Written by: Hannah Santoni, B.S. in Kinesiology & Health, Dietetic Intern at The Ohio State University
Reviewed by: Audrey Clement, RD
What is PCOS?
Chances are if you’re here, you have been affected or know someone who has been affected by Polycystic Ovarian Syndrome (PCOS). PCOS is an endocrine, meaning hormone-related, disorder that impacts pre-menopausal women and females of reproductive age. While the exact cause is not known, research has shown that several factors play a role in disease development including genetics, obesity, insulin resistance, low-grade inflammation, and excessive production of male sex hormones (known as androgens). Insulin is the hormone that takes glucose, our body’s main energy source, and brings it into our cells to be used. Disruption of insulin’s ability to bring glucose into the cells leads to chronically elevated blood glucose levels. This contributes to fat storage and chronic inflammation, which further exacerbates insulin resistance and contributes to the main symptoms seen in PCOS.
PCOS patients may present with symptoms such as irregular menses, hair growth on the face and/or chest, acne, skin tags, thinning hair, and infertility, among others. To be medically diagnosed with the condition, at least two of the following symptoms must be present:
Excess amount of androgen hormones (indicated by blood tests or symptoms related to this)
Irregular ovulation (indicated by irregular or absent menses)
Presence of enlarged or polycystic ovaries on an ultrasound
PCOS has several risks and complications associated with it if not well managed. These individuals are at a greater risk for developing metabolic complications including type 2 diabetes, metabolic syndrome, obesity and cardiovascular disease. Utilizing diet and lifestyle interventions are crucial for improving health outcomes and quality of life.
The link between Nutrition, Exercise and PCOS
Nutrition: An important nutrition goal for PCOS patients is to eat in a way that supports steady blood sugar levels. Carbohydrates are the body’s main energy source and are an important part of the diet, however, when they are eaten alone, they exacerbate the deregulation of blood sugar caused by insulin resistance. Eating all of the macronutrients together at meals (carbohydrates, protein, and fat) slows the digestion of carbohydrates, keeps us energized longer, and helps to regulate blood sugar control and support insulin function.
Exercise: Many of the symptoms associated with PCOS are due to chronic insulin resistance. Exercise, specifically when done at vigorous intensity, has shown to improve insulin response in the body. Regular strength training, when combined with adequate protein intake, will promote muscle mass growth and retention. Greater amounts of lean mass have been shown to improve insulin sensitivity. Improvements in muscle mass can optimize blood sugar regulation in PCOS patients.
5 Tips for Managing PCOS Symptoms
Balanced meals and snacks
Eat every 3-5 hours, depending on your activity level. Blood sugar levels rise and fall between this time frame. Extended periods of time without eating can result in excess stress hormone production to bring low blood sugar levels back up.
At meals, use your plate as a visual tool: ¼ plate lean protein, ¼ plate complex carbohydrates, ½ plate color. Click here for some make-ahead breakfast recipes to kick start your day!
At snacks, pair fiber-rich carbohydrates with a protein source! Protein is the slowest digesting macronutrient, so this will decrease the glycemic load of the meal, promote satiety, and support muscle maintenance/growth.
Regular exercise. Find enjoyable movement that keeps you in a routine. Consistent exercise can improve body composition (decreased fat mass and increased lean mass) over time. Aim for at least 30 minutes of exercise most days of the week. Try to incorporate strength training 2-3 times per week.
Sleep. Prioritize 7-9 hours of sleep per night. If developing a healthy sleep routine is difficult, start by focusing purely on healthy sleep hygiene practices. Try to limit screen time for 60 minutes before bed. Light stimulates the release of cortisol, our stress hormone, and prevents the release of melatonin, the hormone that makes us sleepy. Replace this habit with a stress-reducing task such as reading, meditation, listening to relaxing music, or journaling. Sleep deprivation is connected to an increased risk of insulin resistance, obesity, and type 2 diabetes.
Stress management. PCOS patients have increased cortisol response to stress. Incorporating healthy coping mechanisms like exercise, deep breathing, reading, or taking a bath can help to mediate stress more effectively. Studies have shown that even just spending time in nature can reduce psychological stress.
Consider supplements. There is no more effective supplement than diet and exercise! That being said, there is research to support the use of inositol in PCOS patients. Inositol works to improve insulin sensitivity, fasting blood glucose and postprandial glycemic control. Studies conducted so far have shown moderate improvements in fertility and PCOS symptoms when supplementing with 1-4 grams once daily.