Hacking Hunger, PCOS, Birth Control, Hormones

Q: I'm a 27-year old woman and have been following the Bulletproof Diet for a couple of weeks (I have done moderate low carb for years). I read your amazing book, too, and I'm starting the 10 day carb depletion phase today 

 My problem is that I am ALWAYS very hungry in the morning and bulletproof coffee doesn't seem to help with that. I have tried to get at least a 16 hour fast before lunch but the last hours of the fast I am feeling quite weak and hungry. Too little fat is NOT the problem, I add a LOT of butter to my coffee (I don't drink coffee every morning, sometimes I make "bulletproof hot chocolate" with cocoa butter and raw cocoa powder and of course butter and MCT oil). The hot chocolate seems to do a better job at keeping me less hungry (but I'm still starving before lunch). But I would really like the coffee in the morning, because I need the energy. Hot chocolate doesn't really give me enough energy.

I'm not overweight (I´m 1.71 meters long and weigh about 60 kg). I do have some excess body fat that I would like to shed. My body fat percentage is about 28 %. I do have PCOS if that could be the problem. I´m treating it now with birth control pills (I don´t want anymore children, already have two. :)

A: Thanks for writing in. I feel your pain with the PCOS. I went down a lot of rabbit holes and hit a lot of dead ends before (knock on wood) beating my endometriosis and PCOS for good. I almost got talked into a total hysterectomy at 24. It took me forever (and a fortune) to figure it out for myself and I hope to God that if a woman who was my age then is reading this now, she'll explore smarter avenues that aren't as difficult or expensive to implement. <steps off soapbox>.

I am not a medical doctor and cannot treat your conditions over the blogosphere. Everything I'm about to say is based on my own experience and research for my issues. I'm telling you what I would tell my best friend, niece or sister. This is ultimately up to your doctor, partner and most importantly, YOU.

First, there are a lot of things at play here. To answer your question simply: Yes. Yes, I do think PCOS has a lot to do with it. And so do the birth control pills. BC pills are very complicated, very diverse in their make up,  and for women still in their reproductive years can be detrimental. After trying who knows how many types of BC, I stopped them all together. They weren't worth it and I finally found my way to true hormone balance and healthy body fat, thus alleviating a ton of gynecological and reproductive issues. It never had to be that way.

The Hormone Cure by Dr. Sara Gottfried is a must read.

There needs to be a clear understanding of what your hormone levels are. And I mean having an enlightened professional who will explain and help you understand where you are hormonally and what the added hormones are doing to you.  I don't know what type of contraceptive you've been proscribed. Is it progesterone only? Estrogen only? A combo? Are you estrogen dominant? Has this introduction of oral contraceptive hormones made your body stop producing them naturally? What are your tests showing as far as how this impacts the natural balance of your body's hormones? Are they increasing one and decreasing the other? Because this will impact everything... your sex drive, weight, hunger, mood, metabolism, skin... on and on.

I'm not saying there aren't positives that BC provides. Every woman is different. But I'd have your doctor really go into details about the pros and cons of what these hormones are doing to you metabolically, among other things. There are other ways to prevent pregnancy that don't have to wreak so much havoc on your health. Same goes for PCOS. Of course, that's a talk for you and your partner.

The PCOS Paleo Cookbook

I highly recommend reading The Hormone Cure by gynecologist Dr. Sara Gottfriend.  In addition, check out The PCOS-Paleo Cookbook: Nutrient Dense Recipes To Support Female Health.

As far as the hunger, I'd skip the hot chocolate in the morning. Do the coffee. Eat the right nutrients when you are hungry. Don't worry about the fast or how many hours for now. Eat clean and let's get your hormones back to a happy place.

I wish you the very best and look forward to hearing how you're doing soon.

Yours in health and happy hormones,
Skye