PCOS is a hormonal disorder that affects 1 in 10 women worldwide. If you have PCOS, you may have irregular or absent periods. This is because your ovaries don’t release eggs as regularly as they should.
Dr. Megan Lyons, Double Board Certified Doctor of Clinical Nutrition, The Lyons Share, Dallas, USA, explains that one of the key symptoms of PCOS is the presence of multiple ovarian cysts, which gives the condition its name.
However, they are not actually cysts. They are painless, fluid-filled sacs (follicles) around your ovaries that cause them to enlarge. Abnormal hormone levels in PCOS may prevent some follicles from growing and maturing to release an egg. This contributes to irregular menstrual cycles and some cycles where eggs are not released at all (anovulation).
Lyons says: “People with PCOS also have higher levels of androgens. These are traditionally considered male hormones, but they are present at different levels in both men and women. In women with PCOS, these androgens are higher than normal.”
PCOS can manifest in different ways and cause a variety of symptoms, says Alyssa Pacheco, Registered Dietitian, PCOS Nutritionist Alyssa, Greater Boston, USA.
Not every person with polycystic ovaries will have PCOS, and not every person with PCOS will have polycystic ovaries.
For diagnosis, you need any two of the following:
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Polycystic ovaries – usually seen on ultrasound scans. There may be more than 20 cysts in one ovary.
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Symptoms of high androgen levels – for example high testosterone levels from blood tests or symptoms of high testosterone such as hirsutism or acne.
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No or very little menstruation.
In addition to irregularities in your period, these may also include:
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reproductive problems.
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hair thinning or loss.
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acne.
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Tiredness.
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weight gain – Especially around your stomach (tummy).
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abnormal hair growth (Atrophy) – usually in areas such as your face, buttocks, back or chest.
Says Lyons: “It can cause irritability, mood changes, and even depression.”
Pacheco says PCOS is linked to an increased likelihood of developing type 2 diabetes, heart disease, fatty liver, and endometrial cancer.
PCOS Diet: What to Eat to Manage Symptoms?
Graphic: Ben Hudson
70% of women with PCOS have insulin resistance. Insulin is a hormone your body makes to stabilize your blood sugar levels.
Lyons says that although PCOS is often classified as a hormonal disorder, it is increasingly considered a metabolic condition because there is much that can be done to manage it through diet and lifestyle changes. One of the most effective strategies for managing PCOS is blood sugar stabilization.
“By controlling blood sugar, we can help reduce insulin resistance,” Lyon explains. “This, in turn, supports proper metabolic function and contributes to hormone balance.”
Pacheco points out that PCOS is also linked to chronic inflammation.
“Insulin resistance and inflammation can both increase androgens — like testosterone levels — which cause a lot of common PCOS symptoms,” she says. “By incorporating certain foods into specific patterns that maintain stable blood sugar levels and reduce inflammation, you may see a reduction in PCOS symptoms.”
To help stabilize blood sugar levels, it is important to focus on foods that aid with blood sugar regulation and reduce inflammation.
Lyons says that when the body isn’t constantly fighting inflammation, it has more resources available to effectively regulate hormones.
Both Lyons and Pacheco recommend the following foods to help ease PCOS symptoms.
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high fiber foods – Such as fruits, starchy vegetables (especially leafy vegetables), beans, pulses, whole grains and seeds. These are rich in antioxidants and can help reduce inflammation. However, avoid tropical fruits, which can cause a spike in blood sugar.
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high-protein source – Such as chicken, turkey, lean red meat, fish, seafood, tofu, tempeh, edamame, Greek yogurt and cheese. These foods can help balance your blood sugar levels and prevent spikes.
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healthy fats – Like salmon, walnuts, chia seeds, avocado and olive oil. These are necessary for hormone production and some vitamin absorption.
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Spices and Herbs – Like cinnamon (which can help control blood sugar) and turmeric (which can reduce inflammation).
Pacheco recommends combining high-fiber carbohydrates with protein and healthy fats in meals for the optimal combination to keep blood sugar levels more stable.
When modifying your diet to help manage PCOS symptoms, it is important to reduce foods that cause increased blood sugar.
Lyons says these include refined carbohydrates and sugary foods like bread, pasta, pastries, muffins, bagels, and sugary drinks. She also recommends reducing trans fats, low-quality fats, inflammatory oils — such as processed and refined seed oils — and alcohol.
Pacheco agrees that these types of foods can worsen inflammation or insulin resistance if they are consumed frequently or in large amounts.
According to Pacheco, while diet can definitely help with PCOS symptoms, it’s not the only thing you can focus on.
“Exercise, getting enough sleep, and stress management are all big factors when it comes to hormone health,” she says.
make time for exercise
Physical activity plays an important role in the management of PCOS. A balanced exercise routine — including strength training and moderate cardio — can significantly improve PCOS symptoms.
Lyons advises that while people with PCOS should not overexert themselves in intense activities like running a marathon, moderate amounts of low-intensity cardio can also be beneficial.
She adds: “Strength training also helps with blood sugar regulation, reduces insulin resistance and reduces inflammation.”
sleep well, reduce stress
Besides exercise, sleep is another key element of PCOS symptom control.
“Lack of sleep can make insulin resistance worse. Similarly, chronic stress must be managed, as it can lead to cortisol dysregulation,” says Lyons. “Cortisol is a hormone that affects both blood sugar and insulin levels — as well as androgens. So when cortisol levels are out of balance, it can make PCOS symptoms worse.”
supplements
Current UK guidance from the British Dietetic Association (BDA) advises that no supplements are needed – or have a good evidence base – for their use in the management of PCOS.
Effectively managing PCOS symptoms involves an integrated approach that includes healthy dietary choices, regular exercise, quality sleep, and stress management.
Lyon concludes: “By stabilizing blood sugar and reducing insulin resistance, you can address the root causes of many PCOS symptoms. This can improve hormone balance and overall well-being.”
