Polycystic ovary syndrome: Can diet improve symptoms?

Polycystic ovary syndrome aka PCOS is one of the most common reproductive disorders, affecting approximately one in 10 women. Despite being fairly common, from a nutrition perspective, it is quite a poorly understood disorder. This article will summarise the latest research regarding nutrition and PCOS and how changes to the diet can help you manage your symptoms.

So, what exactly is PCOS? PCOS is a hormonal disorder whereby there is an imbalance of the female sex hormones (oestrogen and progesterone) and too much of the hormone generally related to males: testosterone. This results in the growth of non-cancerous masses in the ovaries, known as ovarian cysts. Other problems that can arise with PCOS include (but not limited to) irregular periods, acne, fertility problems, alopecia, excessive hair growth on face and body and insulin resistance.

There is currently no cure for PCOS, but a combination of medications and changes to lifestyle/diet can make a difference.

This article will not discuss weight loss as that is usually the only advice patients will hear when trying to make lifestyle changes, without consideration to other weight neutral modifications that can help improve PCOS symptoms.  Additionally, this article will focus solely on changes you can make to your nutrition. Read on to find out how you can potentially improve your PCOS symptoms through diet!

A low glycaemic index (GI) diet

The internet is rife with claims that you should avoid all carbohydrates if you have PCOS. This is simply not true. However, some people may want to explore a low GI diet. "What is that?" I hear you ask.  Put simply, carbohydrates are digested differently which has an impact on your blood sugar levels.

All carbohydrates have a GI ranking between 1-100 and this relates to the impact of these foods on your blood sugars - those with a higher ranking will cause greater peaks to your blood sugar after eating, whereas those with a lower ranking will cause a more stable increase in blood sugars after eating. Therefore, a low GI diet is a diet that encourages the consumption of carbohydrates that reduce the peak of blood sugars and so in practical terms, that would be limiting refined carbohydrates such as white bread, white rice, full-sugar drinks, sweets and replacing these with whole-grain carbohydrates and foods high in fibre such as nuts, pulses, lentils etc.

Since insulin resistance is quite prevalent in people with PCOS, a low GI diet can help keep the blood sugars stable. Furthermore, some studies have also shown that a lower GI diet may help reduce circulating testosterone levels.

Mediterranean style of eating

Some studies have shown that an ‘anti-inflammatory’ style diet can aid in reducing symptoms of PCOS and inflammation - one extensively studied diet is the Mediterranean diet, which has health benefits beyond those limited to PCOS. This diet, in particular, focuses on meal patterns which incorporate the following:

• whole grains
• vegetables
• nuts
• fish (particularly oily)
• beans
• pulses
• olive oil
• spices
• herbs

It aims to limit foods such as high fat/high sugar food with limited nutritional benefit (think cake, biscuits, deep-fried foods - although still delicious and certainly have a role in a well-balanced diet), sugary drinks and processed red meat.

Meal patterns

Women with PCOS often report having carbohydrate carvings which may be linked to peaks and dips of blood sugar levels. One way to stabilise these blood sugars is to try to incorporate a regular meal pattern, ideally three evenly spaced apart meals throughout the day, and if needing to snack, opt for snacks which are not just sweets, crisps, pastries, biscuits; try snacks which incorporate some protein and healthier fats as well (i.e. hummus and vegetable sticks, rice cake with nut butter, greek yoghurt with fruit).  

Additionally, regular meal patterns may better the body’s sensitivity to insulin, in turn reducing high blood sugars. Furthermore, a few studies in recent years have shown that having larger meals earlier on in the day as opposed to having a very large evening meal can attenuate the spike in blood sugars that many people with insulin resistance tend to experience.

Micronutrients

Zinc and magnesium are two micronutrients that have been shown to be low in people with PCOS.

Magnesium is involved in various body functions which include regulating/controlling mood, blood pressure and insulin levels. Ensuring that you are having enough magnesium in your diet can help to reduce premenstrual related symptoms. Foods high in magnesium include:

• soya beans
• cooked spinach
• Marmite
• peanuts
• pumpkin seeds
• Brazil nuts
• almonds
• cashew nuts
• wheat-based foods

Zinc has also been shown to lead to an improvement in many PCOS related symptoms such as hair loss on the head, too much hair growing on the face, issues with fertility and premenstrual syndrome. Foods rich in zinc include:

• shellfish
• oysters
• red meat
• cashew nuts
• baked beans
• chickpeas
• breakfast cereals that have been fortified

How about supplements?

Inositol: may aid in improving the body’s sensitivity to insulin, lower testosterone levels and can help with improving the chance of fertility.

N- acetylcysteine: the research here is quite mixed to support its use but some studies indicate that it may improve fertility and insulin sensitivity.

Vitamin D and calcium: when taken together, they may improve insulin resistance and help to regulate menstrual cycles.

Omega 3 supplements: these can improve insulin resistance, decrease liver fat in PCOS and since there seems to be an inflammatory component associated with PCOS, they may help improve inflammation in the body.

In conclusion, despite PCOS being an incurable condition, with the right help and changes to your diet, significant improvement can be seen in some individuals if the above tips are implemented consistently. If you would like a personalised approach to help improve your PCOS symptoms, don’t hesitate to reach out!