By understanding the nature of Polycystic Ovary Syndrome (PCOS) we can understand which are the most effective diet and lifestyle choices to help women manage this condition.
PCOS is one of the conditions that I have researched in-depth and, as a qualified and registered nutritional therapist, when I read a previous blog post on this website about PCOS I felt compelled to provide a more informative article about the condition and the ways in which diet and lifestyle can help
As the article suggests, diet and lifestyle choices may be helpful for women with PCOS. But how does diet and lifestyle help? And what are the most effective choices? By understanding the nature of PCOS, we can understand which are the most effective diet and lifestyle choices for women with PCOS.
The condition now known as Polycystic Ovary Syndrome and commonly referred to as PCOS was first recognised in 1935 by two American gynaecologists, Stein and Leventhal, when the condition was known as Stein-Leventhal syndrome. After other conditions have been ruled out, a diagnosis of PCOS is now made on the basis of the Rotterdam Criteria. At least two of the three symptoms must be present, so a woman may have:
polycystic ‘cysts’ and androgen (male hormone) excess
ovulatory dysfunction and androgen excess
polycystic ‘cysts’ and ovulatory dysfunction
polycystic ‘cysts’, ovulatory dysfunction and androgen excess¹
‘Cysts’ are follicles which have failed to mature.
Weight gain, anxiety and depression are common symptoms
PCOS varies in type and also severity between women. Weight gain is a particular struggle facing many (but not all) women with PCOS.² In addition to the distressing physical symptoms, it is also associated with psychological distress; the risks of anxiety and depression are increased.³ The most effective support is an individualised plan which takes into account a woman’s particular needs.
No specific drug has been developed for PCOS and medications are used ‘off-label’ to address the symptoms of PCOS. There is no cure for PCOS but the condition may be managed by addressing the symptoms. Diet and lifestyle choices are very effective in supporting many of the symptoms of PCOS.
Although the incidence of PCOS rose significantly in the 20th century, the complex condition is not yet fully understood.⁴
It is likely that genetic and environmental influences contribute to the development of the condition.⁵
While we cannot change our genes we can influence them with our diet and lifestyle choices.
Infertility and insulin sensitivity
PCOS is a primary cause of infertility and has previously been considered a condition primarily affecting reproduction. A revised view of PCOS, however, places the endocrine (hormone) system at the centre of its development, with complex interactions between hormones.⁶ In particular, insulin resistance is recognised as a central characteristic of PCOS.⁷
Although research has not identified the single most effective diet for PCOS, a key consideration for dietary choices include food to support weight management and improve insulin sensitivity. Even modest weight loss has been reported to improve many symptoms of PCOS, including reproductive function.²
Although an individualised plan provides the most effective support for a woman with PCOS, there are general recommendations which may be helpful for all women with PCOS.
* To support weight management and to improve insulin sensitivity, focus on foods high in fibre and with a low glycaemic index (such as lentils, chick peas, sweet potato, apples, dried apricots).
* An anti-inflammatory diet cuts out or cuts down foods which promote inflammation (such as sugary and processed foods) and adds in foods which have anti-inflammatory properties (such as oily fish such as salmon, anchovies, herring, sardines or mackerel).
* To improve the body’s defence systems eat foods rich in antioxidants by including fruits and vegetables from all the rainbow colours.
*To support the body’s detoxification, ensure regular bowel habits by keeping well hydrated (drinking approximately 2 litres of water a day) and eating foods high in fibre (such as vegetables and fruit).
* Daily exercise routines are important to support metabolic and mental health. A weekly routine should include aerobic training (such as running or cycling) and resistance exercise (such as weight machines or dumbbells).
* A regular pattern of night time sleep and day time wakefulness establishes the circadian rhythm which supports the rhythms of hormones.
Jane Hickey is a registered nutritional therapist. She practises in Chelmsford and Purleigh, creating individualised plans for clients to support their health and wellbeing.
Moran, L., Ko, H., Misso, M. et al. (2013). ‘Dietary Composition in the Treatment of Polycystic Ovary Syndrome: A Systematic Review to Inform Evidence-Based Guidelines’ Journal of the Academy of Nutrition and Dietetics, 113 (4) pp.520-545.
Faghfoori, Z., Fazelian, S. Shadnoush, M. (2017). ‘Nutritional management in women with polycystic ovary syndrome: A review study’, Diabetic & Metabolic Syndrome: Clinical Research and Reviews, 11 (1) pp.S429-432.
McEwen, B. & Hartmann G. (2018). ‘Insulin resistance and polycystic ovary syndrome: Part 1. The impact of insulin resistance’, Journal of the Australian Traditional-Medicine Society, 24 (4) pp.214-9.
Rodgers, R.J., Suturina L. Lizneva, D. et al. (2019a). ‘Is polycystic ovary syndrome a 20th Century phenomenon?’, Medical Hypotheses, 124 pp.31-34.
Teede, H.J., Misso, M.L., Deeke, A.A. et al. (2011). ‘Assessment and management of polycystic ovary syndrome: summary of evidence-based guidelines’ Medical Journal of Australia, pp.S65-S112.
Walters, K.A., Gilchrist, R.B., Ledger, W.L. et al. (2018). ‘New Perspectives on the Pathogenesis of PCOS: Neuroendocrine Origins’, Trends in Endocrinology and Metabolism, 29 (12) pp.841-852.
Nestler Nestler J. (2008). ‘Metformin for the Treatment of the Polycystic Ovary Syndrome’, The New England Journal of Medicine, 358 (1) pp.47-54.