PCOS diet: what foods to eat and what to avoid

If you have polycystic ovary syndrome (PCOS), diet and nutrition are one of the first treatments used to help manage your symptoms. This is because the food you eat can have a significant impact on your hormones and metabolism. Since PCOS is a hormonal disorder, your diet is important to help you manage your symptoms. 

PCOS is one of the most common endocrine disorders impacting women of reproductive age. The exact cause of PCOS is poorly understood, and it’s likely caused by a combination of factors. 

Risk factors for PCOS include genetics, family history, obesity, insulin resistance, and chronic inflammation (Leon, 2021). 

PCOS is often underdiagnosed for many reasons. There isn’t a specific test for PCOS, and it’s only diagnosed when other conditions have been ruled out. For your healthcare provider to diagnose PCOS, two of the following criteria must be present:

• High androgen levels (sometimes called the male sex hormone)

• Ovarian cysts (fluid-filled sacs in or on the ovary)

• Irregular menstrual cycles (longer than 35 days between ovulation)

Symptoms of PCOS may include (Leon, 2021):

• Irregular periods

• Heavy menstrual bleeding

• Acne

• Hair loss on the scalp

• Excess hair growth on the body (hirsutism)

• Weight gain

• Insulin resistance

• Infertility

The food you eat will likely impact your symptoms. With diet changes, you can help improve your symptoms or decrease your chances for complications like (Leon, 2021):

• Type 2 diabetes

• Heart disease

• Metabolic syndrome

• Liver disease 

How it works

There is no one diet for PCOS because everyone has different hormone levels, metabolism, and health history. It may take time to find the right healthy diet for you. If you have questions, consider meeting with a registered dietitian or nutritionist to develop the best plan for your needs. They can also help you adjust your plan as you figure out what does and doesn’t work for you.

There is research to suggest some diet changes that help to improve the symptoms of PCOS and lower your risk of other health problems. 

Changing your diet may help you manage PCOS symptoms in the following ways (Moran, 2013):

• Helps balance hormones: Research suggests that dietary changes may help you balance your hormone levels. Since hormonal problems cause many PCOS symptoms, improving your hormone balance may help to reduce your symptoms. 

• Can help with weight loss: Along with balancing your hormones, eating a more nutritious diet can help support your weight loss journey. 

• Can help with insulin resistance: Insulin resistance makes it more challenging to lose weight and increases your risk for storing fat within your abdomen. Fat in the stomach is called visceral fat and is associated with increased health risks. 

There is no exact plan for what you should eat with PCOS. Still, research suggests the following tips may help support weight loss and symptoms management for PCOS:High fiber foods

Fiber is a type of carbohydrate that your body can’t fully digest. So instead of providing energy like other carbs, fiber has other functions. The health benefits of fiber include (Barber, 2020):

• Digestive health and improved regularity

• Lower risk of colon cancer

• Decreased cholesterol levels

• Better heart health

• Healthier gut microbiome

• Improved insulin sensitivity

• Supports weight loss and healthy weight maintenance

It’s recommended to eat between 25–35 grams of fiber every day (Barber, 2020). Good sources of dietary fiber include:

• Oats

• Legumes and lentils

• Chia and flax seeds

• Leafy greens

• Berries

• Beans

• Avocados

Protein with every meal

Protein helps support your muscle health and keeps you feeling full longer. It takes more time to digest protein than carbs. So try to pair any carb foods with protein to prevent blood sugar spikes and help with losing weight (Moran, 2013). 

Good sources of lean protein include:

• Chicken and turkey

• Fatty fish (salmon, mackerel, tuna, etc.)

• Lean red meats

• Eggs

• Greek yogurt

• Cottage cheese

• Beans and legumes

• Tofu

• Tempeh

Fruits and vegetables

Fruits and vegetables are full of healthy nutrients like vitamins, minerals, and fiber. Non-starchy vegetables and berries are lower in carbs and good sources of fiber. 

Starchy vegetables (like potatoes and corn) and some types of fruit may cause larger spikes in blood sugar levels since they sometimes break down more quickly into glucose. Pairing these foods with a healthy fat or protein may help slow down digestion and help keep blood sugar levels more stable (Moran, 2013).

Whole grains

Try to choose whole grains over more processed grains. Foods like white bread have the fiber and other nutrients stripped away during processing, making them more likely to spike blood sugar levels. This can increase insulin resistance and the risk for type 2 diabetes. Instead of simple carbs, try to eat more whole grains like quinoa, oats, bran, brown rice, and whole wheat.

Research suggests a low-carb diet may also help improve menstrual regularity with PCOS (Moran, 2013). 

Healthy fats

Research suggests a diet higher in monounsaturated fat supports healthy weight loss in people with PCOS (Moran, 2013). Fat takes longer to move through your gut and helps increase feelings of fullness after eating. This may help with more stable blood sugar levels. 

Foods with monounsaturated fat include:

• Olive oil

• Nuts and seeds

• Avocados

• Nut butter

• Olives

Some foods may increase insulin resistance and other symptoms associated with PCOS. Try the following to see if these changes help your symptoms:

Limit processed and sugary foods

Sugary and processed foods have a high glycemic index, meaning that they cause glucose (sugar) spikes in your blood. High glucose levels lead to insulin release—over time, too much insulin causes insulin resistance. 

Insulin resistance is a major concern because it affects up to two-thirds of people with PCOS (Leon, 2021). Insulin is the hormone that brings glucose into your cells and muscles from your bloodstream. 

Consider eliminating dairy and gluten

Some people report improvements in symptoms when eliminating dairy, gluten, or both from their diet. If you’re having challenges managing your PCOS symptoms, you could consider an elimination diet to see if any of these foods affect you. 

Healthy habits help to support your diet changes and may help improve polycystic ovarian syndrome symptoms. Lifestyle changes that may help PCOS include:

Getting enough sleep

Research suggests sleep impacts stress levels, weight, and mental health. Lack of sleep may contribute to weight gain, which is already challenging with PCOS (Ogilvie, 2017).

Tips to get better sleep include: 

• Follow a consistent bedtime routine.

• Keep your room cool, dark, and quiet.

• Use a white noise machine.

• Avoid using electronic devices close to bedtime.

• Limit caffeine in the later parts of the day.

Regular exercise

It’s suggested that people with PCOS complete a minimum of 150 minutes (2.5 hours) of exercise every week. Research suggests regular physical activity helps support a healthy weight, decreases insulin levels, increases insulin sensitivity, and improves ovulation frequency (Woodward, 2020).

Try to increase your daily activity by:

• Walking during half of your lunch break

• Scheduling strength and cardio workouts

• Joining a group fitness class

• Stretching

• Going for a bike ride

• Playing catch or shoot a basketball with family or friends

Stress management

High stress levels impact hormone levels, sleep, mental health, and weight (Xenaki, 2018). Learning stress management techniques helps support both your physical and psychological health, which are essential for helping with PCOS. 

Techniques to help manage stress include:

• Meditation

• Deep breathing exercise

• Physical activity

• Talking with family or friends

• Walking

• Stretching

• Writing in a journal

• Aromatherapy

• Arts and crafts

• Expressing gratitude

If you think you have PCOS, it’s best to meet with your healthcare provider to get an accurate diagnosis and check for any health problems associated with this condition. Sometimes medications are recommended to help balance hormones or support insulin sensitivity. 

If you have any PCOS diet questions, a healthcare professional, like a dietitian or nutritionist, may help you find a diet plan that works for you.