Restoring ovulation without hormonal stimulation is possible. In this webinar organised by Simplycure in collaboration with Biforme-Santé, Clara Materne, a nutritional therapist in Liège, chooses to talk not theory, but real-world practice.
Rather than a biomedical presentation on polycystic ovary syndrome (PCOS), she shares a real clinical case, followed in her practice, to show how a functional approach can restore ovulation and support fertility1.
PCOS, she explains, is always multifactorial. “The key is to trace the causes behind the causes: why is this woman not ovulating?”
The whole argument of this article builds around that question, and its answers.
The starting point: a patient in search of balance
Clara Materne presents a 37-year-old patient, diagnosed with PCOS several years earlier, who comes in with a wish to conceive after a miscarriage in 2023.
Her profile is typical of many women seen in practice: irregular cycles, persistent fatigue, weight gain, back acne, abdominal hair growth and a constant feeling of cold.
Her family history (diabetes, excess weight, bowel problems) already points towards a particular metabolic terrain.
The patient is highly engaged: she eats a healthy diet, exercises three times a week and tracks her cycle using the Sensiplan method.
This close tracking reveals cycles ranging from 28 to 40 days, an adequate luteal phase, but premenstrual spotting, often a sign of progesterone deficiency2.
The test results: understanding the levers behind the ovulatory dysfunction
The work-up confirms the complexity of the terrain:
TSH at 2.4 mIU/L, despite mild thyroid treatment;
oestradiol too low on day 3 (28 pg/mL);
raised prolactin (60 ng/mL);
lowered SHBG, reflecting excess free testosterone;
HOMA = 2, a sign of early insulin resistance;
insufficient vitamin D.
For the practitioner, these markers point to four major causes of ovulatory dysfunction: hypothyroidism, relative hyperandrogenism, hyperprolactinaemia and hypoestrogenism.
Each one feeds a vicious circle: insulin resistance lowers SHBG, low SHBG raises androgens, androgens block ovulation, poor ovulation limits progesterone, and so on.
As Clara Materne points out: “PCOS is made up of self-perpetuating loops. You cannot treat just one entry point, you have to act on all of them.”
The treatment strategy: restoring the cycles, not forcing them
The goal of the protocol is simple: restore functional ovulation, by supporting each phase of the cycle and correcting the metabolic and hormonal levers involved.
The nutritional therapist approaches this restoration systemically, acting on progesterone, oestrogens, prolactin, insulin and the thyroid all at once.
Physiological goalActions / levers usedExpected effects1. Support the luteal phase- Progesterone-like plants: chasteberry, lady’s mantle, wild yam
- Borage oil rich in GLA- Stimulation of progesterone
- Regulation of the hypothalamic-pituitary axis
- Anti-prolactin and anti-inflammatory effect2. Relaunch the follicular phase- Sage and hops (unless hormone-dependent contraindication)- Stimulation of the oestrogen rise and the LH peak
- Support for follicular growth
- Sedative effect of hops in anxious profiles3. Lower prolactin- Chasteberry as a mother tincture (approximately 25 drops/day)
- Repeated biological monitoring- Normalisation of prolactin
- Restoration of the hypothalamic-ovarian dialogue
- Support for progesterone secretion4. Correct insulin resistance- A low-glycaemic-index diet - Regular physical activity
- Synergy of berberine, cinnamon, chromium, zinc and ALA- Decrease in hyperinsulinaemia
- Reduction in ovarian androgen stimulation
- Target: HOMA < 1.55. Reassess the thyroid- Adjustment of intake of iodine, selenium, zinc
- Close monitoring of TSH/T4/T3- Improvement in SHBG
- Reduction in prolactin
- Better insulin sensitivity
This progressive, precise and individualised approach makes it possible to move beyond standardised protocols and build a tailored response to each patient’s physiology, an essential condition for lasting restoration of ovulation.
The gut, the forgotten link in PCOS and fertility
At the second consultation, the patient presents with dysbiosis with suspected mixed SIBO (H₂S + methane).
The breath tests, poorly supervised at the hospital, nonetheless confirm early fermentation in the small intestine3.
Clara Materne then opts for a progressive strategy:
hepatic support as a first step (desmodium, milk thistle, chrysanthellum);
gentle antimicrobial treatment (caprylic acid, oregano, olive leaf);
a low-sulphur diet for three weeks;
biliary and enzymatic stimulation via dandelion and liquorice (anti-androgenic).
The aim is not to “cleanse” but to reduce systemic inflammation and to support hormonal balance.
The outcome: from rebalancing to pregnancy
Over the following weeks, the patient reports a marked improvement in her vitality, digestive troubles easing, and a more regular cycle.
Then, a few months later, a spontaneous pregnancy is confirmed.
The protocol is then scaled back: berberine, the hormonal herbs and the antimicrobials are stopped; close thyroid monitoring continues, and a bio-identical progesterone prescribed by the doctor is introduced4.
To support the gut during pregnancy, the nutritional therapist favours targeted probiotics and butyrate, which is compatible with pregnancy.
Restoring ovulation, restoring confidence: what this case teaches us
Through this case, Clara Materne shows that PCOS treatment is not just about “regularising cycles”, but about giving women back the ability to ovulate naturally.
This is not a purely ovarian disorder, but an overall imbalance: endocrine, metabolic, inflammatory and intestinal.
The functional approach makes it possible to act on every link in the chain, without ever disconnecting the clinical picture from the biology.
A few key lessons:
always date hormone work-ups (day 3 for baseline, day 7 post-ovulation for progesterone);
consider SHBG as a pivotal marker of hyperandrogenism;
combine herbal medicine, micronutrition and lifestyle rather than pitting them against one another;
adapt care during the pregnancy phase to protect the mother and the foetus.
An approach that calls for time, precision and genuine collaboration between practitioners.
To take your PCOS follow-up further, explore the hormonal, metabolic and digestive levers, and access validated protocols, join Simplycure! Create your account for free or contact us to find out more.
