Got PCOS? What you eat could help ease your symptoms

A PCOS diagnosis can be upsetting – especially if you’re worried it might impact your fertility. Diet and lifestyle changes can make a big difference.

Polycystic ovarian syndrome (PCOS) is a hormonal condition that affects up to 10 per cent of menstruating women.

Causing a range of symptoms, it can be associated with other medical problems, such as reduced fertility and an increased risk of diabetes.

Eating a healthy diet can go a long way in helping to ease symptoms.

But what does a PCOS eating plan look like? Here’s what you will want to know.

What are the symptoms of PCOS?

A diagnosis of PCOS may be made if women experience at least two of these symptoms:

  • Irregular or absent periods
  • Hirsutism (excess hair on the face or body), or high levels of androgens (male-type hormones) shown in a blood test
  • Polycystic ovaries on ultrasound

Other symptoms common with PCOS are acne, hair loss, reduced fertility and weight gain.

Dietitian and reproductive health nutritionist Stefanie Valakas says PCOS is a collection of symptoms, which means it can look different for everyone as not all women will experience the same symptoms or to the same degree.

“For some people, the impact can be quite significant,” Stefanie, founder of The Dietologist, says.

“Some women shave their face every day because of excess hair growth, and it can really affect their body image and self-esteem.

“For others, they kind of forget they have it until their period is late, or they decide they want to get pregnant.”

What causes PCOS?

While the precise causal factor is not known, fertility specialist and gynaecologist Dr Raewyn Teirney says it is believed genetic and environmental factors may be involved.

“What happens is there are raised male hormones called androgens made by the ovary itself,” Dr Teirney says.

“These ovarian androgens then feed back to the brain, affecting what we call hormone secretion from the brain, which feeds back to the follicles in the ovary and affects the follicle and egg growth – it can stop egg growth, leading to all sorts of symptoms that affect women’s daily lives.”

Compounding the problem, around 85 per cent of women with PCOS also have insulin resistance, which causes the body to make more insulin.

“When you’ve got raised insulin, that in turn goes back to the ovary and causes increased androgen – so it’s kind of like a double-effect,” Dr Teirney explains.

How diet and lifestyle can influence PCOS

Diet and lifestyle are considered the number one strategy to begin with to manage PCOS, Stefanie says.

“Insulin and androgen are quite responsive to changing our diet and lifestyle,” she says.

She explains an overall healthy lifestyle – including being physically active, not smoking and avoiding alcohol and sugary drinks – will help manage PCOS symptoms, while a healthy eating plan can assist with managing weight and helping to balance hormones.

“Diet can improve glycaemic markers, androgens and period regularity,” Stefanie says.

“For example, people who are trying to conceive and have ovulation problems, simple dietary changes can improve their fertility and ovulation by 80 per cent.”

When you boost ovulation, she notes, fertility improves.

“If you’re not ovulating once per month like most people with a regular period, you’ve got fewer opportunities per year to potentially conceive,” Stefanie says.

“We’re really trying to bridge that gap to get you more opportunities per year.

“Sometimes that’s with diet alone, sometimes it’s with diet and some medical help – it’s always going to look different for everyone.”

What does a healthy eating plan for PCOS look like?

As PCOS affects everyone differently, Stefanie says there is not a one-size-fits-all dietary approach to managing it.

“However, we know that changing the diet seems to be beneficial overall,” she says.

“That gives us lots of scope to not be too boxed in to one diet with a nice label on it.

“We can be flexible and use key principles to customise a diet and lifestyle approach for each person.”

Stefanie recommends including fresh fruits and vegetables, nuts and seeds, extra virgin olive oil, herbs and spices, wholegrains that are rich in antioxidants, as well as omega-3-rich oily fish.

“We’re usually trying to boost dietary fibre (and) ensure there’s enough quality proteins to maintain muscle mass, and looking at carbohydrates – that doesn’t mean you cut out carbs but actually match it to your lifestyle,” she says, adding that it is useful to look at timing, total amount and type of carbohydrates.

“If you’re somebody who sits at your desk all day, you probably don’t need as much carbohydrate as someone who is active and on their feet all day,” she notes.

What diet is best for managing PCOS?

The low GI diet or Mediterranean diet provides a good starting point for a healthy, balanced approach to eating, but Stefanie says these need to be considered in the context of the individual.

“The Mediterranean diet has lots of benefit in terms of heart health, mental health and weight, but it needs to be modified for PCOS, particularly around carb-load, as it wasn’t really designed for people who are insulin resistant,” she says.

There is good evidence supporting the low GI diet in relation to PCOS, but Stefanie says it is still important to remember the total carbohydrate component.

“The low GI diet has merit, but it needs to be alongside an understanding of how much of those lower GI carbohydrate sources you actually need at different meals and snack times each day.”

Stefanie says low-carbohydrate or keto diets are not recommended for managing PCOS as they are very difficult to sustain, and there is no good evidence a gluten-free diet can benefit PCOS.

“That’s come from social media and grown its own legs and gone for a run,” she says.

“It can potentially create nutrient gaps, and replacing gluten-containing foods with more processed, lower-fibre gluten-free alternatives can create a mismatch in relation to focusing on wholefoods and unprocessed sources of carbohydrates.”

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Written by Claire Burke.