An estimated 1 in 10 women of childbearing age have polycystic ovary syndrome (PCOS), according to the Office on Women’s Health (OWH). However, there’s still a lot we don’t know about the hormonal disorder.
Given how common it is, this condition is insufficiently researched, especially when you consider how disruptive it can be to daily life, Heather G. Huddleston, MD, a specialist in reproductive endocrinology and infertility, and director of the PCOS Clinic at UCSF Health, tells Eat This, Not That!.
What is PCOS?
PCOS is a common disorder characterized by higher than normal levels of male hormones called androgens, Huddleston says. Individuals with PCOS also experience irregular or absent menstrual cycles and have ovaries that appear polycystic, or having multiple cysts.
What are some common PCOS symptoms?
Increased androgens not only cause testosterone levels to elevate but also acne or hirsutism, a condition in women that describes excessive growth of dark or coarse hair primarily on the face, chest, and back.
According to Huddleston, PCOS is often accompanied by other symptoms, such as depression, insulin resistance, and obesity. Additional symptoms may include anxiety, hair loss, non-alcoholic fatty liver disease, and sleep apnea.
When it comes to diagnosis, it’s important to note that the term PCOS can often be a misnomer. For example, you may have irregular periods, plus minor hirsutism and hormonal acne, but also fall within a normal BMI range and not have insulin resistance.
“Polycystic ovaries is an old term that was coined by physicians who noticed that women with irregular cycles and hirsutism had ovaries that appeared ‘polycystic,'” Huddleston says. “We now know that women with PCOS have ovaries that simply have an increased number of resting follicles and often have an increased volume.”
Resting follicles describe the way that follicles sit on the ovaries. Women who don’t have PCOS also have follicles—they just don’t have as many that are visible on the ovaries, which can be seen through a transvaginal ultrasound scan. Follicles contain egg cells, and in someone without PCOS, they will mature and eventually release the egg during ovulation. Though, in someone with PCOS, these follicles won’t mature and will accumulate on the ovaries instead.
“The reason there is an increased number of resting follicles in PCOS isn’t completely known, but we know that often these follicles fail to develop to maturity, leading to lack of ovulation,” Huddleston says.
While it can be hard to become pregnant with PCOS, it’s not impossible. The OWH states that PCOS is one of the most common but treatable causes of infertility in women. If one of your PCOS symptoms is insulin resistance, there are certain dietary choices you can make to help manage your blood glucose (sugar) levels.
What is the best PCOS diet?
While there currently isn’t a set diet to follow with PCOS, Felice Ramallo, MSCN, RD, LD, and lead registered dietitian at Allara—a virtual women’s healthcare platform that helps women manage PCOS symptoms—recommends choosing a diet that’s both sustainable and enjoyable long-term to help manage symptoms.
“To manage and prevent insulin resistance, the emphasis should be put on the quality of carbohydrates—not the quantity,” she says. “Remember, insulin resistance occurs from spiking blood sugar levels.”
Choosing foods with a lower glycemic index is less likely to make your blood glucose levels spike. Some examples include:
Brown, black, and wild rice
Whole grain pasta
Ramallo adds that higher glycemic options like white rice can still be enjoyed, though she suggests pairing them with fibrous sides like a salad or cruciferous vegetables such as broccoli, Brussels sprouts, and cauliflower.
“Blood sugar is best kept consistent by eating balanced meals and snacks. Additionally, eating frequently throughout the day, with three meals and many snacks, has been shown to balance blood sugar,” Ramallo says. “In part, this is due to preventing extreme hunger, which can prompt unhealthy food choices.”
If you’re someone who’s looking for a specific diet to follow, Ramallo recommends either the Mediterranean diet or the DASH diet. Both of these diets call for nutrient-dense, anti-inflammatory fruits and vegetables like berries and leafy greens. Fatty fish (salmon), nuts, and seeds are a few more foods that make great additions to a PCOS diet.
“The only foods people with PCOS should avoid is low-fat dairy or foods they are sensitive, intolerant, or allergic to,” she adds. “Full-fat or whole fat dairy is recommended and may even improve symptoms.”