Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age, with an estimated 1 in 10 women and those assigned female at birth experiencing it during their reproductive years.

Diagnosis

PCOS is diagnosed using the Rotterdam Criteria. A diagnosis requires at least two of the following three criteria:

Irregular periods – cycles that are shorter than 21 days or longer than 35 days.
High androgens – elevated levels of male sex hormones detected through blood tests, or physical signs like acne, hair loss, or hirsutism (excessive hair growth).
Polycystic ovaries on ultrasound – identified by a pelvic ultrasound showing the accumulation of immature follicles (commonly referred to as “cysts”).

While the exact cause of PCOS is unknown, it is believed to be linked to both genetic and environmental factors, although much remains unclear.

Signs & Symptoms

PCOS is a complex condition with a range of signs and symptoms that can vary widely from person to person. Common signs and symptoms include:

Irregular or absent periods
Lack of ovulation
Difficulty conceiving
Excess body hair (particularly facial hair, known as hirsutism)
Acne
Scalp hair thinning or loss
Darkened skin patches
Weight gain or difficulty losing weight
Anxiety or depression

Additionally, many women with PCOS experience insulin resistance (difficulty managing blood sugar levels) and elevated levels of testosterone and other androgens.

Understanding Insulin Resistance

Around 75% of women with PCOS also experience insulin resistance. Insulin is a hormone produced by the pancreas to help regulate blood sugar (glucose) levels by allowing glucose to enter cells and be used for energy. When insulin resistance occurs, the hormone becomes less effective, causing the pancreas to produce more insulin and leading to higher blood sugar levels. This can increase testosterone production, making it harder to lose weight and often worsening PCOS symptoms.

Management

PCOS management varies depending on how the condition presents in each individual, personal goals, and lifestyle. It can be managed through a combination of dietary strategies, physical activity, medications, and certain supplements. Personalised management is key.

Nutrition

Diet plays a critical role in managing PCOS symptoms. Nutritional strategies include:

Prioritising wholegrains, fruits, vegetables, lean proteins, healthy fats, and fibre.
Eating regular, balanced meals.
Following Mediterranean and/or anti-inflammatory dietary patterns, which are high in omega-3, fibre, vitamins, minerals, antioxidants, and polyphenols, to improve insulin sensitivity, reduce androgen levels, decrease inflammation, and support sustainable health.

Top Nutrition Tips

ONE. Choose low-GI carbohydrates

Low glycaemic index (GI) carbohydrates release glucose slowly into the bloodstream, preventing rapid blood sugar spikes and helping insulin work more effectively. Avoid cutting out carbohydrates altogether, as they provide essential energy for the body.

Low-GI carbs include:

Rolled oats
Untoasted muesli
Grainy/seeded breads
Traditional sourdough
Wheat or pulse pasta
Legumes (kidney beans, lentils, chickpeas)
Basmati or brown rice
Quinoa
Buckwheat
Sweet potato
Corn kernels
Vita-Weats

Simple swaps:

Swap white Jasmine rice for brown or basmati rice.
Swap white potatoes for sweet potatoes.
Swap white bread for grainy wholemeal, rye, or sourdough varieties.
Swap white pasta for pulse pasta

TWO. Balanced meals

Incorporating lean protein and healthy fats with low-GI carbs will slow carbohydrate metabolism, helping to maintain stable blood sugar levels.

THREE. Focus on anti-inflammatory and antioxidant-rich foods

Women with PCOS may have higher levels of oxidative stress and low-grade inflammation. A Mediterranean diet, rich in monounsaturated fats, omega-3s, fibre, and antioxidants, can provide significant benefits.

Include:

Extra virgin olive oil (EVOO)
Wholegrains, legumes, fruits, vegetables, nuts, and seeds
Oily fish like salmon, sardines, trout, or mackerel (2–3 times per week)
Moderate amounts of dairy and poultry
Less frequent consumption of red meat and sweets

FOUR. Optimise your gut microbiome

Research suggests differences in the gut microbiome between women with and without PCOS. Support gut health by consuming probiotics and prebiotics, along with dietary fibre and a variety of wholegrains, fruits and vegetables.

Probiotic foods:

Yoghurt
Cheese
Kefir
Sauerkraut, kimchi, miso, tempeh
Kombucha

Prebiotic foods:

Garlic
Onion
Cashews
Asparagus
Chickpeas
Black beans
Lentils
Barley
Oats

Supplementation

While overall diet is the first priority, supplementation can sometimes be beneficial, especially when deficiencies are identified through blood tests. Always seek personalised advice from a healthcare professional.

Key supplements for PCOS could include:

Inositol: Research supports its benefits in improving insulin sensitivity, lowering testosterone, and enhancing fertility. Myo-inositol and D-chiro-inositol, at a 40:1 ratio, are most effective.
Magnesium: Can help improve insulin sensitivity and lower fasting blood glucose. Focus on meeting magnesium requirements through food first.
Omega-3: Reduces inflammation and may help with testosterone levels and menstrual cycle regulation. Ideally, consume oily fish 2–3 times per week.
Cinnamon: May help with menstrual cycle regularity and blood glucose control.
Vitamin D: Supplementation can benefit those with PCOS who are vitamin D deficient, improving insulin resistance.

Maintaining a Healthy Weight

Achieving and maintaining a healthy weight is an important aspect of managing PCOS and improving fertility. Research shows that a 5–10% reduction in body fat can help restore menstrual cycle regularity and ovulation.

Exercise & PCOS

Regular exercise improves insulin sensitivity and can help with weight management. One study found that brisk walking had psychological benefits for women with PCOS. Exercise can also help manage stress and support mental well-being, which is especially important as women with PCOS are at an increased risk of mental health challenges.

Key Takeaways for Managing PCOS with Nutrition:

Aim for a moderate carbohydrate intake and balance meals with carbs, protein, and healthy fats.
Choose low-GI carbs whenever possible.
Load up on colourful fruits and vegetables to maximise your intake of antioxidants.
Embrace a Mediterranean-style diet rich in legumes, nuts, seeds, and seafood.

If you’re feeling overwhelmed, you don’t need to go through this alone. With evidence-based dietary strategies, meal plans, and ongoing support, I can help you feel more in control of your health. Get started today!

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disclaimer: the advice on this post is general in nature and does not consider your personal circumstances. For personalised advice please reach out to your GP or healthcare professional

Nutrition for PCOS (Polycystic Ovary Syndrome)