Polycystic ovary syndrome (PCOS) is an endocrine (hormonal) disorder, that affects roughly 10%1 of reproductive age women worldwide. It not only has a negative effect on fertility but is also associated with reduced psychological and physical well-being and increased risk of diabetes, obesity, heart disease, depression, and certain reproductive cancers.
We can see that… excess insulin release, development of insulin sensitivity, and excessive androgen production, leading to many of the symptoms of PCOS.
Although there is a great deal of research into the causes, effects, and symptoms of PCOS, the underlying root cause remains difficult to pin down. Fortunately our understanding of this condition is ever growing, with recent research furthering our knowledge on the growth and changes in the ovary follicles in PCOS.
What Are Polycystic Ovaries?
Women with PCOS have abnormally high levels of androgens such as testosterone in their system. This can cause menstrual and fertility problems and the development of cysts on the ovaries.
Compared to a ‘normal’ ovary, polycystic ovaries have an increased number of immature follicles or cysts. A follicle normally matures and releases a single egg, but the development of these polycystic ovary follicles to maturation is halted due to their altered hormonal profile.
It is thought that in combination with genetic susceptibility, high levels of luteinising hormone (LH), or high insulin levels in the blood causes the release of the excessive androgens from the ovaries, disrupting ‘normal’ ovulation.2
How Does This Affect Us Physically?
As well as causing fertility problems, PCOS is associated with various metabolic effects, most notably weight gain, insulin resistance, and hyperinsulinaemia (excess levels of insulin circulating in the blood). This means that glucose uptake from the blood into muscle and fat tissue is altered.
Insulin is released from the pancreas in response to increased blood sugar levels and it acts on fat and muscle tissue to allow the uptake of glucose into the cells for storage or energy use. Insulin resistance is when your body’s cells become less sensitive to insulin concentrations, the cells stop recognising and binding to insulin, leaving it circulating in the blood. Because insulin has not acted on our cells, glucose is left circulating and the pancreas continues to receive the message to produce more insulin. This (not so) merry-go-round ends up with high levels of circulating glucose and insulin (hyperinsulinaemia) in the blood. In turn, these cue the body to produce more androgens, which affects the release of further hormones, with knock on affects on the menstrual cycle and fertility.
Women with PCOS have a slower metabolic rate or basal metabolic rate (BMR).3 This is the amount of calories your body needs to keep the brain, heart, and organs alive and ticking. Effectively this means that at rest they require less energy. It’s been demonstrated that women with PCOS need as much as 400 fewer calories each day then women without PCOS. In other words, if you have PCOS and consume the standard recommended allowance of 2000 calories, you’re likely to gain weight!
How Can We Use Diet to Help PCOS?
Improvement of insulin sensitivity in women with PCOS by exercise and diet maintenance are currently the main therapeutic treatments. We can see that continuously high blood sugar levels can lead to excess insulin release, development of insulin sensitivity, and excessive androgen production, leading to many of the symptoms of PCOS. What we want to do is stick a spanner in the works and disrupt this pattern. Here are five ways you might go about doing that:
- Eliminate dairy. Dairy foods have been shown to have a high insulinaemic response (increased insulin response), which can result in increased androgen levels.4
- Low carbohydrate diet. Keeping your carbohydrate consumption restricted will ensure that you do not have wild blood sugar fluctuations and reduces the stimulation for insulin secretion. This will minimise any development of insulin sensitivity.
- Always have carbohydrates with protein. Consuming your carbohydrates as part of a balanced meal, i.e. with protein and fats, will increase your digestion time, causing the sugars to be released slower and more steadily into the bloodstream. This reduces the chance of a sudden dump of sugar and consequently insulin into circulation.
- Eliminate high glycaemic index (GI) foods, particularly refined sugars and refines carbohydrates. High GI foods are those which cause a rapid and high peak in blood sugar levels. By replacing any of these foods with low GI substitutes you can reduce any blood sugar spikes after a meal.
- Get active. Being constantly active on an everyday basis – think walking instead of driving, taking the stairs instead of the lift – combined with some high intensity exercise and weight-bearing movements (yes, lifting weights!) will improve insulin sensitivity and metabolic health. The more often you do them the better: start by adding in one session of exercise a week and continue to do so each month until you’re moving everyday!
So What Should I Be Eating?
With PCOS you may need to eat a lower calorie diet then what is traditionally recommended as your energy requirements are lower then an average women. These calories should be made up from lots of fresh grass-fed or organic meats, fish and poultry, healthy fats such as avocado, nuts, coconut products, and olive oils, and a rainbow of low GI vegetables at every meal. Exact amounts, proportions, and timings are dependent on each person as an individual. If you have PCOS and need help or support with your diet try getting in touch with a local nutritionist or nutritional therapist that holds primal ideals.
Have you found that eating in a primal way has helped you with your symptoms of PCOS? Please feel free to share your experiences below.
- Lin, A.W., Lujan, M.E. (2014). Comparison of Dietary Intake and Physical Activity between Women with and without Polycystic Ovary Syndrome: A Review. In Advanced Nutrition, 5, 486–496. Retrieved http://advances.nutrition.org/content/5/5/486.long
- Mason, H., Colao, A., Blume-Peytavi, U., et al. (2008). Polycystic Ovary Syndrome (PCOS) Trilogy: A Translational and Clinical Review. In Clinical Endocrinology, 69(6), 831–844. Retrieved http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2265.2008.03329.x/full
- Georgopoulos, N.A., Saltamavros, A.D., Vervita, V., et al. (2009). Basal Metabolic Rate is Decreased in Women with Polycystic Ovary Syndrome and Biochemical Hyperandrogenemia and is Associated with Insulin Resistance. In Fertility and Sterility, 92(1), 250–255. Retrieved http://www.ncbi.nlm.nih.gov/pubmed/18678372
- Phy, J.L., Pohlmeier, A.m., Cooper, J.A., et al. (2015). Low Starch/Low Dairy Diet Results in Successful Treatment of Obesity and Co-Morbidities Linked to Polycystic Ovary Syndrome (PCOS). In Journal of Obesity & Weight Loss Therapy, 5(2), 259. Retrieved http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516387/