What is PCOS?
Polycystic ovarian syndrome (PCOS) is defined by a set of symptoms that can include irregular or missed periods, cystic ovaries, hyperandrogenism, hirsutism (excess body hair), weight gain, acne or oily skin, infertility, or the presence of skin tags. This is a common genetic condition experienced by many women of childbearing age. To be diagnosed with PCOS, you must meet two of the three following criteria: irregular periods or anovulation (no periods), high levels of androgens (“male” hormones that both men and women have), and the presence of cysts on the ovaries.
Identification of these symptoms can be done through ultrasounds to examine ovaries for possible cyst development and blood tests to measure hormone levels. PCOS is related to several complications, including diabetes, metabolic syndrome, infertility, inflammation, and endometrial cancer.
There is a dynamic interplay between obesity, insulin resistance, and PCOS. Often, women with PCOS who also live with obesity can present with more prominent or common symptoms from the list above. Simultaneously, women with PCOS are at a greater risk of developing obesity, but not all women with PCOS also live with obesity. Insulin resistance relates to both obesity and PCOS because it is more likely to develop when both are present.
What causes PCOS?
The cause of PCOS is not entirely understood but is assumed to be associated with: genetics, obesity, insulin resistance, hyperandrogenism, and inflammation. Insulin resistance can contribute to the diagnosis of PCOS because increased insulin causes the ovaries to release more androgens. With more androgens in the body (hyperandrogenism), ovulation can become irregular or stop altogether. These alterations in ovulation can lead to cyst development on the ovaries. Inflammation is often present in women with PCOS, which can also be related to insulin resistance and hyperandrogenism in the body.
How can my diet affect this condition?
Diet modifications are not the only line of treatment that should be considered for PCOS. However, knowing that PCOS is closely related to nutrition-related conditions, dietary interventions have been explored to help treat this condition. More specifically, we know that insulin resistance is related to hyperandrogenism, one of the possible indicators and causes of this syndrome. Insulin resistance is our body’s lack of response to insulin, which is responsible for helping our cells uptake glucose for energy and lower blood glucose. When our bodies are insulin-resistant, we cannot lower our blood sugar effectively, leading to extended periods of elevated blood sugar levels and insulin production. By improving diet and controlling insulin resistance, we can mitigate the chances of developing future conditions that women with PCOS are already at a heightened risk for.
What changes should I make in my diet?
When considering dietary modifications for PCOS, we want to target insulin resistance. A generally healthful diet with an emphasis on protein, healthy fats, fiber, fruits, and vegetables, can help to manage insulin resistance.
Carbohydrates are the primary driver of blood sugar. When eating to manage insulin resistance, we like to think about pairing carbohydrates with a lean protein or healthy fat source. Doing so signals our body to slow digestion of carbohydrates and better handle the blood sugars that enter our bloodstream. Lean protein sources include poultry, fish, beans, and legumes. Healthy fats include nuts, seeds, avocados, olive oil, and nut butter.
Another way to slow down digestion of carbohydrates is the addition of fiber. Fiber is the roughage that is found in carbohydrates such as in whole-grain bread or pasta, beans, fruits, and vegetables.
An emphasis on fruits and vegetables can not only help manage insulin resistance through the fiber they contain but also be great for overall health. They contain antioxidants, vitamins, and minerals that help our bodies function properly and aid in chronic disease prevention later in life.
Consult a registered dietitian for assistance in making these dietary changes. They can help you make these changes in a way that feels sustainable and personalized to your needs. However, PCOS is a dynamic condition that requires dynamic care. Consulting healthcare providers like an OBGYN, endocrinologist, dermatologist, or fertility specialist may help you better understand and manage this condition.
Bottom Line:
PCOS is an understudied and under-discussed area of women’s health. PCOS is also complicated; its causes, symptoms, and related conditions are all closely linked, and not every woman with PCOS experiences this condition the same way. As we better understand this condition, we may see more specific dietary recommendations. Given what we know thus far about the interplay of PCOS, obesity, insulin resistance, and other related conditions, a generally healthy diet can help manage the associated conditions with PCOS and possibly minimize some of its associated symptoms.
Written by: Carolyn McHugh, Dietetic Intern
Resources:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos
https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos
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