Being pregnant with PCOS: Interview with Julie Mokhtar

As a part of our Share your Story initiative, we are doing deep dives with real women who are living with hormonal imbalances. Our goal with this series is to de-stigmatize and normalize hormonal imbalances.

Today we sat down with Julie Mokhtar to chat about her experience with being pregnant with PCOS. Read on if you’re interested in learning about:

• What are the symptoms of PCOS?
• How can I increase my fertility and get pregnant naturally with PCOS?
• What is it like to have PCOS while being pregnant?

Fast facts

• Name: Julie Mokhtar
• Age: 33
• Location: Kuala Lumpur, Malaysia
• Fun fact: I’m a total nerd for jigsaw puzzles!
• Business / occupation: Certified Ketogenic Living Coach. Being diagnosed with polycystic ovary syndrome (PCOS), I embarked on a life-changing keto journey in 2017 and am now dedicated full-time to helping women get healthier and happier through the healing wonders of good food.
• PCOSer since: 2002

Julie’s story with PCOS

Tell us about your history with PCOS in just a few sentences: what symptoms led you to know something was wrong, how did you get your diagnosis, where do your symptoms currently stand?

I was 15 when I first lost my period. I also started developing male-like hair growth (I was sporting a moustache and a manly strip under my navel) and I was also gaining a whole lot of weight. It took me several check-ups with different gynecologists to eventually get diagnosed with PCOS.

Unfortunately, information available on PCOS was so limited at the time, and the only advice I had gotten was to take birth control pills to regulate my period. I didn’t take the doctor up on the offer though.

I figured PCOS was just something I had to live with. So over the years, I lived with missing periods, frustrating weight gain, terrible acne, hair loss (on the head), and weird hair growth (everywhere else). Once I’d gotten married in 2014, I became familiar with a new heartbreaking symptom: infertility.

But now you’re pregnant! How far along are you?

I’m 33 weeks now and it still feels as surreal today as when we first found out we’re having a little bub!

Congratulations. Now, we all know it can take cysters’ bodies a little bit more time and effort to conceive. Did you experience any fertility struggles prior to getting pregnant? How long did it take you to conceive?

After getting married, it took me over 2 years of worsening PCOS symptoms and countless negative pregnancy tests to finally take a step back and ask myself, “What is actually causing all this? And what can I do about it?”

I took my time learning about the root causes of PCOS, and I got some lab work done to help identify which ones applied to me. It turned out I had chronic inflammation. I also found out that my estrogen dominance was due to super low progesterone levels.

In 2017, I started to change the way I ate, moved, slept, and thought. In 2020, after an enlightening series of trial and error, I woke up feeling a little odd one morning, peed on a stick, and finally saw that life-changing word appear on the little screen: “Pregnant.”

What were the major factors you addressed to optimize your fertility?

• Nutrition: I was on the standard Malaysian diet, which is made up of A LOT of sugar and refined carbohydrates, vegetable oils, and processed foods. I got to know about the keto diet and how the wholesome high-fat low-carb foods advocated on the diet can greatly help with a condition like PCOS. It helped that the foods are naturally flavourful too. It blew my mind that it’s possible to be “on a diet” and never have to feel deprived.
• Exercise (but not too much): To make up for years of being sedentary, I went super hardcore at the gym when I first changed my lifestyle. And then I realized I was overtraining my body and that was doing me zero favours in terms of reducing inflammation and balancing my hormones. I found my sweet spot with low-to-medium intensity workouts, which mostly consisted of taking 10,000 steps a day, swimming, and yoga.
• Tuning in to my circadian rhythm: I started a new routine where I spent the first part of my day outdoors to get some sunshine. From sunset onwards, I limited my exposure to blue light, and tried to go to bed by 11pm most nights. I used blue-light blocking glasses on nights that I couldn't avoid being on my phone or laptop.
• Stress management: My inability to conceive became a huge stress point for me, but once I had embarked on the lifestyle change, I got a lot more realistic with my expectations and I let that stress go completely. I was finally taking good care of my body and mind in a way I’d never done before. I just had to be patient and I believed I would eventually conceive when my body finally felt safe and nourished enough to grow a baby.

We’d love to hear more about your diet. How did you know this was best for you, did you do any lab work with a specialist or just trail and error? Is it possible to take it too far with keto?

When I started with the keto diet, I kept track of changes in both my physical and mental health - and that was super helpful in determining if I was on the right track.

In the 2-plus years of doing keto, I was finally able to get my weight down from 92kg to 66kg (definitely not something this cyster thought was ever possible!). I felt energetic and alert throughout the day (which was a welcomed change to my pre-keto sluggish, fueled-by-6-cups-of-coffee days), and my period came back (not as regular as it should have been, but it was an awesome start). Mentally, I felt clearer and calmer.

A common misstep with doing keto I would say is going with the one-size-fits-all approach. With any diet, it’s important to customize it according to our own body’s needs.

For me, I had started off with classic keto. When I got to know a lot more about keto for hormonal health, I started limiting my intake of dairy and soy. Going through a weight loss plateau halfway through sparked me to take a food intolerance test, and I started eliminating foods I was intolerant to from my diet. In 2019, I was still dealing with some skin issues and I also wanted to regulate my period properly, so I went a little deeper with my food elimination experiment and tried out a carnivore-style keto. That seemed to be the final step that brought about the biggest health improvements in me.

A follow-up lab test I’d done showed a huge improvement in my inflammation levels. My period started becoming a lot more regular too, and after 5 months of maintaining a meat-heavy keto way of eating, I managed to conceive naturally.

Let’s switch gears a bit to talking about being pregnant with PCOS. Have you added anything else to your routine / are you finding that you need either more or less of any of the above items in your routine?

My routine hasn’t changed much since getting pregnant, but I am making a conscious effort to listen to my body and give it what it needs. Food-wise, there’ll be days when my body just calls out for carbs and I’ll increase my carb intake accordingly. Other days, I seem to do just fine with my usual low-carb eats.

I’m continuing with my daily steps and yoga (swimming is off-limits now due to COVID-19 concerns) as they’re incredibly helpful in supporting my body for labour. Though I do have to say my energy definitely takes a dip in the first and the third trimester, so some days I’d take it easy and have a much-needed afternoon nap.

Have your PCOS symptoms changed at all with pregnancy?

I was pretty concerned going into pregnancy with a condition like PCOS, but thankfully it has been a pretty smooth ride so far. My biggest concern was developing gestational diabetes and it was a huge relief for me when my test results came back normal. I was thinking perhaps my acne problem may make a comeback but that hasn’t happened as well.

What advice do you have for women who are pregnant or trying to get pregnant with PCOS?

How we eat, move, sleep, and think has a profound effect on our fertility health so whether you’re pregnant or trying to get pregnant with PCOS, I do believe supporting your body with a wholesome lifestyle is key to boosting your fertility and enjoying a healthy pregnancy.

For women who are looking to heal and thrive, I would not recommend going with the Calories In, Calories Out approach. Obsessing over calories takes our attention away from the more important thing to focus on: the quality of food and how the food we’re consuming impacts our hormones and overall health.

We need to eat enough to be healthy. Going on a low-calorie diet robs our body the chance of getting all the nutrition it needs. When our body doesn’t have enough nutrition to perform all its functions, it will need to prioritize functions that are crucial for survival - and start shutting down the ones that are not. That's how our menstrual cycle starts to go haywire, our fertility goes out the window, our mental health deteriorates, and more.

I wrote about this topic and other fertility-boosting habits in my e-book Keto for Her. If you’re keen to find out how to optimise your lifestyle for healthier hormones (and a happier you!), you can grab a copy of the e-book here.

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