Polycystic ovary syndrome or PCOS affects around 10% of the female population in the UK (1). It is a reproductive condition that can lead to unwanted symptoms as well as problems with fertility. We know that diet and lifestyle changes can support people with PCOS by reducing symptoms and increasing fertility. So what does a PCOS fertility diet or PCOS meal plan look like? Read on to find out.
What is PCOS?
Imbalances in hormones and higher levels of androgens (male sex hormones, such as testosterone) are classic signs of PCOS.
The criteria set out to diagnose PCOS sets our that 2 out of the following 3 symptoms must bee met for diagnosis. In lots of cases a PCOS diagnosis is received without seeing cysts on the ovaries. Meaning the name is actually misleading.
- Irregular periods (anovulation)
- Hyperandrogenism – clinical signs (e.g., hirsutism) or biochemical (raised free androgen index or free testosterone)
- Scans showing ovarian cysts
Symptoms can differ between women. Common symptoms include;
- Irregular periods
- Fertility issues
- Excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks.
- Weight gain.
- Thinning hair and male pattern baldness
PCOS, weight, diet and fertility
A lot of people with PCOS are told to lose weight. However, weight loss can be harder for those with PCOS due to insulin resistance. Insulin works to lower our blood sugars when we eat carbohydrates. However, when we are insulin resistant our bodies don’t respond as well as they should to insulin which causes us to have higher than desirable blood sugars.
To attempt to lower our blood sugars to a normal level, an insulin resistant person will have to produce a lot more insulin than someone who is sensitive to insulin. It is this large volume of insulin that some researchers think causes high testosterone and consequently all the symptoms seen with PCOS.
It is true that for women with PCOS, losing 5% of body weight can improve PCOS outcomes. Weight loss can be part of a PCOS fertility diet if that is the right direction for you.
So what is the best PCOS fertility diet?
There have been many studies on how different diets affect PCOS. Diets involving carbohydrates (foods such as bread, pasta and rice) have had a large amount of interest due to the potential mechanism of PCOS.
Recent research collecting data from 8 studies concluded that a lower carbohydrate intake in women with PCOS is beneficial for (3);
- weight loss
- hormonal balance
- menstrual cycle regularity
There have also been studies assessing how the type of carbohydrate we eat can affect PCOS. Every carbohydrate has a certain glycaemic index (GI), which is a measurement of how much it raises our blood sugar. Studies have shown that low glycaemic index diets can help PCOS and reduce obesity (4). Reducing consumption of refined sugars, such as sweets and chocolate can also help with this. These tips can help you create your PCOS meal plan.
Although a lower carbohydrate diet may reduce severity of PCOS symptoms, we don’t want to cut out carbohydrates completely. A reduction could be advantageous. Please consult a dietitian before embarking upon this as there is a risk of creating nutritional deficiencies.
Protein can also help to stabilise blood sugar, control appetite and keep you feeling full. Moderate increases in protein intake can improve weight loss and glucose metabolism and can be useful when creating a PCOS meal plan.
Following a PCOS fertility diet that is based on the Mediterranean style of eating can incorporate all of these dietary elements and improve severity of PCOS symptoms.
Whilst carbohydrates have been the main focus so far, there has also been anecdotal stories of a reduction of gluten and dairy causing an improvement in symptoms. However, evidence here is lacking. Some women may find it beneficial to keep a food dairy to see if there are any common triggers between certain foods and symptoms.
Lean PCOS – what does this mean for a PCOS fertility diet
Do you have a diagnosis of PCOS but are a healthy weight? If so, you have what is called lean PCOS. Some people with lean PCOS may still have a typical PCOS body shape which includes weight storage primarily over the stomach area, whilst some may be lean all over and have a healthy BMI.
Studies have shown that insulin resistance is still quite common in lean PCOS. Therefore you may benefit from similar diet tips to those who also struggle with their weight. However, it is important that those with lean PCOS get plenty of healthy fats and protein to ensure they are meeting their energy requirements.
Aside form creating your PCOS fertility diet there are additional things that can help support your fertility and symptoms.
Increasing our activity levels can help us lose weight and improve PCOS symptoms. Being active doesn’t have to mean doing a gruelling 10km run in the freezing cold which you have no desire to do at all. Instead it could be walking to work instead of driving, or even spending a day spring cleaning. One study found that women with PCOS that exercised 3 times a week for 30 minutes had a decreased BMI and waist circumference (5). Other research has shown that vigerous aerobic exercise and resistance training could be effective for PCOS by reducing androgen levels and improving hormone levels (6).
Other treatments that are often used in women with PCOS include:
- Laser hair removal to treat excess hair growth
- Acne treatments ranging from topical solutions to medications
- Dietary supplements or other medications
- There may be supplements or medications that could help but it is recommended to discuss this with your dietitian or GP.
Want more help?
A PCOS diagnosis may feel daunting, especially if you are trying to conceive. Making a few lifestyle changes though can dramatically change the outlook and your symptoms. Make a start by incorporating some of these PCOS friendly snacks.
To help you create your PCOS fertility diet and manage your symptoms longer term, find a PCOS meal plan right for you. We have one PCOS meal plan and guide that focuses on weight loss and the another that supports healthy weight maintenance. Check them out.