Nutritional Help for Polycystic Ovary Syndrome (PCOS)

Paper cutout model of the uterus and ovaries with small cysts on right ovary and the letters PCOS, depicting polycystic ovarian syndrome.

Like numerous other “adult” diseases now seen in children due to the obesity epidemic, PCOS is being seen more frequently in adolescents. To clarify, PCOS is not always associated with obesity, nor does it always cause ovarian cysts. It is considered a metabolic disorder that affects hormone levels and ovarian function, leading to menstrual and infertility issues. 

Did you know that nutrition can have a positive impact on this condition? Taking measures to improve your health is empowering. The first step is education. This information is intended to complement other treatments and recommendations from your doctor.

Let’s take the first step!

The Facts

According to the World Health Organization (WHO), PCOS is the most common cause of anovulation among women globally and a leading cause of infertility, affecting 10-13% of reproductive-aged women.

PCOS is a constellation of findings. These include the following, but not all are typically present.

Ovarian dysfunction with irregular menses

Hirsutism - excess hair growth in a male pattern from high androgens, or hair loss

Acne

Multiple cysts on the ovaries

Insulin resistance/high insulin levels

Obesity

Metabolic syndrome

A schematic showing multiple causes and effects of insulin resistance which can lead to PCOS and other diseases.

Women with PCOS are at higher risk for:

Type 2 diabetes

Lipid abnormalities

Heart disease

Infertility, mostly due to a lack of ovulation

Vitamin D deficiency

Insulin resistance is at the core of this syndrome. High insulin leads to hyperandrogenism (high levels of androgens or male hormones) and problems with ovulation. Too much insulin adversely affects the work of the ovaries. 

The good news? High insulin levels are responsive to changes in diet. 

Since excess insulin leads to more androgen production, lowering insulin levels can lower male hormone levels and increase estrogen levels. Lowering androgens can improve hirsutism, acne, and alopecia (hair loss). Improving estrogen levels can help with irregular menses and potentially improve fertility. 

Many teens with PCOS have insulin resistance with high insulin levels. During puberty, weight gain and body fat increase due to rapid growth. Sometimes this is in excess, leading to insulin resistance. This leads to more androgen production and irregular periods. The high insulin and androgen levels also interfere with regulation of the puberty hormones from the pituitary gland in the brain.

How Do We Counteract This?

Nutrition can enhance other treatments for PCOS and excess insulin.

Proper nutrition will contribute to:

Weight loss

Lowered insulin levels and improved insulin sensitivity

Reduced androgen levels

Improved hormone-binding carrier proteins

Improvement of ovarian function

Reduced risk of infertility

Better hormone balance

Carbohydrates are converted in the blood to glucose (sugar), which triggers insulin production.

Since insulin levels react to the carbohydrates and starches we eat, we choose fewer and better carbohydrates.

What Makes a Carbohydrate Better?

Complex - from whole grains

Unprocessed - in its most natural form

Contains natural sugars

Has a low glycemic index (GI) - doesn’t raise blood sugar rapidly

Contains fiber

Where Do I Find These?

Whole, non-starchy fruit and vegetables 

Non-starchy vegetables such as

• leafy greens (arugula, collards, spinach, kale, escarole, endive, lettuce, radicchio, Swiss chard, etc.), 

• artichoke, asparagus, bok choy, broccoli, cabbage, cauliflower, celery, cucumbers, eggplant, fennel, green beans, peppers,  mushrooms, okra, onions, peppers, radishes, snow peas, tomatoes, turnips, water chestnuts, and zucchini.

Non-starchy fruits (fresh, not dried)

• berries (strawberries, blueberries, blackberries, raspberries),

• citrus fruits (oranges, tangerines, lemons, grapefruit), 

• melons (cantaloupe, watermelon),

• stone fruit (peaches, plums, cherries, kiwi, nectarines, apricots, avocado, olives), apples, and pears.

  
  

  Eating whole fruit for dessert provides fiber, which aids digestion and slows sugar absorption. 

  
  

  Most of the above are also low-glycemic foods. These food lists do not cover all options.

Whole grains - whole wheat items (bread, crackers, pasta), quinoa, barley, farro, old-fashioned oats, brown rice

Whole grains that are minimally processed, such as 

• brown rice, barley, sorghum, and others. 

• Pastas made from whole grains, whole wheat, or vegetables. 

• Whole grain breads, sourdough, rye, and pumpernickel. 

• Wheat tortillas. 

• Oatmeal, oat bran, and rice bran cereals.

Dietary fiber is a vital component for managing blood sugar and insulin levels. Increasing dietary fiber can help to improve insulin sensitivity and hormonal balance. A lack of fiber can worsen insulin sensitivity in PCOS.

The foods listed above, along with legumes, nuts, and seeds, will also provide sources of fiber.

Other Foods for PCOS:

• Omega-3-rich fish, such as salmon, tuna, shrimp, and trout (not fried or breaded), and other seafood

• Olive and avocado oil instead of butter or margarine

• Beans and other protein-rich legumes (can be used in recipes instead of meat)

• Nuts, seeds, and nut butters with no added sugar

• Plain Greek yogurt

• Lean meats like chicken, turkey, grass-fed beef, lamb, and pork

• Eggs and egg whites

• Tofu

Some recommendations include minimizing animal products and focusing on plant-based foods, but getting adequate protein is a priority.

Avoid these high-glycemic foods:

• Fried foods, including French fries, chips, fried meats, and fish

• Saturated fats, such as butter or margarine, or from processed foods

• Processed snacks: cakes, pies, cookies, candies, donuts, pastries

• Cereals high in sugar, including instant oatmeal and granola

• Sugary beverages such as sodas, teas, sports drinks, and dessert coffees

• Refined flour, white bread, rolls, pizza crust, and pasta

• White rice

A variety of low-glycemic foods including fruit, vegetables, whole grains, dairy, legumes, nuts, and seeds.

A low glycemic index (GI) diet is typically high in dietary fiber, resulting in lower post-meal sugar levels, stable blood sugar and insulin levels, and a gradual reduction in androgen levels. All this without medication.

You can begin tackling these issues now, simply by changing your eating patterns. Take charge of your health and be an advocate for yourself.