PCOS Diet: Best Diet For Managing PCOS

“PCOS is a metabolic disorder that affects different parts of the body. It’s the most common cause of not ovulating,” says Randy S. Morris, M.D., a Naperville, Illinois-based board-certified reproductive endocrinologist and OB-GYN and the creator of Infertility TV on YouTube.

The following are typical symptoms of PCOS, according to the American College of Obstetricians and Gynecologists (ACOG):

• Irregular menstrual periods
• Infertility
• Obesity
• Hirsutism—excessive hair on the face, chest, abdomen or thighs
• Acne
• Oily skin
• Acanthosis nigricans—dark, thick and velvety patches of skin
• Ovaries with several fluid-filled sacs

“PCOS is a complex disorder that doesn’t have a single specific cause,” says Dr. Morris. “It’s considered polygenic (multiple genes can contribute) and multifactorial.”

The cause of PCOS is unknown, but a combination of factors like insulin resistance, elevated levels of the hormone androgen and irregular menstrual cycles may be related to PCOS, according to the ACOG.

Women with PCOS are more likely to have insulin resistance, obesity, inflammation, metabolic syndrome or a combination of these conditions, which can increase the risk of developing heart disease and type 2 diabetes. Because maintaining a healthy weight is key in managing insulin resistance, obesity and metabolic syndrome, dietary changes can help with both these cofactors, and PCOS itself.

“A low-sugar diet and consuming whole fresh foods can help with PCOS symptoms by balancing blood sugars and enhancing insulin sensitivity,” says Brigitte Zeitlin, a New York City-based registered dietitian and women’s health coach. “Conversely, a high-sugar diet increases insulin resistance and exacerbates PCOS symptoms,” she explains. A diet high in processed white carbs (white bread, white rice) can cause similar insulin issues. A diet high in fiber could also be beneficial to people who have PCOS.

A PCOS diet can offer several benefits, says Zeitlin, citing a 2021 Maedica systematic review of dietary patterns and polycystic ovary syndrome. This review looked at different dietary patterns including the Mediterranean diet and a low glycemic index diet (a diet that limits foods that can raise blood sugars). Based on the research, the authors concluded that dietary changes generally resulted in the following benefits:

• Weight loss
• Lower blood sugars
• Improvement in hormonal balance
• Lower cholesterol, triglycerides and LDL (bad) cholesterol
• Decrease in hair loss, acne and menstrual irregularities
• Improvement in inflammatory markers

“Since PCOS can differ greatly from one person to the next, the benefits of a particular diet may be limited only to the population being studied,” notes Dr. Morris. For example, diet advice given to a person with PCOS who has obesity may not work in the same way as in a person with PCOS who does not have obesity, he explains. Although the following section outlines general nutritional guidelines, it’s important to seek personalized nutrition advice from a health care professional.

While there’s no consensus among experts on a specific type of PCOS diet, they do agree that a well-balanced and nutritious diet is essential for managing PCOS symptoms. Listed are healthy foods and eating habits to incorporate, according to Dr. Morris and Zeitlin.

1. Fruits and vegetables. These foods offer fiber and an array of nutrients and antioxidants to help optimize overall health and potentially lower the risk of chronic diseases like diabetes and heart disease. “Aim to eat different colors of produce,” advises Zeitlin.
2. Lean proteins. Include lean proteins like fish, chicken and eggs with meals, says Zeitlin, explaining that this helps with blood sugar management instead of eating only carbs.
3. Pulses like beans, lentils, chickpeas and split peas. While you don’t have to follow a plant-based diet, it’s important to note the benefits of pulses. These plant-based proteins are low-fat, high-fiber and low-glycemic index, which means they don’t increase blood sugars as much compared to high glycemic index carbs (like white bread and pastries), explains Dr. Morris. He notes that a pulse-based diet has been shown to improve blood pressure and cholesterol in women with PCOS, citing a 2018 Nutrients study.
4. Whole grains. Whole grains include the entire grain kernel, providing fiber and various nutrients. A diet high in whole grains instead of refined grains (where the outer layers of the grain are removed) is associated with a lower risk of developing chronic diseases, says Zeitlin. Examples of whole grains include brown rice, oats and quinoa.
5. Healthy fats. Healthy unsaturated fats offer benefits like a reduction in inflammation and supporting heart health, says Zeitlin, noting examples like nuts, seeds, olive oil, avocados and omega-3 fat-rich fish like salmon. They can also help balance blood sugar.
6. Soy protein. Soy products like edamame, tofu and soy milk are good sources of plant-based protein, says Dr. Morris. They’re also low in saturated fat and offer fiber, he adds, citing a 2018 Journal of Human Nutrition and Dietetics study comparing the effects of a diet with soy to a no-soy diet in women with PCOS. “Those on the soy diet showed greater improvements in weight, some androgen levels and insulin resistance,” says Dr. Morris.
7. Spices. Adding spices like cinnamon and turmeric, which have anti-inflammatory properties, to foods offers flavor and can help reduce reliance on sugar and salt, says Zeitlin. Ginger and cumin are also great for blood sugar and insulin resistance.
8. Eat small, frequent meals. Eating smaller amounts consistently during the day can help keep blood sugars stable, says Zeitlin. She recommends aiming for a small meal every three to four hours.
9. Eat at least three hours before bedtime. “This allows your body to fully digest your last meal before going to sleep and repair mode, which improves sleep quality,” says Zeitlin. She notes a 2018 International Journal of Preventive Medicine study indicating that sleep disorders are prevalent in people with PCOS and poor sleep quality is linked to an increased risk of insulin resistance and having obesity.
10. Hydration. Adequate hydration is important to support overall health. Water should be the primary source of hydration since it has no sugar or calories.

It’s also important to limit sodium to 2,300 milligrams daily to help manage blood pressure and inflammation. If you opt for a prepared or processed food item, look for products labeled as “reduced sodium,” “unsalted,” or “no salt added.”

The following foods can cause inflammation and should be limited in a diet for PCOS, says Zeitlin.

• Sugar-sweetened drinks like soda and juice
• Alcohol
• Sugary foods like candy, cookies and sugary cereals
• Refined carbs like white bread and white rice
• Fried foods
• Saturated fat like butter or margarine
• Red meat
• Processed meats like hot dogs and luncheon meat

“Incorporate self-care practices to help manage stress, which is beneficial in balancing hormones—insulin being one,” says Zeitlin. She recommends activities like yoga, meditation and journaling.

Physical activity can also help alleviate PCOS-related depression and confer numerous benefits for overall health like reducing the risk of weight gain and lowering blood pressure. Weight training is also beneficial as it helps manage blood sugar.

As mentioned, adequate sleep is also important for blood sugar and weight management. “Aim for seven or more hours of sleep every night,” says Zeitlin.

“You should see a doctor as soon as you feel or notice symptoms,” says Zeitlin. “Your doctor can discuss lifestyle changes and if medication is needed. And if you’re looking for a personalized PCOS diet, consult a registered dietitian.”