Polycystic ovarian syndrome (PCOS) affects 1 in 10 women. Despite how common PCOS is, I’ve found that there is a major lack of support from a diet and lifestyle standpoint for women with PCOS. Fortunately there are many ways to manage PCOS naturally. Diet and lifestyle interventions for PCOS are incredibly personalized and multi-faceted, so keep in mind that these recommendations are not personalized to address your specific needs.
Stabilize Blood Sugar and Improve Insulin Resistance
Insulin resistance and excess amounts of insulin are common in women with PCOS. This combination contributes to metabolic problems and affects the hormones that control your menstrual cycle. High levels of insulin can stimulate the ovaries to produce more testosterone. This can lead to acne, hirsutism, anovulation and infertility.
Insulin is a hormone produced by the pancreas and it’s primary job is to bring glucose out of the blood stream and into your cells to be used for energy. Your cells need glucose to function optimally, but the mechanism that allows insulin to usher glucose into your cells does not always work properly in PCOS.
Because your cells are already having a difficult time accessing energy, cutting out carbs or overly restricting carbohydrates is not the answer. This can make thing worse and lead to further disruptions to endocrine function, hypoglycemia, fatigue and intense cravings. Overly restricting carbohydrates also typically leads overeating them later on.
We also don’t want to chronically overeat carbohydrate foods leading to big spikes in blood sugar and higher levels of circulating insulin.
So how do you stabilize blood sugar and improve insulin resistance?! Focus on eating consistently throughout the day (about every 4 hours or so) and including moderate amounts of carbohydrates at meals and snacks. Choose fiber rich carbs which are broken down and digested more slowly to prevent rapid spikes in blood sugar (starchy vegetables, beans, quinoa, oats, fruit). Pair starchy foods with protein, fat and non-starchy vegetables for optimal blood sugar stability.
The amount of carbohydrates you need daily is very individualized, but a good starting place is to think about ¼ plate high fiber carb, ¼ plate protein, ½ plate non-starchy vegetables and 1-2 servings fat at meals. This is NOT about perfection! This is also not about beating yourself up over the pizza and beer you enjoyed with friends last weekend. There is a lot of flexibility here. It’s about mindfulness and fueling your body appropriately on a consistent basis.
Inflammation is a trendy topic right now that you can read more about here. PCOS is associated with chronic, low grade inflammation that isn’t fully understood (evidenced by elevated inflammatory markers in women with PCOS). Chronic inflammation can increase the risk for a number of chronic diseases, therefore one of the goals in managing PCOS is to reduce chronic inflammation.
So how do you support your body in reducing inflammation? Include more omega 3 fatty acids which are super important for reducing inflammation. Some of my favorites include fatty fish, hemp seeds, chia seeds, tahini, walnuts and olive oil.
Eat more plants! Higher fruit and vegetable intake is associated with lower levels of inflammatory markers and a decreased risk for developing chronic disease. Vegetables and fruit are rich in vitamins, minerals and antioxidants that have an ant-inflammatory and protective effect on our bodies. Aim for 7-9 servings daily and choose a variety of colors!
Use herbs and spices liberally. Not only are herbs a great way to flavor your food, but they’re also really amazing chemical compounds that have the ability to disrupt inflammatory pathways and even inhibit the release of inflammatory messengers. Use more turmeric, cinnamon, ginger, black pepper, oregano, thyme and rosemary to flavor food.
Prioritize and Protect Time for Daily Stress Management
Chronic stress disrupts your body’s stress response systems and results in increased cortisol secretion (one of your body’s stress hormones). Chronically elevated levels of cortisol impacts insulin, progesterone, testosterone, DHEA and thyroid hormone production. Stress can impact your body’s ability to regulate inflammation, impair digestion, promote weight gain, and result in the loss of a normal period. Is this stressing you out?! Unfortunately stress isn’t going anywhere, so it’s important to prioritize stress management activities daily to support healthy hormonal balance.
Stress management is also very personalized. The most important thing is to find something that works for YOU and to make it a part of your daily life. Some ideas include guided mediation, yoga, seeing a therapist, going for a walk and getting fresh air and deep belly breathing.
Talk about supplements with your Dietitian or Doctor.
There are several supplements that can be very helpful with PCOS. Women with PCOS are commonly deficient in a number of vitamins and minerals which might be due to increased needs, poor absorption or increased secretion. Common deficiencies include zinc, copper, magnesium and vitamin D. I always prioritize these crucial vitamins and minerals via food and supplementation as necessary.
In addition to correcting any deficiencies, there are other supplements that can be used to help with balancing sex hormones, promoting insulin sensitivity and reducing inflammation. Below are some common supplements I use in my practice with clients. Keep in mind that supplements are very individualized. Please consult your Dietitian or Doctor before starting anything new.
Inositols are pseudovitamins found in many foods. Myo and d-chiro inositols are the most well researched in PCOS. Myo + d-chiro inositol supplementation in a 40:1 ratio has been shown to help with insulin resistance, dyslipidemia, hypertension, weight loss and egg quality. Learn more here and here.
NAC is a derivative of L-cysteine which is a precursor to glutathione. NAC acts as an antioxidant and an amino acid that can help reduce oxidative stress, improve insulin resistance, improve egg quality and ovulation and lower androgens. Learn more here.
Omega 3s are essential fatty acids. This means that the body does not produce them, and we have to obtain them from food. In addition to including more omega 3 rich foods (see above), an omega 3 supplement may be beneficial for decreasing inflammation, improving insulin resistance, lowering androgens and improving depression (women with PCOS experience higher rates of depression and anxiety). Learn more here.
Reduce Exposure to Endocrine Disrupting Chemicals
Endocrine disrupting chemicals can impact hormone levels that may contribute to inflammation, infertility and metabolic alterations seen in PCOS such as weight gain and insulin resistance.
It’s impossible to completely eliminate exposure to ALL endocrine disrupting chemicals in the world that we live in. However it is possible to consciously reduce your exposure to endocrine disrupting chemicals with small but impactful changes:
Minimize your use of plastics in the form of single use plastic bottles and tupperware. Purchase a glass or stainless steel water bottle and glass tupperware.
Look for personal care products free of parabens, formaldehyde, phthalates, petroleum jelly, PEG, food dye and coloring and synthetic fragrances. I love Follain, Credo Beauty and Beauty Counter for personal care products.
*Remember that these are general tips and not a substitute for individual medical or nutrition advice. Always consult with your health care provider before making changes or starting supplements.
If you’re ready to work together on a personalized diet and lifestyle plan with the support of an Integrative Registered Dietitian, set up a free introductory phone call to learn more about the program.