Key Takeaways

PCOS is a common disorder with complex causes. Its symptoms can affect your fertility, hair, skin, and body weight.

PCOS is best managed by following a PCOS-friendly diet. Get started today by downloading this free 3-Day Meal Plan. Or join my free 30-Day PCOS Diet Challenge for a more comprehensive experience.

See your primary care physician if you suspect you may have PCOS. They can provide both a diagnosis and treatment options for managing your symptoms.

Polycystic ovary syndrome (PCOS) is a term used to describe a confusing collection of symptoms. It’s a metabolic and hormone disorder that affects around 6 to 12% of women of childbearing age.

What most of these women don’t know is that diet and lifestyle changes can be used to keep this syndrome in check. As a Nutritionist with PCOS, I’ve done it myself. Using the latest evidence-based information and proven practical tools, my free PCOS food plans have now helped over 100,000 other women too.

My free 30-Day PCOS Diet Challenge and my free 3-Day PCOS meal plan are great first steps towards taking back control of your health and fertility.

What is PCOS and How to Get Diagnosed

For decades, experts have disagreed about how best to diagnose polycystic ovary syndrome. However, the most up-to-date recommendation is to use the modified Rotterdam Consensus [1, 2]. These require two of the following three criteria:

• Irregular or absent periods
• Elevated androgen levels
• The presence of polycystic ovaries (seen via ultrasound)

Because only two out of three criteria are needed, there are four sub-types of PCOS:

Women with Frank PCOS have the greatest metabolic health risks. By comparison, PCOS women with normal androgen levels have fewer health risks [3, 4]. The Ovulatory PCOS sub-type shows that you can still have PCOS even if you have a regular period. And despite the confusing name, the non-PCO subtype shows that you can still have PCOS and not have polycystic ovaries!

It’s worth noting also, that despite the common perception, your body weight is not part of the diagnostic criteria. Many doctors only suspect PCOS in the case of overweight patients. This means that lean women are more likely to have their diagnosis missed. This is what happened to me and many other women I meet through my free 30-Day PCOS Diet Challenge.

The other important thing to keep in mind is that the Rotterdam criteria are used by doctors and medical researchers. But they’re not that useful from a patient’s perspective. That’s why many people are drawn to the four types of PCOS used in naturopathic medicine. These alternative sub-types of PCOS tend to focus more on the underlying drivers of your symptoms.

Common PCOS Symptoms

PCOS adversely affects hormonal balance. This can result in a wide range of seemingly disparate symptoms. The most common signs of PCOS include:

• Irregular or absent periods
• Heavy or painful bleeds
• Difficulty losing weight (and keeping it off)
• Unwanted hair growth, especially on the face
• Thinning hair or hair loss (sometimes male-pattern baldness)
• Oily skin, acne, and eczema
• Dark skin patches in the neck, groin, or under the breast
• Insomnia
• Anxiety and depression

Associated Health Risks

Understandably, the symptoms of PCOS can cause low self-esteem and dissatisfaction. But it’s the associated health risks that often drive people to take action. A lot of the women who join my free 30-Day PCOS Diet Challenge do so for their families. They want to be healthy so they can take better care of their loved ones.

PCOS is a metabolic disorder. This means that women with PCOS have increased risks of type 2 diabetes, heart disease, and some forms of cancer [5].

But because it’s a metabolic disorder, this also means there’s a lot you can do about PCOS yourself. Even if they disagree on the details, almost all experts advise that diet and lifestyle interventions should be the first treatment prescribed for managing PCOS.

PCOS and Pregnancy

Between 70 and 80% of women with PCOS have trouble falling (or staying) pregnant [6, 7]. That’s because PCOS:

• Impairs ovulation and reduces egg quality [8-11].
• Makes the womb less receptive during implantation [12, 13].
• Increases the risk of miscarriage by 40-60% [14-16].

Being overweight is one of the main causes of these issues [10, 17-19]. Although infertility affects lean women with PCOS too. Somewhat ironically, this is good news. Because this is a problem that can be addressed through diet and lifestyle interventions. We’ve seen this in scientific studies [20]. It’s also something we witness daily within my PCOS community. Just take a look at these PCOS pregnancy success stories and learn more about getting pregnant with PCOS here.

PCOS and Body Weight

PCOS makes it hard to lose weight and easy to gain it [21, 22]. That’s why more than half of women with this syndrome are considered overweight [23].

Insulin resistance is the primary mechanism that causes PCOS weight gain. This is where your cells are less capable of processing glucose. Over time, insulin resistance causes higher rates of body fat accumulation [24-26].

But like infertility, this is a problem that can be fixed with the right information and support. That’s what these PCOS weight loss success stories show. Switching to the right diet for PCOS can help you lose weight, even when all previous diets have failed you.

Learn how to lose weight with PCOS here.

What Causes PCOS?

The causes of PCOS are complex. Some experts argue that the high prevalence of this syndrome, along with many other chronic illnesses, is a consequence of our modern environments [27].

Estimates suggest that approximately 70% of PCOS has a genetic basis [28]. But we also know that it’s triggered during gestation by imbalances in the womb [29-32]. Chemical or biological toxicant exposure, for example, plays an important role in fetal programming of PCOS [33, 34].

Your diet, lifestyle, and environment also drive the development of PCOS [35, 36]. Especially during your teens. The negative impact of an unhealthy diet and lifestyle on PCOS has been well-established in the scientific literature [37]. More specifically, an unhealthy gut microbiome can account for all three PCOS diagnostic criteria [13, 38].

But this isn’t all bad news. The fact that PCOS is made worse by a poor diet and lifestyle, and an unhappy gut, speaks to the reversibility of this syndrome.

How to Treat PCOS

Medical treatment of PCOS is largely restricted to treating the presenting symptoms.

Birth control is the most common treatment given to women with PCOS. That’s because this treatment strategy is to override your hormonal imbalances. But using birth control for PCOS is not without its risks. I explain more here.

Metformin is another common treatment for PCOS. That’s because metformin improves insulin sensitivity, which in turn, can help restore hormone balance. Metformin is prescribed to help with weight management and to lower the risk of developing diabetes. It’s also used to improve menstruation and to help treat PCOS infertility.

Unfortunately, the weight of scientific evidence does not support the use of metformin for these purposes. As explained in more detail here, since 2018, experts have recommended against the use of metformin as a PCOS treatment for “any indication”.

In my view, you’re much better off taking myo-inositol and/or berberine which work just as well.

Spironolactone is another medicine that is commonly used off-label for the treatment of PCOS acne, hair loss, and hirsutism. Spironolactone lowers androgen levels, which can help relieve PCOS symptoms. However, the FDA has put a black box warning on this medicine due to concerns that it may cause tumors.

Diet & Lifestyle Changes

PCOS symptoms are predominantly caused by insulin resistance and chronic inflammation [37, 39-44]. This is great news for anyone wanting to treat PCOS naturally. That’s because both of these mechanisms can be dialed up or down by your diet and lifestyle.

The best diet for PCOS reduces inflammation and improves blood sugar regulation. Healing the gut is a core part of this process.

Download a free 3-Day PCOS meal plan here to see what this looks like in real life.

You can also take a bolder step forward by completing my free 30-Day PCOS Diet Challenge. During this event, you’ll join a supportive community of like-minded women. You’ll also receive meal plans, recipes, shopping lists, video lessons, and more.

There are also many dietary supplements and herbal medicines that can also relieve your symptoms. In many cases, these are just as effective as pharmaceutical solutions.

For example, I recommend that all of my clients consider supplementing with vitamin D and magnesium. That’s because the risk of inadequacy is high for these essential nutrients. But from a therapeutic perspective, myo-inositol is one of the most well-studied PCOS supplements. As explained here, myo-inositol is great for fertility and is an equally powerful substitute for metformin. Berberine also has pharmaceutical-level effects for the management of insulin resistance.

When to See a Doctor

If you suspect you may have PCOS, it’s best to see a doctor. Getting a formal diagnosis is helpful for managing your long-term health risks. Your doctor can also advise on your reproductive health. This is especially important if you intend to start a family in the future.

The Bottom Line

Common symptoms of PCOS include irregular periods, and challenges with your weight, skin, and hair. This syndrome has a significant impact on fertility. It also presents increased metabolic and cardiovascular health risks.

Medical treatments can relieve the symptoms of PCOS. But many women with this syndrome are able to manage their symptoms through diet and lifestyle interventions alone. Become one of these women today by joining my free 30-Day PCOS Diet Challenge here. Or download this free 3-Day meal plan to get started.

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References

¹Christ, J.P. and M.I. Cedars, Current Guidelines for Diagnosing PCOS. Diagnostics (Basel), 2023. 13(6).

²Teede, H.J., et al., Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod, 2018. 33(9): p. 1602-1618.

³Clark, N.M., et al., Prevalence of Polycystic Ovary Syndrome Phenotypes Using Updated Criteria for Polycystic Ovarian Morphology: An Assessment of Over 100 Consecutive Women Self-reporting Features of Polycystic Ovary Syndrome. Reproductive Sciences, 2014. 21(8): p. 1034-1043.

⁴Sachdeva, G., et al., Comparison of the Different PCOS Phenotypes Based on Clinical Metabolic, and Hormonal Profile, and their Response to Clomiphene. Indian J Endocrinol Metab, 2019. 23(3): p. 326-331.

⁵Daniilidis, A. and K. Dinas, Long term health consequences of polycystic ovarian syndrome: a review analysis. Hippokratia, 2009. 13(2): p. 90-2.

⁶Melo, A.S., R.A. Ferriani, and P.A. Navarro, Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo), 2015. 70(11): p. 765-9.

⁷Joham, A.E., et al., Prevalence of infertility and use of fertility treatment in women with polycystic ovary syndrome: data from a large community-based cohort study. J Womens Health (Larchmt), 2015. 24(4): p. 299-307.

⁸Patil, K., et al., Compromised Cumulus-Oocyte Complex Matrix Organization and Expansion in Women with PCOS. Reprod Sci, 2021.

⁹Chang, R.J. and H. Cook-Andersen, Disordered follicle development. Mol Cell Endocrinol, 2013. 373(1-2): p. 51-60.

¹⁰Palomba, S., J. Daolio, and G.B. La Sala, Oocyte Competence in Women with Polycystic Ovary Syndrome. Trends Endocrinol Metab, 2017. 28(3): p. 186-198.

¹¹Patel, S.S. and B.R. Carr, Oocyte quality in adult polycystic ovary syndrome. Semin Reprod Med, 2008. 26(2): p. 196-203.

¹²Giudice, L.C., Endometrium in PCOS: Implantation and predisposition to endocrine CA. Best Pract Res Clin Endocrinol Metab, 2006. 20(2): p. 235-44.

¹³Shan, H., et al., Abnormal Endometrial Receptivity and Oxidative Stress in Polycystic Ovary Syndrome. Front Pharmacol, 2022. 13: p. 904942.

¹⁴Luo, L., et al., Early miscarriage rate in lean polycystic ovary syndrome women after euploid embryo transfer – a matched-pair study. Reprod Biomed Online, 2017. 35(5): p. 576-582.

¹⁵Sha, T., et al., A meta-analysis of pregnancy-related outcomes and complications in women with polycystic ovary syndrome undergoing IVF. Reprod Biomed Online, 2019. 39(2): p. 281-293.

¹⁶Matorras, R., et al., Polycystic ovarian syndrome and miscarriage in IVF: systematic revision of the literature and meta-analysis. Arch Gynecol Obstet, 2022.

¹⁷Schulte, M.M., J.H. Tsai, and K.H. Moley, Obesity and PCOS: the effect of metabolic derangements on endometrial receptivity at the time of implantation. Reprod Sci, 2015. 22(1): p. 6-14.

¹⁸Gonzalez, M.B., et al., Inflammatory markers in human follicular fluid correlate with lipid levels and Body Mass Index. J Reprod Immunol, 2018. 130: p. 25-29.

¹⁹Broughton, D.E. and K.H. Moley, Obesity and female infertility: potential mediators of obesity’s impact. Fertil Steril, 2017. 107(4): p. 840-847.

²⁰Abdulkhalikova, D., et al., The Lifestyle Modifications and Endometrial Proteome Changes of Women With Polycystic Ovary Syndrome and Obesity. Front Endocrinol (Lausanne), 2022. 13: p. 888460.

²¹Sam, S., Obesity and Polycystic Ovary Syndrome. Obes Manag, 2007. 3(2): p. 69-73.

²²Lim, S., et al., Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study. BMC Endocr Disord, 2019. 19(1): p. 106.

²³Deswal, R., et al., The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci, 2020. 13(4): p. 261-271.

²⁴Zeng, X., et al., Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity. Clin Chim Acta, 2020. 502: p. 214-221.

²⁵Bannigida, D.M., B.S. Nayak, and R. Vijayaraghavan, Insulin resistance and oxidative marker in women with PCOS. Arch Physiol Biochem, 2020. 126(2): p. 183-186.

²⁶Petersen, M.C. and G.I. Shulman, Mechanisms of Insulin Action and Insulin Resistance. Physiol Rev, 2018. 98(4): p. 2133-2223.

²⁷Naviaux, R.K., Perspective: Cell danger response Biology-The new science that connects environmental health with mitochondria and the rising tide of chronic illness. Mitochondrion, 2020. 51: p. 40-45.

²⁸Vink, J.M., et al., Heritability of polycystic ovary syndrome in a Dutch twin-family study. J Clin Endocrinol Metab, 2006. 91(6): p. 2100-4.

²⁹Tata, B., et al., Elevated prenatal anti-Mullerian hormone reprograms the fetus and induces polycystic ovary syndrome in adulthood. Nature Medicine, 2018. 24(6): p. 834-+.

³⁰Filippou, P. and R. Homburg, Is foetal hyperexposure to androgens a cause of PCOS? Human Reproduction Update, 2017. 23(4): p. 421-432.

³¹Raperport, C. and R. Homburg, The Source of Polycystic Ovarian Syndrome. Clinical Medicine Insights-Reproductive Health, 2019. 13.

³²Fenichel, P., et al., Which origin for polycystic ovaries syndrome: Genetic, environmental or both? Annales D Endocrinologie, 2017. 78(3): p. 176-185.

³³Hewlett, M., et al., Prenatal Exposure to Endocrine Disruptors: A Developmental Etiology for Polycystic Ovary Syndrome. Reproductive Sciences, 2017. 24(1): p. 19-27.

³⁴Akgul, S., et al., THE ROLE OF ENDOCRINE DISRUPTORS IN THE AETIOPATHOGENESIS OF ADOLESCENT POLYCYSTIC OVARY SYNDROME. Journal of Adolescent Health, 2019. 64(2): p. S128-S129.

³⁵Puttabyatappa, M., R.C. Cardoso, and V. Padmanabhan, Effect of maternal PCOS and PCOS-like phenotype on the offspring’s health. Molecular and Cellular Endocrinology, 2016. 435(C): p. 29-39.

³⁶Bremer, A.A., Polycystic Ovary Syndrome in the Pediatric Population. Metabolic Syndrome and Related Disorders, 2010. 8(5): p. 375-394.

³⁷Barrea, L., et al., Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev, 2018. 31(2): p. 291-301.

³⁸Tremellen, K. and K. Pearce, Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome. Med Hypotheses, 2012. 79(1): p. 104-12.

³⁹Carvalho, L.M.L., et al., Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review. Endocr Regul, 2018. 52(4): p. 208-221.

⁴⁰González, F., Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids, 2012. 77(4): p. 300-5.

⁴¹González, F., et al., Hyperandrogenism sensitizes mononuclear cells to promote glucose-induced inflammation in lean reproductive-age women. Am J Physiol Endocrinol Metab, 2012. 302(3): p. E297-306.

⁴²Popovic, M., G. Sartorius, and M. Christ-Crain, Chronic low-grade inflammation in polycystic ovary syndrome: is there a (patho)-physiological role for interleukin-1? Seminars in Immunopathology, 2019. 41(4): p. 447-459.

⁴³Rudnicka, E., et al., Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci, 2021. 22(7).

⁴⁴Wang, J., et al., Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sciences, 2019. 236.

The post Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment appeared first on Smart Fertility Choices.

Key Takeaways

Download this free 3-Day PCOS Meal Plan pdf to get started. Or sign up for my 30-Day Challenge and receive a free 30-Day PCOS Meal Plan.

PCOS can be managed with a diet that reduces inflammation and improves blood sugar regulation.

A good PCOS nutrition plan is high-fat, low-carb, and protein-adequate. It emphasizes the importance of non-starchy vegetables and gut-health-supporting foods.

Gluten, dairy, sugar, “vegetable oils”, and processed foods are avoided.

When it comes to managing PCOS with dietary interventions, I have a unique perspective to share with you. That’s because I’m a Nutritionist and I’ve won my own battle with this challenging diagnosis. Using the latest evidence-based information and proven practical tools, my free PCOS food plans have now helped over 100,000 women take back control of their health and fertility.

This free 3-Day PCOS Meal Plan is the easiest way to get started. But my more comprehensive free 30-Day PCOS Diet Challenge brings you into a supportive community of like-minded women. Here, you’ll receive free weekly PCOS meal plans, shopping lists, nutritional video lessons, and much more.

As a companion to these free resources, this article describes what a PCOS diet is and why it’s important.

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is an endocrine disorder that affects roughly 1 in 10 women of childbearing age.

The most common symptoms are irregular menstrual cycles and difficulty with weight loss. Unwanted hair growth, thinning hair, and acne are also commonly caused by high testosterone levels. Your healthcare provider is likely to make several checks before confirming your diagnosis. These include using ultrasound to look for multiple ovarian cysts and blood tests to assess your hormone levels.

How Diet Affects Your PCOS Symptoms

An unhealthy diet is one of the key causes of PCOS [10]. More specifically, imbalances within the gut microbiome can account for all aspects of a PCOS diagnosis [11, 12]. This is true regardless of which type of PCOS you have.

PCOS is driven by two diet-related mechanisms. Inflammation and poor blood sugar regulation. These mechanisms cause the hormonal imbalance that drives the wide range of common PCOS symptoms and health risks [13-18].

If you’ve ever eaten a food that upsets your stomach, you can be sure it’s damaging your intestinal lining. This causes an inflammatory response which then makes all PCOS symptoms worse. Starchy and sugary foods that raise blood sugar levels quickly are also a problem. These readily digested carbohydrate-rich foods result in elevated insulin secretion. When your diet frequently causes high insulin levels, insulin resistance can develop.

Insulin resistance drives weight gain making even modest weight loss exceptionally difficult. It also leads to high blood pressure, high cholesterol levels, and increased heart disease risk. What’s more, insulin resistance exacerbates other PCOS symptoms. This includes challenges with fertility, skin, hair, and mental health. Overweight and obese women are more likely than lean PCOS patients to suffer from insulin resistance.

Here are a few women from my free 30-Day PCOS Diet Challenge who learned how powerful a healthy diet can be for managing PCOS symptoms.

3-Day Starter PCOS Meal Plan

To help you put a PCOS diet into action, I’ve put together a free 3-Day PCOS Diet Plan pdf which you can download here. It includes simple, everyday recipes and a shopping list too. I find that this is the best starting point for people who feel overwhelmed at the prospect of changing their diet. Anyone can do three days!

Comprehensive PCOS 30-Day Meal Plan

If you want a more comprehensive resource, you can sign up for my free 30-Day PCOS Diet Challenge. Each week you’ll receive a free beginner 7-day PCOS diet plan pdf. These menus have been carefully designed to minimize meal prep time. You’ll also receive video lessons, activities, and access to a supportive online community.

This program has launched thousands of women toward better overall health and fertility. You can see many of their success stories here.

Breakfast, Lunch, Dinner, Snack, & Dessert Recipes

Just looking for one-off recipes or PCOS meal ideas? Find 37 PCOS recipes to get you started here.

All of these delicious recipes treat PCOS by addressing the two underlying mechanisms. Inflammation and poor blood sugar regulation. With these nutrient-dense recipes, you’ll see for yourself that you can treat PCOS while still enjoying fantastic food. Even my dessert recipes are healthy.

Food to Eat for PCOS

The best foods to eat for PCOS meet at least one of three criteria. They’re good for blood sugar regulation, they promote better gut health, or they reduce inflammation.

The combination of fat, protein, and carbohydrate-rich foods is key for getting blood sugar regulation right. Women with PCOS generally see the best outcomes with a low-carb, high-fat, moderate-protein diet. Getting up to 60% of calories from whole food sources of fat is a powerful way to drive weight loss and reverse insulin resistance. Achieving adequate protein intake also promotes these outcomes [19]. Around 20-30% of energy should come from high-fiber foods that are rich in carbohydrates. High-fiber foods tend to have a low glycemic index (GI) which helps combat insulin resistance. Learn more about a low GI diet and the best macros for PCOS here.

Gut health can be improved with foods high in prebiotic fiber and those containing probiotics. Probiotics are live cultures of “good” gut bacteria. Foods high in prebiotic fiber provide the nutrients they need to thrive.

Non-starchy vegetables should be the largest portion on your plate. Non-starchy vegetables improve gut health and help to reduce insulin resistance. They also provide vitamins, minerals, and unique phytonutrients that make them anti-inflammatory foods.

Here are some of the most PCOS-friendly foods. For a more comprehensive list of nutritious foods to include in your PCOS eating plan, download my PCOS Food List PDF.

Foods to Avoid for PCOS

There are several key foods to avoid with PCOS. These are all foods that can impact gut health, inflammation, or blood sugar regulation.

Reducing sugar and readily digested carbohydrates improves blood sugar regulation. To minimize inflammation and improve gut health, it’s best to avoid anything that causes noticeable symptoms. This includes things like acid reflux, bloating, abdominal pain, constipation, and diarrhea. For example, many people see noticeable improvements after eliminating gluten from their diet. Learn more about gluten and PCOS here.

PCOS and dairy, also share a fraught relationship as explained here. It’s not just a matter of lactose intolerance. Many people with PCOS have a sensitivity to milk proteins without being aware of it. Like gluten sensitivity, an undiagnosed dairy intolerance can damage the intestinal wall lining. This drives inflammation and worsens the effects of PCOS.

Processed foods, junk food, and fast food are also best avoided. These foods often contain industrial “vegetable” oils, trans fats, and food additives that cause inflammation. This especially applies to fried foods.

The following foods are best avoided or minimized. For a more comprehensive list, download my Foods to Avoid checklist here.

PCOS Diet vs Other Popular Diets

A PCOS diet is a unique approach to nutrition. But it shares nutritional principles with other evidence-based diets.

For example, a PCOS diet is an anti-inflammatory diet. This makes it similar to the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet [20]. The key problem with the Mediterranean diet for PCOS is that it includes low-fat dairy and gluten. Otherwise, nourishing foods like whole-grain toast are not helpful for PCOS in my experience.

The problem with the DASH diet is that it unnecessarily restricts saturated fat and salt. Studies show that these restrictions are outdated [21, 22]. Saturated fats from whole food sources shouldn’t be excluded from the “healthy fats” category. This reduces the importance of consuming only lean protein foods like skinless chicken breast. For example, there’s now compelling evidence that beef from well-raised animals can be good for human health and the environment [23, 24].

A PCOS diet is rich in plant foods, like a vegetarian or vegan diet for PCOS. But the problem with plant-only diets is that it’s hard to get adequate protein without consuming too many carbs. This is especially important for weight loss or the treatment of insulin resistance. The same “clean” diet, with the addition of whole food sources of animal protein, is likely to result in better health outcomes.

That’s why I prefer my clients include whole food sources of eggs, fish, and seafood. This makes it well suited to people following a PCOS pescatarian diet. The inclusion of whole food sources of meat also makes my recommendations suitable for people wanting a paleo PCOS meal plan. The only thing that makes my PCOS meals not strictly paleo, is the inclusion of healthy whole grains like rice, corn, quinoa, and buckwheat.

A PCOS diet incorporates the high-fat benefits of a keto diet for PCOS without suffering the downsides of this approach. A PCOS diet is easier to follow than a keto diet. This makes it better suited to people who have experienced disordered eating in the past.

Intermittent fasting can also be included within a PCOS diet framework. Research looking at the effects of fasting specifically on PCOS is limited [25-28]. However many non-PCOS studies show the potential for intermittent fasting to further enhance a PCOS diet [29-31]. Limiting your food intake to 8-12 hours per day is safe for most people [31-35]. This doesn’t mean skipping meals. It just means eating your last meal of the day early or delaying breakfast by a few hours. Even if you find you need to have frequent meals to keep your blood glucose levels stable, this can still be accommodated within a healthy fasting regime.

Unlike many fad diets, a PCOS diet is balanced and sensible. It’s designed to be a sustainable lifestyle intervention.

Other Ways to Manage PCOS Symptoms

A healthy diet is one of the best interventions for PCOS. But other evidence-based lifestyle changes are well known to further improve health outcomes.

Addressing vitamin deficiencies is an obvious place to start. Especially vitamin D and magnesium. There are many other nutritional supplements for PCOS, with inositol being the most well-proven.

Both aerobic exercise and resistance training can improve PCOS-related hormonal imbalances [36-39].

Studies show that improving sleep quality can reduce food cravings making it easier to eat well [40, 41].

Stress is a known co-morbidity of PCOS [42]. It increases inflammation and can exacerbate insulin resistance [43, 44]. One study found that the most stressed women were twice as likely to suffer from infertility compared to more relaxed women [45].

The Bottom Line

Diet is a powerful way to manage PCOS symptoms. That’s because it treats the underlying mechanisms. The right diet can influence gut health, insulin levels, and systemic inflammation.

The most important foods to avoid are gluten, dairy, sugar, “vegetable oils”, and highly processed foods. A PCOS diet is whole-food based and rich in non-starchy vegetables. Macronutrients are balanced to optimize blood sugar regulation.

A good PCOS food plan includes the best aspects of other healthy diets. But it overcomes their shortcomings. The right PCOS nutrition plan can help you lose weight and then maintain a healthy weight long term. It can also help overcome all the other associated symptoms of a PCOS diagnosis. This includes infertility.

Take back control of your health and fertility today by joining my free 30-Day PCOS Diet Challenge. This free 3-Day PCOS Meal Plan is also another great way to get started.

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References

¹⁰Barrea, L., et al., Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev, 2018. 31(2): p. 291-301.

¹¹Tremellen, K. and K. Pearce, Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome. Med Hypotheses, 2012. 79(1): p. 104-12.

¹²He, F.F. and Y.M. Li, Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review. J Ovarian Res, 2020. 13(1): p. 73.

¹³Carvalho, L.M.L., et al., Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review. Endocr Regul, 2018. 52(4): p. 208-221.

¹⁴González, F., Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids, 2012. 77(4): p. 300-5.

¹⁵González, F., et al., Hyperandrogenism sensitizes mononuclear cells to promote glucose-induced inflammation in lean reproductive-age women. Am J Physiol Endocrinol Metab, 2012. 302(3): p. E297-306.

¹⁶Popovic, M., G. Sartorius, and M. Christ-Crain, Chronic low-grade inflammation in polycystic ovary syndrome: is there a (patho)-physiological role for interleukin-1? Seminars in Immunopathology, 2019. 41(4): p. 447-459.

¹⁷Rudnicka, E., et al., Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci, 2021. 22(7).

¹⁸Wang, J., et al., Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sciences, 2019. 236.

¹⁹Paddon-Jones, D., et al., Protein, weight management, and satiety. Am J Clin Nutr, 2008. 87(5): p. 1558s-1561s.

²⁰Asemi, Z. and A. Esmaillzadeh, DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: a randomized controlled clinical trial. Horm Metab Res, 2015. 47(3): p. 232-8.

²¹O’Donnell, M., et al., Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med, 2014. 371(7): p. 612-23.

²²Hite, A.H., et al., In the face of contradictory evidence: report of the Dietary Guidelines for Americans Committee. Nutrition, 2010. 26(10): p. 915-24.

²³Provenza, F.D., S.L. Kronberg, and P. Gregorini, Is Grassfed Meat and Dairy Better for Human and Environmental Health? Front Nutr, 2019. 6: p. 26.

²⁴Krusinski, L., et al. Attention to the Details: How Variations in U.S. Grass-Fed Cattle-Feed Supplementation and Finishing Date Influence Human Health. in Frontiers in Sustainable Food Systems. 2022.

²⁵Floyd, R., et al., The Effect of Time-Restricted Eating on Insulin Levels and Insulin Sensitivity in Patients with Polycystic Ovarian Syndrome: A Systematic Review. Int J Endocrinol, 2022. 2022: p. 2830545.

²⁶Chiofalo, B., et al., Fasting as possible complementary approach for polycystic ovary syndrome: Hope or hype? Med Hypotheses, 2017. 105: p. 1-3.

²⁷Han, Y., et al., Time-restricted feeding improves metabolic and endocrine profiles in mice with polycystic ovary syndrome. Front Endocrinol (Lausanne), 2022. 13: p. 1057376.

²⁸Li, C., et al., Eight-hour time-restricted feeding improves endocrine and metabolic profiles in women with anovulatory polycystic ovary syndrome. J Transl Med, 2021. 19(1): p. 148.

²⁹Kang, J., et al., Effect of Time-Restricted Feeding on Anthropometric, Metabolic, and Fitness Parameters: A Systematic Review. J Am Coll Nutr, 2021: p. 1-16.

³⁰Adafer, R., et al., Food Timing, Circadian Rhythm and Chrononutrition: A Systematic Review of Time-Restricted Eating’s Effects on Human Health. Nutrients, 2020. 12(12).

³¹Moon, S., et al., Beneficial Effects of Time-Restricted Eating on Metabolic Diseases: A Systemic Review and Meta-Analysis. Nutrients, 2020. 12(5).

³²Gabel, K., et al., Time-Restricted Eating to Improve Cardiovascular Health. Curr Atheroscler Rep, 2021. 23(5): p. 22.

³³Moro, T., et al., Twelve Months of Time-restricted Eating and Resistance Training Improves Inflammatory Markers and Cardiometabolic Risk Factors. Med Sci Sports Exerc, 2021. 53(12): p. 2577-2585.

³⁴Uldal, S., et al., Is Time-Restricted Eating Safe in the Treatment of Type 2 Diabetes?-A Review of Intervention Studies. Nutrients, 2022. 14(11).

³⁵Anic, K., et al., Intermittent Fasting-Short- and Long-Term Quality of Life, Fatigue, and Safety in Healthy Volunteers: A Prospective, Clinical Trial. Nutrients, 2022. 14(19).

³⁶Almenning, I., et al., Effects of High Intensity Interval Training and Strength Training on Metabolic, Cardiovascular and Hormonal Outcomes in Women with Polycystic Ovary Syndrome: A Pilot Study. PLoS One, 2015. 10(9): p. e0138793.

³⁷Cheema, B.S., L. Vizza, and S. Swaraj, Progressive resistance training in polycystic ovary syndrome: can pumping iron improve clinical outcomes? Sports Med, 2014. 44(9): p. 1197-207.

³⁸Covington, J.D., et al., Higher circulating leukocytes in women with PCOS is reversed by aerobic exercise. Biochimie, 2016. 124: p. 27-33.

³⁹Kogure, G.S., et al., Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome. Med Sci Sports Exerc, 2016. 48(4): p. 589-98.

⁴⁰Blumfield, M.L., et al., Dietary disinhibition mediates the relationship between poor sleep quality and body weight. Appetite, 2018. 120: p. 602-608.

⁴¹Al Khatib, H.K., et al., Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study. Am J Clin Nutr, 2018. 107(1): p. 43-53.

⁴²Benson, S., et al., Disturbed stress responses in women with polycystic ovary syndrome. Psychoneuroendocrinology, 2009. 34(5): p. 727-35.

⁴³Hackett, R.A. and A. Steptoe, Type 2 diabetes mellitus and psychological stress – a modifiable risk factor. Nat Rev Endocrinol, 2017. 13(9): p. 547-560.

⁴⁴Wirtz, P.H. and R. von Känel, Psychological Stress, Inflammation, and Coronary Heart Disease. Curr Cardiol Rep, 2017. 19(11): p. 111.

⁴⁵Lynch, C.D., et al., Preconception stress increases the risk of infertility: results from a couple-based prospective cohort study–the LIFE study. Hum Reprod, 2014. 29(5): p. 1067-75.

The post Nutritionist PCOS Meal Plans (Free PDFs) + Foods to Eat/Avoid appeared first on Smart Fertility Choices.

Key Takeaways

Naturopathic medicine describes four functional types of polycystic ovarian syndrome. Post-pill PCOS, insulin-resistant PCOS, inflammatory PCOS, and adrenal PCOS. Knowing which type you have can help optimize treatment.

The same three underlying factors cause all types of PCOS. Elevated androgen levels, poor insulin regulation, and chronic inflammation. That’s why a PCOS diet is valuable to all women with PCOS.

Get started today with this free 3-Day Meal Plan. Or join my free 30-Day PCOS Diet Challenge for more recipes and support.

In naturopathic medicine, there are four types of PCOS. Identifying which type you have can help guide your treatment. This article (and the quiz at the end) will walk you through the process.

As you’ll discover, a PCOS diet is foundational for health and fertility. This is the case for all types of PCOS. The results from the diverse range of women that complete my free 30-Day PCOS Diet Challenge show this to be true. Download this free 3-Day Meal Plan for a sample of PCOS recipes.

First Check You Meet the Diagnostic Criteria

The first step in identifying which type of PCOS applies to you is checking you actually have PCOS. Polycystic ovarian syndrome comes in all shapes and sizes making it difficult to diagnose. But to have PCOS you must meet at least two of three criteria:

1. Irregular periods
2. Elevated androgens
3. Polycystic ovaries

As you’re about to see, you can meet the diagnostic criteria, and still not have PCOS. But it’s a good place to start.

Rule Out Hypothalamic Amenorrhea

The next thing you want to check is that your “PCOS” isn’t hypothalamic amenorrhea (HA). HA looks a lot like lean-type PCOS, but it’s a different diagnosis from polycystic ovary syndrome. If you’re relatively lean, it’s important to rule this diagnosis out.

Hypothalamic amenorrhea is when the control center of your brain causes your periods to stop. It’s typically caused by excessive exercise, stress, and under-eating.

HA is often confused with lean-type PCOS for several reasons. Women with HA can present with polycystic ovaries. They can also have hair loss, excess hair growth, and other signs of mild hirsutism. It’s more likely in women under 30, but it can happen at any age.

The best way to rule out HA is a blood test for luteinizing hormone and follicle-stimulating hormone. PCOS patients have a high LH to FSH ratio (>1). HA patients, by comparison, have a low LH to FSH ratio (<1) [1].

Treatment for HA is mostly focused on eating more and exercising less. Seeing a mental health professional can also be an important part for many people.

Okay. So, you meet the diagnostic criteria, and you’ve ruled out hypothalamic amenorrhea. Now it’s time to consider the four types of PCOS.

1. Post-Pill PCOS

When looking at the different types of PCOS, it’s important to consider post-pill PCOS.

Post-pill PCOS is where non-PCOS women show PCOS-like symptoms after going off birth control. Despite the name, this type of PCOS isn’t limited to the oral contraceptive pill. All forms of hormonal birth control can cause post-pill PCOS. This includes the Depo-Provera injection and hormonal IUDs like Mirena and Skyla. Vaginal rings, skin, and subcutaneous patches can also cause post-pill PCOS.

If you didn’t experience PCOS symptoms in the past. And they only began when you stopped taking birth control, then it’s likely you have post-pill PCOS.

The good news about this diagnosis is that it’s generally a temporary problem. It’s not actually a form of polycystic ovary syndrome. Post-pill PCOS can resolve on its own.

Anti-androgenic supplements can also help. Spearmint tea and green tea are effective and safe anti-androgens. Other proven herbs for PCOS include red reishi, licorice, and Chinese peony [2]. Saw palmetto extract is also often used as an anti-androgen.

2. Insulin Resistant PCOS

Insulin resistance affects all women with PCOS. Along with poor diet, it’s one of the underlying causes of this syndrome [3, 4]. Even lean PCOS women with normal insulin sensitivity benefit from reducing insulin secretion [5].

But insulin-resistant PCOS is the type of PCOS where insulin resistance is the primary driver of your symptoms. The majority of women with PCOS fit into this category [6, 7]. If you find it particularly difficult to manage your weight, it’s most likely that you have insulin resistance PCOS. But normal-weight women can also have this type of PCOS.

Having a waist-to-hip ratio greater than 0.85 is a simple measure that can indicate insulin resistance in patients with PCOS [8]. But blood testing is the best diagnostic tool.

The best way to treat insulin-resistant PCOS is a lower carbohydrate diet and lifestyle changes. This isn’t just about avoiding high-sugar foods and you don’t need to eat less. Following the best macros for PCOS can sometimes mean eating more. Reducing inflammation can also help you better balance blood sugar levels.

Dietary supplements like inositol, berberine, magnesium, vitamin D, and many others can also be helpful. Learn more about the best PCOS supplements here.

To reverse insulin resistance and improve your health, follow the 15 strategies laid out here. These steps drive weight loss, but they can also help you get pregnant.

3. Inflammatory PCOS

Like insulin resistance, chronic inflammation is a problem for all types of PCOS. It’s one of the underlying drivers of all PCOS symptoms [9-13].

But inflammatory PCOS is the type of PCOS where inflammation is the primary factor. Many insulin-resistant PCOS patients will share the same symptoms as inflammatory type PCOS. But you only have inflammatory PCOS if you don’t have insulin resistance.

The most obvious indicator of inflammatory PCOS is an autoimmune comorbidity. PCOS is closely associated with autoimmunity as explained more here. This includes thyroid disease and rheumatoid arthritis [14-16]. Skin conditions like sclerosis, psoriasis, and eczema are also common signs of inflammation.

Gut-related issues, especially IBS and SIBO, indicate inflammatory PCOS. These need to be treated with the help of a functional medicine or naturopathic doctor.

Blood testing for C-reactive protein can help identify inflammatory PCOS. This biomarker is high in PCOS women independent of body weight [17].

Women with inflammatory PCOS need to pay particular attention to gut health. Balancing gut bacteria and repairing leaky gut tissue are essential objectives of treatment. This means cutting out all the foods to avoid with PCOS. By addressing potential food sensitivities, you can reduce your inflammatory burden. Cutting out gluten, dairy, sugar, and vegetable oils is the most important place to start. Eating more anti-inflammatory foods, fiber, and vegetables can also make a big difference.

In some cases, a low FODMAP or Autoimmune Protocol diet may be appropriate.

4. Adrenal PCOS

Adrenal PCOS should only be suspected once you’ve excluded the other different types of PCOS. It’s caused by exposure to androgen excess in the womb [18, 19]. When coupled with unfavorable environmental factors, this causes an upregulation of the adrenal glands. Too many adrenal androgens are produced resulting in PCOS-like symptoms.

Adrenal PCOS can be identified when DHEA-S levels are the only “male hormone” that’s elevated. You should have normal testosterone and androstenedione levels.

Estimates suggest that high DHEA-S levels affect around 20 – 30% of PCOS patients [20, 21]. But only some of these people will have adrenal PCOS because another type of PCOS will be more dominant.

A naturopathic or functional doctor will treat adrenal PCOS by healing the gut. Diet is critical for balancing gut bacteria and repairing leaky gut tissue. But lowering stress levels is also essential. Many nutritional and herbal products can help support these goals.

The Cause of All Types of PCOS

Knowing which type of PCOS you have can help optimize your treatment. But from a patient’s perspective, there’s a simpler way to understand your diagnosis.

All PCOS symptoms are driven by three underlying mechanisms [4, 11-13, 22, 23]:

• Elevated androgens
• Poor insulin regulation
• Chronic inflammation

Each of these factors exists on a spectrum. If your hair falls out or you have acne or hirsutism, then your androgen dial is turned up. If you have trouble maintaining a healthy body weight, then your insulin regulation is likely to be poor. If you don’t get a regular period, then this could be affected by all three mechanisms.

What’s more, none of these factors are static. Major life events can alter your diagnosis. Birth control, pregnancy, and breastfeeding can all alter your physical symptoms. Trauma, surgery, infections, or toxins can also change your immune and endocrine systems.

This simple understanding of PCOS covers all the various ways this diagnosis manifests.

It also points towards the best approach to treatment.

Same Foundational Treatment for All PCOS Types

Regardless of which type of PCOS you have, a PCOS-friendly lifestyle provides a foundation for better health.

Imbalances in the gut microbiome drive most of the pathology seen in PCOS [24, 25]. An unhealthy diet is also a primary contributor [3]. Together, poor gut health and a bad diet activate all three mechanisms that drive PCOS.

This is why a PCOS diet is a prerequisite to getting your symptoms under control. If you eat poorly, then any other treatment is likely to have limited benefits. You can see the power of diet change alone from the women that complete my free 30-Day PCOS Diet Challenge. I’ve heard from many women who feel better just after trying my free 3-Day PCOS Meal Plan.

Take the Quiz!

The Bottom Line

In naturopathic medicine, there are 4 types of PCOS. Categorizing PCOS into different types helps naturopathic practitioners optimize treatment for their patients.

But from a patient perspective, the best way to understand PCOS is that there are three drivers of all symptoms. Elevated androgens, poor insulin regulation, and chronic inflammation. These factors exist on a spectrum and can change over time.

This is why a PCOS diet is beneficial to everyone. Regardless of your PCOS body type. Start embracing a better diet today with this free 3-Day Meal Plan. Or sign-up here for my free 30-Day PCOS Diet Challenge.

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References

¹Abou Sherif, S., et al., Investigating the potential of clinical and biochemical markers to differentiate between functional hypothalamic amenorrhoea and polycystic ovarian syndrome: A retrospective observational study. Clin Endocrinol (Oxf), 2021. 95(4): p. 618-627.

²Grant, P. and S. Ramasamy, An update on plant derived anti-androgens. Int J Endocrinol Metab, 2012. 10(2): p. 497-502.

³Barrea, L., et al., Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev, 2018. 31(2): p. 291-301.

⁴Wang, J., et al., Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sciences, 2019. 236.

⁵Baillargeon, J.P. and A. Carpentier, Role of insulin in the hyperandrogenemia of lean women with polycystic ovary syndrome and normal insulin sensitivity. Fertil Steril, 2007. 88(4): p. 886-93.

⁶DeUgarte, C.M., A.A. Bartolucci, and R. Azziz, Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril, 2005. 83(5): p. 1454-60.

⁷Legro, R.S., et al., Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab, 1999. 84(1): p. 165-9.

⁸Majumdar, A. and T.A. Singh, Comparison of clinical features and health manifestations in lean vs. obese Indian women with polycystic ovarian syndrome. J Hum Reprod Sci, 2009. 2(1): p. 12-7.

⁹Dimitriadis, G.K., I. Kyrou, and H.S. Randeva, Polycystic Ovary Syndrome as a Proinflammatory State: The Role of Adipokines. Curr Pharm Des, 2016. 22(36): p. 5535-5546.

¹⁰Escobar-Morreale, H.F., M. Luque-Ramírez, and F. González, Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril, 2011. 95(3): p. 1048-58.e1-2.

¹¹González, F., Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids, 2012. 77(4): p. 300-5.

¹²Popovic, M., G. Sartorius, and M. Christ-Crain, Chronic low-grade inflammation in polycystic ovary syndrome: is there a (patho)-physiological role for interleukin-1? Seminars in Immunopathology, 2019. 41(4): p. 447-459.

¹³Rudnicka, E., et al., Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci, 2021. 22(7).

¹⁴Garelli, S., et al., High prevalence of chronic thyroiditis in patients with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2013. 169(2): p. 248-251.

¹⁵Romitti, M., et al., Association between PCOS and autoimmune thyroid disease: a systematic review and meta-analysis. Endocrine Connections, 2018. 7(11): p. 1158-1167.

¹⁶Sharmeen, S., et al., Polycystic ovary syndrome: epidemiologic assessment of prevalence of systemic rheumatic and autoimmune diseases. Clin Rheumatol, 2021. 40(12): p. 4837-4843.

¹⁷Aboeldalyl, S., et al., The Role of Chronic Inflammation in Polycystic Ovarian Syndrome-A Systematic Review and Meta-Analysis. Int J Mol Sci, 2021. 22(5).

¹⁸Abbott, D.H., et al., Fetal programming of adrenal androgen excess: lessons from a nonhuman primate model of polycystic ovary syndrome. Endocr Dev, 2008. 13: p. 145-158.

¹⁹Zhou, R., et al., Adrenal hyperandrogenism is induced by fetal androgen excess in a rhesus monkey model of polycystic ovary syndrome. J Clin Endocrinol Metab, 2005. 90(12): p. 6630-7.

²⁰Yildiz, B.O. and R. Azziz, The adrenal and polycystic ovary syndrome. Rev Endocr Metab Disord, 2007. 8(4): p. 331-42.

²¹Goodarzi, M.O., E. Carmina, and R. Azziz, DHEA, DHEAS and PCOS. J Steroid Biochem Mol Biol, 2015. 145: p. 213-25.

²²Carvalho, L.M.L., et al., Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review. Endocr Regul, 2018. 52(4): p. 208-221.

²³González, F., et al., Hyperandrogenism sensitizes mononuclear cells to promote glucose-induced inflammation in lean reproductive-age women. Am J Physiol Endocrinol Metab, 2012. 302(3): p. E297-306.

²⁴Tremellen, K. and K. Pearce, Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome. Med Hypotheses, 2012. 79(1): p. 104-12.

²⁵Shan, H., et al., Abnormal Endometrial Receptivity and Oxidative Stress in Polycystic Ovary Syndrome. Front Pharmacol, 2022. 13: p. 904942.

The post 4 Types of PCOS & How to Determine Yours (Take the Quiz!) appeared first on Smart Fertility Choices.

Key Takeaways

Nutritional supplements can play a valuable role in the treatment of polycystic ovary syndrome.

This article reviews the 15 most well-proven PCOS supplements based on the latest scientific research.

All supplements for PCOS are better when combined with dietary interventions. Start following a PCOS diet today with this free 3-Day Meal Plan. Or join my free 30-Day PCOS Diet Challenge for a more immersive experience.

A PCOS diet is the best foundational treatment for managing PCOS. But dietary supplements can help a lot too. The challenge here is sorting the wheat from the chaff. The 15 supplements described below are the most well-supported by solid scientific evidence.

1. Myo-inositol

Of all the many PCOS supplements, inositol is one of the best. Ovasitol by Theralogix is the leading brand for the treatment of PCOS. Inositol supplements improve insulin sensitivity and blood sugar regulation [1, 2]. This has a cascading effect on hormone balance that can alleviate a wide range of common PCOS symptoms.

Myo-inositol can improve fertility and reduce the risk of gestational diabetes [3-7]. It can also help some women reduce acne and unwanted facial hair growth [8, 9]. Inositol supplements appear to be better than metformin for menstrual regularity and metabolic disorders [10, 11]. It’s also much better tolerated as side effects are minimal.

Despite popular belief, myo-inositol isn’t one of the best supplements for PCOS weight loss. It’s great for your health. But weight loss benefits (if any) are insignificantly small [12-14].

Learn more about inositol supplements for PCOS here.

2. B-Vitamins

There are a lot of different B vitamins. All of which serve an important role in health and fertility. But B12 and B9 (folate/folic acid) are the most salient for polycystic ovarian syndrome. These B vitamins play a key role in regulating the amino acid, homocysteine. Homocysteine is elevated in PCOS. This leads to an increased risk for cardiovascular and reproductive problems [15-17]. B vitamin supplementation can lower these risks [18].

The most important time to consider B vitamin supplements is before pregnancy. For women with PCOS, it’s important to avoid folic acid. PCOS is associated with MTHFR gene mutations [19, 20]. If you have this mutation, then taking folic acid during pregnancy can affect your child’s lung function [21]. What you want instead, is the active form of folate (methyl folate) [22].

TheraNatal® Core Preconception Vitamins is one of the best prenatal supplements for PCOS. This product contains methyl folate rather than folic acid.

Experts also recommend testing and supplementing B vitamins whenever metformin is used. Metformin is well-known to deplete nutrients.

3. Vitamin D

Vitamin D supplementation has been studied extensively in polycystic ovary syndrome patients. The well-established benefits include:

• Improved hormone levels, inflammation, and oxidative stress [23].
• Reduced insulin resistance and hyperandrogenism [24-26].
• Improved lipid metabolism and triglycerides [24, 26-28].

There is strong evidence that these benefits improve fertility and menstrual cycle regulation [29-31]. Fertility treatment outcomes are also better with adequate vitamin D levels [32-34].

Unfortunately, approximately 67 – 85% of women with PCOS have vitamin D deficiency [35]. These risks are highest in people with darker skin tones that live in northern climates [36-40].

Vitamin D is one of the most important of all PCOS vitamin supplements. Learn more about dosing and brands here.

4. Magnesium

More than half of Americans have inadequate dietary intake of magnesium [41]. Rates are even higher among PCOS women [42]. That’s because many of the risk factors for insufficient magnesium are common in PCOS. This includes being overweight, having insulin resistance, and taking medications [43-49].

Taking magnesium supplements has a significant effect on PCOS hormone imbalances [50]. On its own, it can help with weight loss, high blood pressure, and PCOS period pain [50-53]. When combined with other PCOS vitamins and supplements, magnesium can also help with glucose metabolism, hirsutism, anxiety, and quality of life [54-59].

Learn more about magnesium supplements for PCOS here. This article includes tips on blood testing, safety info’, and recommended products.

5. Zinc

There’s a good reason that you’ll find zinc on most lists of the best supplements for PCOS.

Insufficient zinc levels are a common problem for PCOS patients. This contributes to the hormone imbalances that cause PCOS symptoms [60, 61].

This is a relatively easy problem to fix. Zinc supplementation in PCOS patients can improve hormonal imbalances. This reduces the risks of insulin resistance and cardiovascular disease [61]. At least one clinical trial has also shown the value of zinc supplements for PCOS hair loss and hirsutism [62].

Zinc is best taken as part of a multivitamin product like Women’s Multi 50+ by Thorne Research. This product includes 15 mg of zinc as TRAACS® Zinc Bisglycinate. This is a bioavailable form of zinc. It also includes a lot of the other PCOS vitamin supplements included in this article. Most importantly, products like Women’s Multi 50+ exclude copper and iron. This is important because PCOS women tend to have high levels of these nutrients [63].

6. Chromium

Chromium picolinate has been shown to improve insulin resistance and metabolic health in women with PCOS [64, 65]. Trials using 200 μg/day have observed reduced rates of hirsutism and acne [66].

Like all PCOS supplements, it’s important to consider individual differences when using chromium. In most cases, the size of the effect is likely to be small.

7. Fish Oil

Fish oil and the omega-3 fatty acids they contain are widely understood to be good for cardiovascular health. Omega-3 fats reduce inflammation which is one of the underlying drivers of all PCOS symptoms. This suggests that there may be widespread benefits from taking omega-3 supplements for PCOS. But these have not been sufficiently demonstrated in clinical trials. In PCOS patients, decreasing cholesterol levels is the most well-proven benefit [67].

Fish oil supplements have also been used for reducing PCOS period pain. Studies suggest that 1,000 mg/day of fish oil is better than taking Advil (Neurofen) [68, 69].

One of the best fish oil supplements for PCOS is Nordic Naturals Ultimate Omega. This product was used in a high-quality trial that demonstrated the health benefits of omega-3 supplements for PCOS women [70].

8. CoQ10

Coenzyme Q10 (CoQ10) is an antioxidant that has anti-inflammatory properties. This means it can combat chronic inflammation, one of the underlying mechanisms that drive all PCOS symptoms [71-74].

CoQ10 has been well-studied as a PCOS treatment. A recent systematic review and meta-analysis found the following benefits [75]:

• Improvements in insulin resistance, fasting insulin, and fasting plasma glucose.
• Better sex hormone balance.
• Improved triglycerides and cholesterol levels.
• CoQ10 is not associated with adverse effects. It’s a safe therapy.

Because CoQ10 is only soluble in fat, many formulations are not well absorbed in the gut. Proprietary formulations like VESIsorb increase the absorption of CoQ10 by more than 600% compared with standard oil-based CoQ10 [76]. It’s also many times more bioavailable than solubilized formulations.

NeoQ₁₀ by Theralogix uses the patented VESIsorb technology. This product can be purchased online here.

9. Curcumin

Curcumin is a naturally occurring compound with potent anti-inflammatory and antioxidant effects. This well-tolerated plant-derived medicine has been widely studied for a range of conditions [77]. In women with PCOS, curcumin can improve cardiovascular health and help with weight loss [78].

Curcumin is an excellent alternative medication for PCOS pain. For example, a two-gram dose of the proprietary formulation, Meriva, can produce comparable pain relief to two Tylenol (Panadol) extra-strength tablets [79].

It’s important when buying curcumin supplements to look for advanced delivery systems (like Meriva) that increase bioavailability. It’s unlikely that cheaper formulations of turmeric root extract will achieve the same therapeutic effect [80-82].

10. Melatonin

Out of all the many PCOS supplements, melatonin may be one of the most underrated. Like vitamin D, melatonin has massive impacts on health [83].

Women with PCOS have lower melatonin concentrations. This doesn’t just impact sleep. Ovarian function is also affected [84]. This drives a lot of the hormone imbalances common in PCOS. Yet studies show that supplementation can reduce these effects [85-87].

Melatonin supplementation makes sense if you’re trying to conceive or get your period back. It also makes sense if you have difficulty losing weight or you want to reduce excessive hair growth and other signs of hirsutism [88, 89].

11. NAC

The research on N-acetylcysteine (NAC) for PCOS has produced mixed results, largely as a result of biases in study design. This has presented challenges in determining its appropriate use and clinical value.

Based on the most recent reviews of the evidence though, NAC appears to be one of the better supplements to treat PCOS. In PCOS patients, NAC can reduce testosterone levels and increase follicle-stimulating hormone levels [90]. One analysis found that it was better than metformin for weight management and lowering total testosterone [91]. Others have shown that it’s superior for improving fasting blood sugar and fasting insulin levels [92].

These benefits translate into real-life outcomes. For example, NAC improves pregnancy rates. It may be particularly beneficial when combined with clomid or letrozole [93, 94].

12. Berberine

Berberine is one of the few herbal supplements with pharmaceutical-level effects. This is a great option for insulin-resistant PCOS women that aren’t trying to conceive.

Many clinical trials have shown that berberine is at least as good as metformin for treating insulin resistance in PCOS patients [95-97]. It’s also good for blood pressure, weight loss, and other markers of metabolic health [97-101].

Berberine improves hormone balance and can boost fertility [97, 101]. Many people prefer it to metformin because it has fewer side effects. Berberine is a relatively safe supplement, but it’s important to check drug interactions before use.

Learn more about berberine including dosage, safety, and the best brands here.

13. Resveratrol

Resveratrol is a natural antioxidant found in grapes, nuts, and berries. Its use as a PCOS supplement mostly centers around its anti-inflammatory properties and its effect on the ovaries [102-104]. Studies have shown that resveratrol can improve menstrual regularity in PCOS women [105].

Care is needed when supplementing with resveratrol. It shouldn’t be used during the luteal phase of your cycle and may not be safe during pregnancy [106].

14. Cinnamon

Cinnamon is an ancient traditional medicine. It’s also one of the best herbs for PCOS. Several reviews have shown that cinnamon can improve metabolic parameters in PCOS patients [107-109]. These include fasting blood sugar, fasting insulin, cholesterol, and triglyceride levels.

Cinnamon is generally considered a safe supplement. But higher doses of 1.5 g/day are needed for the best clinical outcomes [109].

15. Probiotics and Prebiotics

Poor gut health may be one of the underlying causes of PCOS. Dysbiosis of the gut microbiome can account for all three components of a PCOS diagnosis [110, 111]. It can also cause insulin resistance in women with PCOS [112]. So, the growing popularity of prebiotic and probiotic supplements for PCOS makes good sense.

Several meta-analyses show the benefits of probiotics and prebiotics for the treatment of PCOS [113, 114]. They appear to improve many hormonal and inflammatory markers. They can help with insulin sensitivity, weight gain, and cardiovascular health. They can also lower testosterone levels and relieve hirsutism.

The greatest challenge with using prebiotic and probiotic supplements for PCOS is picking the right type. Many over-the-counter products may not be worth the cost.

But following a PCOS diet is. Adding more prebiotic and probiotic foods into your diet can help improve gut health. Cutting out the foods to avoid with PCOS, makes a big difference too. The benefits of these steps have been well-demonstrated by participants from my free 30-Day PCOS Diet Challenge.

The Bottom Line

Nutritional supplements are a valuable intervention for women with polycystic ovary syndrome. In some cases, dietary supplements can be as effective as pharmaceutical drugs. But often with fewer side effects.

The 15 compounds described above provide a good short-list for consideration. A naturopathic or functional medicine doctor can help you determine which of these supplements are best for you.

Irrespective of your drug or supplement protocol, a PCOS-friendly diet will help you achieve the best health outcomes. To get started today, join my free 30-Day PCOS Diet Challenge or download this free 3-Day Meal Plan.

FAQ

What are the best supplements for PCOS weight loss? The most effective PCOS weight loss supplements are those that help improve insulin sensitivity. These include inositol, vitamin D, magnesium, zinc, chromium, berberine, cinnamon, and CoQ10. Curcumin, melatonin, and probiotics may also be helpful. It’s important to keep in mind that the strength of the effect is very small for all of these PCOS weight loss supplements. Even modest dietary changes are likely to overshadow any benefits. Learn more about how to lose weight with PCOS here.

What are the best PCOS fertility supplements? Myo-inositol and products like Ovasitol are the most well-proven PCOS fertility supplements. TheraNatal® Core Preconception Vitamins, are another obvious choice. For women undergoing IVF, supplementation with NeoQ₁₀ is recommended [115]. Many of the other supplements listed above may also help you conceive.

What are the best supplements for PCOS hair loss? The treatment of hair loss requires supplements that lower testosterone in PCOS. NAC may be one of the best options. But myo-inositol, B vitamins, vitamin D, magnesium, zinc, chromium, CoQ10, and melatonin may also be helpful.

What are the best PCOS acne supplements? Like hirsutism and hair loss, PCOS acne supplements need to reduce androgen hormones like testosterone. The most well-proven PCOS acne supplements include myo-inositol, zinc, and vitamin B3 (niacin). Some probiotics may also be helpful [116]. Learn more about the best ways to treat PCOS acne here.

What about all the other supplements I read about online? The list above is not exhaustive. But it includes products that have been the most well-proven in PCOS patients. That said, other supplements may be useful as part of a holistic PCOS treatment plan. Products like selenium, carnitine, CBD oil, licorice root, maca root, saw palmetto, vitex, and many others may be helpful too. A naturopathic or functional medicine doctor can help you determine what’s best for you.

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References

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The post The 15 Best Supplements for PCOS According to Science appeared first on Smart Fertility Choices.

Key Takeaways

Saw palmetto can treat polycystic ovarian syndrome because it has anti-androgenic properties. But the benefits of saw palmetto for PCOS are not well-proven.

There are many herbs and other dietary supplements that are more effective.

A PCOS diet is also much better at treating underlying hormonal imbalances. Start following a PCOS diet today by joining my free 30-Day PCOS Diet Challenge. Or download this free 3-Day Meal Plan.

People use Saw palmetto to treat polycystic ovary syndrome (PCOS). But this herb hasn’t been well-studied in clinical trials. A scientific understanding of the benefits of saw palmetto for PCOS is based on mechanistic knowledge about how it works.

This article reviews the benefits of saw palmetto for PCOS and provides guidance on how to take it.

As you’ll discover, there are many better ways to treat PCOS. Nothing beats dietary change as participants from my free 30-Day PCOS Diet Challenge show.

Benefits of Saw Palmetto for PCOS

PCOS symptoms result from hormone imbalances like elevated testosterone levels [1, 2]. These androgenic, male hormones cause a wide range of symptoms including:

• Thinning hair, hair loss, and male pattern baldness
• Excess body hair, and facial hair growth
• Oily skin
• Irregular periods

Saw palmetto is given to women with PCOS because it can reduce excess androgens. Like many other plant-derived anti-androgens, it’s assumed it will help reduce symptoms.

The mechanism by which this herbal medicine reduces excess testosterone levels is understood. But there are no placebo-controlled trials in PCOS patients showing noticeable benefits. At least at the time of writing.

This means that any potential benefits of saw palmetto for PCOS are based on clinical experience only.

What the Science Says

Most research on saw palmetto is for the treatment of benign prostatic hyperplasia (BHP). BHP is a noncancerous growth of the prostate. It only affects males making the research of limited value for treating polycystic ovary syndrome. Even so, most studies conducted to date have not found a consistent or compelling benefit [3-5].

Saw palmetto has also been studied for male androgenic alopecia where it’s shown modest potential [6-8]. But other treatments like dutasteride, finasteride, and minoxidil appear to be more effective [9-11].

As a treatment for female hair loss, saw palmetto is most promising when combined with other dietary supplements. For example, Nutrafol is a hair growth supplement that contains 21 phyto-compounds. Its ingredients include saw palmetto, ashwagandha, curcumin, palm extract, amino acids, and more. Nutrafol appears to improve hair growth [12, 13]. But because it’s a complex mixture of ingredients, studies of this product say nothing about the effectiveness of saw palmetto.

Given the plethora of treatments for hair loss, it seems hard to make a compelling argument in favor of saw palmetto. This review explores treatment options for androgenic alopecia offered by both conventional medicine and complementary medicine.

Saw Palmetto PCOS Side Effects

Adverse events associated with saw palmetto were scientifically reviewed in 2009. They found that in the trials reviewed, saw palmetto was well-tolerated with few adverse effects [14].

The most common side effects were abdominal pain, diarrhea, nausea, fatigue, headache, decreased libido, and rhinitis.

There were isolated cases of more serious events such as death and cerebral hemorrhage. But it seems unlikely that this was caused by the saw palmetto.

No drug interactions were reported.

There haven’t been any studies looking at the safety of saw palmetto during pregnancy or while breastfeeding. Given it has the potential to affect hormone levels though, it’s best avoided under these circumstances.

Alternative Anti-Androgen Treatments

For women with PCOS, there are much better herbal treatments than saw palmetto. Learn more about the best herbs for PCOS here.

If you specifically want a herbal remedy with anti-androgenic effects, there are many to choose from. Spearmint tea and green tea are cheap and effective places to start. Other evidence-based herbs for androgen excess include red reishi, licorice root, Chinese peony, and others [15, 16].

If you’re specifically looking to treat PCOS acne, you’re better off with these solutions.

Anti-androgenic herbs, like saw palmetto, may help on the margins. But if you want to see life-changing results, then there’s something much more important you must do.

Why Diet Outshines All Other PCOS Treatments

Anti-androgens are used to treat PCOS because excess androgens are one of the underlying causes of PCOS.

But a treatment that focuses only on androgens isn’t going to succeed.

All PCOS symptoms are caused by a combination of excess androgens, inflammation, and insulin resistance [1, 17-21]. The gut microbiome is dysregulated in PCOS and this has a causal effect on symptoms [22, 23]. A poor diet makes everything worse [24].

It’s well-known that androgen production in women with PCOS is linked to insulin resistance [1, 2]. If you want to lower androgens, you need to improve insulin sensitivity. This is best achieved through a healthy diet that helps better manage your blood sugar levels.

A good PCOS diet can reverse insulin resistance. But it also improves gut health. This is about avoiding foods that are harmful to PCOS. And eating more good whole foods with anti-inflammatory properties.

Adapting to a PCOS diet can be confusing and overwhelming. There’s also a lot of conflicting information that makes it difficult for busy people to get the quick answers they need.

That’s why I created my free 30-Day PCOS Diet Challenge and this free 3-Day Meal Plan. These are the perfect place to start for anyone new to a PCOS diet. During the 30-Day Challenge, you’ll start seeing the results for yourself.

A PCOS diet provides an essential foundation for managing PCOS. But dietary supplements can enhance these benefits. Learn more about the best PCOS supplements here.

The Bottom Line

Experienced naturopathic and functional medicine doctors use Saw palmetto for treating PCOS. But the clinical benefits of this intervention have not been proven in scientific trials. The mechanism of action is understood. But we don’t know that this translates into noticeable benefits for patients.

There are many better herbs and supplements for treating PCOS.

Switching to a PCOS diet is also much more effective than Saw palmetto extract. Discover this for yourself by joining my next free 30-Day PCOS Diet Challenge. Or download this free 3-Day Meal Plan for a sample of PCOS recipes.

FAQ

Should I take saw palmetto for PCOS weight loss? Saw palmetto is not known to support weight loss in PCOS women. Learn more about how to lose weight with PCOS here.

Does saw palmetto work for PCOS? There’s insufficient evidence to show that saw palmetto is an effective treatment for PCOS. This doesn’t mean that it doesn’t work. There just isn’t evidence to show that it does.

But I’ve seen many Saw palmetto success stories with PCOS. How do you explain these? It’s possible that for some women, Saw palmetto on its own may improve PCOS symptoms. Often though, people take saw palmetto alongside other treatments. This makes it difficult to assign any health or fertility improvement to the saw palmetto intervention. Teasing apart the benefits of a single treatment requires well-designed scientific trials.

What’s the typical saw palmetto dosage for PCOS? There’s no single recommended dosage of saw palmetto for PCOS. But typical doses range from 160 to 450 mg of saw palmetto extract per day. It’s recommended that you start on a low dose and work your way up over time.

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References

¹Wang, J., et al., Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sciences, 2019. 236.

²Zeng, X., et al., Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity. Clin Chim Acta, 2020. 502: p. 214-221.

³Csikós, E., et al., Treatment of Benign Prostatic Hyperplasia by Natural Drugs. Molecules, 2021. 26(23).

⁴Franco, J.V., et al., Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement. Cochrane Database Syst Rev, 2023. 6(6): p. Cd001423.

⁵Kwon, Y., Use of saw palmetto (Serenoa repens) extract for benign prostatic hyperplasia. Food Sci Biotechnol, 2019. 28(6): p. 1599-1606.

⁶Prager, N., et al., A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med, 2002. 8(2): p. 143-52.

⁷Wessagowit, V., et al., Treatment of male androgenetic alopecia with topical products containing Serenoa repens extract. Australas J Dermatol, 2016. 57(3): p. e76-82.

⁸Gupta, A.K., M. Talukder, and M.A. Bamimore, Natural products for male androgenetic alopecia. Dermatol Ther, 2022. 35(4): p. e15323.

⁹Arif, T., et al., Dutasteride in Androgenetic Alopecia: An Update. Curr Clin Pharmacol, 2017. 12(1): p. 31-35.

¹⁰Boersma, I.H., et al., The effectiveness of finasteride and dutasteride used for 3 years in women with androgenetic alopecia. Indian J Dermatol Venereol Leprol, 2014. 80(6): p. 521-5.

¹¹Rossi, A., et al., Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol, 2012. 25(4): p. 1167-73.

¹²Ablon, G. and S. Kogan, A Six-Month, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of a Nutraceutical Supplement for Promoting Hair Growth in Women With Self-Perceived Thinning Hair. J Drugs Dermatol, 2018. 17(5): p. 558-565.

¹³Stephens, T.J., et al., A Prospective Six-month Single-blind Study Evaluating Changes in Hair Growth and Quality Using a Nutraceutical Supplement in Men and Women of Diverse Ethnicities. J Clin Aesthet Dermatol, 2022. 15(1): p. 21-26.

¹⁴Agbabiaka, T.B., et al., Serenoa repens (saw palmetto): a systematic review of adverse events. Drug Saf, 2009. 32(8): p. 637-47.

¹⁵Grant, P. and S. Ramasamy, An update on plant derived anti-androgens. Int J Endocrinol Metab, 2012. 10(2): p. 497-502.

¹⁶Dhariwala, M.Y. and P. Ravikumar, An overview of herbal alternatives in androgenetic alopecia. J Cosmet Dermatol, 2019. 18(4): p. 966-975.

¹⁷Carvalho, L.M.L., et al., Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review. Endocr Regul, 2018. 52(4): p. 208-221.

¹⁸González, F., Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids, 2012. 77(4): p. 300-5.

¹⁹González, F., et al., Hyperandrogenism sensitizes mononuclear cells to promote glucose-induced inflammation in lean reproductive-age women. Am J Physiol Endocrinol Metab, 2012. 302(3): p. E297-306.

²⁰Popovic, M., G. Sartorius, and M. Christ-Crain, Chronic low-grade inflammation in polycystic ovary syndrome: is there a (patho)-physiological role for interleukin-1? Seminars in Immunopathology, 2019. 41(4): p. 447-459.

²¹Rudnicka, E., et al., Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci, 2021. 22(7).

²²Tremellen, K. and K. Pearce, Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome. Med Hypotheses, 2012. 79(1): p. 104-12.

²³He, F.F. and Y.M. Li, Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review. J Ovarian Res, 2020. 13(1): p. 73.

²⁴Barrea, L., et al., Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev, 2018. 31(2): p. 291-301.

The post Saw Palmetto for PCOS: A Scientific Review appeared first on Smart Fertility Choices.

Key Takeaways

Choose dairy-free ice cream that’s low in sugar and additives.

Fronen and O’My! offer the most PCOS-friendly ice cream products.

Making your own PCOS ice cream is best because you can choose the ingredients, avoid additives, and ensure a low sugar content.

I can relate to anyone in my free 30-Day PCOS Diet Challenge who doesn’t want to give up ice cream. Before I got serious about PCOS, I was a heavy-hitting ice cream aficionado too.

If you’re managing your PCOS with dietary interventions, but you still want to enjoy ice cream, then I have just what you need. Below you’ll find some great PCOS-friendly ice cream recipes from my PCOS Meal Planner. I’ve also selected some of the best store brands for you too.

What Makes an Ice Cream PCOS-Friendly?

As much as I wish it were so, ice cream isn’t a healthy food.

When choosing products (or recipes), it’s all about what’s NOT included that makes an ice cream PCOS-friendly.

The most important requirement is that the ice cream is dairy-free. As I explain in my article on PCOS and dairy, it’s not just lactose that’s a problem. You also want to avoid dairy proteins too and that means cream.

The other major consideration is sugar-content. Sugar is at the top of the list of foods to avoid with PCOS. Participants from my free 30-Day PCOS Diet Challenge see for themselves the effects of cutting back on sugar. Long story short, the less sugar you eat, the better.

The last thing I look at when comparing different ice creams is all the other ingredients. Vegetable oils, food additives, and things that we can’t recognize as food. The long-term health hazards are often poorly quantified. What’s more, as the examples I share below prove, they’re also not needed to make a delicious product.

3 PCOS-Friendly Ice Cream Store Brands

So, which ice cream is good for PCOS? Fronen, O’My! and So Delicious are three good PCOS ice cream brands. These products meet the requirements described above.

Fronen

Fronen makes some of the best ice creams for PCOS. Their products have the fewest ingredients. None of these are additives and all you’ll recognize as whole foods. For example, their chocolate dessert contains only coconut cream, water, honey, and cocoa powder. With 13 grams of sugar per 3.5 oz (100 gram) serving this ice cream is also relatively low in sugar.

O’My!

O’My! also make some nice PCOS-friendly ice cream products. I like that they use organic coconut cream and also minimize ingredients. Their ice cream is sweetened with sugar, which isn’t awesome. But at 17 grams per 100-gram serving, it’s not all that much higher than Fronen.

So Delicious

So Delicious is a big brand in dairy-free foods. I’m hesitant to recommend their entire range of frozen desserts because they generally contain too much sugar. But products, like their vanilla bean coconut milk frozen dessert, are comparable to O’My! They also offer low-sugar desserts with less than 4 grams per 100-gram serving. That can be helpful if you’re struggling with insulin resistance. Just be aware that their low-sugar products use erythritol, and monk fruit extract as sweeteners. As far as non-nutritive sweeteners go, these are among the better ones. But they’re not really whole foods. So Delicious frozen desserts also include more additives than Fronen or O’My!

PCOS-Friendly Ice Cream Recipes

Making your own PCOS-friendly ice cream is the best way to control the ingredients. You’ll find many dairy-free, low-sugar recipes to choose from. This Chai Tea Frozen Yogurt is a nice one to start with. The two recipes below from my PCOS meal planner are also very popular.

Banana-Berry Soft Serve Recipe – Serves 2

Ingredients

• 1 ½ Bananas (cut and frozen into small chunks)
• ½ cup Frozen strawberries
• 4 tbsp Coconut cream
• ½ tsp Vanilla extract

Instructions

• Using a food processor or high-powered blender, process all the ingredients for a minute or two until smooth and creamy.

Chocolate Ice Cream – Serves 2

Ingredients

• 1 ½ cup Coconut cream
• 1 tbsp Cacao powder
• 1 tsp Stevia or Monkfruit 1:1 sugar substitute
• 1 tsp Ceylon cinnamon powder
• 1 pinch Salt

Instructions

• Stir all the ingredients together until the mixture resembles a thick mousse.
• Drizzle in a tablespoon of coconut oil at the end. This will freeze and become like chocolate chips.
• Place in the freezer for a couple of hours before serving.

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The post 3 PCOS-Friendly Ice Creams – Best Store Brands + Recipes appeared first on Smart Fertility Choices.

There’s a LOT of solid science supporting natural treatments for PCOS. But what’s more motivating is seeing what a PCOS diet and lifestyle can do in real life.

The following PCOS natural treatment success stories show you what’s possible. These are real-life stories from women just like you.

If you’re ready to make a similar transformation, then there’s no better place to start than my free 30-Day PCOS Diet Challenge. If 30 days seems like too big of a commitment to start with, then try this free 3-Day Meal Plan first.

What Every PCOS Success Story Shares

The primary mechanisms that cause all PCOS symptoms are well understood. Chronic inflammation, insulin resistance, and high androgen levels [1-6]. Having elevated androgens is largely a result of chronic inflammation and insulin resistance.

All these factors are modulated by the gut microbiome [7, 8].

People who beat PCOS know that they need to reduce inflammation and improve insulin sensitivity. While there are many ways to do this, they know that working on their gut health is a big part of the solution.

I explain the many ways you can do this in my PCOS natural treatment article. But a PCOS diet is key.

When you treat PCOS naturally, you don’t just lose weight or improve your reproductive health. You don’t just have more energy and feel better mentally. Your skin and hair don’t just improve. Given enough time, all your symptoms can resolve. It takes work to make the right diet and lifestyle changes. But the women below have led the way.

LeeAnne

When she first joined my free 30-Day PCOS Diet Challenge, LeeAnne was a complicated mess of health issues. She was on so many medications, and she still felt terrible all the time. As it turned out, the fix was quite simple. The transformation in LeeAnne’s health after changing her diet is one of the most remarkable I’ve seen to date.

You can read LeeAnne’s full story here.

Raynetta

Raynetta is a high-energy woman who put her determination to good use. After a long battle with both infertility and other common PCOS health issues, Raynetta was ready for a change. She hit almost all the usual obstacles along the way. After several years though, she’d realized a new healthy normal. She lost 50 pounds, overcame her symptoms, and finally had a baby.

Learn more about Raynetta’s story here.

Kristin

Kristin took a long-term approach to adopting a PCOS-friendly diet. She didn’t do everything perfectly, which is completely normal. Instead, she kept doing things a little bit better over the weeks and months following my 30-Day Challenge. After a year, she’d lost 47 pounds and dropped six pant sizes.

Jamie

Jamie has been a great inspiration in our PCOS support group. She used my Challenge as a pivot point in her journey through infertility. She started seeing results shortly after changing her diet. Jamie’s periods became more regular, and she lost 50 pounds. Within six months or so, she fell pregnant naturally overcoming four years of infertility.

You can read more about Jamie’s journey here.

Valerie

Valerie was motivated to change her diet because she was concerned about her metabolic health. She was insulin-resistant and had a family history of diabetes. After taking part in my 30-Day Challenge and then pushing herself further with my 10-Week Program, Valerie saw the results in her bloodwork. Within half a year her A1C levels fell within normal ranges.

Kendall

Kendall is a great example of how a little information can go a long way. After taking part in my 30-Day Challenge, Kendall figured out how to make a PCOS diet part of her lifestyle. This wasn’t easy, but over three years, she lost 110 pounds of excess weight. She’s since gone on to have two healthy children that were conceived naturally.

Learn more about how Kendall did it here.

Krystal

Krystal shows that beating PCOS need not be a years-long project for some lucky people. She was starting to lose hope that she’d ever have a baby. But a week after completing my 30-Day Challenge, Krystal was amazed to find she’d fallen pregnant naturally. It’s not clear how much of a role her diet changes played in this case. But Krystal was convinced it helped a lot.

The Bottom Line

PCOS affects us all differently. But the underlying drivers of all symptoms are all the same. From a what-can-I-do-about-it perspective, there are three things to know. You need to reduce inflammation, improve insulin regulation, and heal your gut. Switching to a PCOS diet is the best way to achieve this.

For help putting proven diet changes into practice, join my next 30-Day PCOS Diet Challenge. This free program runs four times a year. If you want to get started today, download this free 3-Day Meal Plan for a sample PCOS meal plan and some great easy-to-make recipes to get you started.

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References

¹Carvalho, L.M.L., et al., Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review. Endocr Regul, 2018. 52(4): p. 208-221.

²González, F., Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids, 2012. 77(4): p. 300-5.

³González, F., et al., Hyperandrogenism sensitizes mononuclear cells to promote glucose-induced inflammation in lean reproductive-age women. Am J Physiol Endocrinol Metab, 2012. 302(3): p. E297-306.

⁴Popovic, M., G. Sartorius, and M. Christ-Crain, Chronic low-grade inflammation in polycystic ovary syndrome: is there a (patho)-physiological role for interleukin-1? Seminars in Immunopathology, 2019. 41(4): p. 447-459.

⁵Rudnicka, E., et al., Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci, 2021. 22(7).

⁶Wang, J., et al., Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sciences, 2019. 236.

⁷Tremellen, K. and K. Pearce, Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome. Med Hypotheses, 2012. 79(1): p. 104-12.

⁸He, F.F. and Y.M. Li, Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review. J Ovarian Res, 2020. 13(1): p. 73.

The post PCOS Natural Treatment – Success Stories from 7 Women appeared first on Smart Fertility Choices.

Key Takeaways

Most soy and PCOS studies investigate soy-derived supplements. Data on soy foods is limited.

Soy supplements can be good for PCOS. But it’s unclear if this benefit translates to soy foods.

Fermented soy is the best type of soy for PCOS. Traditionally prepared, non-fermented, organic soy foods may be okay for some people.

All soy made from conventionally farmed soybeans should be avoided.

Soy has potential benefits for PCOS. But it can also cause harm. That’s because it depends on what you’re talking about when you say, “soy”.

During my free 30-Day PCOS Diet Challenge I include soy in my list of suspicious foods. When starting a PCOS diet, it’s best to exclude soy. When re-introducing it, you’ll still want to be selective of the products you choose.

To cover all the nuances of this important food, here’s everything you need to know about soy and PCOS.

Pros and Cons of Soy (According to Science)

You need to be skeptical of studies that show soy is good for PCOS. The goal is seldom to provide dietary guidance. But that doesn’t stop people from using it for that purpose.

Most research isolates one component of soy for study. They then give it to test patients in supplement form rather than have them consume soy whole foods. Soy isoflavones are the most well-studied. Soy isoflavones are also known as phytoestrogens. That’s because they have a similar structure to estrogen and have weak estrogenic effects [1].

Is soy good for PCOS? Some studies suggest that soy isoflavones are good for PCOS [2-7]. But others have found that it makes little to no difference or can cause PCOS symptoms [8-10]. One argument against soy for PCOS is that phytoestrogens can disrupt hormones [11, 12]. A recent review of the literature found, “no homogenous improvement” on hormones or fertility associated with soy and PCOS [13].

During my free 30-Day PCOS Diet Challenge and 10-Week Program, I err on the side of caution. If soy has the potential to disrupt hormones, then it’s best avoided. Even if the risk is low [14]. This makes the most sense during the first few months of switching to a PCOS diet. It’s better to re-introduce soy after your PCOS is back under control. You can then see how it affects you.

Some women, like Raynetta, find that cutting out soy can have a huge impact on their health.

The point of most studies looking at soy and PCOS is to develop soy-derived supplements [3, 4, 15]. They take a reductionist approach that isolates a single component of soy. This means they have limited value in providing dietary advice.

These studies can’t be used to determine if soy foods are good for PCOS or not. That’s because soybeans contain protein, fat, carbs, fiber, and many other micronutrients. They also have several other bioactive compounds besides isoflavones [13].

The key take home here is that any benefits or harms of soy isoflavones for PCOS, shouldn’t be conflated with soy foods. The over-emphasis on studies focusing on soy supplements also explains why the science is so confusing.

4 Soy Foods to Eat

Based on the advice of trusted doctors, I have a negative bias toward soy and PCOS. But there’s a reasonable case for including certain soy foods in a PCOS diet. This is especially true if you’ve tried a soy-elimination diet first.

But which soy foods are okay for PCOS? Even though direct evidence on this question is lacking, we can let history guide us.

There’s compelling evidence that soy intake consistent with a traditional Japanese diet is healthy [16-19]. Fermented soy appears to provide the lion’s share of the health benefits of soy [20]. This may be why some large studies that look at soy consumption as a whole fail to find health benefits [21]. Several studies have found that only fermented soy is associated with a lower risk of heart disease [22, 23]. Others have shown that only fermented soy decreases the risk of some breast cancers [24].

With this in mind, fermented soy products are likely best for PCOS. This includes:

1. Miso
2. Natto
3. Tempeh
4. Tamari sauce

These foods contain live cultures of microorganisms that support better gut health. It’s believed that fermentation improves soy’s digestibility and absorption.

Types of Soy on the Maybe-List

Tofu, edamame, and soy nuts are the few no-fermented soy foods that may be suitable for a PCOS diet. Again, that’s assuming you’re reintroducing them after having first eliminated soy for a period. Like many foods, this decision depends on your perception of the risks and benefits. The quality of the soy beans used though, should always be one of the most important considerations. You only want to buy organic products as explained further below.

To be clear here. I recommend that everyone taking part in my free 30-Day PCOS Diet Challenge avoid these soy foods to be on the safe side. The same goes for those doing my Beat PCOS 10-Week Program. I intentionally exclude non-fermented soy foods in my PCOS Meal Planner and in my free PCOS recipes. That’s because I want to maximize your probability of success.

Types of Soy Foods to Avoid

People with PCOS should avoid all soy foods made from conventionally-grown soybeans.

This includes but is not limited to:

• Tofu, edamame, and soy nuts that aren’t organic
• Soy milk and cheese
• Soy protein powder
• Meat alternatives
• Soy snacks
• Soybean oil

That means pretty much all processed foods with soy in them are out.

Why Conventionally-Grown Soy is Bad for PCOS

Conventionally-grown soybeans are bad for PCOS because over 90% are glyphosate-tolerant (GT). Glyphosate a.k.a. Roundup, is the most used herbicide in the world. GT soybeans started being grown in 1996, so this is a relatively new problem. They’ve become the dominant soybean crop because they simplify weed management. Growers can spray their crops with glyphosate as they grow and it only kills the weeds.

This is great for reducing operating costs. But it’s not good for the soybeans.

A 2014 study found that GT soybeans grown in Iowa contained high residues of glyphosate and its products of degradation. The average was 9 mg/kg compared to non-detectable levels in “normal” soybeans [25]. Levels in other major producing countries are many times higher [26].

To put this into context, the US maximum allowable level is 40 mg/kg. In Europe and Australia, the level is 20 mg/kg. But experts in the field have raised several concerns that these “safe limits” underestimate the real health risks [27-31]. This is a complex area to get into. But, notably, the “safe limits” set by regulators are not based only on human health. They’ve been adjusted upwards to facilitate more intensive glyphosate use by industry [30]. It’s also worth noting that the acceptable daily intake limits in the US are six times higher than those in Europe.

There are many reasons people with PCOS should be concerned about glyphosate residues in soy foods:

1. The International Agency for Research on Cancer has classified glyphosate as “probably carcinogenic”.
2. Glyphosate is an endocrine-disrupting chemical (EDC) [32, 33]. This means it can interfere with hormone systems. EDC exposure has been fingered as an underlying cause of PCOS [34, 35].
3. Glyphosate can disrupt the human gut microbiome [36-38]. Imbalances in the gut microbiome are also closely linked to the underlying drivers of all PCOS symptoms [39-41].
4. Glyphosate has been linked to decreased fertility, adverse birth outcomes, and developmental issues [32, 36, 42-49].

If you want to avoid glyphosate in soy, then you need to buy only organic products. These contain no glyphosate residues. Organic soybeans are also more nutritious [25].

The Bottom Line

Not all soy foods are equal. It’s over-simplistic to say that soy foods are good or bad for PCOS. Studies show that soy-derived supplements may be helpful for people with PCOS. But that’s quite different from eating soy foods.

Fermented soy products have the most scientific credibility in terms of their health benefits. Other traditional non-fermented foods like tofu and edamame may be okay following a soy elimination diet. This is a risk-based decision. But either way, you’ll want to make sure all your soy foods are organic.

What you don’t want is any soy foods made with conventionally-grown soybeans. These foods contain high levels of glyphosate residues, a known hazard for PCOS.

FAQ

Is soy okay for PCOS? Soy is one of several important foods to avoid for PCOS. But there’s some nuances to this position. Conventionally cultivated soybeans contain high levels of herbicide residues [25, 26]. These herbicides are endocrine disruptors [32, 33] which are a known health hazard for PCOS [34, 35]. But organic, fermented soy foods are likely to support good health in the PCOS population [20, 22-24]. Supplements containing soy isoflavones may be good for PCOS [2-7]. But this remains controversial [8-10, 13].

Should I avoid soy for PCOS? When switching to a PCOS diet, it’s best to cut out all soy foods for at least two months. When reintroducing soy, start with organic fermented soy foods only. Non-fermented, organic soy may be okay for some people. All soy products made from conventionally grown soybeans should be avoided.

Is too much soy bad for PCOS? Too much soy can be bad for PCOS for several reasons. Evidence suggests that the phytoestrogens in soy can disrupt hormones [11, 12]. Glyphosate residues found in conventionally grown soy foods are also a hazard for people with PCOS. Glyphosate is an endocrine disruptor [32, 33]. It can impact the gut microbiome [36-38]. It’s also been linked to decreased fertility, adverse birth outcomes, and developmental issues [32, 36, 42-49].

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References

¹Gaya, P., et al., Phytoestrogen Metabolism by Adult Human Gut Microbiota. Molecules, 2016. 21(8).

²Haudum, C., et al., Impact of Short-Term Isoflavone Intervention in Polycystic Ovary Syndrome (PCOS) Patients on Microbiota Composition and Metagenomics. Nutrients, 2020. 12(6).

³Jamilian, M. and Z. Asemi, The Effects of Soy Isoflavones on Metabolic Status of Patients With Polycystic Ovary Syndrome. J Clin Endocrinol Metab, 2016. 101(9): p. 3386-94.

⁴Khani, B., et al., Effect of soy phytoestrogen on metabolic and hormonal disturbance of women with polycystic ovary syndrome. J Res Med Sci, 2011. 16(3): p. 297-302.

⁵Ma, X., et al., Soy isoflavones alleviate polycystic ovary syndrome in rats by regulating NF- κB signaling pathway. Bioengineered, 2021. 12(1): p. 7215-7223.

⁶Rajan, R.K., S.S. M, and B. Balaji, Soy isoflavones exert beneficial effects on letrozole-induced rat polycystic ovary syndrome (PCOS) model through anti-androgenic mechanism. Pharm Biol, 2017. 55(1): p. 242-251.

⁷Zilaee, M., et al., The effects of soy isoflavones on total testosterone and follicle-stimulating hormone levels in women with polycystic ovary syndrome: a systematic review and meta-analysis. Eur J Contracept Reprod Health Care, 2020. 25(4): p. 305-310.

⁸Forouhari, S., et al. The Effect of Soya on some Hormone levels in Women with Polycystic Ovary Syndrome (balance diet): a cross over Randomized clinical trial. 2013.

⁹Patisaul, H.B., et al., Soy but not bisphenol A (BPA) induces hallmarks of polycystic ovary syndrome (PCOS) and related metabolic co-morbidities in rats. Reprod Toxicol, 2014. 49: p. 209-18.

¹⁰Romualdi, D., et al., Is there a role for soy isoflavones in the therapeutic approach to polycystic ovary syndrome? Results from a pilot study. Fertil Steril, 2008. 90(5): p. 1826-33.

¹¹Jefferson, W.N., H.B. Patisaul, and C.J. Williams, Reproductive consequences of developmental phytoestrogen exposure. Reproduction, 2012. 143(3): p. 247-60.

¹²Patisaul, H.B. and W. Jefferson, The pros and cons of phytoestrogens. Front Neuroendocrinol, 2010. 31(4): p. 400-19.

¹³Rizzo, G., et al., The role of soy and soy isoflavones on women’s fertility and related outcomes: an update. J Nutr Sci, 2022. 11: p. e17.

¹⁴Multigenerational reproductive study of genistein (Cas No. 446-72-0) in Sprague-Dawley rats (feed study). Natl Toxicol Program Tech Rep Ser, 2008(539): p. 1-266.

¹⁵Nasimi Doost Azgomi, R., et al., Potential roles of genistein in polycystic ovary syndrome: A comprehensive systematic review. Eur J Pharmacol, 2022. 933: p. 175275.

¹⁶Kurotani, K., et al., Quality of diet and mortality among Japanese men and women: Japan Public Health Center based prospective study. Bmj, 2016. 352: p. i1209.

¹⁷Nagata, C., Soy intake and chronic disease risk: findings from prospective cohort studies in Japan. Eur J Clin Nutr, 2021. 75(6): p. 890-901.

¹⁸Yamori, Y., et al., Soy and fish as features of the Japanese diet and cardiovascular disease risks. PLoS One, 2017. 12(4): p. e0176039.

¹⁹Zhang, S., et al., A cross-sectional study of the associations between the traditional Japanese diet and nutrient intakes: the NILS-LSA project. Nutr J, 2019. 18(1): p. 43.

²⁰Nozue, M., et al., Fermented soy products intake and risk of cardiovascular disease and total cancer incidence: The Japan Public Health Center-based Prospective study. Eur J Clin Nutr, 2021. 75(6): p. 954-968.

²¹Namazi, N., et al., Soy product consumption and the risk of all-cause, cardiovascular and cancer mortality: a systematic review and meta-analysis of cohort studies. Food Funct, 2018. 9(5): p. 2576-2588.

²²Katagiri, R., et al., Association of soy and fermented soy product intake with total and cause specific mortality: prospective cohort study. Bmj, 2020. 368: p. m34.

²³Nozue, M., et al., Fermented Soy Product Intake Is Inversely Associated with the Development of High Blood Pressure: The Japan Public Health Center-Based Prospective Study. J Nutr, 2017. 147(9): p. 1749-1756.

²⁴Shirabe, R., et al., Fermented and nonfermented soy foods and the risk of breast cancer in a Japanese population-based cohort study. Cancer Med, 2021. 10(2): p. 757-771.

²⁵Bøhn, T., et al., Compositional differences in soybeans on the market: glyphosate accumulates in Roundup Ready GM soybeans. Food Chem, 2014. 153: p. 207-15.

²⁶Bärwald Bohm, G.M., et al., Glyphosate Effects on Yield, Nitrogen Fixation, and Seed Quality in Glyphosate-Resistant Soybean. Crop Science, 2014. 54(4): p. 1737-1743.

²⁷Nicolopoulou-Stamati, P., et al., Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture. Front Public Health, 2016. 4: p. 148.

²⁸Mesnage, R. and M.N. Antoniou, Ignoring Adjuvant Toxicity Falsifies the Safety Profile of Commercial Pesticides. Front Public Health, 2017. 5: p. 361.

²⁹Bøhn, T. and E. Millstone, The Introduction of Thousands of Tonnes of Glyphosate in the food Chain-An Evaluation of Glyphosate Tolerant Soybeans. Foods, 2019. 8(12).

³⁰Myers, J.P., et al., Concerns over use of glyphosate-based herbicides and risks associated with exposures: a consensus statement. Environmental Health, 2016. 15.

³¹Cuhra, M., Review of GMO safety assessment studies: glyphosate residues in Roundup Ready crops is an ignored issue. Environmental Sciences Europe, 2015. 27(1): p. 20.

³²Ingaramo, P., et al., Are glyphosate and glyphosate-based herbicides endocrine disruptors that alter female fertility? Mol Cell Endocrinol, 2020. 518: p. 110934.

³³Muñoz, J.P., T.C. Bleak, and G.M. Calaf, Glyphosate and the key characteristics of an endocrine disruptor: A review. Chemosphere, 2021. 270: p. 128619.

³⁴Hewlett, M., et al., Prenatal Exposure to Endocrine Disruptors: A Developmental Etiology for Polycystic Ovary Syndrome. Reproductive Sciences, 2017. 24(1): p. 19-27.

³⁵Palioura, E. and E. Diamanti-Kandarakis, Polycystic ovary syndrome (PCOS) and endocrine disrupting chemicals (EDCs). Rev Endocr Metab Disord, 2015. 16(4): p. 365-71.

³⁶Madani, N.A. and D.O. Carpenter, Effects of glyphosate and glyphosate-based herbicides like Roundup on the mammalian nervous system: A review. Environ Res, 2022. 214(Pt 4): p. 113933.

³⁷Mesnage, R. and M.N. Antoniou, Computational modelling provides insight into the effects of glyphosate on the shikimate pathway in the human gut microbiome. Curr Res Toxicol, 2020. 1: p. 25-33.

³⁸Rueda-Ruzafa, L., et al., Gut microbiota and neurological effects of glyphosate. Neurotoxicology, 2019. 75: p. 1-8.

³⁹He, F.F. and Y.M. Li, Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review. J Ovarian Res, 2020. 13(1): p. 73.

⁴⁰Li, G., et al., Alterations of Gut Microbiome and Fecal Fatty Acids in Patients With Polycystic Ovary Syndrome in Central China. Front Microbiol, 2022. 13: p. 911992.

⁴¹Tremellen, K. and K. Pearce, Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome. Med Hypotheses, 2012. 79(1): p. 104-12.

⁴²Chatzicharalampous, C., et al., THE ROLE OF GLYPHOSATE IN INFERTILITY: THE MECHANISTIC LINK. Fertility and Sterility, 2019. 112(3): p. E75-E76.

⁴³de Souza, J.S., et al., Maternal glyphosate-based herbicide exposure alters antioxidant-related genes in the brain and serum metabolites of male rat offspring. Neurotoxicology, 2019. 74: p. 121-131.

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The post Soy and PCOS: 4 Types to Eat & Which Ones to Avoid appeared first on Smart Fertility Choices.

Key Takeaways

Experts recommend against the use of metformin for PCOS.

It has limited benefits for both weight loss and fertility. Yet it has significant side effects and depletes nutrients.

There are better alternatives to metformin for all purposes related to PCOS. These include supplements, other drugs, and a PCOS diet.

Start implementing PCOS diet principles today. Download this free 3-Day Meal Plan or sign-up for my free 30-Day PCOS Diet Challenge.

Metformin is one of the most commonly prescribed treatments for PCOS. But it shouldn’t be. In this article, I describe the failures and shortcomings of metformin for PCOS. I also describe better alternatives. Chief among them are dietary interventions.

This is an evidence-driven perspective. But you can see how the consequences play out among women that take part in my free 30-Day PCOS Diet Challenge.

1. It’s Not Recommended for Polycystic Ovarian Syndrome

Experts recommend against the use of metformin for PCOS without diabetes. Even if you have glucose intolerance and are prediabetic. It’s only supposed to be for patients with type 2 diabetes.

In 2003, Dr. Robert Barbieri authored a guide on the use of metformin therapy to treat PCOS [1]. Many prescribing physicians may still rely on this guidance.

But, by 2018, Barberi and his colleagues had changed their recommendations. Based on more recent data, they no longer recommend the use of metformin as a first-line therapy for, “any indication” [2].

You can refer your doctor to their review of the literature here.

2. It’s Only a Band-Aid for Polycystic Ovary Syndrome

Metformin is a band-aid solution for preventing diabetes. The same is true in the treatment of PCOS. It only lowers your insulin levels as long as you’re taking it daily.

In 2002, the Diabetes Prevention Program Research Group quantified these benefits. They found that over 3 years, metformin reduced the incidence of newly developed diabetes cases by 31% [3]. But in a follow-up study, the majority of the benefit didn’t persist when the treatment was stopped [4]. This means that unless you make other changes, you’ll need to take metformin for life.

The same researchers compared metformin to a diet and lifestyle intervention. Their “lifestyle group” enrolled in a 24-week program focusing on diet and exercise. This group reduced their risk of type 2 diabetes by 58% [3]. This was significantly better than the 31% achieved by the metformin group. After 15 years, the lifestyle program still proved to be better than metformin at preventing diabetes [5]. For women in this study, the lifestyle program was also better at reducing microvascular complications.

This supports what I see within my PCOS support group. Many women that take part in my free 30-Day PCOS Diet Challenge take metformin. For those that can adapt to a PCOS diet, their insulin sensitivity improves dramatically. Over time, many of these women get key biomarkers back within normal ranges and stop taking this unnecessary drug.

3. It Doesn’t Help with Weight Loss

Many women are told that metformin helps with weight loss. That’s why “metformin PCOS weight loss” and “PCOS belly fat metformin” are such heavily searched terms on Google. A quick look at the scientific literature though shows that any weight loss benefits of metformin for PCOS are small at best.

Metformin can cause weight loss in non-diabetic people. In one study, people with severe insulin resistance lost more weight than insulin-sensitive people [6]. These benefits were independent of age, sex, and BMI. But the results are different for women with PCOS.

In a 2017 meta-analysis, Morely and colleagues reviewed 42 metformin studies in women with PCOS. They found that metformin had a slight improvement in the distribution of excess body fat. This led to a small improvement in waist to hip ratio. But there was no effect on body weight [7].

Meta-analyses like these are the most powerful assessments of scientific evidence. Smaller (and older) metformin weight loss PCOS studies have shown a slight benefit [8]. But the size of the effect was small. When considering the entire body of evidence, metformin is unlikely to help you lose weight.

The impact of dietary change overshadows any potential gains. This is because managing your diet is the best way to reverse insulin resistance. The right diet can also address chronic inflammation. This is another underlying mechanism driving PCOS weight gain. You can see this at play when PCOS women lose weight during my free 30-Day PCOS Diet Challenge. Many of their other symptoms go away too.

Learn more about how to lose weight with PCOS here.

4. It Doesn’t Help Much with Fertility

Metformin is often used for treating anovulatory infertility in women with PCOS. It’s really common and I include myself in this cohort.

But the benefits of metformin for fertility are unclear. A 2019 review investigated the effectiveness of metformin for fertility treatment in women with PCOS. They found that for a live birth rate of 19% with no treatment, adding metformin could raise this rate by 0 to 18% [9]. This large range reflects the paucity of good data. It means that metformin therapy on it’s could have no benefit at all for fertility.

The potential benefits also seem to depend on your body weight. The quality of evidence is poor on this point too. But it appears that metformin is more likely to help non-obese PCOS women than those that are overweight [9].

The Endocrine Society Clinical Practice Guidelines state that “[metformin] has limited or no benefit in treating hirsutism, acne, or infertility [10].”

These statements would be more definitive if metformin improved PCOS infertility in a meaningful way. Given the alternatives, it’s likely that metformin will be seldom used for fertility treatment in the future.

The women from my PCOS community provide powerful testimony to the use of diet over metformin. Here are some examples from my free 30-Day PCOS Diet Challenge.

5. Metformin Depletes Nutrients

There’s a lot of evidence showing that metformin use is associated with decreased vitamin B12 status.

A study on older adults found that metformin use was the best predictor of vitamin B12 deficiency [11]. The larger the dose and the longer you use metformin, the lower your serum B12 levels are likely to be [12, 13]. This is because metformin impairs B12 absorption [14-18]. Given the importance of B12, this is bad news for women with PCOS. A sub-clinical deficiency can affect pregnancy outcomes, vascular, cognitive, bone, and eye health [19, 20].

Unfortunately, many women are not informed of this risk.

Metformin can also affect other vitamins and minerals. This includes vitamin B1, folic acid, vitamin D, and magnesium [21]. Nutrient supplements may be required especially if you’re trying to conceive.

Learn more about the importance of magnesium for PCOS here. This article on vitamin D for PCOS explains why this nutrient, in particular, should be at the top of the list for most people.

6. Side Effects Are Common

In one study, approximately 88% of people experienced metformin side effects [22]. The most common side effects include diarrhea, heartburn, nausea, abdominal pain, bloating, and retching [23].

When I polled my PCOS support Facebook group, 78% reported adverse effects. If you’re looking for metformin for PCOS reviews, here’s what some of the respondents said.

“I was violently sick and couldn’t eat, everyone thought I had morning sickness so I had to stop taking it”.

“It made me super sick and it was a terrible experience”.

“I was always sick to my stomach on it”.

“I had numerous side effects, tiredness, nauseous, headaches, pain in my abdomen.”

“the metformin I started taking for fertility made me bleed for over 20 days and I had to go to urgent care due to anemia.”

Metformin also has other less common side effects. Lactic acidosis is a rare but serious side effect [24]. There have been many case studies of metformin causing liver injury [25-27]. Studies on rats also suggest an increased risk of Alzheimer’s disease [28].

The take home here is that metformin may be a safer drug, but it’s not without its risks.

7. There Are Better Alternatives for Insulin Resistance

The effectiveness of alternatives to metformin for PCOS is one of the biggest reasons not to take this drug.

Inositol supplements show the most promise for PCOS. For example, inositol supplements are more effective than metformin at improving menstrual frequency [29].

A 2019 meta-analysis compared the insulin-sensitizing effects of myo-inositol and metformin. Again, myo-inositol was found to be as good as metformin. Myo-inositol also performed as well as metformin when it came to improving testosterone levels, body mass index, and more [30].

One argument in favor of metformin use is for reducing the risk of ovarian hyperstimulation syndrome during IVF [31]. But inositol supplements also offer this protection [32, 33].

The natural herb, berberine, also shows great potential in patients with PCOS. Trials show that it can improve insulin resistance, blood lipids, and ovulation [34-37]. Meta-analysis suggests that berberine is as effective as metformin for improving insulin sensitivity [38].

Like inositol supplements, berberine is generally well-tolerated. This means fewer side effects and less disruption to your everyday life. It’s important to keep in mind though, that berberine is not safe during pregnancy.

Metformin was first approved for us in 1994. This was back when PCOS was known as polycystic ovarian disease. Since then, many other insulin-sensitizing drugs have come to market. New treatments like Ozempic, Wegovy, and Mounjaro may be suitable alternatives. Especially for patients that can’t tolerate the side effects of metformin.

Of course, the best alternative to metformin for PCOS is changing how you eat. Metformin’s health benefits come from its anti-inflammatory and antioxidant properties [39]. Its alteration of the gut microbiome is also key to its effectiveness [40-42]. Both of these mechanisms depend on your diet.

A PCOS diet reduces inflammation and improves gut health. It can also reverse insulin resistance. By addressing the underlying causes of PCOS, the right diet can displace the need for metformin. It also improves other PCOS symptoms at the same time.

The Bottom Line

It’s hard to justify metformin treatment for PCOS. Experts in the field no longer recommend its use as a first-line therapy for PCOS patients. Even for PCOS women with diabetes, metformin is a band-aid solution with better alternatives.

Metformin doesn’t provide meaningful weight loss results. Its cost/benefit as a fertility treatment is also tenuous given the alternatives. Metformin depletes important nutrients and has significant side effects. Ovasitol and berberine perform just as well but are much better tolerated.

A PCOS diet is the most important step for improving insulin regulation and fertility. A PCOS diet can displace the need for metformin and can further improve other PCOS symptoms.

Start your journey to better health and fertility by signing up for my free 30-Day PCOS Diet Challenge. If you aren’t ready to commit to 30 days try this free 3-Day Meal Plan instead.

FAQ

Are there any foods to avoid when taking metformin for PCOS? Anyone with PCOS should reduce or avoid refined carbohydrates, sugar, and processed foods. But there’s no specific dietary change needed to take metformin. Learn more about the foods to avoid with PCOS here.

What does metformin do for PCOS? Insulin resistance causes or exacerbates symptoms in the majority of PCOS patients. Metformin is an insulin-sensitizing drug that works to reverse insulin resistance. But metformin has shown limited benefits in numerous studies of PCOS women. There are now many good alternatives to metformin for PCOS.

What about metformin for PCOS acne? Metformin is an effective treatment for PCOS acne [43]. But given the side effects, many people will prefer alternatives. Learn more about treating PCOS acne here.

Metformin vs birth control for PCOS. Metformin may be a suitable alternative to oral contraceptives for lowering androgen levels in PCOS patients [44]. This can help with hirsutism and acne. The relative risk differences regarding diabetes, cardiovascular disease, or endometrial cancer remain unknown [45].

How long does it take for metformin to work for PCOS? Metformin takes 2-3 months to work, although some changes may happen sooner. Early signs metformin is working for PCOS include more energy and reduced sugar cravings. Improvements in menstruation and acne are often also observed.

How long to take metformin for PCOS? Metformin is often used as a long-term treatment. That could mean many decades for some people. The diabetes prevention program has followed patients for more than 15 years [5].

What is the typical metformin dosage for PCOS? As well as getting the dose right it’s important to understand how to take metformin for PCOS. The starting dose for metformin is typically 250 mg taken twice a day. This should be gradually increased every 2 weeks to reach the desired therapeutic dose. The target dose for effectiveness is between 1500 -2500 mg/day. There’s no specific metformin dosage for PCOS weight loss.

What is the lowest dose of metformin you can take for PCOS? 1500 mg per day is the most common metformin dosage for PCOS used in clinical trials. Doses of 1000 mg per day have been used in trials when taking metformin and clomid together [46].

What happens if you miss a dose of metformin for PCOS? Provided your blood sugar levels are being managed, missing one dose shouldn’t matter too much. If it’s been less than a few hours since you missed the dose, take the missed dose right away. Otherwise, skip the dose and continue on your regular schedule at the next dose. Don’t take a double dose.

What to expect when taking metformin for PCOS. It’s common to experience side effects when starting metformin. Nausea and gut discomfort are particularly common.

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References

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²Barbieri, R.L.E., D.A., Metformin for treatment of the polycystic ovary syndrome. UpToDate, 2018.

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⁹Sharpe, A., et al., Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. Cochrane Database Syst Rev, 2019. 12(12): p. Cd013505.

¹⁰Legro, R.S., et al., Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 2013. 98(12): p. 4565-92.

¹¹Laird, E.J., et al., Voluntary fortification is ineffective to maintain the vitamin B12 and folate status of older Irish adults: evidence from the Irish Longitudinal Study on Ageing (TILDA). Br J Nutr, 2018. 120(1): p. 111-120.

¹²Aroda, V.R., et al., Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab, 2016. 101(4): p. 1754-61.

¹³Ting, R.Z., et al., Risk factors of vitamin B(12) deficiency in patients receiving metformin. Arch Intern Med, 2006. 166(18): p. 1975-9.

¹⁴Bauman, W.A., et al., Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin. Diabetes Care, 2000. 23(9): p. 1227-31.

¹⁵Kozyraki, R. and O. Cases, Vitamin B12 absorption: mammalian physiology and acquired and inherited disorders. Biochimie, 2013. 95(5): p. 1002-7.

¹⁶Wulffelé, M.G., et al., Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial. J Intern Med, 2003. 254(5): p. 455-63.

¹⁷Quadros, E.V., Advances in the understanding of cobalamin assimilation and metabolism. Br J Haematol, 2010. 148(2): p. 195-204.

¹⁸Reinstatler, L., et al., Association of biochemical B₁₂ deficiency with metformin therapy and vitamin B₁₂ supplements: the National Health and Nutrition Examination Survey, 1999-2006. Diabetes Care, 2012. 35(2): p. 327-33.

¹⁹O’Leary, F. and S. Samman, Vitamin B12 in health and disease. Nutrients, 2010. 2(3): p. 299-316.

²⁰Rogne, T., et al., Associations of Maternal Vitamin B12 Concentration in Pregnancy With the Risks of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analysis of Individual Participant Data. Am J Epidemiol, 2017. 185(3): p. 212-223.

²¹Wakeman, M. and D.T. Archer, Metformin and Micronutrient Status in Type 2 Diabetes: Does Polypharmacy Involving Acid-Suppressing Medications Affect Vitamin B12 Levels? Diabetes Metab Syndr Obes, 2020. 13: p. 2093-2108.

²²Florez, H., et al., Impact of metformin-induced gastrointestinal symptoms on quality of life and adherence in patients with type 2 diabetes. Postgrad Med, 2010. 122(2): p. 112-20.

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²⁴Salpeter, S.R., et al., Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev, 2010. 2010(4): p. Cd002967.

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The post Metformin for PCOS – 7 Reasons to Avoid it appeared first on Smart Fertility Choices.

Key Takeaways

Diet plays a key role in driving PCOS. Poor blood sugar regulation and chronic inflammation are the underlying causes of all symptoms.

Avoiding foods that impact these mechanisms leads to a reduction of symptoms. When replaced with more PCOS-friendly foods, you can manage PCOS symptoms long-term.

Put a PCOS diet into practice starting with my free 30-Day PCOS Diet Challenge and free 3-Day Meal Plan.

There are two steps involved in beating PCOS. Knowing which foods to avoid and what you should eat instead. You then need to know how to put these ideas into practice.

This article is all about the first step.

For help with both steps, join me and other like-minded women for my free 30-Day PCOS Diet Challenge. Having run this program since 2016, it’s safe to say it’s got a proven track record of getting great results. Alternatively, you can get started by downloading this free 3-Day Meal Plan.

Download a full list of common foods to avoid here.

How Diet Affects PCOS Symptoms

The relationship between diet and PCOS boils down to two mechanisms. Poor blood sugar regulation and chronic inflammation. Poor blood sugar regulation leads to insulin resistance. Chronic inflammation puts your immune system into overdrive.

These two mechanisms cause the characteristic hormonal imbalances responsible for all PCOS symptoms. This includes irregular periods, weight gain, excess hair growth, and acne. But they also result in elevated risks for cardiovascular disease. This often starts with high blood pressure and insulin resistance. The gut microbiome plays a key role in linking diet to PCOS symptoms. But the health of your microbiome is also a function of your diet.

Managing PCOS symptoms is all about how you eat. That’s why it’s important to avoid the following 13 foods.

1. Refined Carbohydrates

Avoiding refined carbohydrates is the best way to improve blood sugar regulation. Over time, this can improve insulin sensitivity and reverse insulin resistance.

Refined carbohydrates include things like white bread, sugary beverages, rice, pasta, and cereal. These are all highly processed foods that have had their fiber, vitamins, and minerals removed.

For a list of common refined carbohydrate foods download my free Foods to Avoid Checklist.

2. Sugar

Sugar is the refined carbohydrate of all carbohydrates. This includes high fructose corn syrup, maple syrup, pasteurized honey, and fruit juice concentrate. Sugar is half made out of glucose which goes straight into your blood when you eat it. That makes blood sugar regulation tough.

But sugar is unhealthy for another reason too. Fructose.

Fructose makes up the other half of the sugar molecule. It’s known to cause inflammation [1, 2]. Excessive fructose intake deteriorates the intestinal barrier and causes endotoxemia [3]. This is where toxins in our gut leak into the bloodstream causing an immune response.

Fructose is processed by the liver. It can exacerbate insulin resistance. This is why high consumption has been linked to liver disease and [4, 5].

Cutting back on sugar is the single most important step you can take to manage PCOS. I emphasize this point in my free 30-Day PCOS Diet Challenge.

3. Vegetable Oils

There’s a lot of confusion about what counts as unhealthy fats for PCOS.

Despite popular opinion, whole food sources of saturated fats are not unhealthy. Large studies show no difference in heart disease risk between saturated fat and polyunsaturated fat [6]. It’s well-known by scientists that government recommendations to limit saturated fats, ‘lack rigor’ [7, 8].

The unhealthy fats that you most need to be wary of are “vegetable oils”. This includes oils from soybeans, corn, rapeseed (canola), cottonseed, and safflower seeds. These oils are high in omega-6 fatty acids and low in omega-3s. That’s the opposite of what you want to maintain a healthy weight. Consumption of vegetable oils causes weight gain and obesity [9]. Imbalances in omega fats are also associated with depression, cardiovascular disease, and autoimmunity [10, 11].

4. Trans-Fats

Trans fats used to be a widespread problem. These engineered vegetable oils have been linked to heart disease, cancer, diabetes, and obesity [12].

Fortunately, the FDA and other government regulators have banned these fats as a food ingredient. Australia is one of the few countries that continues to allow the inclusion of trans fats in its food products.

Until regulators catch up, Australians should check ingredient lists for trans fats. They’re labeled as “hydrogenated”, or “partially hydrogenated” vegetable oils.

5. Gluten

Gluten is a group of proteins found in wheat, rye, and barley. Common gluten-containing foods include pasta, bread, breakfast cereals, and other processed foods.

Gluten is a problem for PCOS because it can cause “leaky gut syndrome” in predisposed people [13]. This is a major source of chronic inflammation. Studies have shown that gluten increases intestinal permeability even in healthy people [14].

“Predisposed people” includes those with non-celiac gluten sensitivity. There’s no evidence-based research connecting PCOS to non-celiac gluten sensitivity. But there are obvious risk factors. For example, autoimmune disorders are a predisposing factor for non-celiac gluten sensitivity [15, 16]. As explained here, PCOS is closely associated with autoimmunity.

Other risk factors include gastrointestinal disorders [17-20], eating disorders [21], food intolerances [21-23], and being female [24-26]. These are all common within the PCOS community.

The collective experience of women from my free 30-Day PCOS Diet Challenge supports the link between PCOS and gluten. The most successful participants find that going gluten-free is an essential step in their journey.

For a list of common foods that contain gluten, download this foods to avoid checklist.

6. Dairy

Like gluten, there’s limited evidence linking dairy to PCOS. Reasonable arguments can be made on both sides of this debate as detailed here.

This is a situation where clinical experience is required.

From what I’ve observed as a health coach, it seems that some women with PCOS tolerate dairy better than others. But without having completed an elimination diet first, the hazards of dairy outweigh the benefits. Consuming dairy when you have a sub-clinical intolerance drives inflammation, making PCOS worse.

During my 30-Day PCOS Diet Challenge, all participants go gluten and dairy-free. It’s common for participants to discover that gluten and dairy no longer agree with them.

7. Other Foods that Trigger Sensitivities

Like gluten and dairy, eating foods you’re sensitive to triggers an immune response. This means inflammation.

Some of the most common foods that trigger sensitivities include eggs, soy, fish, and shellfish. Different nuts and seeds are also often a problem. Some people react to nightshade vegetables like potatoes, tomatoes, eggplant, and peppers. Sulfites used as a preservative in wine and dried fruit can also cause a reaction in sensitive individuals.

Food allergy and sensitivity testing have several shortcomings. As a result, many healthcare practitioners continue to use an elimination diet as a core part of their diagnostic toolkit.

Exploring the impact of other food sensitivities makes sense after you’ve eliminated gluten and dairy.

8. Caffeine

Coffee and caffeine are not the same thing. Disentangling these things is important for optimizing your PCOS diet. There’s compelling evidence that the bioactive compounds in coffee are good for you [27-29]. But caffeine, in the absence of coffee, is best avoided if you have PCOS. That means energy drinks are out.

Caffeine alone reduces insulin sensitivity and raises blood glucose levels [30]. It also activates our stress response. Women with PCOS have a disturbed stress response [31]. So, drinking caffeinated beverages is likely to make you more anxious. It can also exacerbate other symptoms.

Caffeinated coffee has health benefits. But the over-activation of the stress response it may cause means it’s worth considering alternatives. Decaf gets you the best of both worlds and is an easy substitute.

Learn more about the pros and cons of coffee for PCOS here.

9. Alcohol

From a nutritional perspective, alcohol is one of the most obvious foods to stay away from. Even rare consumption has been associated with increased rates of liver disease in women with PCOS [32].

Moderate alcohol consumption may disrupt the balance of estrogen to progesterone [33]. It’s also associated with reduced fertility [34] and is unsafe during pregnancy.

At all dosages, alcohol reduces sleep quality [35]. It’s also known to reduce self-control and increase cravings [36]. If you’re working hard on your diet or exercise habits, that can be a major problem.

But this doesn’t mean you should never drink alcohol. As I explain in my article on PCOS and alcohol, there’s still plenty of room for nuance on this subject.

10. Soy

Soy is one of the most confusing foods to understand from a PCOS perspective. This is because most studies looking at soy and PCOS use a single, isolated, bioactive compound. These are soy supplement studies. The results cannot be used to make informed choices about soy foods.

Any potential benefits of soy foods for PCOS rely on weak evidence. For example, a recent review investigated the role of soy on PCOS. They found “no homogenous improvement” in hormonal imbalance or fertility [37]. Many experienced healthcare practitioners believe that soy can be harmful to their PCOS patients. They recommend avoiding soy foods based on their clinical experience.

What’s much more certain is that conventionally grown soy foods are bad for PCOS. This isn’t about the soy products themselves. It’s the spray used to grow the beans. 90% of conventionally-grown soybeans are glyphosate-tolerant (GT). This enables growers to use large amounts of the herbicide, Glyphosate, to cut costs. A 2014 study found that US-grown GT soybeans contained high residues of glyphosate [38]. This is a big problem for PCOS as explained in my article on soy and PCOS.

11. Pesticide-Intensive Foods

Glyphosate isn’t the only pesticide that can harm human health. Regulators have long known that chemical pesticide exposure is linked to many chronic illnesses. This includes cancer, heart, respiratory, and neurological diseases. A large European study found 46 pesticides in the urine of adults and children [39]. At least two pesticides were present in 84% of participants [40].

Pesticide-intensive foods are especially bad for PCOS. Many pesticides are endocrine disruptors (EDCs). EDCs have been linked to insulin resistance, obesity, thyroid, and reproductive issues [41-43].

The Environmental Working Group (EWG) has identified the 12 most pesticide-intensive foods. In an ideal world, all our food would be organically grown, but these “dirty dozen” are a practical place to start.

12. Processed Foods

The problem with processed foods is that they’re often high in refined carbs and sugary foods. This disrupts healthy blood sugar regulation. They also tend to contain vegetable oils, dairy, gluten, soy, and food additives. These ingredients can cause inflammation.

Fast food and fried food are the quintessential processed foods. But any product that’s been mechanically, thermally, or chemically treated is technically processed food. It’s important to understand here that it’s all about the ingredients, rather than the definition.

The ingredients used also determines the suitability of processed meats. Additive-free sausages are usually fine. But it’s best to avoid foods like ultra-processed hot dogs.

The key take-home here is that if it comes with a nutrition label, then it’s worth reading it. If you don’t like the look of the ingredients (or you don’t know what they are), then it’s a food that’s best avoided.

13. FODMAPS (If You Have IBS)

Estimates suggest that around 1 in 4 women with PCOS suffer from irritable bowel syndrome (IBS) [44, 45]. It’s a common cause of PCOS bloating. I see this a lot within my PCOS Support Group. For these women, it’s best to avoid high-FODMAP foods.

A low FODMAP diet is difficult and intense. That’s because FODMAPS are found in many healthy everyday foods. A low FODMAP diet is generally followed for a short duration to alleviate symptoms. A reintroduction phase is then used to identify specific trigger foods. This should enable a less restrictive low FODMAP diet afterward.

Experts recommend that all patients with IBS undergo a parasite investigation. Protozoan parasites cause IBS yet this diagnosis is often missed [46, 47].

What To Eat Instead

With all this knowledge of what not to eat with PCOS, the obvious next question is, “what should I eat instead?” The short answer is to follow these core principles:

• Eat slow-carb and low-carb, from whole food sources. A low-carb, high-fiber, low-GI diet helps stabilize blood sugar levels. This improves insulin levels and restores hormone balance. Learn more about optimizing carb intake for PCOS here.
• Consume healthy fats. Getting up to 60% of calories from whole food sources of fat is one of the best ways to improve insulin sensitivity and drive weight loss. Learn more about the best macros for PCOS here.
• Get enough protein. Adequate protein is essential for good health. But what counts as “adequate” varies with sex, age, body mass index, activity levels, and more. The USDA provides a useful online calculator for estimating an appropriate protein intake.
• Eat high-fiber foods. Especially those rich in prebiotic fibers. Doing so supports gut health, and reduces inflammation.
• Eat non-starchy vegetables. Non-starchy vegetables are rich in fiber which is good for gut health. They’re also an excellent source of vitamins, minerals, and other micronutrients.

Learn more about a PCOS Diet here, and download my PCOS Diet Cheat Sheet.

The Bottom Line

PCOS is driven by poor blood sugar regulation and chronic inflammation. Both of these mechanisms are dialed up or down by the foods we eat. Because of this, dietary change is a powerful intervention for reducing the full scope of PCOS-related symptoms.

The most obvious foods to avoid with PCOS are refined carbs, sugar, vegetable oils, trans-fats, and highly-processed foods. Doing an elimination diet to determine your sensitivity to gluten, dairy, and other foods is also critical. Women with PCOS should be strategic about how they approach caffeinated drinks and alcohol. Soy and other pesticide-intensive foods are best avoided. For PCOS women with IBS, a low FODMAP diet should be followed until a better long-term solution can be found.

If you’re ready to embrace a PCOS diet today and avoid these foods, then sign-up now for my free 30-Day PCOS Diet Challenge. You can also get started with this free 3-Day Meal Plan.

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