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As a registered nutritionist specialising in women's hormonal health, I've taught many women diagnosed with Polycystic Ovarian Syndrome (PCOS) how exactly to implement the dietary and lifestyle changes needed to reduce their unwanted symptoms and support their hormones to better manage their condition.
In this blog post, I explore the research that looks at the role of some of these KEY changes that have been shown to reduce high androgens (male hormones) and improve insulin sensitivity - two of the sneaky culprits which have been found to contribute to PCOS symptoms.
What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is a prevalent hormone disorder affecting around 1 in 10 women of reproductive age. Contrary to its name, PCOS doesn't always involve cysts but manifests through a number of troublesome symptoms like irregular cycles, stubborn weight gain, acne, hirsutism, thinning head hair, and possibly even fertility challenges.
While there is no specific test to diagnose the condition, women with PCOS typically have at least two of the following symptoms:
Irregular or no ovulation (leading to either irregular or non-existent periods)
High androgen levels (such as testosterone, as detected in a blood test)
A high number of follicles on the ovaries (detected via an ultrasound)
The Connection Between Blood Sugar, High Insulin, Testosterone + PCOS
Issues with blood sugar are traditionally thought of something that just diabetics need to be aware of, but this couldn't be further from the truth and something we should all be thinking of...especially those with PCOS.
If you're reading this blog because you have PCOS, you have probably been told to minimise foods high in sugar or carbohydrates. When you eat high refined carbohydrates such as white bread, white pasta, sweets, pastries and crisps, this causes a huge surge in blood sugar. Your pancreas responds by releasing insulin to help the body to process and regulate the blood sugar effectively and get it into the body's cells. However, eating these types of foods on a regular basis can cause insulin to store the excess blood sugar away as fat, which can lead to can lead to weight gain and excess body fat. However, it's also important to know that even some foods you might think are 'healthy' can actually have the same impact on your blood sugar levels (more on this below!).
What is insulin resistance?
Eating these types of foods on a regular basis will not only cause a quick rise in blood sugar but will then plummet, and this is when we tend to feel hungrier, more tired and crave sweet foods. When this cycle happens over and over again, our body's cells can become tired and stop listening to insulin, a condition known as insulin resistance, which serves as an early warning sign of potential diabetes. Up to 70% of PCOS sufferers exhibit insulin resistance and are at a higher risk of developing type 2 diabetes, emphasising the critical role of insulin in this condition.
Many women with insulin resistance also have high androgen hormones, such as high testosterone. This is because high insulin causes the ovaries to make MORE androgens and less of a hormone called Sex Hormone Binding Globulin (SHBG), the main protein that binds testosterone and stops it from getting too high. Although testosterone is often thought of as a male hormone, all women need a small amount. However, too much can disrupt your natural hormone balance.
Treating PCOS
Managing PCOS isn't a one-size-fits-all approach and I completely appreciate how disheartening and unhelpful it is receive generic advice like "just lose weight" or "take the birth control pill" when dealing with a complex condition like PCOS. The truth is, it can be difficult to lose weight when you have PCOS – weight gain is one of the symptoms associated with PCOS after all! This is why advice like this is just sooooooo unhelpful.
Natural Strategies for PCOS Support
1. Balance Your Blood Sugar
One of the number one recommendations I make to clients with PCOS is to make sure they are eating lots of foods that are LOWER on the glycemic index - a ranking system which shows how quickly your blood sugar levels rise after eating certain foods.
Low GI Foods include things like:
Eggs
Chicken
Dairy - Full Fat Yoghurt, Milk
Beef
Fish
Wholegrains (wholemeal breads, wholewheat pasta etc)
Vegetarian Protein sources such as tofu, tempeh
Nuts and seeds
Beans and lentils
Most vegetables
Some fruits - especially those ones traditionally grown here in the UK (apples, pears, plums, strawberries, raspberries, blueberries)
Reduce Intake of High GI Foods which include things like:
White bread
Bagels
Cornflakes
Instant porridge
White rice
Baked Potato
Banana
Dates
Couscous
Rice cakes
Orange Juice
Fizzy dtinks
Sweets
FYI - this doesn't mean you have to avoid high GI foods completely! Part of the work I do with clients is teaching them how they can enjoy their favourite foods to balance their blood sugar in a sustainable way. Just be mindful of how many of these foods you're consuming and ideally don't consume these on an empty stomach.
One of my top tips to balancing your blood sugar is to make sure you're consuming protein with EVERY meal (especially at breakfast which many of my clients don't do before we start working together!)
High-protein breakfast suggestions to support your blood sugar levels:
2 x poached eggs, 30g smoked salmon, asparagus on sourdough
180g Greek yoghurt, berries, 2 tbsp nuts and seeds
1 bowl of porridge (not instant - ideally organic oats) with 1 tbsp. clean protein powder such as Purition, 1 tbsp. almonds and berries. Check out one of my favourite recipes here.
2. Vitamin D
While there is a small amount of vitamin D in foods such as eggs, fish and butter, according to studies, up to 85% of women with PCOS are said to be low in vitamin D and given the role optimal vitamin D plays in so many functions of the body (hormonal health, nervous system regulation and sleep) this is something I encourage all my clients with PCOS to get tested to find out their baseline level to see if supplementation is required.
Aim for an optimal vitamin D reading between 125-150nmol/L. Consider testing your levels privately - check out BetterYou for more information.
3. Omega-3 Fatty Acids
Making sure you include a variety of healthy fats in your diet can really help to promote fullness after meals and help you to avoid any energy crashes. Omega-3 Fatty Acids such as those found in oily fish such as salmon, sardines and mackerel have been shown to help improve insulin sensitivity and reduce high levels of androgen hormones. There is also some research which shows that women with PCOS who consumed more omega-3 had lower levels of testosterone.
4. Green Tea
Green tea can be a game-changer for women dealing with PCOS. Packed with powerful antioxidants, especially catechins, it helps fight inflammation and oxidative stress linked to PCOS. There is also some research to suggest that Green tea may be beneficial for improving insulin sensitivity and reducing testosterone in those with PCOS.
PCOS can be difficult to navigate alone. If you want to find out more information on how nutritional therapy can give you the tools to help manage your symptoms of PCOS and no longer want to feel in the dark about your condition, please feel free to book a FREE 30-minute Discovery call to find out if I can help you.