Polycystic Ovary Syndrome (PCOS) is a common complex hormonal condition which affects how the ovaries work. Lifestyle choices such as the type and amount of food you eat, as well as the activity you do, can improve symptoms. This Food Fact Sheet will look at PCOS and how to manage it with lifestyle changes.
PCOS is a syndrome (a collection of symptoms) which affects millions of people in the UK – up to one in ten people with ovaries. Having two or more of the following signs and symptoms can lead to being diagnosed with PCOS:
Other common symptoms of PCOS include:
Many of these symptoms are related to high hormone levels such as androgens and insulin. Insulin is a hormone which helps the body use energy from food. Up to 80 per cent of people with PCOS are resistant to the effects of insulin and thus have more insulin in their blood to compensate. Insulin also increases testosterone levels. Although testosterone is often thought of as a male hormone, all women need a small amount. Having even slightly higher levels of testosterone can upset the balance of hormones in the body and lead to acne, excess hair and irregular periods.
Long term health concerns associated with PCOS include heart disease and diabetes, particularly if you have any of the following:
The symptoms of PCOS can be controlled using a combination of lifestyle changes, cosmetic measures (such as threading and waxing or permanent hair-reduction techniques for the removal of unwanted hair) and medication. Although you may have read about various fad diets for managing PCOS, international guidelines recommend adopting healthy lifestyle behaviours, including healthy eating and regular activity. However there is not one way of eating that’s best for PCOS. A dietitian can support you with creating healthy lifestyle habits tailored to you, which will help manage your PCOS symptoms.
There are some general nutrition principles which can help improve PCOS symptoms.
Eating regularly helps keep blood sugar levels stable, reducing insulin resistance. Having regular, varied, and balanced meals or snacks is a great place to start in achieving a healthy diet.
Glycaemic Index (GI) is a ranking system, showing how quickly your blood sugar rises after eating different carbohydrates. Low GI diets, choosing mostly low or moderate GI foods which cause your blood sugar levels to rise slowly, can be useful to reduce the symptoms of PCOS. This is because eating low GI foods can improve insulin levels and reduce insulin resistance.
You may find swapping some high GI foods for low GI foods helpful, as it has been shown low GI diets improve the body’s ability to respond to insulin in people with PCOS. Eating low GI foods is also linked with having more regular periods. Many wholegrains have a low GI.
Having balanced meals and snacks can also improve insulin levels as adding protein and fats to low GI carbohydrates can reduce the impact of the whole meal on blood sugar levels. This is called glycaemic load (GL). Having balanced meals means including protein rich foods, healthy fats, and lots of low GI fruits or vegetables, as well as high fibre, low GI carbs. This also helps keep you fuller for longer and reduces cravings.
Oily fish is a rich source of omega-3 fats which can help lower inflammation commonly seen in those with PCOS. Aim for one to two portions a week of oily fish. Try to include some plant-based sources of omega-3 such as seaweed, algae, chia and flaxseeds, and walnuts.
If you are trying to conceive, it is particularly important that you have enough nutrients in your diet, and also take a folic acid supplement. Speak to your doctor or dietitian about this.
PCOS can affect people of all sizes. If you are living with overweight, some weight loss may improve PCOS symptoms, however this can be challenging for many people with PCOS. Insulin resistance, food cravings and binge eating can make weight loss with PCOS hard. It is important not to follow fad or restrictive diets. Instead try to focus on what to include in your diet, and trying the ideas above is a good place to start. The most important thing is finding something which suits your lifestyle without missing out on important foods or nutrients.
There are many benefits to be gained from being physically active but the most relevant to PCOS is that it improves your body’s response to insulin. Many types of movement have been shown to support PCOS management. These include strength/resistance training, cardiovascular and HIIT training as well as more gentle forms of movement like yoga. It’s important to find something that you enjoy and can fit into your lifestyle. Guidelines suggest aiming for 150 minutes per week of moderate intensity activity or 75 minutes per week of more vigorous activity, and including some strength/resistance training twice a week.