PCOS is a common condition among women. Perhaps you know someone who has PCOS, or you might even have it yourself.
What is PCOS, and what type of diet can help manage symptoms?
We’ve put together a PCOS diet plan to help you start making more informed choices and hopefully improve your overall health.
What is PCOS?
Polycystic ovary syndrome, or PCOS, is a condition that impacts hormone levels in women. Most often, PCOS causes high levels of androgens, a type of male hormone.
Elevated levels of androgens can lead to PCOS symptoms such as irregular periods due to lack of ovulation, cysts on the ovaries or enlarged ovaries, weight gain, oily skin, acne, unwanted hair growth (especially on the face), hair thinning, and infertility.
PCOS is one of the most common causes of infertility and is estimated to impact 6-12% of women of childbearing age. PCOS can affect you regardless of your weight, though many women with PCOS are considered overweight or obese.
Doctors diagnose PCOS if you meet at least two of three categories: high androgen levels (testosterone levels), lack of or absent ovulation, and cysts on your ovaries.
4 types of PCOS
There are four types of PCOS recognized by certain healthcare professionals. Not all healthcare providers will differentiate between different subsets of PCOS and simply use a blanket diagnosis of PCOS.
Knowing the possible roots of your PCOS you have can help you better manage it and hopefully reduce your PCOS symptoms.
Insulin-resistant PCOS is one of the most common types of PCOS. Insulin resistance is when your body doesn’t respond to insulin effectively. Insulin is a hormone released by your pancreas that helps lower your blood sugar levels.
When you have insulin resistance, your body will produce more insulin to try to lower your blood sugar levels. High insulin levels drive high androgen levels, which worsen PCOS symptoms.
Insulin resistance can lead to weight gain, which is why many women with insulin-resistant PCOS are considered overweight or obese. Having insulin resistance also increases your risk of developing diabetes. Women with a bodyweight considered “normal” may also have insulin resistance, though it isn’t as common.
This type of PCOS isn’t recognized in medical literature but is recognized anecdotally among some PCOS authors and experts.
Post-pill PCOS describes the hormonal imbalance that can occur when you stop taking hormonal birth control. Women without a history of PCOS might have some symptoms of PCOS when coming off the pill, but those symptoms likely won’t linger once hormones have come back into balance.
Hormonal birth control suppresses your body’s hormone balance. While taking hormonal birth control can mask pre-existing PCOS symptoms, it doesn’t treat the root cause of the hormonal imbalance.
Once you come off hormonal birth control, your body has to work to figure out how to regulate its hormones again. This can take a long time, sometimes up to a year or more.
Adrenal PCOS refers to women who have an abnormal stress response. With adrenal PCOS, you’ll likely have elevated levels of DHEA-S (dehydroepiandrosterone sulfate), which is another type of androgen (male sex hormone).
With other types of PCOS, the elevated levels of androgens primarily come from the ovaries. Adrenal PCOS is unique because the adrenal glands (one located in each kidney) are the primary source of the hormone DHEA-S.
Levels of DHEA-S increase with acute stress, which is why adrenal PCOS is associated with reduced stress tolerance.
Inflammation drives many types of disease and health issues. Excess androgens may lead to low-level inflammation, which is one of the symptoms of PCOS.
If you have inflammatory PCOS, you may have high blood levels of C-reactive protein, an indicator of inflammation in your body. You might also be sensitive to certain foods and have digestive symptoms, as well as a general feeling of being unwell or feeling fatigued.
Symptoms and complications of PCOS
Some of the symptoms and potential complications associated with PCOS include:
- High androgen levels – high levels of androgens such as testosterone and DHEAS can lead to symptoms like thinning hair, unwanted hair growth, acne, and oily skin. Acne along the jawline is especially common with excess androgen levels.
- Insulin resistance – blood tests can identify high insulin levels and/or high blood sugar. Skin tags and darkened patches in your skin can also be a sign of insulin resistance.
- Irregular periods or very light periods.
- Lack of ovulation
- Infertility – many women with PCOS need fertility treatment to aid in conceiving.
- Metabolic syndrome – excess weight gain in your belly, high blood sugar, high cholesterol, and high blood pressure are all aspects of metabolic syndrome.
- Pelvic pain
How does diet affect PCOS?
Your diet plays a significant role in the management and treatment of PCOS. Insulin resistance and inflammation can both be affected by your diet.
If you have insulin resistance, your blood sugar levels can become too high if you eat a high carbohydrate diet, especially refined carbohydrates and added sugar. The higher your blood sugar levels rise from eating these foods, the more insulin resistant you become.
Some foods can promote inflammation and worsen PCOS symptoms. On the other hand, anti-inflammatory foods, including healthy fat and antioxidants, can help combat inflammation.
Everyone with PCOS will have different responses to foods. Some PCOS diets advertised in books and online promote going gluten-free, dairy-free, and cutting out all refined sugar. While these diet changes may be helpful in certain ways, it’s important not to be too restrictive with your diet since it likely won’t be sustainable.
Instead of over-restriction, try to include more whole, less processed foods with natural health benefits into your PCOS diet while working on cutting back on less nutritious foods.
If you want to experiment and see how you react by eliminating certain foods (e.g., gluten, dairy, etc.), do so one at a time and assess your symptoms after several months. If you don’t notice any improvement, then you can try eliminating another potential problematic food.
Foods to avoid with PCOS
Foods and drinks high in added sugar
Sugary beverages are the leading contributor of added sugar in a typical Western diet. Drinks like soda, sweetened teas, sugary coffee drinks, energy drinks, and many more are high in added sugar.
Drinking sugary drinks regularly can worsen insulin resistance and may contribute to inflammation. Consuming extra calories from added sugar can make it difficult to reach a healthy weight if you’re working towards weight loss.
Added sugar isn’t always easy to spot in foods. Sugar is added to foods that might otherwise seem healthy, like yogurt, dried fruit, some nutrition bars, and granola. Many processed foods contain added sugar.
Cutting back on added sugar can also help with weight loss. Losing weight often improves insulin sensitivity and may reduce PCOS symptoms in some women.
Foods high in omega-6 fatty acids
Omega-6 fatty acids are pro-inflammatory, while omega-3 fatty acids have anti-inflammatory properties.
The typical Western diet is much higher in omega-6 fatty acids than omega-3 fatty acids. Some sources of omega-6 fatty acids and foods to avoid with PCOS include corn oil, vegetable oil, soybean oil, sunflower, and safflower oils. Meat from animals fed a grain-based diet is also higher in omega-6 than omega-3s.
Instead, try to include healthy fat from foods like fatty fish, nuts, seeds, and grass-fed meat.
Foods to eat with PCOS
Blueberries are rich in anthocyanins, a type of antioxidant. Antioxidants help fight inflammation by preventing cell damage from free radicals.
Blueberries are a great source of fiber and are a source of natural sugar. They raise your blood sugar levels less than foods high in refined sugars or other low-fiber carbohydrates due to their high fiber content. Blueberries are a healthy, tasty addition to a PCOS diet.
Foods high in magnesium
Women with polycystic ovary syndrome are more likely to be deficient in magnesium. Magnesium not only helps promote relaxation to help manage stress levels, but it might also play a role in insulin resistance.
Some magnesium-rich foods to eat with PCOS include:
- Pumpkin seeds
- Peanuts, peanut butter, and other types of nut butter
- Black beans
- Dark chocolate with 60-69% cocoa
Not only are vegetables among the best foods to eat for PCOS, but they have many other health benefits. Non-starchy vegetables are very low in carbohydrates, which means they won’t raise your blood sugar or insulin levels significantly. If you have insulin-resistant PCOS, this is especially helpful.
Vegetables, especially those with rich colors like orange and dark green, are rich in phytochemicals and antioxidants that can help fight inflammation and are a great choice for a PCOS diet.
Starchy vegetables can be included in a PCOS diet, but be careful with your portion size if you have insulin resistance. Starches break down into blood sugar, which means large portions of starchy vegetables (or combining starchy vegetables with other types of carbohydrates) can raise your blood sugar levels and worsen insulin resistance.
Examples of low-carbohydrate, non-starchy vegetables to eat with PCOS include:
- Brussels Sprouts
- Green beans, pea pods, snow peas, and sugar snap peas
- Leafy greens such as kale, mustard greens, Swiss Chard, etc.
- Peppers (bell peppers, hot peppers)
- Salad greens such as lettuce, spinach, arugula, endive, and salad mixes
- Squash such as zucchini, yellow squash, and spaghetti squash (not winter squash like acorn and butternut, which are more starchy)
Foods to avoid when taking metformin for PCOS
If you have PCOS, you may take metformin. While taking metformin for PCOS, you may want to adjust your diet. Keep reading to find out five foods to avoid.
- Sugary drinks: If you have insulin-resistance PCOS it’s best to avoid sugary drinks so metformin can more easily do its job to help improve your insulin sensitivity.
- Alcohol: Drinking a lot of alcohol while taking metformin for PCOS could lead you to develop low blood sugar levels. If you choose to drink alcohol while taking metformin for PCOS, try to limit it to no more than one drink per day.
- Foods with added sugar: Foods that are high in added sugar can worsen insulin resistance and PCOS symptoms. The American Heart Association recommends limiting your added sugar consumption to less than 25 grams per day.
- Refined grains: Refined grains are more likely than other grains to raise your blood sugar levels and worsen insulin resistance. White bagels, flour tortillas, white bread, and white rice are just a few examples of refined grains that you should try to avoid if you’re taking metformin for PCOS.
- Fried foods: If you experience gastrointestinal side effects while taking metformin, try eating less fried foods to see if that’s part of the culprit. Cutting back on fried foods might also help you lose weight, which can improve insulin sensitivity and PCOS symptoms.
Foods to eat when taking metformin for PCOS
- Nuts: Nuts are composed mainly of healthy unsaturated fats that can help improve your heart health and promote healthy blood sugar levels. This is important because PCOS increases your risk of having abnormal cholesterol levels.
- Omega-3 fatty acids: Some women have inflammatory PCOS, so eating anti-inflammatory foods with omega-3 fatty acids might help improve their symptoms.
- Protein-rich foods: Foods like chicken, fish, eggs, lentils, and quinoa are rich in protein and don’t raise your blood sugar levels significantly.
- Non-starchy vegetables: Most vegetables are low in carbs and rich in fiber, so they don’t raise blood sugar levels significantly. Richly colored fruits and vegetables are good sources of antioxidants, which help fight inflammation.
Lifestyle changes to help manage PCOS
Some other lifestyle changes that may help in addition to following a PCOS diet include:
- Getting regular physical activity
- Practicing good sleep hygiene
- Managing stress
- Taking certain PCOS supplements
PCOS is a health condition stemming from a hormone imbalance. Eating a healthy diet rich in whole foods that are high in fiber, antioxidants, and other nutrients while avoiding added sugar and inflammatory foods can help PCOS patients manage their symptoms.