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FertilityFor YouNutrition

Nutrition for PCOS

By September 22, 2021No Comments
pcos

By Sarah Trimble – Nutritionist

Polycystic Ovary Syndrome (PCOS) is the most common reproductive disorder affecting women, with around 10% of women suffering from PCOS. For a woman to be diagnosed with PCOS she should have 2 out of the following 3 signs and symptoms:

  1. irregular or absent ovulation
  2. elevated levels of male hormones testosterone and signs of high testosterone (i.e. acne, excess hair, balding of hair on head)
  3. multiple cysts on the ovaries

So the focus for a diagnosis of PCOS is on the imbalances it causes to reproductive function and reproductive hormones and we could be excused for thinking that PCOS is solely a reproductive disorder. However, there is more going on than meets the eye in PCOS, because we know that the root cause of these reproductive problems, for around 80% of women with PCOS, is in fact a metabolic imbalance called insulin resistance. PCOS could be considered a metabolic disorder with reproductive consequences.

What is insulin resistance?

The main role of the hormone insulin is to manage the metabolism of glucose. After we eat a meal containing carbohydrates the level of sugar (or glucose) in our blood rises, at this point insulin is released to signal our cells to take the glucose out of the bloodstream to be converted into energy. In insulin resistance the cells do not respond to this signal and as a result blood glucose levels remain high. The body then produces more and more insulin to try and get the glucose into the cells leading to high levels of insulin being produced. Insulin has the ability to interfere with production of reproductive hormones, it causes the ovaries to produce higher levels of testosterone while increasing luteinising hormone (LH), which further stimulates the ovaries to produce even more testosterone. Insulin also causes a drop in follicle stimulating hormone (FSH) which leads to inadequate maturation of follicles, lack of ovulation and cyst formation on the ovaries.

Addressing and improving insulin resistance should be the primary focus of any nutritional and lifestyle interventions that aim to address PCOS. Dietary and lifestyle changes can significantly improve insulin resistance, reducing the amount of insulin produced by the body. Once the amount of insulin being produced drops the hormonal imbalances that are caused by elevated insulin levels will improve.

Dietary changes to support PCOS

Eat slow carb rather than low carb

The first dietary change that must be made in addressing PCOS is to choose carbohydrate-based foods that release energy gradually and slowly and do not cause a huge spike in blood glucose levels – this dietary approach is sometimes referred to as a low Glycaemic Load (GL) diet. So swap refined carbohydrates such as white bread, white rice and crackers for higher fibre and slow release carbohydrates such as wholegrain bread, rye bread, brown rice, oats and wholegrain pasta. Avoid sugary treats and soft drinks as these will result in a rapid spike in blood glucose levels that results in a significant insulin production. By changing the type of carbohydrates you choose and significantly reducing sugar consumption within days the body will begin to produce less insulin and degree of insulin resistance will improve.

 Add in some good quality protein

An important way to help manage blood glucose levels after a meal is to eat a source of quality protein at each meal and snack, avoiding meals that are completely carbohydrate based such as bowls of breakfast cereal, toast and jam or pasta with tomato sauce. Protein takes longer for the body to digest and doesn’t cause blood glucose levels to increase. Therefore, by adding a source of protein to each meal and snack we slow down the time it takes to digest and release energy from that meal or snack – resulting in a sustained and steady release of blood glucose after that meal and lower blood glucose levels. Great sources of protein to include in your diet are eggs, Greek yoghurt, nuts and seeds, fish, chicken, lean meat and beans and lentils.

Very high protein diets, such as ketogenic or paleo diets are sometimes recommended for women with PCOS as they can produce impressively rapid improvement in symptoms. However, the research indicates that such benefits are often short term as these diets are difficult to sustain in the long run. If you are changing your diet when trying to conceive it is always important to consider if you will be able to sustain those dietary changes throughout pregnancy.

Food Swaps for PCOS

SWAP FOR
Toasted white bread and jam Toasted rye bread with peanut butter
Cornflakes Porridge topped with chopped nuts and apple
Croissant Sourdough bread with scrambled eggs
Banana Greek yoghurt with berries
White bread sandwich Wholegrain pitta stuffed with chicken and salad
Vegetable soup Minestrone soup with beans or lentil soup
Packet of crisps Handful of nuts
Biscuits Oatcakes topped with nut butter or hummus
Chocolate bar Few squares dark chocolate and a small handful nuts
Risotto Stir fry with salmon/ prawns and brown rice
Pasta with tomato sauce/ vegetarian sauce Pasta dish with tuna/ prawns, grass fed beef

 

Time how you eat

Time-restricted eating has become popular in recent years and rightly so, it has been shown to provide significant health benefits and this is partly because it reduces insulin production and helps to reduce insulin resistance. Time-restricted eating is an approach to eating that involves eating all your meals within a restricted window of time (usually 8-10 hours) so that for the majority of a day your body is in the fasted state. When you are in the fasted state your body is not producing insulin, so women with PCOS are recommended to have an overnight fast of at least 12 hours.

One piece of research found that women with PCOS saw significant improvement in hormonal imbalances (54% reduction in insulin and 50% reduction in testosterone) by eating their largest meal of the day at breakfast (around 900 calories) and smallest meal at dinner time (around 150 calories)  for 90 days along with a 12 hour fast overnight.

 

 Introduce anti-inflammatory foods

The elevated levels of blood glucose and insulin that women with PCOS experience also promote inflammation in the body. Then this inflammation can make insulin resistance worse so a vicious cycle develops of insulin resistance causing inflammation that then promotes further insulin resistance.

This inflammation can contribute to a number of the symptoms that we associate with PCOS. Yet, we also know that inflammation has a negative impact on our reproductive health and chances of conceiving. Eating a diet rich in anti-inflammatory foods is an important way of breaking this vicious cycle of insulin resistance and inflammation.

Anti-inflammatory foods include: omega-3 fats from oily fish, spices especially ginger and turmeric, mushrooms, green leafy vegetables, extra-virgin olive oil, green tea.

Pro-inflammatory foods should be reduced in the diet at the same time. These include: processed foods containing vegetable oil or sunflower oil, margarine, high fat red meat, processed meats, alcohol, sugar.

Key Foods for PCOS

Together with the dietary guidance already discussed specific foods deserve special mention because eating them has been shown to support a big improvement in women with PCOS.

Cinnamon – the spice cinnamon helps to treat and improve the insulin resistance that is the root cause of PCOS. In one study women eating 0.5g of cinnamon with each meal for 6 months saw an improvement in the regularity of their menstrual cycle. Try adding cinnamon to porridge or breakfast cereal or have a cup of cinnamon tea after meals.

Flax seeds – flax seeds can improve levels of a hormone carrier called Sex Hormone Binding Globulin (SHBG), which is often low in women with PCOS. Eating 30g of milled flax seeds every day improved insulin resistance and inflammation in women with PCOS.

Extra Virgin Olive oil – olive oil is rich in monounsaturated fat (also found in rapeseed oil, avocado and almonds) and eating a diet rich in monounsaturated fat can improve insulin resistance and promote hormone balance in PCOS.

Green Tea –  green tea can support hormone balance in 2 ways for women with PCOS: it can improve levels of SHBG and reduce levels of testosterone. Aim to drink 2-3 cups of green tea daily.

It’s not just diet

While dietary changes should be the primary focus of an approach to improve PCOS, however, by combining these dietary changes with specific lifestyle changes you can further support PCOS.

Check your vitamin D levels

Women who live in Northern Europe are at risk of vitamin D deficiency and there is a close relationship between vitamin D deficiency and PCOS symptoms. Women with PCOS who have lower vitamin D levels have a higher level of insulin resistance, which then drives the hormonal imbalances in this condition.  Testing for and treating vitamin D deficiency can have an improvement in PCOS symptoms and also support fertility in general. Our main source of vitamin D is sunlight (hence why we are at risk of deficiency in Northern Europe) so adequate supplementation is needed to treat deficiency.

 Exercise

Regular exercise is an important way to bring about an improvement in insulin resistance. However, instead of sweating it out on the treadmill try and focus your exercise regime around resistance training. Resistance training, where we lift weights or pull against resistance that could be our own bodyweight, dumbbells, resistance machines etc. is more effective than cardiovascular exercise in improving insulin resistance so aim to incorporate resistance training into your exercise regime as much as possible.

Sleep

Ever wondered why you can’t stop eating sugary foods the day after a bad night’s sleep? It’s because insufficient sleep (less than 6 hours) can have a negative impact on insulin and blood glucose levels, making insulin resistance worse. Not getting enough sleep on a regular basis could, therefore, contribute to PCOS symptoms so make an effort to get a good night’s sleep, no late night Netflix binges.

Address your Stress

At the beginning I mentioned that for around 80% of women PCOS is caused by insulin resistance, the other 20% of women with PCOS actually suffer from an imbalance in their adrenal gland function that contributes to the condition. Our adrenal glands main function is to produce adrenaline and the stress hormone cortisol, however, they also produce a certain amount of sex hormones too. If we are under sustained and prolonged stress then the function of the adrenal glands can get out of balance leading to increased testosterone production from the adrenal glands. The stress hormone cortisol also promotes insulin resistance, so all manner of hormonal imbalances can be exacerbated because of stress and improvement experienced from dietary changes can easily be negated if we are under a lot of stress.

Stress reduction techniques can be very individual, one person will find meditation beneficial, another going for walks in nature. The key is to find the stress reduction technique that works for you and making time for it.

Support your gut microbiome

I’ve come to this point last, but supplementing the gut microbiome could be the most important change you make in an effort to improve PCOS. As we’ve explained insulin resistance is the root cause of the various hormonal imbalances seen in PCOS, but in recent years we have begun to understand that an imbalance in the gut microbiome (the name for the population of GOOD bacteria that live in our gut) could actually be the root cause of this insulin resistance. Women with PCOS have been found to have imbalances in their gut bacteria that contributes to increased release of glucose into the bloodstream after a meal and also promotes inflammation. Correcting this imbalance should be a priority in any treatment protocol for PCOS.

A key way to support the gut microbiome is to supplement with a high quality probiotic, especially one that contains the bacteria Lactobacillus Rhamnosus GG as this bacteria has been shown to improve blood glucose levels and insulin resistance.

Dietary changes can also support an improvement in the balance of the gut microbiome:

  • Eat fermented foods such as live natural yoghurt, kefir, sauerkraut, kombucha, or miso daily.
  • Eat a large variety of fruits and vegetables, don’t just focus on the same fruits and vegetables daily. We should aim for 30 different plant-based foods in a week.
  • Eat plenty of soluble fibre from whole grains and beans and lentils – soluble fibre feeds our good bacteria.
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Amy Martin

Marketing Director

Amy is a high achieving individual with a number of marketing awards under her belt, including Young Digital Business Person of the Year 2019. She is a big believer in digital marketing and an expert in executing personalised targeted campaigns. Amy strives to learn from data and campaigns that show return on investment.

Robert Gordon

Managing Director, Gordons Chemists

 

Robert Gordon, director at Gordons Chemist's. Gordons Chemists is a chain of more than 60 pharmacies, located in NI and Scotland. Gordons Chemists is Northern Ireland's largest independent pharmacy chain.

Dr. Debbie Collins

MBBchBAO MRCGP

 

Dr. Debbie Collins MBBchBAO MRCGP, a practicing GP and partner in Belfast. She has a passion for patient education and advocacy. Her special interests are Women's Health and Fertility

Sarah Trimble

Nutritional Therapist

 

Sarah Trimble - a nutritional therapist with a passion for good food instead of fad diets. Sarah has a particular Interest in using the power of nutrition to support hormonal imbalances and reproductive health.

Barbara Scott

Director, Seren Natural Fertility
Chair, Association of Reproductive Reflexologists

 

Barbara Scott is Chair of The Association of Reproductive Reflexologists, founder of Seren Natural Fertility and author of Reflexology for Fertility. In 2017, she was awarded ‘Complementary Therapist of the Year’ by the Federation of Holistic Therapists and has been nominated for several awards within the field of complementary therapy. In 2019 she was awarded the Innovation in Reflexology Award by the Association of Reflexologists.

Barbara speaks and lectures globally on her integrative approach to supporting couples having difficulties conceiving. She has spoken at many of the Fertility Shows and Fertility Fest. Alongside her own busy clinics, she also trains practitioners in providing this integrative, approach to fertility and reproductive healthcare and well-being. The ARR (Association of Reproductive Reflexologists) has trained practitioners globally, from Australia, New Zealand, Canada, Europe, and most areas of the UK.

Her expertise and passion is in advocating a patient-centred and integrative approach to supporting both men and women on their journey to parenthood.

Cindy Charles

Fertility coach and Founder of Fertilelife

 

Cindy Charles- Fertility coach and Founder of Fertilelife. Cindy is a committed advocate of social and personal development. Her own life experiences inspired her fertility support services. Cindy has worked with the Fertility Network UK, and has had the privilege to work as a resident Fertility Coach for the London Women's Clinic on Harley Street. Cindy believes in the importance of nurturing our own fertility.

Dr. Lyuda Shkrobot

MD, MSc Gynecologist, Fertility specialist at unq.life fertility clinic

 

Dr Lyuda has a special interest in reproductive immunology. Dr Shkrobot assisted in establishing the first European Donor Egg programme at Sims, coordinating and liaising with Intersono Clinic in Ukraine Advisors. She is passionate about patient-centred, results-driven care.

Jill Martin

Business Development Director

 

Jill Martin is a trained nurse and highly experienced pharmaceutical professional. Most of her business acumen and skills were developed by the world class training she received at Glaxo Smith Kline (GSK). Hard work and focus have resulted in a varied and successful career working in several different disease areas. As part of the Diabetes team at GSK, an opportunity arose to develop and support education programmes that were rolled out to the NHS across the UK, which resulted in improvement of Strategy and Patient Care. Jill feels that education is the key to understanding and has made it a personal goal to self-improve and support learning for others especially within the healthcare arena. The last 10 years have been devoted to trying to impart the importance of Fertility Health early in the life cycle of us all, rather than when infertility issues arise. She is delighted to have joined Nua Fertility on their mission to support people and communities to understand the importance of gut health on our fertility well-being.
 

Share a little about yourself—the things we wouldn’t learn from simply reading your professional bio.

The most important thing to me in life are family and friends, it breaks my heart when people are broken and I know that I am always trying to find solutions to problems. I love being outside rather than sitting at a desk and would rather lift the phone and have a chat with someone rather than email or message. I find people interesting and will often be that annoying person who starts a conversation on a train or plane.
 

What was your journey to parenthood like?

I feel very blessed to have had my family naturally, although not without some challenges. Following a miscarriage and thyroid issues conception wasn’t as easy as I would have hoped. My personal experience made me appreciate how important it is to value ways to improve your fertility health. This set me on my own journey to find out more, by surrounding myself with a network of experts in this area who I am continually learning from. When possible I take every opportunity to share best practice or send information to others that I know who are also seeking to understand more.
 

What is your ideal way to relax and unwind?

Juggling home life and working full time with a lot of travel, for most of my adult life made me find a way to relax that may seem strange. I love getting my trainers on and going for a long walk or run, even in the rain! Sometimes I will listen to a podcast and other times just be mindful of my surroundings. I find this a great way to clear my head, think about priorities and take time out for myself.
 

If there was just one thing you could impart on women on their journey to parenthood, what would it be.

From an early age I loved to make jigsaws, little did I know that this skill would help me later in life to understand the complexity of fertility and the miracle of life. Everyone is unique, every situation is different, like a jigsaw there are lots of pieces that need to be put together to become complete. Explore all options, chat to experts don’t be afraid to ask for help.

Aoibheann Murphy

Chief Financial Officer

 

Having trained with PWC, Aoibheann qualified as a Chartered Accountant in 1997. She subsequently spent eight years working in industry, gaining invaluable experience in many areas In 2005 Aoibheann became MD of Pangur Consulting, providing professional expertise to a broad client base. She is looking forward to the new challenge of Nua Fertility.
 

Share a little about yourself—the things we wouldn’t learn from simply reading your professional bio.

 

What was your journey to parenthood like?

Right craic!
 

Do you prefer podcasts or books? And of the one that you prefer, what is a show or title that you recommend?

I love sport…any sport…and the outdoors. Living in the Barrow valley I get to enjoy swimming and kayaking in the Barrow and exploring the Blackstairs mountains. Since I hung up my soccer boots (the body just couldn’t take it anymore!), I’ve been cycling with my lovely friends in Mount Leinster Wheelers and was chuffed to have completed the Ironman 70.3 triathlon event in Dublin in 2019!
I’m an avid reader…books beat podcasts hands down!...although recently I’ve dabbled with audio books through the library app Borrow Box. “A Little Life” left its mark on me. A harrowing story, definitely not for the faint hearted.
 

If there was just one thing you could impart on women on their journey to parenthood, what would it be?

Don’t be consumed by the roles in your life – parent, partner, employee etc. Parenthood, be it getting there or going through it, will have its tough times. Cherishing yourself as an individual and making time for yourself can help you through those times….it’s good to be a bit selfish!!

Mark Mullins

Director of Sales

 

What was your journey to parenthood like?

To be honest it was very difficult. At the beginning we thought that when we decided that we wanted to start a family Deborah would fall pregnant shortly afterwards like many of her friends. As time went by, we started to suspect something was wrong. After initial tests we found out that I had a low sperm count which meant that we would have to go down the assisted pregnancy route. This took me several months to get my head around as I blamed myself for this. All I wanted was my wife to be able to go through the pregnancy journey. We couldn’t wait to become parents. There were many long and painful nights where I thought this would never happen for us. After several failed attempts we decided to look at further ways of improving our chances. This led us to look at fertility supplements, our diet, exercise. I will never forget when that morning during our Two Week Wait when Deborah woke me up at 5 a.m. to show me those two lines, we had both been yearning for! We are blessed to now have our beautiful daughter.
 

On challenging days, what kept you going? Where did you find inspiration?

My wife was my inspiration. She kept me going through those challenging months and years. She was there to help me deal with everything. The guilt I felt when I saw her having to go through everything.
 

What is your ideal was to relax and unwind?

My latest passion is cooking on my BBQ. I find it so peaceful and I just switch off. It just gives me a bit of alone time which everyone needs.
 

If there was just one thing you could impart on men as they begin trying to become parents, what would it be?

I would highly recommend communicating with friends and family. A problem shared is a problem halved. Failing that there are some really good private Facebook groups for men suffering from infertility. I found this great support through the good and especially the bad times.