A Natural Approach to PCOS Support with Diet and Lifestyle

Living with polycystic ovary syndrome can be insanely frustrating. Not only is PCOS highly underdiagnosed, undertreated, and underfunded in research (despite affecting 1 in 10 women of childbearing age), but PCOS treatments are often much more prescriptive than proactive. In fact, PCOS treatments rely heavily on medical intervention (often through hormonal medications).

But what if there were other approaches you could take before resorting to medication? The etiology (or the set of causes) for the condition is complex, but we are aware of the incredible impact that diet and lifestyle change can have on PCOS. Here’s what to know about the lifestyle changes for PCOS.

What the heck is PCOS?

Polycystic Ovarian Syndrome (PCOS) is a complex condition of hormone and metabolic imbalances. It involves androgen excess (androgens are male hormones such as testosterone, androstenedione, and DHEA-S) and ovulatory dysfunction. Immature follicles on the ovaries that are often described as “polycystic” are ironically not always indicated in a true PCOS picture allowing the condition to sometimes go undiagnosed in women.

In addition, PCOS is a leading cause of infertility, affecting approximately 5 million in the US alone.

What are some of the symptoms of PCOS?

Common symptoms of PCOS include

  • Irregular or missing period 
  • Excessive facial and body hair 
  • Acne 
  • Scalp hair loss 
  • Weight gain
  • Infertility 
  • Fatigue 

In addition to the daily symptoms, PCOS is associated with a long-term risk of diabetes, metabolic syndrome, and heart disease.  

You can see that PCOS is much more than just a period problem. In fact, it’s a whole-body hormonal condition that can significantly impact quality of life. 

Problems with conventional PCOS treatment strategies

Often with PCOS, women are advised to lose weight, start or restart birth control, or take another prescription without much of any diet or lifestyle recommendation. The problem with this is that supporting specific diet and lifestyle factors can be a GAME changer for PCOS symptoms. Plus, diet and lifestyle can reduce any inflammation that could be further driving the condition.  

Additionally, many times a PCOS diagnosis is provided without a thorough assessment of what type of PCOS is present. The types of PCOS are: 

  1. Insulin resistant PCOS
  2. Inflammatory PCOS  
  3. Adrenal PCOS 
  4. Post-pill PCOS

Having a clear picture of your PCOS presentation creates a better roadmap for symptom relief and healing. 

Diet and lifestyle changes for PCOS 

Where to start with PCOS?  I refer to a set of foundations when kicking off a care plan with a new PCOS client.  These include blood sugar balance, anti-inflammatory nutrition with nutrient seeking, healthy gut function, optimal liver detoxification, stress resilience (including adrenal health, movement, and sleep practice), and lifestyle awareness (including environmental exposures and xenoestrogens).

This might sound like A LOT. But looking whole picture at your diet and lifestyle is the BEST way to optimize your PCOS care.

Here are my top 3 diet and lifestyle changes for PCOS to start with.

1) Prioritize blood sugar stability 

Keeping blood sugar stabilized during the day is one of the best ways to keep hormones like insulin in balance and cool the inflammatory cascade that can come from blood sugars surging.  

My top recommendations for blood sugar stability?

  • Eat a balanced breakfast with at least 20 g of protein within 1 hour of rising 
  • Eat a balanced meal or snack every 3-4 hours to prevent dips in blood sugar and promote energy 
  • Always pair either a protein or fat source with any carbohydrate choice 
  • Include nutrient dense carbohydrates regularly (i.e., starchy vegetables, beans, fruit) and eat more fun carbohydrates with joy and intention, trying to pair again with a fat and fiber or a protein to keep blood sugars stabilized. 

Bottom line? Creating intention around meal timing, building a balanced plate, and portion size mindfulness are helpful strategies to support blood sugar stability.

2) Audit and practice daily stress management 

When the stress response is activated, the body must prioritize where its resources are going. Under the impression of a high prolonged stress, the body is not prioritizing the pathways that would support hormone production for ovulation and becoming pregnant. Also, when levels of the stress hormone cortisol increase, this blocks maturation of ovarian follicles (hello PCOS!).  

I recommend taking inventory of current stressors in your life and establishing both your non-negotiable daily stress support and a stress care tool kit. 

Bottom line? Stress can challenge sex hormone function. Addressing both diet and lifestyle stress with awareness and intention is a first step in creating change.  

3) Reduce inflammation by focusing on foods to include.

It is very popular for women with PCOS to explore a variety of elimination diets to manage their symptoms. I find this strategy only encourages a restrictive and lack mindset as well as under prioritizes nutrients and compounds to INCLUDE in your diet to best support PCOS root imbalances.

I call this approach “Nutrient Seeking.”  By directing focus toward meals and ingredients that first sound good to you, then rounding them out to be blood sugar balanced and include “Nutrient Seeking” boosts, I find that women can more realistically and consistently support their health goals. 

Bottom line? Focus on what you include more than what you exclude! 

Up-leveling strategies for PCOS

In addition to the diet and lifestyle foundations, there are other tools that can be very helpful In the PCOS treatment process. Recruiting specific blood work and advanced lab testing, one can uncover more specific details about their PCOS presentation. Baseline blood work can establish an understanding of inflammation, blood sugar regulation, insulin sensitivity, and nutrient deficiencies.

Labs like DUTCH Hormone Assessment and GI MAP stool test can also be used to gain a deeper understanding of hormone communication, stress response, detox pathways, and GI inflammation and bacterial balance! All these factors intersect with a PCOS presentation. 

The benefit of testing is that it provides data points to better understand the root cause factors influencing PCOS. A greater understanding of factors = greater direction for personalized care!

Final thoughts on lifestyle changes for PCOS

Diet and lifestyle strategies are regularly overlooked in the management of PCOS. Understanding root imbalances to a PCOS presentation is essential for optimizing treatment and lab testing can be a tool here to up-level your path to healing. Remember, one in 10 women have PCOS. If you are one of these women, know that you’re not alone and support in healing is possible. 

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Women's Health

About Olivia Wagner

Olivia is a Functional Dietitian (RDN) with a strong foundation in nutritional and exercise science, advanced training in integrative and functional medicine, and certificates in mindful/intuitive eating practices so she has a deep understanding of the relationship between food, body and mind. She specializes in helping women achieve holistic transformation without ruining their relationship with food. Olivia helps growth-focused women balance hormones, beat the bloat, and create confidence with an empowered mindset. She works with a variety of conditions including PCOS and hormonal imbalances, irregular cycles, gastrointestinal conditions and autoimmune disease.