what is the most nutrient dense, but like what's economical, what's going to stretch the budget, what is easy to make.

So I want to start there. What tips do you have for people who. are wanting to know how to navigate the grocery store, select the items that [00:04:00] truly help them with their hormones and not feel like they buy all this stuff and now they've got to do this, like, you know, 40 step recipe at home.

Cory Ruth: Totally. Yeah. So I, and I'm glad you brought up the economical piece because grocery prices right now are wild. And I think that puts pressure on us, especially if we're told to do this and this and this and that when we have PCOS, don't do this. We feel really in a box and we feel like if we go to the store and we're not able to get everything organic and everything, you know, in an ideal, perfect world, then we fail and we give up.

 So, yeah, you know, that's why I like to do grocery hauls even at Walmart because lots of us shop there and you can get similar things as you can find in Whole Foods for a much cheaper price. So, why not, you know? , so, I, one of the things I focus on in, while shopping is looking at added sugar. So sugar is very different than say the sugar you find in fruit, right?

Fruit comes packaged in fiber that helps to regulate our [00:05:00] blood sugar. Something like added sugar though, man, if you look at the back of a, you know, any box or any package food, kids foods, totally wild. Um, the amount of added sugar is just, there's so much. So I really try to teach women with PCOS to focus on that and try to be mindful of that intake.

I mean, we can't, We don't want to eliminate foods completely added sugar included, but just look at the amount that you're, you know, turn that box around, look at that nutrition label and see how much added versus just natural sugars is in something. And really weigh that out. We're supposed to stay under about 25 grams per day of added sugar.

So keeping that in mind, you can tally up kind of, you know, your day and see where you're at, but that's a big thing that I like to teach women to look for. Another thing is looking at fiber components. Americans just in general, we under eat fiber and fiber is so important. Fiber is not only important for blood sugar, but it's also important for our estrogen levels.

Fiber can help regulate our estrogen in the [00:06:00] body and help kind of bind and get it out. So we want to make sure we're, we're getting enough of that. So look at how many grams of fiber is in something. I typically recommend trying to get about 25 to 35 grams of fiber per day, and that really helps with your hormones.

So that's another thing. Um, we always say, you know, as dietitians shop the perimeter of the store, you know, try, try not to go into the middle of the aisle. So let's kind of outdated advice because things can exist everywhere. You know, air quotes, not so good. Um, but you know, the, the pre package more, I hate this term because it's It's so vague and tossed around so much, but processed, you know, what does that even mean?

Um, but I think everyone knows what I'm talking about when I say that, so I will use it. Um, but we really want to focus more on foods that, you know, whole fresh foods, vegetables, beans. And lentils, um, fruits, meats, seafood, eggs. These things are more supportive than say something like a cracker, you know, that has 85 different [00:07:00] manmade ingredients and no fiber.

So those are things that I really like to teach women to focus on and also go with the convenience. If that's what works for you, it's okay to rely on convenience foods as long as they're, You know supportive of our hormones and we're looking at protein and fiber and added sugar It's okay to to go the easy route if you're a busy mom of three or four, you know, you work I mean, there's that's that's a really high bar to set where you have to go and make every single thing yourself from scratch That's not realistic.

So I really want to remind women that go, you know Go with what is convenient for you and what's doable over this perfect, you know ideal You Um, you know, maybe unattainable way of eating.

Dr. Brighten: Yeah, I love that balanced, really nuanced take on things. You know, when I was getting my nutrition degree, I studied concurrently. I took the science track, so the biochemistry track, and I did the didactic track, which really, I love that I did [00:08:00] that for lab interpretation. It's where I first learned about nutrient depletions from medications, like birth control.

But it did open my eyes to like, this is not a route that I really meant to take. To go into in terms of my passion, but it's something that I remember giving this presentation and it was called the fast fast food for the fast you and everybody had these presentations to give and I gave this presentation of how do we approach somebody who's going to eat fast food and help them select better choices at the drive thru window I got so much hate so much hate from people and people were like You should tell everyone not to eat this food.

I'm like look in this day and age most people Understand that ultra processed food like you get at mcdonald's at these fast food chains It doesn't have value in the same way that something that you pull out of the ground does Like people know that and to me is the same as like Finger wagging at someone who smokes, people know that smoking is bad.

They know it's bad. And so [00:09:00] instead we have to meet people where they're at. And what I would say is that, so everybody knows, I'm not saying go eat ultra processed food, but also if you find yourself in a bind and it's the difference between not eating and eating. It's often not wise for your hormones, for your mental health or for your family or the people who reside in your life if you skip that meal.

And so I love that you give that kind of permission. I want to go back to the sugar piece because I feel like sugar is such a controversial one. Okay. Firstly, everyone, I want to echo what you said. We're not talking fruit, like leave the banana alone. Okay. Don't be side eyeing your berries. And what we're talking about is added sugar.

Why is added sugar a problem for hormones?

Cory Ruth: Yeah. So added sugar can basically throw off our blood sugar regulation and contribute to insulin resistance. Insulin resistance is a main driver of PCOS and something that can cause weight gain, irregular periods, fatigue, cravings, [00:10:00] skin darkening, skin tags, more infections, and it really can predispose us to set us up or set us up to be at a higher risk of type two diabetes, um, for type eighties, gestational diabetes, all of these things, um, which are not so fun to have.

So, yeah, so it's, it's definitely something to be mindful of because it is so prevalent and we just don't know it. But again, it's not to say you can't ever go enjoy a donut or ice cream. You absolutely can. It's really what we do the majority of the time that makes the biggest difference, and that's what I want women to know and remember about sugar,

Dr. Brighten: mm hmm. I always look to the French as a culture who really lives life well, and they always say, like, you have to include pleasure. And that's something that you also talk about, is that, that pleasure component, like, food is not just fuel. Whenever, I mean, there was a big trend, do you remember that? I cringed.

I cringed. I was like, anybody who says Food is fuel and nothing more does not [00:11:00] get to go to dinner with me. We're not hanging out at the dinner table because I'm like, food is information. It is nutrients. It is fuel, but it is also pleasure. And that is why we were given taste buds.

Cory Ruth: Yes. Agreed. A hundred percent. Agreed. Yep. Yep. Yeah. So much more.

Dr. Brighten: I want to talk a little bit though, about this diabetes issue that you raised specifically with PCOS. Because I feel like, you know, you know how the story goes. You and I, we talk about it. I feel like anybody who is really. Trying to progress and move women's medicine forward talks about the issue with women with PCOS are often just put on the pill for their periods, for their acne, and no one talks to them about these metabolic issues until it's time to sign them up for metformin.

 What are we looking at? By the time a woman is age 40, how many women with PCOS are falling into that camp of getting the diagnosis of diabetes, full on diabetes?

Cory Ruth: I'm glad you brought this up. Here is a really staggering statistic. Over 50 percent of women with PCOS will develop type two diabetes by age [00:12:00] 40. So I love that you brought that up, you know, when it comes to treatment protocol and a lot of us are diagnosed in our twenties and thirties and it's getting, I'm seeing earlier and earlier diagnosis, which I have my own thoughts on, but we're really leaving that metabolic component out of the conversation.

And it's. And it's really something we don't sit and think about until boom, it's on our doorstep, right? So, yeah, it's a huge part of the dietary and nutrition link when it comes to PCOS and really why I got into this business because, this field, because As a dietician, we focus heavily on diabetes, and we have to, it's so prevalent in our country.

And then, you know, I have PCOS, so obviously there's a personal link there, but the PCOS and diabetes connection is huge. Mm hmm.

Dr. Brighten: And I just want everybody to really like know that this one, we can prevent it. We'll talk about that because we're not gonna leave you hanging. Uh, but also we're talking [00:13:00] about by the time you're 40 now, what's happening when we're 40, we're going into perimenopause. Once we hit menopause, which is on average around age 51, we've lost estrogen and with the loss of estrogen creeps in visceral adiposity, that is the belly fat, as everybody calls it.

And now everyone's risk. For insulin resistance and type two diabetes goes up every single person who their ovaries stop making estrogen are now at risk for that. So if you have PCOS, you already have one step forward unless you do some of the things we're going to talk about today. But before we get into that, I got to go back.

Why is it you think we're seeing PCOS diagnosed sooner?

Cory Ruth: I've thought about this a lot. Um, I think we're talking about it more. First of all, thankfully, and of course that, um, we see more testing for it, just more investigating on it. Um, and then also, I think, you know, a lot of us are starting our periods earlier and that's a lot of us.

That's when our symptoms start to really rear, you know, especially with obviously irregular periods. [00:14:00] So, um, yeah, I think maybe those two components and I don't know exactly, but that's my theory on it.

Dr. Brighten: Yeah, I absolutely agree with us talking about it a lot more. I think every change that we have seen for the better in women's medicine has come from patients demanding better, from people getting noisy on social media. I mean, if it wasn't for social media, women wouldn't have access to the information that they do now and the ability to advocate for themselves.

And so for everybody listening, it's really you. Who are changing it and making it better for future generations.

Cory Ruth: that. Absolutely. Yep. Just by listening to this. Mm-Hmm.

Dr. Brighten: Absolutely. Now, something I really appreciate is how you've shared honestly about struggling with using food as a coping mechanism. And I'm curious as a dietician, having that be your personal experience, do you feel like that shaped how you talk about food with other people?

Cory Ruth: Absolutely. Absolutely. Yeah. Like we talked about, food is not just fuel. Food can be comfort. [00:15:00] Food can be love, um, you know, and active love. There's so many other things, um, and it can be a coping mechanism for a lot of us. So, and it's, it's not so easy to say to a client, um, just stop eating. Stop eating the doughnuts, you know, um simple sounds really simple But when food is more than just fuel it that becomes really convoluted and extremely difficult to carry out Maybe you can for a couple weeks couple months, maybe even a year, but it doesn't work in the long run So, you know like we talked about meeting people where they are and teaching them and stuff Instead, how to navigate eating in a way that doesn't feel restrictive and you know, just, just eliminate gluten or just eliminate soy or whatever it is, right?

It's it's how do we, how do we create balance and how do we incorporate these foods into the way that we eat in our daily lives in a way that's still supportive of what our health goals are? So I think it's just nuanced. It's so convoluted [00:16:00] and um, yeah, and you really have to meet people where they are.

Um,

Dr. Brighten: And I think, , to add to that is the cultural component as well. As a Latina, I remember when the paleo movement was really big and corn was like, you know, Satan's a baby to everybody. It was like, uh, you know, the antichrist. And how many people were telling me, like, you didn't evolve to eat corn, your ancestors didn't eat corn.

And I'm like, my ancestors are from Mexico and they actually have this like wide variety of corn. And like, I just can't. see myself giving up tacos. Like, and I have always been like tacos are healthy if they're done. Right. Um, and so it is, I mean, food is so nuanced. There's such a cultural component. There is, I mean, it's so ingrained in our life.

And so, you know, I appreciate everything you're saying and I want everybody to sit through the lens as they listen to today's conversation of. What is true for me? What is possible for me? And what is the first step that I could be [00:17:00] taking? Not, I have to do all of these things. And also recognize like the things that you are doing well.

Cory Ruth: Yes. Yeah, yeah, absolutely. I love that. Yeah. Yeah,

Dr. Brighten: realized that we've mentioned PCOS several times, but we haven't defined it. We haven't told people what it is. So what I actually want to do is like, what do people think PCOS is? And then what PCOS actually is.

Cory Ruth: People really associate PCOS I think most with the fertility piece. So you can't get pregnant if you have PCOS or it's going to be really, really difficult for you. And they also, they also associate it with obesity and weight gain. And those two things are probably the two biggest I've literally heard a doctor and MD call PCOS a fat, lazy girl condition.

Dr. Brighten: Oh!

Cory Ruth: Yeah. Yeah. Um, so if we have people, you know, uh, with credentials walking around saying that you can imagine how that perpetuates so many myths about us, [00:18:00] about our condition to the everyday person. So PCOS really is so, so much more than that. You know, there's the metabolic component. being at an increased risk of, like we said, type two diabetes, um, higher cholesterol, high blood pressure, hypertension.

 Heart disease, stroke, all of these things. And then during pregnancy we have a higher risk of miscarriage, preeclampsia, and gestational diabetes. So there's that, um, once we do get pregnant. And then there's also, we are at, we have a three times higher risk of anxiety and depression. We struggle more with IBS and gut health issues.

We have cringes. Um, we have more fatigue and we can talk a little bit more about why these things happen. And then we have symptoms like acne, facial and body hair growth, hair loss on the head. And then of course the irregular period part as well. So there's a lot going on. It's much more than fertility and weight gain.

Dr. Brighten: What are the red flags with PCOS that people shouldn't ignore? They shouldn't just chalk [00:19:00] up to like, this is normal because I have PCOS.

Cory Ruth: Irregular periods, if you're going a really, really long time without shedding that uterine lining. So if you have had a period missing for months and months and months and months, maybe even years, you really, really, really want to get that under control because it can potentially put us at a higher risk for endometrial cancer, which I should have.

Earlier because we're not shedding that uterine lining, right? So it's just building up Um, so that's one thing and then another thing is if you are noticing, increased Thirst and increased urination skin tags darkening of the skin like dark skin patches Really intense fatigue and cravings that could be a sign of insulin resistance and a sign that type 2 diabetes or pre diabetes might be around the corner.

So you really want to get a grip on those. And you know, if you're noticing those, especially if there's weight gain involved, like you've gained a ton of weight, you know, just kind of out of the blue, out of nowhere. That's a big red flag . Then of course, if you have something like facial body hair [00:20:00] growth, acne, hair loss, um, those can come up.

can be caused by elevated androgens like testosterone is probably the most well known androgen aka male sex hormone. And that is a sign that you need to get that testosterone under control because it can cause more blood sugar issues and it also can just perpetuate some of those symptoms that Nobody, nobody wants to shave a beard every day if you're a woman.

Dr. Brighten: cancer. This is absolutely a time and a place for us to use hormonal birth control or progesterone withdrawal. I want people to understand. Because I think, um, You know, I talk a lot about it and I try to talk in a very nuanced way about the pill, but then I feel like sometimes people pick up on some of the things I say and they say, Oh, if you have PCOS, you should never use the pill.

There are certainly better ways to manage your symptoms that have less side effects. However, it's always your choice to use the pill if you want to. The endometrial hyperplasia. is one of those times that if your doctor says, I want to use the pill to induce a withdrawal bleed so that [00:21:00] you lower your risk of endometrial cancer and we can shed that lining.

It's a better route than a DNC. It's a better route than somebody actually going in and scraping your uterine lining. It sounds exactly right. It's exactly like what it is, um, and so I just, I wanted to touch on that because that is a real risk that women with PCOS face and I would hate for anybody to, you know, hear anything and be like, I just want to go it naturally. I always want to go it naturally and support your body. But sometimes, and I will tell you this as a doctor, we got to use a medication cause that's, that's the place where we're at. And we always want to have an exit plan from a medication if we can as well. You mentioned PCOS cravings

Cory Ruth: yes, yes,

Dr. Brighten: why do women with PCOS have cravings?

Cause it's not just willpower. It's not just, you know, some bro telling you like you're, you're just weak. Uh, it's so much more than that.

Cory Ruth: yeah. And I love that. I recently have heard a lot about cravings being described as food noise. And I really like that [00:22:00] term because if you've experienced cravings, that's exactly what it is. You cannot. Turn the volume knob down and imagine how hard it is to work on weight management if that's your goal When you've got really loud food noise all the time.

So

Can you define like food noise? Like what, how do people describe that?

I think it's kind of like the way that I I've experienced it and heard it kind of described is sort of like intrusive thoughts About food, right? We're constantly thinking about food. We're constantly it's on our mind. We're thinking about, you know You We and we joke about this all the time like oh, I'm always thinking about dinner my next meal This is next level you guys this is like you cannot turn that thought off It is an intrusive thought continuously all day long every day, and it's all the always for foods that are calorically dense So that would be carb You know sugar heavy foods because we're not just walking around craving like romaine lettuce and you know [00:23:00] so that that

Dr. Brighten: That would be nice.

Cory Ruth: Yeah, I know I would.

Um, but that can really hurt us if we are working on weight management. So yeah, so cravings very real and it comes back to that blood sugar regulation piece, that insulin resistance piece. Insulin resistance is so famously tied to cravings, carbon sugar cravings. When our blood sugar is dysregulated, That's what happens.

It's basically, um, sending us messages and that's what we want to kind of, we're low on this or, you know, we're too high on this. And so here's what we want to bring in. And it's, it's very heavily tied to that. And so if you can get your blood sugar under control, get that better regulated, cravings can really, really be reduced.

And I've seen

Dr. Brighten: Mm hmm.

Cory Ruth: day. Yes.

interesting too, is we also understand in addition to the insulin component, serotonin could be playing a role, which is very, very connected to estrogen as well. What you're talking about people recently, this phenomenon, I'm talking more [00:24:00] about food noise. This is coming, I've seen mostly, and maybe you've seen it somewhere else, coming out of people who have used the GLP who didn't even realize they had so much food noise.

And with that in mind, We know we have DLP1 affecting our neurological system. also affecting our gut as well. And so it starts to raise the question, you said before, women with PCOS have IBS, it's our hormones interfacing with our neurological health, interfacing with our gut health, and it isn't just a matter of grit your teeth and bear it and get some willpower.

Exactly. Yeah. That gut brain connection is so real too. I'm glad you brought that up. Absolutely.

Dr. Brighten: And just to go to your point, mentioning the IBS, the gut component, why is it that women with PCOS are struggling? You know, we see this, um, in PCOS women, endometriosis women, there are subsets of the female population that have conditions and it manifests so much in the gut. So with PCOS, what's [00:25:00] really going on there?

Cory Ruth: It's actually a gut bacteria imbalance. So we have trillions of bacteria and we have this whole host of them inside of our gut. And we have done tons of research on PCOS and gut health and finding that women with PCOS have these altered levels of certain gut bacteria, um, that can exacerbate some symptoms.

And as we know, we have gut bacteria that can contribute to mood, even weight. Um, we definitely need more research here, but, but yeah, it's really fascinating to, to learn about. And there's lots of work we can do to sort of rebalance our gut microbiota and make them happier and make them more balanced and get more of the bacteria that we need and push out some of those opportunistic bacteria.

So there's, there's definitely work you can do around gut health. And I've seen so many times working on gut health can have these profound impacts in areas that you wouldn't even believe, like eczema, like, like clients seeing improvements in their eczema just by working on gut bacteria balance. It's really [00:26:00] interesting.

And especially if your has, you know, constipation, diarrhea, gas, Lots of bloating. That is a definitely a sure sign that you, you should be doing some work around your gut health because you can

Dr. Brighten: Mm hmm.

Cory Ruth: things that you would not have even realized. Great.

Dr. Brighten: pregnancy, but this, I just want to connect this for people listening, that if you have got dysbiosis, And whatever's going in your gut gets shared with baby. And so that's not to say that, like, you should feel guilty or bad. I, you're a mom, I'm a mom, anyone who's a mom is like, just give me a reason to feel guilty and bad.

Actually don't. I'm gonna do it on my own anyways. Um, but it is to say that gut health should be part of that preconception journey. And so if you are experiencing those symptoms now, What are some things people can do to take steps? I mean, of course, if you're having some of those more extreme symptoms, you want to get worked up by a provider, but there are day to day habits that we [00:27:00] all can be employing that we know help with gut.

Cory Ruth: Yes. I think anyone who's struggled with gut health has been to a doctor and gotten a prescription for like, I don't know, Miralax and told to eat more fiber and drink more water. I think we've all experienced that, but yeah, there are so many things that we can do outside of those suggestions. I am going to talk about the fiber piece though, just because I don't think we always

Dr. Brighten: to.

Cory Ruth: understand the connection between fiber and gut bacteria.

Fiber, Our gut bacteria feeds off of fibers, so feeding them fiber can actually help to multiply our healthy gut bacteria. And what happens when we multiply, our healthy gut bacteria, it crowds out the opportunistic bacteria. So we've got more of that normal gut bacteria. bacteria, less of the unhealthy, you know, opportunistic guys.

So it really helps to create that better environment. So fiber, I always say it's kind of like sprinkling those little gut bacteria with fish food, right? We're feeding them that fiber, get that fiber in. Like I said, I recommend [00:28:00] 25 to 35 grams per day of fiber. How do I know how much fiber I'm eating? Cory, you can track it.

You can track it for a couple weeks and just see, you can use something like my fitness power, you know, carb manager, any free app on your phone and track it and just see and see if you're on track for that goal. Um, and then the other thing too, is eating a variety. Our gut bacteria want to eat everything under the sun.

So if you're somebody who very similarly, like same breakfast, same kind of lunches, same sort of dinners, you've fallen into that routine, mix it up. Your body, your gut bacteria want that variety, they crave that diversity. So, make sure you're mixing up what types of vegetables, what types of beans, what types of meat, you know, all the different things.

Um, so that you can give them that diversity that they're craving. You can try something like a probiotic. There's a lot out there and I, I hate to just say, just take a probiotic. It's not always as simple as that and sometimes it's like, sometimes you have to try several probiotics before you find your prince, uh, your princess and you know, [00:29:00] just keep testing out different ones and see if there's one that you find particularly helpful depending on what types of bacteria are in there.

Dr. Brighten: for prebiotics as well to be included, I think is a really good idea. Can you talk about what fiber sources should people be looking for? You mentioned lentils, beans, vegetables. What are some other fiber sources and what are some, and how does that differ from prebiotics?

Cory Ruth: Prebiotics are what feeds the gut bacteria and fiber is what the gut bacteria are eating. So fiber can be found in beans, lentils, I think about plant based sources, beans, lentils, nuts and seeds, chia seeds, flax seeds.

I always say fiber, you know, you can find some bigger bang for your buck fiber sources. So like one tablespoon of chia seeds, which you can add into a smoothie. And it's okay to grind them. It's okay to eat them without soaking them. Um, first, you can add that in and you get five grams of fiber just in one tablespoon.

And flax seeds are almost on that same level. So [00:30:00] that's a very large amount of fiber for a very small amount of food. You know, of course, fruits and vegetables are really good sources of fiber. You want to be getting lots of those in anyway. Um, avocado is actually a really excellent source of fiber.

We think of it as a healthy fat, which it is, but one has about 13 grams of fiber. So if you're an avocado lover, know that

Dr. Brighten: that's a lot.

Cory Ruth: That's a lot. Yeah, that's like almost halfway to your goal, right? So, um, whole grains, of course, you know, if you're looking at a bread, turn that bread around, look at that nutrition label, and if it's got at least three grams of fiber per slice, that's a good bread for you.

So don't settle for less than that. If you're going to choose a bread, make sure you're getting that nutritional bang for your buck. If it has protein in it, amazing too, but I think a lot of us too, you know, um, who are looking, if you're gluten free and you're looking for gluten free options, we immediately equate gluten free to healthy, but there's so many actually like breads and, um, different, you know, whole grain products that are [00:31:00] gluten free that actually don't have any fiber in them or very little.

So make sure you're looking out for that. If you're gluten free, you know, look at the fiber content of gluten free items. Um, whole grain and gluten free or high protein like chickpea pastas and lentil pastas are a great way to get

Dr. Brighten: hmm.

Cory Ruth: Great way to get an extra protein. There's a lot in there as well. So there's lots of good options.

Dr. Brighten: I appreciate you saying that about gluten free because, when gluten free really, you know, hit its peak and I would just want to say, you know, I am, I am someone who's gluten free. I have multiple autoimmune diseases because I feel like people are like, if you don't have celiac disease, you should eat gluten.

And I'm like, I wish, like, I would like to go back to home brewing beer and, uh, you know, living my best life on gluten. It was amazing, but I cannot. And so I just want to respect that that can be the case for people. And I had a lot of patients who would be like, Oh, we're, you know, I'm asking about their diet and they're like, yeah.

And I had a cookie and I had a cupcake and I'm like, would you normally do [00:32:00] that? And they're like, well, cause they were saying it was gluten free and they're like, no, but it was gluten free. And I'm like, okay, gluten free is kind of become synonymous with healthy and that's not necessarily true. And so, uh, again, there's so much more nuance to it.

It's not that I have any problem with you having a cookie. It's just more of like, when you start, Opting for those things over, you know, what would be your normal selection? Especially if you're like i'm passing on the carrot and hummus for the cookie then i'm like wait a minute Your gut your gut bugs.

They deserve better. Okay

Cory Ruth: exactly. Yes. Give them a cookie every once in a while, but get those carrots and hummus into. Yeah. Mm 

Dr. Brighten: you've given us some actual tangible ways to start to get fiber in and that you touched also on the chia seeds don't have to be soaked. If you're only doing a tablespoon, um, if you're gonna do like a fourth a cup people, then you're going to be in trouble. Uh, so I just want to highlight, she said a tablespoon.

Cory Ruth: it

Dr. Brighten: I, yeah, so don't, don't get crazy with the chia seeds and, and just reiterate, as you [00:33:00] said, Diversity, diversity of fiber, diversity of food coming in means diversity of these organisms. And as you were saying, they're going to crowd out the, the guys that belong there, but shouldn't be like, you know, taken over your gut.

And that is really important. And this is honestly a step that everybody can take. Right now, I want to switch gears a bit to something that you brought up earlier, which was the anxiety and depression component of PCOS. This is something that so many people don't recognize. I think in women's health, um, anxiety and depression always gets kind of put in its own bucket, and it's never connected with other things going on.

You personally have shared online that you struggled with depression with all three of your pregnancies. And I'm just curious, as a starting place, what would you share with other women who are also having a similar experience with depression during pregnancy?

Cory Ruth: First of all, [00:34:00] you're not alone there. I think there's so much talk about postpartum depression as there should be. But I

Dr. Brighten: Mm hmm.

Cory Ruth: less talk about antenatal depression, which is depression during pregnancy. Um, and I hope that that gets talked about more because I think there are people who, who, I know there are people who just enjoy every moment of pregnancy.

They just love it. And I love that for them. That was never me. And I think it took me a long time to understand that it wasn't just because I was annoyed by XYZ symptom or I really was struggling with antenatal depression and it really hit hard in the second and third trimesters. So yeah, it's I know that you're not alone.

Know that even though it's not as talked about as postpartum depression, your experience and your symptoms are real and know that it can potentially get a lot better after you have your baby. And after those hormones have a little bit of time to calm the heck down and [00:35:00] understand that this phase is over.

And I always tell myself, you know, this too shall pass. This is a phase. Um, for me, keeping busy was my best strategy. So if I was just sitting there, you know, looking at the wall, not that I do that a lot, um, you know, not much to do, not much going on. That's when it really crept in. So keeping busy was, was my best, uh, my best tool in my toolkit against that.

So, you know, trying to find new things and new ways to kind of work my brain, work my body and, um, exercise was another one. So movement is so powerful. I always say. If you were to bottle up like a intense sweat session, um, you know, a couple hours and into a pill, it would be like one of the strongest anti anxiety and antidepressants out there.

Movement is so powerful in lifting our mood. So if you're experiencing antenatal depression, that's another thing that you can incorporate if you aren't doing that already.

Dr. Brighten: I really appreciate you saying that, you know, anytime I [00:36:00] have found that I struggle with my mood, it is movement. And I always know if, if I do not exercise regularly, then I can expect like dark days will try to set in. And, um, And when you look at the research, exercise is always winning. Did you find like getting outside, sunshine, some of these other things that are recommended were helpful at all?

Cory Ruth: Yeah, totally. Actually, I live in Oregon and it rains a lot here. So I bought an indoor bike and I did that a lot in the days I couldn't get outside. But getting outside is the best for me. You know,

Dr. Brighten: Mm hmm.

Cory Ruth: humidity, being in nature, it's calm, it's quiet, it's comforting, that's always the best. Um, so if you can do that, awesome, but know that it's not, if that's not an option for you, you can absolutely still reap the benefits of movement working out inside.

Dr. Brighten: Okay. I did not know you were in Oregon. I don't know how I missed that. I spent over a decade in Portland. Um, so. Anybody that high up from the Equator [00:37:00] knows that saying get sunshine is a joke come February. Um, and that is where I recommend instead if you can buy a light that mimics the same UV, um, so putting it in your bathroom. There's um, you know, there's the alarm clocks that can to mimic, you know, sunrise, but I have also instructed patients like in your bathroom, put lights that mimic UV rays and put plants in your bathroom. And if your plants are thriving, that, you know, that's a good sign that you've got a good light bulb.

bulb working, but also surrounding yourself with nature indoors. There's been good research showing that blood pressure alone, blood pressure levels in people who have hypertension. So that is, you have high blood pressure. They can start to come down when they fill their workplace with plants. So if you live in a place like Minnesota and you're like, it's freezing, I can't go outside.

Um, those are certainly some tips as somebody who lived in Oregon, like my kid just had like a full rain. [00:38:00] Like outfit, like it was just, um, like, um, you know, a Christmas story kind of style of like getting into, um, but I still would go outside and like bundle up and like wrap myself up and be soaking wet and freezing cold in the rain.

Um, because I was just like, I need this like so bad, so bad, but there are alternatives. Where are you at in Oregon?

Cory Ruth: Southern Oregon. So, if you know Midford, Ashland, I live in

Dr. Brighten: I definitely know.

Cory Ruth: White country right here. Yeah, it's beautiful. 

Dr. Brighten: For everybody listening, if you've ever judged yourself because it's cold outside, it's raining, it's dark outside, you have food cravings.

You want to eat to comfort with food or any, or the sleep problems. Know that this is like seriously the episode that you can find home in because we totally understand you in those struggles. 

So, did you find that after you gave birth, was it like a cloud, you know, it was like clouds parted, a curtain was lifted, or did it take some time for your mood to improve?

Cory Ruth: No, [00:39:00] I am very grateful that I have not experienced true postpartum depression. For me, I feel a lot better after I give birth. So that's not the case for everybody and I want to acknowledge that, but I will say if you're listening to this and you, you are in that, you know, space, um, of the antenatal depression and you are wondering, will this get better?

Potentially yes. There's a good chance it can. So yeah, I felt instantly better and I've felt more and more myself as time goes along, even with the chaos and the sleep deprivation, all of those things.

Dr. Brighten: Mm. That's encouraging. When would you recommend people seek help when they have mood symptoms?

Cory Ruth: As soon as you notice them, don't let them get worse. You don't want to let them linger and not pay attention to them and just, you know, try and tough it out. Oh, it's pregnancy. It's going to end in XYZ months. Get the help that you need. And if that just means finding a [00:40:00] therapist, you know, incorporating in a movement session, several times a week, do it.

Do it.

Dr. Brighten: Mhm. Yeah, I echo that. I always tell patients it's better to find a mental health provider when you think you might need them than when you desperately need them because it is like dating. I would say, you know, we talk about like you got to find the right provider to you. I feel like mental health is more than anything where I want to give everyone permission if the shoe don't fit.

Like, drop it off the balcony. Like, get rid of it. Like, and if they are a good mental health therapist, counselor, they should understand that. That, like, there has to be a connection. There has to be the level of support. And they have to have the right kind of training to support you. And with PCOS, anxiety and depression being so common, I think having an understanding of the hormonal component is important.

What is it though, from what you've read in the research, from what your experience is with clients that [00:41:00] contributes to this higher anxiety and depression in those with PCOS? Mm

Cory Ruth: Yeah, gosh, it's, there's a lot of different theories circulating. Um, and I think one of them to pay attention to is the hormones themselves and estrogen and progesterone. I always say estrogen and progesterone are like yin and yang, right? They kind of balance each other out. If you are someone who has irregular periods, you're not getting that consistent progesterone, right?

 So progesterone is kind of our calming chill hormone and estrogen can be a little bit anxiety inducing a little bit like, okay, get up and go, get up and go. So if you're never having that progesterone balance with that estrogen, Yeah, that's going to definitely contribute to something like anxiety, right?

And then PCOS symptoms alone, my gosh, if you're dealing with, if you have to wake up and shave your face every day and you can't lose weight for the life of you and you're trying to, or you're trying to get pregnant and it's been years, imagine how hard that is on you mentally. So I think it's important to, you know, step away from the science a little bit and just think about the lived [00:42:00] experience of those of us with PCOS and how much these symptoms that we struggle with that are a lot of them very distinct, you know, not, not all of our girlfriends are growing beards.

It's us. So that alone can contribute to things like anxiety and depression. And I want to, I really want to pay attention most to those because, um, yeah, those, those are so real. And those are things that we wrestle with every single day. There's also insulin resistance going back to that again. Um, insulin resistance can potentially be linked to type two diabetes.

There's a higher risk. So blood sugar dysregulation can contribute to mood disorders. So lots of different, lots of different things going on there.

Dr. Brighten: In anyone, insulin dysregulation can impact their mood and their neurological symptoms. We know this is a risk for brain fog, fatigue, depression, anxiety, Alzheimer's. How many women with PCOS are walking around potentially insulin [00:43:00] resistant?

Cory Ruth: Researchers estimate up to 70% So, and that is, I don't like this term, but, um, that is also including air quotes, lean PCOS, basically someone who's experiencing PCOS who's not in a larger body size. So that's, you know, I think a lot of us think too, Oh, if I have, you know, lean PCOS, I don't have insulin resistance.

That's not true. You absolutely can. So yeah, that's, that's what we think is around that, that number.

Dr. Brighten: Yes, and this is why you need to get tested. Because This, and I harp on this all the time, um, and not everybody loves it cause I think a lot of people still want to attach to if you. You look out of shape and overweight, therefore you are just unhealthy, and yet we really don't know until we look at the cardiometabolic profile.

So you can be somebody who is a size two and yet be at a very high risk for diabetes [00:44:00] and cardiovascular disease because you may have genetics that are setting you up for that and you need different level of intervention. So why should people be testing, exploring to really understand their risk factor?

Cory Ruth: Thank you for asking this. This is one of actually the biggest questions I get asked. So I think it's really important to talk about. And also too, if you say to me, I got my labs tested and they were normal, what do I do now? I always ask what labs were tested because so many times we're not getting the right labs run and it's really an insufficient, insufficient lab work.

Thank you. So I recommend getting your, what I call a full hormone panel, and that can include things like estrogen, progesterone, testosterone, FSH, LH, and then also consider things like, um, your prolactin, vitamin D, iron, vitamin B12, SHBG, which is sex hormone binding globulin, and what's called DHEAS, which is R H E A S T I N G L O B U L I N.

Another androgen, but it's produced by [00:45:00] your adrenals and it can cause others, you know symptoms that mimic androgen excess so those are those are things to look at and then also check your your thyroid because lots of symptoms can overlap that are also due to thyroid issues like fatigue and hair loss and weight gain.

So take a look at that too. And for your blood sugar, get your A1c and either fasting insulin or fasting glucose checked as well because we want to see what's going on in that department. That is huge. And then the last thing too is if you are someone who's, you know, sort of thinking about pregnancy or fertility.

You can get your AMH checked and just see what that looks like. A lot of times it's elevated in PCOS, but if it's low, that is something to know. Um, and then the last thing is a pelvic ultrasound. If you really want to look into potentially, you know, your ovaries and see if you've got polycystic ovaries.

And I want to clarify that in a second. That's something that your doctor can do for you. Um, I think that there's a lot, [00:46:00] a big misconception about PCOS, PCOS and cysts because PCOS what is, is these tiny immature underdeveloped follicles that collect on the ovaries. They're basically how I describe it is they're all competing to ovulate and nobody's winning.

So they

Dr. Brighten: Mm hmm.

Cory Ruth: And that's what that ultrasound looks like. That looks like a string of pearls, and that's where that description comes from, obviously, but it's very different than like a dermoid cyst. Or, um, uh, you know, a functional cyst and these cysts you hear about women who, you know, these cysts, they burst and they rupture and they cause pain and they go to ER, the ER, those are not the same polycystic ovary cysts that are associated with PCOS.

You can have both. You absolutely can have both, but those cysts won't get huge and rupture and cause you this intense pain. So, , when you're looking at an ultrasound and you're assessing it for PCOS, it's really those teeny tiny little underdeveloped follicles that you're looking for.

Dr. Brighten: Is pain a primary symptom of [00:47:00] PCOS?

Cory Ruth: No. You can have pain. You can have pelvic pain. That is, you know, I, whenever I say that, I always get told that I'm gaslighting women and I really want to clarify that because I'm the last person to gaslight you. Um, but you can have pain from many other things. different types of cysts, um, fibroids and infection.

Um, there's lots of reasons that women have pelvic pain, but those polycystic ovaries that cause, that contribute to PCOS, those we can't actually feel. So I want to clarify that too, because you can have period pain, you can have ovulation pain, all sorts of pain, but PCOS itself is separate from your pain, even if you're experiencing pain.

Dr. Brighten: And as a doctor, I agree. And I want to say to you that if you're, if you tell your doctor you're having pain and they say, well, that's just PCOS, you need to get a second opinion because as you're saying, PCOS does not cause pain. So we're not going to just say it's PCOS. [00:48:00] We're going to figure out what's going on because that pain could very well be life threatening and dismissing it.

Now that is gaslighting to say mhm. It's just your PCOS. Go along your way. This is normal. You should expect it. You should not expect it. It should, and pain in any body should always be investigated. And that's where I think it is truly a disservice to perpetuate the myth that PCOS is, you know, a primary symptom is pain.

So I just want to echo what you're saying because somebody is going to get mad about that. And I want them to understand their pain is real. And they need to know why. And if all their doctor has said is just PCOS, they're in front. We need to figure out what else is going on.

Cory Ruth: Agreed. Yeah, absolutely. Yeah, I always tell you, push for answers, you know. That, that's a brush off. So push for more answers to actually get to the root of why you're experiencing pain. Yeah, you're

Dr. Brighten: Mm hmm.

Cory Ruth: Show us or don't worry about it. You know, you're not you're still able to go to work or you know Just take [00:49:00] take a Tylenol it that's not okay Yeah,

Dr. Brighten: discussed a lot of things so far about, like, gut health and, and, , insulin, and I want everybody to know these are the things that you've already discussed. So much of this is how you prevent type 2 diabetes. But what I want to hone back in on and maybe get some more specifics around Is this mood component of PCOS?

What are steps that someone can take to improve their mood if they're struggling with anxiety or depression?

Cory Ruth: I think the first one is is working on blood sugar regulation because of that huge link right to mood so working on Incorporating in more protein more fiber more fats and less of the carbs in the sugar and really working on Regulating your blood sugar don't Wait until 2 p. m. To put the first bite of food.

You're gonna eat into your mouth Wait, the goal is to wake up hungry Not to just down a bunch of coffee and head out the door and think about you [00:50:00] know Your meal at maybe 2 p. m. 3 p. m. 6 p. m. I've seen it all We really

Dr. Brighten: And we've all been guilty of it?

Cory Ruth: Guilty yeah, but here's your sign to Make changes , try to get a breakfast in that includes some protein and some fiber that will set your blood sugar off on the right foot.

It's nice and happy with you. Um, and then have your coffee, you know, that's totally fine. You don't have to eliminate caffeine. That's not what it's about, but try to get breakfast in, try to have a lunch that has the same components. Dinner, same thing. Don't go all day without eating and then eat at, you know, right before bedtime and like stuff yourself.

That's going to cause you to sleep worse, um, and your blood sugar is not going to be happy with you. So, work on your blood sugar regulation. Your diet is the best way to impact change there. And that can in turn have huge effects on our mood, which is we don't always make that connection right between blood sugar and our diet and our mood.

Um, also if we're going so long without eating and our, you know, our blood sugar is [00:51:00] dipping low, that can really exacerbate anxiety. So, um, keep that in mind too if you're somebody who struggles in that department. Secondly, work on movement, get that movement. And like we talked about, movement can be so powerful when it comes to our mood and especially easing stress and anxiety and just brightening our mood overall.

We're more resilient. We're more able to adapt to stress or stress is going to keep happening. We cannot eliminate stress. Um, but if we can help our body respond and adapt to it better, that's really where the magic happens and can help to prevent things like anxiety and depression to keep happening. 

Dr. Brighten: What kind of movement do you recommend for women with PCOS?

Cory Ruth: I like, um, a mix of cardio and strength training. Um, and then I also like to include what I call restorative workouts. So those are ones that are going to really be more working on your adrenals and nourishment and cover recovery. So things like walking don't, , underestimate the power of walking.

It's an absolutely great tool [00:52:00] for all women, all people. Um, humans

Dr. Brighten: agree.

Cory Ruth: Yeah. Um, so, uh, cardio strength training, I like a mix of those and then those restorative workouts. So walking, hiking, slow biking. Yoga, gentle Pilates, Pilates can get pretty intense. So gentle Pilates would be grouped in that, but don't forget about those types of movement along with working on getting your heart rate up and working on that strength training because strength training can help to boost your metabolism and also help with insulin resistance.

So all three of those can have benefits.

Dr. Brighten: On social media, you're going to see people who say, if you have PCOS, you need to be in the gym, grinding it an hour every day. If you want to lose weight, you need to be in a caloric deficit, like, you know, eating like 1200 calories a day. Like you're an 11 year old. What do you say to that? Like, what is the ideal program?

Does one exist? And what is wrong with that advice?

Cory Ruth: think that [00:53:00] there's two big myths on social media that I see perpetuated about exercise and fitness and PCOS. The first, yeah, is you gotta just grind it out all day, you know, get it in, sweat, sweat, sweat, sweat buckets. And the second one is don't do any intense workouts. You know, you have to stick to exercises that don't um, spike your cortisol and, and that's that.

So, um, There's lots to say, but to keep it short, um, not one of those, those are two extremes. And we really, again, come back to that component, that, that balance factor. And if we're exercising all day and we're going super, super hard, that's not healthy. That's not good for our adrenals. If we have no recovery, we're just burning ourselves out.

That's not good. The second one there, cortisol spikes during exercise are normal. That's a normal thing and it's actually a temporary thing. Your cortisol is going to come back down. The benefits of exercise as a whole far outweigh any very temporary cortisol spike. So you [00:54:00] can do intense exercise. Do I recommend it every day like the first example or the first scenario?

No, all day. No, but you can, you can do that. I recommend typically getting in four to five days of movement a week. You don't need to go super hard seven days a week, but also don't do one day a week and then be sedentary the rest of the week. Get a good balance, good mixing. Do a couple of days of cardio, a couple of days of strength training, and then maybe one day or two days of those restorative workouts that feel just really good for your stress and your mood, your energy.

You can have all of those components, um, just don't fall into, you know, one, one extreme or the other. I think one of the things I see with that second myth of, um, you can't do any intense exercise, women get scared, they get scared to exercise, and then what happens is they're sedentary. That's not good. We don't want to scare them into thinking and being so confused about what they can and can't do that.

They just say, well, I'm not going to exercise is bad for me. They really think exercise [00:55:00] is bad for them. And that's just not the way that we work. You know, we're biologically and physiologically. 

Dr. Brighten: No, I it's spot on and I definitely think so. If you're someone listening to this and being like, how do we know what intensity to be at? If you're waking up with headaches, exhausted, like, you know, there is this adrenal component and you feel fatigued all the time. You're dragging through your day. I mean, there's things we already talked about that we want to check.

We want to work up like you're not a candidate for a marathon. Don't go start a marathon, but you are a candidate to still maybe do a high intensity interval training that is five to seven minutes. Maybe that's all it takes. And I think that there is a, you know, there, there's this mindset that more is better, but as we understand, I mean, when you look at the research, as you were talking about with walking, as we increase our steps, our morbidity and mortality rate starts to decline.

And so. If all you're getting is 5, 000, right? We talk about 10, 000 being a goal. If all you're [00:56:00] getting is 5, 000, like you're doing well. If you can get up to 7, 000, even better. And we know as we add steps, like we have more health benefits. I think about this the same as like, we know saunas that like, oh, saunas have tremendous benefits when we're using them like four to six days out of the week, like more is better.

However, That's not where we start. And I think starting wherever you're at and the most powerful thing to do is listen to your body. If you do a workout that's so hard and four days later, you can't, you still can't work out again. Because you haven't recovered and you feel exhausted. That's data.

Cory Ruth: Yeah.

Dr. Brighten: too far this time.

Maybe you could do it again in the future, but I think approaching it more of respecting your own body to give you the feedback and that you have expertise just by way of living in it, that these so called health experts don't necessarily have.

Cory Ruth: That's very true. It's very individualized. Mm hmm. 

Dr. Brighten: Have really given us so much to set a very great [00:57:00] foundation for health, which I anticipate is part of how we improve fertility and how you approach those with PCOS who are wanting to get pregnant. What else would you add in to already the foundation that you've set so far?

Cory Ruth: The main reason why PCOS is the leading cause of infertility is because many of us are. Ovulating either irregularly or not at all and Ovulation is essential to get pregnant. So what we really want to first understand is why is someone not ovulating?

And that's where that lab work component can be so powerful because if we're looking to get pregnant and we're like why is my period? Has been MIA for eight months Why? What's going on? What do I do to get it back? Getting those labs run. If you see your testosterone is sky high, boom, we need to work on lowering that testosterone.

If your vitamin D is like in the toilet, that can cause irregular ovulation. So we want to boost that up and help your period come back. So [00:58:00] that lab work component, I always recommend first and foremost. And then also, you know, if you can. Check your partner too. You know, it takes two to tango. It's not always all on us.

Even if we have a PCOS diagnosis, that's always helpful. Um, and then second, I think really working on your supplement game can be helpful, making sure you're taking a high quality prenatal. Um, CoQ10 is great. Omega 3 fatty acids and anositol supplement. Vitamin D if you need it, there's lots of things that you can do to just kind of, you know, make, make progress and boost the nutritional value of whatever your diet looks like.

Make sure you're getting all the nutrients that you need. So take a look at your supplement routine and you can boost that up. Um, make sure you're sleeping well. Sleep is really, you know, whenever I talk about sleep on my social media, it's like crickets, like no one cares, but sleep is really the foundation of good hormonal health.

If you're not sleeping well, your body can't repair itself. So work on a solid sleep routine. Make sure you're not staying up late, doom scrolling [00:59:00] and getting up early and going to work and make sure you're getting in healthy rest. That's so important. Tracking your cycle is a huge one. It can be a game changer, especially if you have irregular periods.

If you have irregular periods, you totally could be having intercourse at the wrong time. And it is kind of all about timing. Of course, there's so many more factors involved in conception, but timing is key. You have to time it right. And it's actually a very small window that we have to conceive. You know, I think a lot of us think that you can get pregnant any time of the month, right?

Any day, Um, but that's false, it's really only like a five ish, six ish day window that we have. So making sure you're timing your intercourse appropriately leading up to ovulation. Um, after we ovulate, the shop is closed. We can't get pregnant in our luteal phase, which is that phase in relation to when a potential period comes.

So if you're learning how to track your cycle, there's different devices that I like that are called BBT thermometers. You [01:00:00] can understand so much about your unique cycle, your hormones, what they're doing. It'll help you troubleshoot, right? If you see that your luteal phase is only nine days. That's not enough.

We want it to be longer in order for a pregnancy to happen in order to be, you know Producing adequate progesterone to keep that pregnancy going So tracking your cycle is so key and something that we really don't learn about at all when we're growing up And we really really should 

Dr. Brighten: What devices do you like, , for tracking a cycle?

Cory Ruth: My favorite is called the temp drop and it's a wearable device, which means I think a lot of us, you know, we're taught the BBT thermometers.

Um, the traditional ones you have to wake up at the same exact time every morning and take your temperature in order for it to be accurate. And you have to do that before you do anything else before you talk, get out of bed, go pee. Um, and that's hard, especially if you have other kids or you, you know, you're, you've got a crazy schedule.

It's difficult. So The temp drop is [01:01:00] a wearable. It's a armband and it tracks your temp all night long and it spits out an average in the morning. You can take it off whenever you want. And I love that one because it just makes it more realistic and doable to actually get those temperature readings.

Dr. Brighten: Mhm. Why is it if your luteal phase is less than 10 days, you're not going to be able to be successful in conceiving?

Cory Ruth: Yeah, your luteal phase, , your progesterone basically keeps your luteal phase going and your luteal phase, , progesterone keeps that lining up intact and keeps a potential pregnancy intact. So if you're, if you're not having that lengthy luteal phase, it can cause a pregnancy to basically just not, not occur because you don't, you're not giving your body enough progesterone enough time.

Dr. Brighten: Enough time is so key because I think people think, So often like sperm and egg meet and you're pregnant and they don't realize that happens in the fallopian tube. It's got to take a little journey and it might not be until day [01:02:00] eight that the embryo arrives in the uterus. And at that point, if there's not beta HCG, The corpus luteum, what produces progesterone fails.

And so even if that embryo could implant, it won't get those beta HCG levels up fast enough to keep progesterone around, it's not always often that people bring up that luteal phase length. And so I really appreciate you bringing that up because these are such the nuanced conversations, right?

That nobody had with us. When we got our periods, right? They scared us. You can get pregnant any time of your cycle and then you try to get pregnant and you're like, literally everyone lied to me about everything.

Cory Ruth: Yes, 100%. Yeah, we spend so much of our education learning how not to get pregnant. And then when we want to, we have absolutely no tools in our toolkit. Yeah. When I was learning about all of that, I was like, Oh, LPD. What is, what is this luteal phase defect? It's a real thing. It's a real thing. Mm hmm.

Dr. Brighten: Yeah. And as [01:03:00] I always say, you should not have to go to medical school to understand the body that you live in.

Cory Ruth: A thousand percent.

Dr. Brighten: This has been Such a fantastic conversation. We covered so much. You gave so many practical, applicable tips. I want everyone to follow you because, um, everything we talked about today, she will display to you graphically, or she will give you recipes to actually adopt.

So where can people find

Cory Ruth: Love food. We love food over here. Um, so my Instagram is at the women's dietitian. That's dietitian with two T's. Um, and then I also have the same handle on TikTok, YouTube. Um, my website is thewomensdietitian. I, um, have a supplement line for PCOS specifically and I have a podcast, which Dr. Jolene Brighton was on as well.

So yeah, find me there. I'd love to chat.

Dr. Brighten: Awesome. We will link to everything. And as always, we love hearing from you all. I love hearing from you all. I read your comments. I am definitely invested on the information to bring you. So let me know, what did you love [01:04:00] about this and what do you need more of? And certainly, certainly make sure that you are following us, subscribing and definitely check out Kory Ruth, the women's dietician.

Thank you so much.

 

Cory Ruth: Thank you, Dr. Brighton.