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PCOS, Nutrition, and Your Health

Katie Horrell, MS, RDN
What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a hormonal condition characterized by having at least two out of the three following symptoms: elevated androgens (aka. male sex hormones), an irregular hormone cycle, or an ultrasound indicating cysts on the ovaries. One of the most confusing things about the PCOS diagnosis is in the name. A woman may not even have cysts on her ovaries when diagnosed with Polycystic Ovary Syndrome.  Elevated male sex hormones, like testosterone, and an irregular cycle can meet the technical diagnostic criteria.  Two women with PCOS can face different, prominent symptoms.

What are the symptoms of PCOS?
  •      Hirsutism (excess hair growth on the face and body)
  •      Weight gain
  •      Thinning hair
  •      Irregular menstrual cycle
  •      Mood changes
  •      Pelvic pain (apart from the menstrual phase of the a woman’s cycle)
  •      Acne
  •      Chronic fatigue

The symptoms listed above do not necessarily mean a person has a PCOS diagnosis. Talk to your doctor or gynecologist if you suspect any issues with your hormones and would like to have your hormones tested. If you have recently been diagnosed, you may be wondering if there’s anything you can change in your diet to help manage your symptoms. There are a handful of dietary changes that can impact hormones, as well as options your doctor or gynecologist can discuss with you. Let’s discuss, from a nutrition standpoint, what you can do to help your hormones today.

A Quick View: Hormones Influencing PCOS

In short, there is still much research to be done in the realm of PCOS.  A few terms you might come across in your research are: Androgens, Insulin, and Progesterone. These are the particular hormones that get skewed in individuals with PCOS, resulting in the symptoms mentioned above. Let’s first review what those terms mean:

A few PCOS terms:
  •      Androgens: Androgens are commonly known as male sex hormones but are also present in females in smaller amounts. When androgens, like testosterone, DHT, and DHEA, are elevated, this can lead to symptoms including acne, hirsutism, and thinning hair.  
  •      Insulin: Insulin allows the body to absorb glucose (blood sugar) for energy. PCOS is commonly correlated with insulin resistance, which can increase risk of Type 2 Diabetes. Balancing blood sugar is one of the more “controllable” dietary interventions for PCOS, which we’ll talk more about below.
  •      Progesterone: Progesterone is a hormone that peaks after ovulation and lowers before menstruation. If Progesterone is off, and this peak does not occur, a woman’s cycle can get disrupted  leading to irregular periods.
Nutrition Recommendations

Full disclaimer, we CAN’T totally control all the hormones in our body. Genetics and other factors play a role in our hormonal predispositions. That said, what we CAN do is improve the symptoms of PCOS by tailoring nutrition to balance blood sugar and insulin and manage these particular hormones through helping our body naturally excrete waste (e.g. excess hormones).

In PCOS, due to hormonal fluctuations, it is common to experience frequent cravings for carbohydrate-rich foods. Research indicates that focusing on high fiber, whole grain carbohydrates is more helpful for management of cravings as opposed to strictly reducing carbs. Need another reason to go high fiber? Fiber is good for “regularity” which naturally helps us excrete excess waste products the body doesn’t need (e.g. excess androgens). Furthermore,  due to a propensity for insulin resistance, women with PCOS are commonly recommended a diet similar to that for diabetics: Carb controlled (spacing out carbohydrates evenly throughout the day), and small, frequent meals to balance blood sugars.

When reading labels, look for low-added sugar in packaged foods and beverages. The recommendations for added sugar for Americans is below 10% of calories each day (or about 200 calories in a 2,000 calorie diet.) For individuals with PCOS, aiming for even lower amounts of added sugar by swapping out sugar for calorie-free sweetener is one option, but the absolute best way to cut back on sugar is incorporating more whole foods in your diet!

You might also be wondering if there are any supplements recommended for PCOS. Small research samples have found potential benefits in taking Omega-3 supplements and Vitamin D for reducing common PCOS symptoms. Spearmint tea has also been shown in a few studies to help lower androgen levels. Remember to look for a high quality supplement and check with your doctor before taking anything new.

Be wary of diets promising quick fixes, instant results, or complete “control” over symptoms. The truth is there is no quick fix to balancing your hormones, and it takes time, patience and listening to your body to figure out what works best for you. Talk to your doctor or Registered Dietitian if you have questions on how to build a PCOS-friendly meal plan, and then Noom can help you make the changes you need to make!