Understanding PCOS and Busting Common Nutrition Myths
PCOS (polycystic ovarian syndrome) is a common health condition which affects 10% of individuals with ovaries in Australia. The exact cause of PCOS is still unknown, however genetics (family history), lifestyle factors e.g. stress, poor quality diet and environmental are thought to be linked to the development of the condition. The diagnosis of PCOS is based on the presence of two or more symptoms, and unlike the name suggests, the presence of ovarian cysts alone is not enough for a diagnosis. A person with PCOS can have a range of symptoms and these can change with age.
Common symptoms of PCOS include:
- Irregular periods (oligomenorrhoea) or a lack of periods (amenorrhoea)
- Irregular ovulation (Olig ovulation) or a lack of ovulation (anovulation)
- Challenges with fertility or difficulty becoming pregnant
- Dark or thick facial or body hair (hirsutism)
- Oily skin and/or acne
- Thinning hair or hair loss (alopecia)
- Insulin resistance
- Higher body weight, commonly around the abdomen and difficulty losing weight
- Depression (36-40%)
- Anxiety (42%)
- Mood changes
If any of these symptoms sound familiar, it may be worth discussing them first with your GP to see if you have PCOS. An early diagnosis of PCOS can help manage the symptoms and reduce long-term health risks. These health risks include a higher chance of developing type 2 diabetes (2-3 times higher risk), high blood pressure, high cholesterol, heart disease, stroke, sleep apnoea, disordered eating and eating disorders. The good news however is that some of these these risks can be managed through nutrition.
Understanding insulin resistance in PCOS
Insulin resistance lies at the heart of PCOS, affecting approximately 70% of people diagnosed with it. Insulin is a hormone released by the pancreas in response to sugar (glucose) entering the blood after eating. Insulin acts as a key to allow glucose into the body’s cells, where it is used for energy. In the case of insulin resistance, this ‘key’ can be thought of as a bit rusty and so is not able to open the door into the cells as effectively as it used to. This results in the glucose remaining in the bloodstream i.e. the cells are ‘resistant’ to the insulin. Since the body’s cells don’t respond as well to insulin, more insulin is made by the body. Insulin resistance is thought to drive some of the other symptoms and presentations seen in PCOS. The high levels of insulin in the blood decrease the amount of Sex Hormone Binding Globulin (SHBG), which is responsible for binding free testosterone in the body. This can trigger the ovaries to produce more male hormones- testosterone and other androgens which can lead to excess hair growth, acne and irregular or no periods. High levels of insulin can also cause increased fat storage around the belly or darkening of the skin.
Common PCOS nutrition myths
With so much nutrition information readily available at our fingertips it can be difficult and overwhelming to try and decipher nutrition facts from myths. Current trending diet ‘solutions’ for PCOS include weight loss diets, keto or low carb diets, going gluten and/ or dairy free and avoiding high intensity exercise.
- Low carb diets– research has found that low carb diets low are linked with poorer health outcomes. They were found to be overly restrictive by participants and studies had a high dropout rate. What has shown to be helpful in the management of PCOS however was not the amount of carbs but the quality and distribution of them.
- Gluten or dairy-free diets– this stems from the idea that these foods cause chronic inflammation in the body (chronic inflammation is often present in people with PCOS) but this is often related to high insulin levels. Unless an individual has a known allergic reaction i.e. coeliac disease or dairy allergy eating these foods will not cause inflammation in the body. In fact, food sources such as wholegrains, cereals and dairy foods contain essential nutrients which can be helpful in managing PCOS.
- Avoidance of high intensity exercise– it has been suggested that it increases inflammation in the body, however, this response is transient, and levels quickly return to normal. Engaging in physical activity of any nature has been shown to support the management of PCOS. For example, engaging in a brisk walk after a meal has been shown to help manage blood glucose levels.
How a PCOS dietitian can help
Nutrition for PCOS doesn’t need to be confusing. Our dietitians can support you in your journey putting your specific goals at the centre of your care. Some ways a PCOS dietitian can help includes:
- Recommending dietary changes to optimise insulin resistance, blood glucose and hormone levels
- Improved insulin sensitivity to prevent type 2 diabetes or gestational diabetes
- Improving energy levels including the 3 pm slump in energy levels
- Managing hunger and sugar cravings
- Providing education on quantity, quality and timing of carbs
- Navigating nutrition supplementation specifically for PCOS, including recommendations for specific blood tests
- Identifying common nutritional deficiencies through targeted dietary and/or supplementation to support your overall health
- Managing any gut issues such as bloating, constipation, diarrhoea, including irritable bowel syndrome (IBS)
- Supporting gut health and microbiome diversity
- Helping you break free from the restrict-binge cycle
- Screening for disordered eating and eating disorders if relevant
- Helping foster a positive relationship with food, body, weight and shape
- Using principles of gentle nutrition to help reduce inflammation
- Supporting mood through food
- Helping optimise fertility before or while trying to conceive
- Exploring accessible ways of moving your body
- Answering any nutrition-related questions you may have about PCOS
Get in touch with us today
Whether you are newly diagnosed with PCOS, diagnosed for some time and never thought of seeing a dietitian or perhaps have just been told to lose weight, it’s time for a fresh approach. We can help you navigate what your diagnosis means in relation to food and nutrition, fill in the gaps, and sort nutrition fact from fiction. At Dietwise we understand the importance of tailoring nutrition to the individual and creating an environment free from judgement or shame.
If you or someone you know with PCOS needs guidance with nutrition contact our Care Coordinators to get started by contacting us on – 08 9388 2423 or reception@dietwise.net.au. You can even contact us through our website here. We are open 6 days per week for in-person and Telehealth appointments including both after-hours and Saturdays.
Written by:
Accredited Practising Dietitian & Accredited Nutritionist