CAN DIET MAKE A DIFFERENCE TO PCOS?

PCOS (polycystic ovary syndrome) is a complex condition which has metabolic, reproductive, and psychological consequences which can affect individuals in different ways.

PCOS covers a wide variety of symptoms, and each individual can experience PCOS differently, as a result- each person who experiences PCOS needs to be treated individually.

The pathophysiology of PCOS is very complex and many of those with the syndrome also experience insulin resistance and have high levels of androgens (male hormones) - both of these can stimulate an increase of the other, causing a vicious cycle.

High levels of male hormones are responsible for typical PCOS symptoms such as hirsutism, male pattern hair loss, and acne. Both high androgens and insulin resistance can have a negative impact on ovulation, increasing the risk of infertility, as well as increasing the risk of diabetes and cardiovascular disease. 

For those diagnosed with PCOS, medications and advice regarding lifestyle modification for symptom control may be offered…

Medications may include the oral contraceptive pill, Metformin or medication that work against androgens (e.g Spironolactone). However, according to the latest international guidelines, first line advice is to use lifestyle modification.  Unfortunately, this first line advice involves most women being told to lose weight, restrict carbohydrates or avoid sugar without any further support. This can be really harmful to some women, as this can lead to yoyo dieting and anxiety around diet. PCOS is also linked to mental health issues such as anxiety and depression.

As a result, lifestyle management needs to individualised and holistic to avoid leading to negative consequences of restrictive diets. Focussing on positive changes and looking at what can be added into diet & lifestyle, instead of restriction is often a more effective way of approaching PCOS and diet.

Although there is no one recommended way of eating for those diagnosed with PCOS, there is evidence to support the following diet & lifestyle strategies:

1. Regular meals and eating enough – skipping meals can cause cravings and being desperately hungry could lead to poor food choices or bingeing. 

2. Balanced meals including protein and healthy fats with your high fibre carbs help to reduce the glycaemic load of the meal. Protein can also reduce androgen and insulin levels. Examples include lean meat, poultry, fish eggs, tofu, and Quorn.

3. Low GI (glycaemic index) carbohydrates – help to manage blood sugar levels and reduce insulin resistance. These can include oats, wholegrain bread, brown rice etc.

4. Fruits and vegetables – are high in fibre as well as important micronutrients which can help reduce inflammation which is common in PCOS. 

5. Omega-3 rich foods – oily fish are rich in omega 3 fatty acids which help with the chronic inflammation associated with PCOS.

6. Work on decreasing stress – stress plays a huge role in PCOS; and stress management is key to PCOS management. Meditation, journaling, breathwork and yoga can be really helpful in managing your stress levels. 

7. Regular activity can improve ovulation and menstrual cycles as well as support weight management, and insulin resistance. Try and aim for moderate movement 3-5 times a week, but what is most important is that you do something that you enjoy! 

8. Sleep – Getting enough sleep can be a struggle for many, but poor sleep is linked to poor blood sugar control, increased cortisol production, and it can also interfere with appetite signalling which can lead to cravings and overeating. 

In summary, diet can make a difference to PCOS; but individuals with PCOS need a personalised and holistic approach to managing their condition and restrictive diets are very rarely the answer. Instead, the focus should be on what you can add into your diet, your lifestyle, and your self-care practices to ensure you are nourishing yourself in all possible ways in order to optimise your PCOS symptoms.