);
Polycystic ovary syndrome (PCOS) is a condition associated with hormonal imbalance in women. With a specific diet for PCOS, weight, insulin resistance and regular periods can be achieved and maintained.

This condition is more common among women of reproductive age between 15 to 44, and according to a study, 70% of women who are not diagnosed with PCOS have this condition. (1) Women with PCOS tend to produce more male hormones and have an imbalance in progesterone and estrogen levels. This hormonal imbalance is causing irregular menstrual cycles, increased facial hair growth, and difficulty conceiving. Furthermore, women with this hormonal imbalance are at increased risk of developing insulin resistance, diabetes, high blood pressure and cardiovascular diseases, but by implementing appropriate lifestyle changes and a specific diet for PCOS, those can be avoided. (2)

Causes

Ovaries are the productive organs in women producing estrogen, progesterone, and androgens controlling the menstrual cycle. Women suffering from PCOS not only have hormonal imbalances but are also more likely to have cysts on the ovaries interfering further with hormone production causing a lack of ovulation. In turn, this lack of ovulation in ovaries is what further alters the production of estrogen, progesterone, FSH, LH and androgens causing menstrual cycle irregularities. Hope you can see how this is somewhat a bit of a vicious cycle happening here.

The exact cause of PCOS is still unclear, but the following are some factors that may cause Polycystic Ovary Syndrome:

According to some studies, it runs in families, and some genes may contribute to the development of PCOS.
Insulin resistance is associated with PCOS. Up to 70% of women with PCOS are insulin resistant. As we start producing more insulin, it triggers the production of androgens in ovaries and results in hormonal imbalance.
Studies have shown that there is a link between increased inflammation and higher levels of androgens. Women with inflammation and extra body weight are more likely to have PCOS. (3)

The most common symptoms are:

Irregular, missed, infrequent, or prolonged periods,
Increased facial hair, or hirsutism.
Acne, especially around the jawline.
Fatigue
Headaches, especially before the period.
Darkening of skin especially on the neck, under the armpits, and the breasts.
Mood swings and many other symptoms. (4)

Risks Associated with PCOS

PCOS is one of the leading causes of infertility in women. It is harder for women with PCOS to get pregnant since they don’t ovulate regularly and don’t release enough eggs to get fertilized.

Up to 80% of women with PCOS are obese or overweight. Being obese with PCOS is associated with higher risks of high blood sugar, insulin resistance, high blood pressure, high bad cholesterol, and low good cholesterol. When all of these conditions are combined there are more chances for progression to diabetes, heart disease, and stroke, but as mentioned earlier implementing lifestyle changes and a specific diet for PCOS the condition can better managed.

Having PCOS also means that we are at a higher risk of developing endometrial cancer. In women with PCOS their uterine wall doesn’t shed like in healthy women causing the uterine lining builds up and increasing the risk of endometrial cancer.

Women with PCOS also have higher chances of developing depression and anxiety. Many of its symptoms such as irregular or prolonged menstrual periods, fatigue, mood swings, weight gain, and excessive facial hair can affect the mood and cause depression. (5)

With so many risk factors listed it is important to start with lifestyle modifications, diet for PCOS, and exercise as soon as possible.

Research shows that the best diet for PCOS management is the one that focuses on managing insulin resistance, maintaining a healthy weight and promoting hormonal balance.

Following a healthy diet such as the Mediterranean diet, or lower carb diet and being physically active can help improve cholesterol levels, lower insulin resistance, lower blood pressure, and blood sugar reducing the risk of diabetes and heart disease. (6)

Firstly a healthy diet for PCOS should include at least 5 servings of fresh fruits and vegetables. An adequate intake of fibre is an absolute must to prevent constipation and balance blood sugar levels. Lower GI carbohydrates, lean meats, fish, good fats, nuts and seeds should also be stapled ingredients in the PCOS diet. Furthermore, processed foods such as processed meats, refined carbohydrates (think of all those delicious pastries and bakery items), fried foods such as French fries or nuggets, and sugary beverages should be consumed sparingly. Those foods should not be used daily as they contribute to blood sugar imbalances, further insulin resistance and inflammation.

Supplements that have been proven to help women with PCOS to better manage their symptoms are berberine, inositol, folates(7), omega 3 fats (8), magnesium, vitamin B12, resveratrol and NAC (9).

Summary

PCOS is a condition associated with a hormonal imbalance. While some women might experience only mild symptoms, others might be experiencing a whole range of symptoms affecting their daily lives. Following a specific diet for PCOS and implementing lifestyle changes have been shown to have a positive effect on the management and prevention of further complications.

Mirela Simic, Nutritionist and PT

References

  1. Boyle J, Teede HJ. Polycystic ovary syndrome – an update. Aust Fam Physician. 2012 Oct;41(10):752-6. PMID: 23210095.
  2. Baptiste CG, Battista MC, Trottier A, Baillargeon JP. Insulin and hyperandrogenism in women with polycystic ovary syndrome. J Steroid Biochem Mol Biol. 2010;122(1-3):42-52. doi:10.1016/j.jsbmb.2009.12.010
  3. Prapas N, Karkanaki A, Prapas I, Kalogiannidis I, Katsikis I, Panidis D. Genetics of polycystic ovary syndrome. Hippokratia. 2009;13(4):216-223.
  4. Ndefo UA, Eaton A, Green MR. Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. P T. 2013;38(6):336-355.
  5. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol. 2013;6:1-13. Published 2013 Dec 18. doi:10.2147/CLEP.S37559
  6. Mirabelli M, Chiefari E, Arcidiacono B, Corigliano DM, Brunetti FS, Maggisano V, Russo D, Foti DP, Brunetti A. Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases. Nutrients. 2020 Apr 12;12(4):1066. doi: 10.3390/nu12041066. PMID: 32290535; PMCID: PMC7230471.
  7. Regidor PA, Schindler AE, Lesoine B, Druckman R. Management of women with PCOS using myo-inositol and folic acid. New clinical data and review of the literature. Horm Mol Biol Clin Investig. 2018 Mar 2;34(2):/j/hmbci.2018.34.issue-2/hmbci-2017-0067/hmbci-2017-0067.xml. doi: 10.1515/hmbci-2017-0067. PMID: 29498933.
  8. Oner G, Muderris II. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J Obstet Gynaecol. 2013 Apr;33(3):289-91. doi: 10.3109/01443615.2012.751365. PMID: 23550861.
  9. Günalan E, Yaba A, Yılmaz B. The effect of nutrient supplementation in the management of polycystic ovary syndrome-associated metabolic dysfunctions: A critical review. J Turk Ger Gynecol Assoc. 2018;19(4):220-232. doi:10.4274/jtgga.2018.0