Managing PCOS through diet and lifestyle

PCOS is a metabolic condition that affects 1 in 10 women, is the most common hormonal condition affecting women of reproductive age and one of the leading causes of infertility. However, the management of the disease through diet and lifestyle is not nearly enough spoken about. I personally have worked with women to go from years of irregular cycles to consistent, 28-30 day cycles, without the use of medication. Since PCOS is a metabolic disorder that creates hormonal imbalances, there are several areas to target in terms of lifestyle and diet related changes. Let’s first clarify what PCOS is.

PCOS - Polycystic Ovarian Syndrome

PCOS is an endocrine disorder commonly associated with menstrual irregularity, infertility, excess weight (or not), acne and hirsutism (body hair). From a medical point of view, women will often present with high androgens, insulin resistance and multiple immature follicles. There is no one definitive test to diagnose PCOS, but rather it is the presentation of two or more symptoms of the following; irregular or absent periods, high androgens or polycystic ovaries. Diagnosis will typically involve consulting a medical professional, blood tests and an ultrasound.

Balance blood glucose and insulin levels

Insulin resistance is one of the major markers of PCOS in women regardless of weight, and contributes to weight gain, ovarian activity and androgen production. Therefore, when considering dietary changes, blood glucose and insulin balance is often the main objective. Balance your blood glucose levels by including quality protein in every meal, a variety of vegetables and a small serve of unrefined carbohydrates - such as wholegrain or wholemeal varieties. Eat meals regularly throughout the day and include high protein snacks.

Increase fibre

Research has shown that women with PCOS often have low intakes of dietary fibre. Dietary fibre can be found in fruit, vegetables and whole grains and can assist with reducing PCOS symptoms in a number of ways. Including adequate amounts of dietary fibre in your meals will help to lower insulin levels, increase microbial diversity and aid in the balance of hormones.

Antioxidants

Progesterone is produced by lutein cells in the corpus luteum but these cells are sensitive to stress, inflammation, nutrient deficiencies, antioxidant status and toxicity. Antioxidants help to relieve oxidative stress in the body. Be sure to include a wide range of coloured foods. Learn more about progesterone here.

Movement

Exercise improves PCOS largely due to the increase in sensitivity to insulin and associated weight loss. Weight bearing exercise is specifically beneficial for PCOS sufferers because it increases the amount of lean muscle mass, which can help to increase your metabolism. Even a weight loss of just 5-10% can help to improve symptoms of PCOS.

Supplements

Inositol - a chemical compound that increases sensitivity to insulin and acts as an antioxidant. Can help to balance blood glucose levels and reduce insulin resistance.

Vitamin D - women with PCOS are more likely to have a vitamin D deficiency. It’s recommended to get tested and supplement accordingly.

Others - many other nutrients may be beneficial to supplement for PCOS, however it is a personalised approach.

References

Douglas CC, Gower BA, Darnell BE, Ovalle F, Oster RA, Azziz R. Role of diet in the treatment of polycystic ovary syndrome. Fertil Steril. 2006 Mar;85(3):679-88

Günalan E, Yaba A, Yılmaz B. The effect of nutrient supplementation in the management of polycystic ovary syndrome-associated metabolic dysfunctions: A critical review. J Turk Ger Gynecol Assoc. 2018 Nov 15;19(4):220-232. doi: 10.4274/jtgga.2018.0077. Epub 2018 Oct 9. PMID: 30299265; PMCID: PMC6250088.

Leung WT, Tang Z, Feng Y, Guan H, Huang Z, Zhang W. Lower Fiber Consumption in Women with Polycystic Ovary Syndrome: A Meta-Analysis of Observational Studies. Nutrients. 2022 Dec 12;14(24):5285

Showell MG, Mackenzie-Proctor R, Jordan V, Hodgson R, Farquhar C. Inositol for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2018 Dec 20;12(12):CD012378. doi: 10.1002/14651858.CD012378.pub2. PMID: 30570133; PMCID: PMC6516980.

Woodward A, Klonizakis M, Broom D. Exercise and Polycystic Ovary Syndrome. Adv Exp Med Biol. 2020;1228:123-136. doi: 10.1007/978-981-15-1792-1_8. PMID: 32342454.