How to eat for PCOS: 15 guidelines

PCOS is the most common hormone dysfunction of women, affecting 10-20% of women (some sources say up to 25%)!

The features of PCOS have enormous mental and physical consequences for women, including acne, menstrual disorders, excessive male distribution pattern body hair, obesity, high blood pressure, diabetes, fertility challenges, low libido, and polycystic ovaries. These features are part of a syndrome, meaning that not all women with PCOS present the same. If you struggle with your appearance, fertility, weight, sex drive, menstrual cycle, and overall well-being, then I am happy to tell you that you have the capacity to heal yourself.

I’m not going to lie. The changes that you need to make take dedication and hard work. But it’s not complicated. And the results will be worth the time and effort.

Conventional and naturopathic medicine both recommend lifestyle modifications as first-line treatment for adolescent girls and women with polycystic ovarian syndrome (PCOS). You guessed it, friend. Diet, exercise, and weight loss. *I can almost hear the eyes rolling*

But, HOW does diet treat such a complex issue? In one word, inflammation.

Enter, the microbiome (oooohhhh, ahhhhh). Unhealthy changes in the microbiome, gut inflammation, leaky gut, dysbiosis (whatever you want to call it), all lead to systemic (aka whole body) inflammation, which leads to insulin resistance, weight gain, hyperandrogenemia (fancy word for high androgens), and ovulatory dysfunction (making it hard to get pregnant). Sounds like the features of PCOS. Basically, inflammation mucks up all the signals that are being sent between the different systems in your body, starting in your gut.

And that’s because those little bacteria communicate with every aspect of our biological systems: digestive, metabolic, nervous, reproductive, mental, immune.

So YES, it’s true. A healthy microbiome is essential for hormone balance in women with PCOS (and other hormonal disorders)! Diet, or more specifically, diversity in the diet, is a major influencer on the microbiome. There are others, but let’s focus on this one for now.

The good news is that you can restore a healthy gut microbiome through dietary choices. And the best part is that eating the right foods will have a cascade effect on the rest of your health, including your weight.

Let’s get started.

  1. Eat 2-3 meals a day and no snacks
  2. Periodic fasting
  3. Local and home grown
  4. Home cooked
  5. Avoid refined oils/trans fats/alcohol
  6. Avoid food allergens and sensitivities – consider elimination diet
  7. Include phytoestrogens: organic, whole soy, flax seeds (talk to your doctor first if you have a personal or family history of hormone related Cancer)
  8. Strive for 100% organic
  9. Sugar free, artificial sweetener free
  10. GF/DF: Gluten free and Dairy free/reduced
  11. High fiber/resistant starch
  12. Non-GMO (based on data on Roundup and Glyphosate)
  13. Real foods in natural state
  14. Variety of colourful fruits and vegetables
  15. Limited processing

As a naturopathic doctor, I tell my patients that food is information, it’s medicine, and it’s nourishment for our gut microbiota. But I completely understand that it’s also social and fun. Do what you can, and do your best. Stress also affects the microbiome. So don’t stress about doing all of these things at once. Pick a couple to start with (or one!), and then add another item when you’re ready for a new challenge.

Here’s a checklist that you can stick on your fridge as a reminder.

If you are interested in balancing your hormones and supporting your overall endocrine system with diet, then following the guidelines above will help you achieve that. That’s because your microbiome is involved in hormone production, metabolism, and signalling. But it will take time. Re-evaluate your symptoms on a monthly basis, but that sweet spot is about 3 cycles. It could take longer depending on the state of your gut, underlying gut infections, stress, sleep issues, medications, exposure to endocrine disruptors, etc. There are lots of things that affect the microbiome. Don’t be discouraged by set backs. More importantly, don’t let set backs further derail you.

I know that you are here because you are trying to fix the underlying cause. In many cases, that underlying cause is gut inflammation. Or at the very least, it is part of the problem. Deep down your gut feeling (pun intended) is that diet is playing a role. Many women will see drastic improvements in their overall health by making these changes. But that’s not to say that you won’t see enhanced benefit from other therapeutic interventions, like botanical medicine and supplements. In some cases, it may be worth considering an appointment with a doctor for a full assessment. As I mentioned before, gut infections might be playing a role. Those should to be resolved before dietary changes are implemented.

If hormonal dysfunction is at play, and your diet is less than veggieful (can I make up words?) then this is a good place to start.

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