Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder estimated to affect 12 to 21% of women of reproductive age.
PCOS is formally diagnosed when you meet the Rotterdam diagnostic criteria, which requires two of the following three conditions to be met:
- Infrequent or irregular ovulation (irregular is where your periods are usually longer than 35 days apart).
- Hyperandrogenism (elevated androgens). This means a higher level of reproductive hormones that are usually more dominant in men. Hyperandrogenism might be seen physically, such as excess body hair typically on the face, or scalp hair loss. It may also be seen on blood tests such as elevated testosterone.
- Polycystic ovaries seen on an on ultrasound. Polycystic means the appearance of multiple “cysts” on your ovaries, which are not really cysts but lots of immature follicles containing eggs.
Contrary to popular belief, PCOS cannot be diagnosed based on ovarian cysts alone.
As the path to getting a formal diagnosis can be tricky, it’s thought that up to 70% of women with PCOS remain undiagnosed!
What are some common symptoms of PCOS?
Although the name suggests PCOS is concerned mainly with the ovaries, it can present with a wide range of symptoms, from mild to more severe. Signs and symptoms may include:
- Period and fertility issues such as amenorrhea (no period) or irregular periods
- Difficulty conceiving
- Excess facial and/or body hair (hirsutism)
- Scalp hair loss (alopecia)
- Acne typically around the jawline
- Darkening of the skin, typically around the armpits and neck area
- Weight gain or difficulty losing weight
- Mood changes including depression, anxiety, low self-esteem and poor body image
Women with PCOS may also be at a greater risk for developing issues including insulin resistance, type 2 diabetes, cardiovascular disease, sleep apnoea and cholesterol abnormalities.
How can nutrition help PCOS?
There is no known cure for PCOS, however, diet and nutrition play a major role in managing its associated signs and symptoms.
Around 85% of women with PCOS experience insulin resistance. Insulin is a hormone produced by the pancreas that regulates how much glucose (sugar) is in our blood. If your body becomes insulin resistant it can aggravate the symptoms of PCOS, as insulin increases the production of androgens such as testosterone within the body. Additionally, insulin resistance can make it harder to maintain a healthy weight.
Managing insulin resistance through diet and nutrition is also vital for supporting skin health. An increase in androgens can worsen acne, a common symptom associated with PCOS.
Specific nutrients such as zinc, vitamin D, omega-3’s and B vitamins can also support ovulation and restore regular periods, which is important if you are hoping to fall pregnant.
Nutrition tips for PCOS
There is no “one size fits all” diet that helps in managing PCOS. However, there are a few basic tips that you can implement and establish what works best for your body and PCOS symptoms.
1. Choose low GI carbohydrates
Low glycaemic index (GI) carbohydrates are foods that slowly release glucose into your blood, helping to manage insulin sensitivity.
This may look like swapping processed and refined foods such as white bread, white potatoes, white rice and packaged cakes for wholegrains including rolled oats, seeded or grainy breads, wholewheat pasta, legumes and sweet potato.
2. Increase protein and fats and enjoy moderate carbohydrates
This isn’t to say cut out carbohydrates completely, but you CAN have too much of a good thing. As insulin resistance is commonly associated with PCOS, it is important to moderate your carbohydrate intake and focus on lean proteins and healthy fats.
Instead of having 2 slices of toast for breakfast, this may look like 1 slice of toast with the addition of 2 boiled eggs and some avocado.
3. Load up on ANTI-INFLAMMATORY and ANTIOXIDANT rich foods
Following an anti-inflammatory diet can improve blood sugar regulation in PCOS and help to restore the regularity of menstrual cycles. Additionally, women with PCOS have an increased risk of oxidative stress, so increasing antioxidants can improve the management of PCOS symptoms.
Following a Mediterranean-style dietary pattern can be beneficial for women with PCOS and includes foods such as:
- Wholegrains, legumes (beans and lentils), vegetables, fruits nuts and seeds
- Extra Virgin Olive oil
- The inclusion of fish 2-3 times per week. Oily fish such as salmon, sardines, trout and mackerel have the richest anti-inflammatory properties
- Sticking to moderate amounts of lean proteins (poultry, egg, small amounts of red meat) as well as full fat dairy such as yoghurt and cheeses
Adopting this dietary pattern ensures your plate is filled with many colours, nutrients and can support the management of PCOS.
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