Table of Contents
- What is PCOS?
- Does PCOS have a cure?
- 1) Find out if you are insulin resistant or if you have any blood sugar issues before cutting carbs
- 2) Figure out your food sensitivities
- 3) Don’t starve yourself
- 4) Count your macros too, not just calories
- 5) Don’t forget your micronutrients
- 6) Take into consideration any other conditions that might influence your diet
- The bottomline
Have you or someone you know been diagnosed with polycystic ovary syndrome (PCOS)? Are you looking for nutrition tips to best manage your PCOS? In this article, I’ll highlight what PCOS is as well as provide you with 6 nutritional tips on how to best manage this condition!
What is PCOS?
The polycystic ovarian syndrome is an endocrinological disorder affecting 15-20% women of reproductive age.1
Because it is a syndrome, it comes with tens if not hundreds of symptoms and it can present itself completely differently in each woman. However, there are a few characteristics that are present in most women suffering from PCOS.
Irregular or absent periods, hair loss, hirsutism, weight gain, especially around the midsection, acne, are some of the more common symptoms.
PCOS is also associated with insulin resistance, and from there, an increased risk of type 2 diabetes, obesity, heart, and liver issues.2
On top of that, women with PCOS often suffer from a high degree of inflammation, which can manifest itself through unexplained fatigue, poor stress tolerance, joint pain, low immunity, and more.3
Does PCOS have a cure?
Unfortunately, there is no cure for PCOS. However, simple diet and lifestyle changes can help manage symptoms and improve fertility. If you try and search the best diets with PCOS, you’ll be flooded with contradictions: quit all the carbs, don’t quit carbs, do Keto, don’t do Keto, fast, don’t fast, quit gluten, eat gluten. The list goes on and it is long enough to drive anyone crazy.
The key is not in finding a strict diet, where you need to think about every single bite you take. It is to find a balanced, sustainable lifestyle, where you eat in a balanced way, move your body, and feel good. Here are a few things that will help you build that diet in an easy, healthy way.
1) Find out if you are insulin resistant or if you have any blood sugar issues before cutting carbs
Because many women with PCOS are insulin resistant, the most common diets for this condition will tell you to limit or eliminate carbs as much as possible. There are a few issues with this.
First, if you’re not insulin resistant, there is little evidence that quitting all carbs or going on the Keto diet will help in any way.
Secondly, you need to remember not all carbs are created equal. Complex carbs give you energy and they are found in foods usually very rich in nutrients.
They are burnt slower by the body as compared to simple carbs. Because of this, they are friendly with your blood sugar and don’t provide a quick spike that drops soon after, as simple carbs do. They are also high in fiber, which means they are more filling and aid digestion. Complex carbs also support brain health, helping you stay focused.
So, unless you have insulin resistance or even diabetes, think twice before eliminating all the carbs.
2) Figure out your food sensitivities
Another popular recommendation with PCOS is eliminating gluten, dairy, and sugar. It is true that all these foods, in excess, can cause a lot of issues. In moderation, however, they might not be as bad. The main reason for this recommendation is that all these foods are, to some degree, inflammatory.4
While an anti-inflammatory diet will help your PCOS5, it might be unnecessary to remove all these foods from your diet. The best way would be to identify your sensitivities. Elimination diets, under the supervision of a registered dietitian or coach can help with that.
Initially, you will quit all potentially allergenic foods for a set period. Then, you will start reintroducing foods one by one, which will allow you to identify your sensitivities.
Quitting gluten, dairy, and sugar will certainly clean your diet a lot. But, if you’re like most people, your favorite foods contain one or more of these ingredients. Wouldn’t it be easier to quit them knowing you have a sensitivity to one of the ingredients than just randomly doing it because it might help your symptoms?
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3) Don’t starve yourself
The most common (and detrimental) advice women with PCOS receive is to lose weight. Some are told to go on strict diets even if they have no weight issues. If one is overweight or obese, the situation gets worse.
The problem is losing weight is not a cure for PCOS. Yes, if you are overweight or obese, you might see an improvement in symptoms if you lose some weight. It could also help your insulin resistance. The problem is your symptoms are usually only managed while you stay on that diet.
I don’t think you need a specialist telling you that you won’t be able to stick to a very low-calorie diet for too long. And once you can’t do it anymore and start adding calories back in or even end up binging, the pounds will come back quicker than you imagine.
Extremely low-calorie diets can also lead to other hormonal issues, including hypothalamic amenorrhea (HA). This is a type of amenorrhea commonly seen in athletes, anorexic women, or those who go through acute stress, such as a shock. However, HA can appear in women at any weight and any level of activity.6
For instance, the shock of starting a new very restrictive diet, along with intense exercise, can be enough to shut down the hypothalamus-pituitary-ovarian axis, landing you in functional hypothalamic amenorrhea. Given that women with PCOS often have irregular or missing periods, the first signs of HA might be very hard to see.7
How to avoid HA
The best way to avoid it is to make sure you are fueling your body in the correct way. Eating at a caloric deficit doesn’t mean you need to starve. Calculate your resting energy expenditure (REE) and your non-resting energy expenditure (NREE). Take into consideration any activities you’ll do and find the total daily energy expenditure (TDEE). To lose weight you can subtract from the TDEE and find the optimal caloric needs for your body. However, to stay healthy, make sure you never go below your REE, which is the energy your body consumes to just exist and do nothing else.8
Beyond this calculation, there are also some clear signs that you’re eating too little. For instance, you might be constantly hungry, constantly craving carbs, you start having less and less energy each day, and you might even get dizzy. If your cycle changes for the worse, it is another sign the changes you’ve been making to your lifestyle are not beneficial for your body.
4) Count your macros too, not just calories
One of the biggest mistakes in any diet is looking only at calories and never at your macros. The amount of protein, carbs, and fat your diet, their ratio, can be more decisive on your journey to health. If you only count calories, you might end up with a very unbalanced diet.
Some say the ideal macros for women with PCOS are 40% fat, 35% protein, and 25% carbs. However, as with anything regarding PCOS, this will not be valid for everyone. Some, especially those without insulin resistance and those very active, will tolerate more carbs.
Regardless of the diet you choose, try not to obsess over numbers from the start. It will end up being exhausting very quickly. Focus instead on balance and on having a bit of everything at each meal: some carbs, some protein, and some fats. You can count calories and macros to see how your day looks like, but focus more on how you’re feeling:
- Do you have enough energy throughout the day?
- Are you constantly craving sweet or salty foods?
- Do you ever feel your getting an energy spike and then crash just as quickly, or is your energy rather constant throughout the day?
You want to feel minimal cravings and fairly constant energy. If you find yourself reaching for treats or coffee to power through the day, or if you crash 1-2 hours after a meal, it’s a sign you’re either not eating enough in general, or your diet is slightly unbalanced.
5) Don’t forget your micronutrients
Nutrition for PCOS shouldn’t be all about losing weight. It should be about eating foods that nourish your body, stabilize your blood sugar, and help you manage symptoms. While macros play an important role, micronutrients are just as important. And yes, there are supplements for just about anything out there, but that is not an excuse to have a diet that lacks vitamins and minerals. On the contrary, if true health is your aim, then you should try and get most of your micronutrients from foods and not from pills. How can vitamins and minerals help your PCOS? Here’s some clear evidence of their role.
A 2018 study showed an improvement in hormonal profiles and biomarkers of inflammation in women with PCOS following a supplementation protocol with magnesium, zinc, calcium, and vitamin D. The clinical trial involved two groups of women with one group on the supplements and the other group on placebo for 12 weeks. Results showed a reduction of hirsutism, C-reactive protein, and plasma malondialdehyde.9
Another similar study showed the same benefits from magnesium and vitamin E supplementation.10
While both studies used supplementation, they prove the importance of micronutrients in women with PCOS. So next time you use a calculator to show you your calories and your macros, make sure you pay just as much attention, if not more, to the vitamins and minerals your diet is providing you.
6) Take into consideration any other conditions that might influence your diet
Finally, just because a diet has been proven to work for many women with PCOS it doesn’t mean it will work for you or that it is even healthy for your body. So, make sure you don’t just focus on PCOS, forgetting any other issues you may have.
For instance, high protein diets are not the best for people suffering from kidney issues.
If you ever suffered from an eating disorder, intermittent fasting is very risky, as it can trigger old patterns from the ED.
Keto diet also has its contraindications. If you have a history of pancreatitis, or elevated triglycerides, active gall bladder disease, liver disease, advanced kidney disease or a history of kidney failure, you may want to look to another diet.
Simple diet and lifestyle changes can help manage PCOS symptoms, improve your fertility, and overall health. Insulin resistance and inflammation, both very common in PCOS, can be reduced through correct nutrition. Eliminate inflammatory foods, maintain a stable blood sugar level, and make sure you’re getting all the vitamins and minerals.
In the end, don’t turn your new lifestyle into an obsession that stops you from living your life. Put more emphasis on eating whole foods, with lots of veggies, proteins, and fats. Take into account any exercise you do and choose a diet that gives you energy for the entire day, one that doesn’t make you constantly think about the next meal, but instead allows you to live a normal life.
Author bio: Laura is a health & nutrition life coach and a fitness trainer, and she is the blogger behind Crimson Confidence, a website for and about women’s hormonal struggles. Laura helps women with PCOS take charge of their health by finding a sustainable lifestyle, that makes them feel strong, confident, and happy.
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- M. M. W. R. N. R. Moran LJ, “Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis,” Hum Reprod Update, pp. 347-363, 2010.
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- A.-M. E. J.-B. G. e. a. Sowińska-Przepiera E, “Functional hypothalamic amenorrhoea — diagnostic challenges, monitoring, and treatment,” Endokrynol Pol, vol. 66, pp. 252-260, 2016.
- R. A. L. Jeff G. Wang, “The Complex Relationship between Hypothalamic Amenorrhea and Polycystic Ovary Syndrome,” The Journal of Clinical Endocrinology & Metabolism, vol. 93, p. 1394–1397, 2008.
- E. T. e. a. Trexler, “Metabolic adaptation to weight loss: implications for the athlete,” Journal of the International Society of Sports Nutrition, vol. 11, no. 1, 2014.
- M. e. a. Maktabi, “Magnesium-Zinc-Calcium-Vitamin D Co-supplementation Improves Hormonal Profiles, Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial,” Biological trace element research, pp. 21-28, 2018.
- M. a. Z. A. Shokrpour, “The Effects of Magnesium and Vitamin E Co-Supplementation on Hormonal Status and Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome,” Biological trace element research, vol. 191, pp. 54-60, 2018.