Polycystic ovary syndrome, or PCOS, is one of the most common hormonal disorders for women. In fact, one in 10 women of childbearing age has PCOS, according to U.S. Department of Health and Human Services' Office on Women's Health.
But no matter how severe your symptoms (which include excessive hair growth, acne, irregular or absent periods, and weight gain) when you've been diagnosed with the syndrome, it can be really hard to know what to do next.
Firstly, it's important to remember that even though PCOS is related to our hormone levels and insulin production, it's not your "fault" if you have it. Sometimes, though, the symptoms can, be managed and — hopefully — improved through diet and exercise.
PCOS and weight loss or weight gain is also a bit of a catch 22. It can be linked to insulin resistance, which can lead to weight gain — and then, because excess body fat causes the body to produce even more insulin, PCOS symptoms can become worse, creating a vicious cycle.
Information online can be overwhelming when it comes to PCOS and lifestyle: Is losing weight the answer? Should you totally ditch all foods that raise your blood sugar? Will exercise help?
If you are overweight with a BMI of 25 or higher,London Clinic, advises that "even a small reduction in weight can significantly improve symptoms — including a low mood or depression, which is often a symptom of PCOS.", MB, BS, MRCOG, a consultant gynecological Surgeon at The
"Generally, you want to focus on 'being healthy,'" he adds. "Polycystic ovarian syndrome is your body's way of saying you can't handle high sugar levels. So your diet is a chance to really change things, and this can help you in your later life, pre-menopause and before and during pregnancy. By keeping your weight stable, your pregnancy is likely to be more straight-forward health-wise."
Daria Tiesler, MSc, a registered nutritional therapist, personal trainer, and performance coach at Ultimate Performance Mayfair, regularly trains clients with PCOS, and she agrees that diet and exercise can really help with managing the condition.
Here are seven ways she advises her clients to overhaul their lifestyle:
1. Focus on nutrition, not diet.
Tiesler advises veering away from fad diets and eating with a focus on fueling your body, managing stress, and balancing your hormones. For her clients, the key is to address insulin resistance and reduce cortisol (aka "the stress hormone") levels by packing their diet with anti-inflammatory foods.
On her shopping list are lots of leafy green vegetables, blueberries, pineapples, whole foods and sources of protein like fish, eggs, and chicken breast, and good fats like nuts and avocado. Tiesler's also a big fan of anti-inflammatory spices like turmeric, cinnamon, fenugreek, and ginger.
One of Tiesler's favorite foods for balancing hormones is flaxseed, which is rich in fiber and omega-3s. She tells her clients to eat two tablespoons per day in salads, sprinkled on oatmeal, or in smoothies.
2. Cut out the stuff that messes with your blood sugar.
Reducing foods in your diet that cause spikes in blood sugar is crucial to managing your PCOS. This means opting for whole-grain sources of carbohydrates over anything with a high glycemic index (GI).
Tiesler advises reducing your consumption of white pasta, white rice, and anything super-processed (including processed meats). She also suggests swapping fruit drinks and smoothies for whole fruit because they contain more fiber, which is vital for a healthy gut. Fruits low in fructose are best, like grapefruits, clementines, limes, lemons, raspberries, blackberries, and strawberries.
3. Try to balance your blood sugar throughout the day.
"Start with breakfast," Tiesler says. "Don't leave home with an empty stomach, and then grab a sandwich at 12. So many of my clients skip breakfast or have coffee and a croissant, and their bodies struggle to process it."
Try something like eggs, salmon, and spinach or a smoothie with vegan protein, a blend of berries, cinnamon, and avocado. Just make sure whatever you're eating stabilizes your blood sugar by including protein, healthy fats, and low-GI carbs.
4. Don't fear (healthy) fats...
Many of her clients with PCOS are scared of fats because they don't want to put on weight, but increasing healthy fats in your diet is a great way to keep you satiated and can help your body absorb vitamins A, D, E, and K.
5. ...or carbs.
Reducing or cutting out processed and high-GI carbs is beneficial for anyone with PCOS, but because everyone is different, you might need to personalize the amount of complex carbs you get from fruits, vegetables, and pulses. There is no need to ditch them entirely, however. Those foods are a great source of phytonutrients, vitamins, and minerals, as well as fiber.
Tiesler recommends experimenting: Try removing the processed carbs from your diet while keeping whole foods, like pulses, lentils, and beans, in there and seeing how you feel. At the end of the day, a bit of trial and error might be needed to find what works for you.
"I try a macronutrient split of around 20 percent complex carbs, 40 percent protein, and 40 percent fat for my clients," Tiesler says. "But I switch it around and get constant feedback from them as to whether it's working or not."
6. Look out for 'hormonal disrupters.'
In a body that's struggling to balance hormones, the last thing you need are factors in your life that cause more hormonal imbalances, such as stress or lack of sleep.
"Review the stress in your life. I train eight to 10 girls at any one time with PCOS, and many of them are super-strong on the outside but totally stressed on the inside," Tiesler says. "Make sure you are getting enough sleep — and good quality sleep, too. I also recommend journaling or breathing techniques to help with relaxation."
Tiesler advises avoiding stimulants — aka coffee — after 2 p.m. or swapping it for spearmint and green tea. Consuming a ton of caffeine will only lead to more of the energy crashes you're trying to avoid and can affect the quality of your sleep.
7. Hit the weights, but don't stress your body out.
Tiesler is a huge advocate for resistance training with weights for women with PCOS. "My first goal with my clients is to manage their insulin resistance — my second is to increase their muscle mass," she says. "The more muscle mass you have means you can better metabolize glucose and can handle carbs better."
She uses a mix of weight training with HIIT (high-intensity interval training) and LISS (low-intensity steady state cardio, like walking) on her clients. But the key is to make sure whatever exercise you're doing is not too stressful on the body because over-exercising is not good for your hormonal balance, either.
Often, clients will come to Tiesler when they have previously been doing lots and lots of cardio (along with prolonged low-calorie and low-fat diets), which she would change to two to three weight training sessions a week for around 45-60 mins, plus some swimming, walking, or yoga. Of course, every body tolerates exercise differently, so for women who are better with stress management, Tiesler also uses HIIT workouts.
Also, Tiesler says to not become too obsessed with the number on the scale — many of her clients won't lose huge amounts of weight doing resistance training, but they will become fitter and totally change their body composition, which has an amazing effect on their health.