PCOS & Implementing Nutrition to Help

Working with primarily women, I often see many women who are experiencing PCOS. Whether they’re beginning to transition off birth control in hopes of starting a family or not, being diagnosed with PCOS can be a frightening and frustrating experience.. If you’ve been diagnosed, I hope these tips can help get you to a healthy hormonal balance and ultimately natural ovulation.

Polycystic Ovary Syndrome, also known as PCOS, effects up to 10% of women. Don’t worry, the symptoms are less scary than the name implies. The health issue is best defined by a group of symptoms related to high androgen levels (male hormones) and an irregular period. Many women with PCOS experience no period at all. Other symptoms include excessive facial and body hair, acne, hair less, weight gain, and infertility.

The confusion of the name PCOS comes from the worst “cyst,” which is simply used to describe ovarian follicles. When you do not ovulate, those follicles are unable to develop fully and either be ovulated or be reabsorbed (like they normally would be) and you end up with many smaller follicles, thus the name “polycystic,” where poly means “many.”

So what causes PCOS? High levels of androgens, or male hormones, such as testosterone, androstenedione, and DHEAS. Woman need some male hormone. They’re important for a variety of reasons - libido, bone health, and mood - but too many androgens can lead to some of those unpleasant symptoms mentioned before, and ultimately prevent ovulation.

There are a few things than can help exacerbate the rise of androgens and thus PCOS, including inflammation, insulin resistance, adrenal stress, and birth control. Of these, insulin resistance and post-birth control hormone rebound are the most common drivers of PCOS, so I want to delve into these first to help you find some relief.

There’s good news - nutrition and a handful of supplements can help resolve PCOS in many cases and promote ovulation. Let’s dive in.

Insulin Resistant PCOS

You don’t have to be overweight to experience insulin resistance. Having a blood test done to measure your fasting insulin levels or your insulin resistance index (HOMA-IR index) can help determine if this might be the driver of your PCOS. Note that a blood sugar test is not the test you’re looking for here. For the fasting insulin test, your result should be less than 8 mIU/L. For the HOMA-IR test, your index should be less than 1.5.

If you find that you are insulin resistance, here are some changes you can make to help:

• Quit sugar - Drop the sweets and sugary drinks immediately. Unfortunately you are not equipped to hormonally handle sugar in your diet due to insulin resistance. Quitting sugar is never easy, but you can improve your sugar cravings by getting enough sleep, eating full and satisfying meals, avoiding calorie restriction, and reminding yourself that any intense cravings should subside after about 20 minutes.

• Reduce other carbs as much as possible - Sweet desserts and soda aren’t the only place we find sugar. Breads, pastries, rice, and potatoes also contain high amount of sugars. You don’t have to complete avoid these carbs. In fact, you should get at least one serving per day, preferably at the end of your day or for dinner. Try avoiding the carbs first thing in the morning, as doing so will naturally prolong the natural fast from carbs you’ve established from sleeping.

• Consider an eating window - Try getting all of your food into an 10-hour window, for example 8am-6pm. This gentle type of intermittent fasting can help reduce insulin sensitivity.

• Exercise - Regular exercise, especially lifting weights and strength training, increases insulin sensitivity by using the glucose and glycogen stored in your muscles.

• Avoid hormonal birth control - Birth control such as the pill can cause or even worsen insulin resistance due to its ability to limit muscle gains via exercise.

• Supplement magnesium - Not only will this help reduce your sugar cravings, bit has also been shown to lower the risk of insulin resistance.

• Supplement vitamin D - This vitamin not only improves insulin sensitivity, but also promotes the healthy development of ovarian follicles.

• Supplement zinc - Zinc deficiency has been correlated with higher risk of PCOS and nourishes ovarian follicles by promotes healthy levels of progesterone, while also having direct anti-androgen effects.

Post-Pill PCOS

Hormonal birth control pills (and all hormonal birth control methods) suppress ovulation, which is their main goal for avoiding pregnancy. Some birth control pills contain low androgen hormones, which can cause a woman’s natural androgen levels to spike after coming off the pill. Your body attempts to adapt to the change, and can create too many androgens, which cause the problems we talked about earlier. This is usually temporary, though unfavorable. One of the only common tests you can do to determine if you are experiencing post-pill PCOS is by looking at your LH to FSH ratio. If your LH is high compared to your FSH (which is true of all PCOS) this could help you determine that your removal of hormonal birth control is the issue.

Here’s a few things you can do to help quick the process for returning to normal hormonal levels post-pill:

• Avoid under-eating and don’t avoid starch - You don’t need to eat too much, but be sure not to avoid these are your body needs them in order to ovulate.

• Supplement zinc after dinner - As mentioned before, it suppresses androgens and promotes ovarian function. Also, zinc deficiency is very common after being on the pill.

• Peony and licorice - This combination can help break away from “stalled” hormones by normalizing pituitary hormones.

If neither of these categories seem to fit your PCOS, fear not. There are more complex options that can help explain your specific imbalances which can be aided by nutrition. Hormonal intervention and fertility treatment may not always be the answer. Let food be your medicine first.