Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders in women from their first period to menopause (reproductive years). It is estimated to affect 8-20% of people worldwide. This number is expected to be higher with up to 70% of people with PCOS remaining undiagnosed.
Each person who has PCOS will experience different symptoms.
For some, their symptoms may not bother them at all, and for others it may impact multiple areas of their lives. Some of the main symptoms of PCOS include:
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- Issues with period regularity, length, and cycles.
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- Fertility struggles
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- Excessive hair growth around the face and body
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- Scalp hair loss
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- Acne
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- Increased rates of depression, anxiety and low self-esteem
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- Trouble losing or maintaining weight
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- Insulin Resistance, which increases the risk of gestational diabetes in pregnancy, and earlier onset of type 2 diabetes
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- Increased risk of high cholesterol
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- Increased risk of cardiovascular diseases
It is important understand that insulin resistance in PCOS can occur in people of all weight ranges. It actually occurs in 75% of people who present as being of a lean body type.
Why do these symptoms occur?
PCOS is a hormonal condition. This leads to the question, which hormones are involved in PCOS?
There are two major hormones that contribute to symptoms of PCOS. These are insulin and androgens. Insulin is a hormone that is made by the pancreas and helps the body to transfer sugar (glucose) from the bloodstream, into our body cells to be used for energy.
Androgens are any group of hormones needed for male sexual and reproductive function. They are responsible for the development of secondary sexual features in men such as facial and body hair growth, and voice changes. Testosterone, the major hormone found in males, is an androgen. I think we can see where this is going! It is thought that the increased levels of insulin in the body cause the ovaries to work differently than they should and produce extra androgens. In theory, if we can balance insulin levels and androgen levels, symptoms should be able to be managed.
How diet affects PCOS?
As PCOS is such a hormonal condition, it can be difficult to comprehend how something as simple as nutrition can help. Research has shown that a healthy lifestyle (nutrition and exercise) is the most helpful approach to managing PCOS, and reducing severity of symptoms. Research is strong is showing a decrease of 5-10 per cent of body weight can improve symptom management in those who fall into an overweight BMI. What is more important than this though, is the change in dietary and lifestyle behaviours that leads to the change. Some of these benefits include decreased insulin levels, improved menstrual cyclicity, and a reduced risk of chronic disease development (type 2 diabetes and cardiovascular disease).
Best Food for PCOS
Key PCOS management principles include:
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- A focus on carbohydrates, specifically type, timing and total amount of carbohydrates.
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- Have a varied and mixed diet that meets 5 serves of vegetables and 2 serves of fruit
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- Include omega 3 fatty acids in the diet for anti-inflammatory and heart health purposes, as well as reducing saturated fat intake. Foods rich in omega 3’s include oily fish such as salmon, mackerel, trout, and anchovies.
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- Have regular bloods taken (annually),
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- Undertake regular enjoyable physical activity
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- Check in with a counsellor or psychologist if needed
The role of glycaemic index
The Glycaemic Index (GI) is the measure from 1 to 100 of how quickly a carbohydrate food raises blood sugars. High GI means that there is a big spike in blood sugars, and low GI means there is a slow, steady and sustained release of glucose into the bloodstream.
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- low GI (less than 55) – includes legumes, lentils, milk, wholemeal pasta, grainy bread, and rolled oats
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- medium GI (55 to 70) – includes honey, and wholemeal bread
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- high GI (greater than 70) – examples include potatoes, white bread and short-grain rice.
When looking to manage PCOS, low GI carbohydrates are key. Low GI carbohydrates are often (not always) higher in fibre, and likely to be of the wholegrain variety. Swapping over to foods such as brown rice, wholegrain bread, quinoa, wholemeal pasta and oats assists in combatting symptoms of insulin resistance, which also assists with improving other follow-on symptoms. Consuming a low GI diet over an extended period of time, has been shown to increase menstrual regularity, insulin sensitivity and reduce body fat in PCOS sufferers. Research has also showed improved bloods in areas of fasting insulin, triglycerides and total cholesterol when following a low GI type diet.
Read more about nutrition for ovulatory dysfunction
Food to avoid for PCOS
I don’t really like to focus on the ‘avoid’ or ‘don’t eat’ category, but it is more of a reduce where possible.
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- Sugary drinks: These spike blood sugars and contribute to insulin resistance. Instead choose soda water, or lightly flavoured sparkling mineral water.
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- Fried foods, processed meats (sausages, hamburgers, deli meats and hot dogs), processed food (cakes, candy, sweetened yogurt): These are high in saturated fat. This can contribute to increased cholesterol, which increases the risk of heart disease.
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- Refined Carbohydrates (e.g. pastries, sweet biscuits): These are higher in added sugars, and are also high GI. This can contribute to pesky symptom flare ups.
Food chart for PCOS
Here is a simple idea of what some lower GI versus higher GI carbohydrate options look like:
Let a PCOS Dietitian help you today
PCOS is a condition where nutrition and lifestyle can play a major role in managing symptoms. You deserve a happy, and full life with someone who can support you! For a more individualised approach, book in for an initial consultation here.
