Lifestyle management of PCOS–A personalized plan

Amy Brownstein, MS, RDN - Registered Dietitian Nutritionist

Polycystic Ovary Syndrome (PCOS) is a complex metabolic condition that is thought to affect 6-20% of women globally, and management is key to feeling better and in control. Read on to learn about this condition and guidelines for lifestyle management of PCOS.

Effective management of PCOS is possible

Polycystic Ovary Syndrome (PCOS) is a complex metabolic condition that is thought to affect 1 in 10 women of childbearing age. PCOS affects women from adolescence to post menopause. Men, while this does not apply to you, it may impact someone you know.

Symptoms of PCOS can vary from person to person. Common symptoms may include:

Infertility
Irregular periods
Unexplained weight gain
Acne
Oily skin
Skin tags
Increased hair growth on the face, chest, stomach, and back
Cysts on the ovaries
Pelvic pain
Male-pattern baldness.

The medical world now recognizes that PCOS can involve more than just the reproductive system. Insulin resistance (IR) is a key feature of PCOS. Insulin resistance is the reduced ability of insulin to carry glucose (sugar) from the blood into the body cells. This means the pancreas produces more insulin. Excess insulin production leads to an increase in stored body fat. In PCOS, IR also appears to increase male hormone production, like testosterone.

PCOS increases the risk of other chronic health conditions like heart disease and type 2 diabetes. Additionally, people with PCOS are more likely to have sleep disturbances, such as insomnia and obstructive sleep apnea. Poor sleep contributes to hormone imbalances, weight gain, IR, and an increased risk of type 2 diabetes and heart disease.

The good news is that women with PCOS can positively impact their condition through lifestyle management, such as a diet and exercise plan. The plan targets treating IR by tempering the cascade of reactions that interplay between the reproductive and endocrine systems. By doing so, a PCOS diet and exercise plan attenuates symptoms and reduces the risk of long-term chronic health conditions.

Your PCOS diet and exercise plan

Lifestyle management of PCOS strives to prevent weight gain and support long-term maintenance of a healthy weight. Exercise and dietary modifications can be effective tools for optimizing health and quality of life for people with PCOS. A healthy lifestyle also improves metabolic health and supports body composition.

There is no one diet for PCOS. Rather, an overall healthy eating pattern that incorporates preferences, lifestyle, and medical history will be most effective for managing PCOS symptoms and complication risks.

Guidelines for the management of PCOS and reducing your symptoms

Eat smaller amounts throughout the day, avoiding going longer than 4 hours without food. Skipping meals is not recommended for PCOS. Consume your largest meal at breakfast and your smallest at dinner for greater insulin sensitivity.
Carbohydrate intake has the most power over the insulin response. Learn which foods contain carbs. Spread carbs throughout the day, and balance them with lean proteins and healthy fats. Severely limiting carb intake is not the answer. Instead, prioritize fiber-rich, low-glycemic carbohydrates.
Choose high-fiber foods and healthy carbohydrates. Include whole fruits instead of juices. Consume whole grains, beans, peas, lentils, and plenty of veggies. High-fiber carbohydrates tend to have lower glycemic indices, which help stabilize insulin levels. Stable insulin contributes to reduced testosterone production and may help with certain PCOS symptoms like acne and irregular menstrual cycles.
Limit such refined carbohydrates as white bread, pasta, baked goods, and desserts. Diets low in refined carbohydrates and high in fiber help regulate blood sugar levels and reduce insulin resistance.
Load up on antioxidant-rich foods like vegetables, fruits, legumes, nuts, and seeds. These foods provide essential vitamins, minerals, and antioxidants to reduce inflammation and manage PCOS symptoms.
Incorporate more omega-3 fatty acids. Omega-3s help reduce inflammation and improve symptoms of PCOS. Add more fatty fish (salmon, mackerel, trout, sardines, and anchovies), flaxseeds, chia seeds, hemp seeds, and walnuts to your diet.
Go Mediterranean. Focus on healthy fats, like olive oil, and vegetable fat sources, like nuts, seeds, avocados, olives, and fatty fish.
The Dietary Approaches to Stop Hypertension (DASH) diet has yielded great success with reducing insulin resistance and weight and improving hormone profiles in people with PCOS. Similar to the Mediterranean diet, DASH emphasizes fruit, vegetables, whole grains, nuts, legumes, and low-fat dairy products.
Opt for lean proteins like chicken, turkey, fish, legumes, and natural soy foods. Meals higher in protein can reduce insulin levels compared to a high-carbohydrate meal. Furthermore, increasing protein may reduce appetite, contributing to greater weight management. Aim for 20 to 30 grams of protein per meal.
Select lean and low-fat meats and dairy to reduce saturated fat. Dodge foods like butter, bacon, cheese, hot dogs, and rich desserts. Also, avoid trans fats as much as possible.
Get sweaty! Guidelines recommend 150 to 300 minutes weekly of moderate-intensity aerobic exercise to prevent weight gain and maintain health. For greater health benefits, such as weight loss, aim for at least 250 minutes weekly of moderate-intensity aerobic exercise. Include two sessions of strength training each week. Strive for at least 30 minutes of aerobic exercise daily. If you move, the insulin will move.
Practice mindful meditation to reduce stress and improve psychological well-being. Emerging research suggests that mindfulness meditation reduces stress, depression, and anxiety symptoms, and improves life satisfaction and quality of life among individuals with PCOS. Furthermore, mindful meditation may help regulate blood sugar levels and hormone production.
Losing just 10 pounds can greatly improve insulin resistance, lessen PCOS symptoms, and, in many women, improve fertility.

Personalize your PCOS diet and exercise plan

A registered dietitian nutritionist familiar with PCOS can help you create a personalized diet and exercise plan to improve symptom management of PCOS. If you identify with the PCOS symptoms above, seek advice from a medical specialist who is trained in endocrinology or women's health.

Certain supplements may reduce insulin resistance and inflammation and improve reproductive health in people with PCOS. A registered dietitian can provide guidance on beneficial supplements, given your life stage, symptoms, and goals. There are medical treatments that can treat PCOS along with a healthy lifestyle plan.