Characterized by symptoms including an irregular menstrual cycle, excess facial and body hair (hirsutism) and acne, PCOS is a chronic – and as yet, cureless – condition that can be frankly exhausting to manage. And the most frustrating part? There is still so little knowledge on the subject.
PCOS: What causes it?
The truth is, no one can say with absolute certainty what causes PCOS. However, Mayo Clinic believes that excess insulin (the hormone that allows cells to utilize sugar for energy), low-grade inflammation, excess androgen (often referred to as ‘male’ hormones, which include testosterone) and your genes could all be factors.
“In simplest terms, PCOS is considered to be an imbalance of hormones that can lead to a range of symptoms, with the central issues arising from irregular or absent ovulation,” says Gary Nakhuda, MD, co-director at Olive Fertility. “The ‘normal’ hormonal feedback system between the brain and the ovaries is disrupted with PCOS so that, in addition to ovulatory issues, a spectrum of other hormonal symptoms may be present.”
PCOS is the most common cause of female infertility and can lead to conditions including type 2 diabetes and cardiovascular disease, among others. (Here are facts about fertility every woman needs to know.) However, whilst Dr. Nakhuda assures symptoms are treatable, the trouble with having so few evidence-based answers is that there is so much speculation when it comes to the best ways of managing PCOS, and nowhere is this more prevalent than on social media.
Case in point: the theory that dieting, restricting and cutting food groups can relieve PCOS symptoms.
Can diet really help you to manage your PCOS symptoms?
Just as there’s no one diet—for want of a better term—that works for everyone (because, ya know, varying motivations, preferences, allergies and intolerances, affordability, accessibility, and so on), there’s also no PCOS-perfect plan—contrary to what some on the ‘Gram might have you believe.
That doesn’t mean, however, that nutrition is out of the equation altogether. In fact, there is evidence to suggest that certain eating habits may help you to manage PCOS symptoms.
Authors of the International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018 recommend a balanced diet based on national guidelines for those with PCOS, which means meals that include plenty of fruit and veg, lean protein, whole grains and water, and a limited consumption of foods high in sodium, sugar and saturated fat. So, broadly speaking, the same diet as the majority of humans (intolerances and illnesses to one side) looking to maximize health, then?
Well, yes. Pretty much. But there’s more: Where insulin resistance is present (which it is in 65-70 percent of women with PCOS), incorporating foods with a low GI (glycemic index) into meals could be beneficial. This is because food items with a lower GI (1 to 55), such as raw carrots, kidney beans, chickpeas, lentils, most fruits and green vegetables, are less likely to cause large spikes in blood sugar levels. That being said, it’s important to discuss your particular situation with your doctor and a registered dietician to ensure your nutritional needs are met, and you aren’t unnecessarily cutting food groups or being misled by unreliable sources.
“Obviously there is a plethora of unreliable and dubious information available on the internet,” says Dr. Nakhuda. “You just have to use good judgment, especially when it comes to taking excessive supplements, or extremely modifying diet or behaviour.”
Steer clear of sites and social accounts encouraging you to remove food groups, or claim that they can offer a cure.
So, how do I manage my PCOS?
Treatment will vary dramatically from person to person depending on the individuals’ preferences and life goals. If conceiving is not a priority then an estrogen and progesterone contraceptive can be used to regulate cycles and reduce excess hair growth, however, it isn’t always a suitable option for the patient. Conversely, for those seeking pregnancy, fertility treatment can help.
As far as diet is concerned, there isn’t yet enough evidence to suggest that a certain way of eating trumps another when the focus is on managing PCOS symptoms, so don’t let influencers scare you into scrapping carbs from the menu. The best you can do is prioritize nutrient-dense foods that make you feel good and refer to your GP for advice (oh, and unfollow any triggering Instagram accounts).
“Ultimately, it is best to seek treatment with a qualified practitioner,” says Dr. Nakhuda. “Not all women with PCOS suffer from the same symptoms, and the symptoms that a patient suffers from may change over time. Therefore, no one easy treatment will be adequate for everyone.”
Next, learn about Pretty Little Liars star Sasha Pieterse’s experience with PCOS.