- Polycystic Ovarian Syndrome (PCOS) is a chronic disorder involving hormonal imbalances that inhibit ovulation, which can lead to infertility.
- Dietary changes like focusing on low-glycemic index and anti-inflammatory foods in the context of a balanced, whole-food diet have been shown to improve outcomes and symptoms of PCOS.
- Other lifestyle factors such as optimizing sleep, managing stress, and getting regular exercise can also support PCOS management.
Polycystic Ovarian Syndrome (PCOS) is one of the leading causes of female infertility. With lots of conflicting nutrition information online, it can feel overwhelming to identify an evidence-based eating pattern for boosting fertility and managing PCOS.
Continue reading to learn more about the optimal PCOS diet for fertility along with other fertility-boosting lifestyle changes.
The Basics of Polycystic Ovarian Syndrome (PCOS) and Fertility
Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder impacting up to 15% of females worldwide. A major characteristic of PCOS is a chronic, irregular menstrual cycle or lack of ovulation.
People with PCOS also tend to have hyperandrogenism or elevated levels of androgen hormones, like testosterone. In many cases, numerous small cysts can develop on the ovaries, which is known as polycystic ovaries.
PCOS is associated with increased insulin levels, which can result in insulin resistance. This impacts your metabolism and makes it harder for your body to regulate blood sugar levels and to manage your weight.
Common symptoms of PCOS include:
- Hirsutism (growth of facial hair.)
- Alopecia (hair loss.)
- Acne and oily skin.
- Weight gain and difficulty losing weight.
- Menstrual irregularities, like skipped periods or heavy bleeding during periods.
- Acanthosis nigricans (dark skin patches, usually on the back of the neck.)
PCOS is a common cause of infertility. The hormonal imbalances that occur with PCOS can make it difficult for the ovaries to release an egg each month. When ovulation stops, pregnancy cannot happen.
Some people with PCOS do ovulate but experience infrequent periods, which means fewer opportunities to get pregnant.
In addition to infertility, people with PCOS have a higher risk of developing other conditions, like:
- Metabolic syndrome.
- Increased cardiovascular risk.
- Type 2 diabetes.
- Sleep apnea.
- Endometrial cancer.
- Nonalcoholic fatty liver disease.
Fortunately, you can decrease your risk of these disorders through consistent lifestyle changes and medical treatment.
Can You Manage PCOS With Diet and Lifestyle Changes?
Polycystic Ovarian Syndrome is thought to be caused by a combination of genetic, environmental, and lifestyle factors. While it has no cure, PCOS can be managed, and many individuals are able to have successful pregnancies.
Lifestyle factors like eating well, exercising regularly, and getting enough sleep can play a role in managing PCOS naturally. While lifestyle changes can improve PCOS symptoms and fertility outcomes, many people also need medical treatment to become pregnant.
How Nutrition Affects PCOS and Fertility
The foods you eat can impact PCOS and your fertility. Because insulin resistance, gut health, and chronic inflammation all play roles in the disease process of PCOS, we can target our food choices to help address these concerns.
In general, a high-fiber plant-based diet low in saturated fat can play a role in reducing insulin resistance, androgen hormone levels, and inflammation while improving gut health. A few specific dietary patterns have been studied in the context of PCOS, like a low glycemic index diet and an anti-inflammatory diet.
The glycemic index (GI) is a chart of numerical values assigned to different foods based on their impact on blood sugar levels. Foods with a low GI value (typically high-fiber, nutrient-dense foods) don’t raise blood sugar levels as much as high GI foods.
A diet emphasizing low glycemic index foods has been linked with improved insulin resistance, waist circumference, and testosterone levels in people with PCOS.
A low GI diet is also rich in soluble fiber, which positively affects the gut microbiome (the balance of beneficial and harmful bacteria in the digestive tract).
An anti-inflammatory diet is rich in lean proteins, healthy fats, whole grains, legumes, fruits, and vegetables and is low in saturated fat and added sugars. This eating pattern can help fight the chronic inflammation present in PCOS.
One small study from 2019 found that a diet high in saturated fat (a pro-inflammatory nutrient) was linked with obesity and more intense PCOS symptoms.
Research also shows that an anti-inflammatory diet is rich in inositol, a compound that may improve insulin resistance, lower androgen hormone levels, and help stimulate ovulation.
When searching for nutrition advice online, low-carbohydrate diets are often the top recommendation for treating PCOS. However, studies have not found a reduced carb diet to improve PCOS symptoms or outcomes. There is some evidence that a ketogenic diet may be beneficial, but more long-term research is needed.
Weight management has been shown to help regulate the menstrual cycle and insulin levels as well as improve symptoms like acne in people with PCOS. However, research shows that a strict low-calorie diet does not result in long-term weight management or improvement of PCOS.
Though dairy-free and gluten-free diets are also commonly recommended online, the evidence does not support eliminating these foods from your diet unless you have a gluten or dairy sensitivity or allergy.
The Best Foods To Eat While Trying To Conceive With PCOS
If you are trying to get pregnant and have PCOS, the research supports focusing on a whole foods diet emphasizing plant-based foods.
Include foods such as:
- Lean proteins, like poultry, fish, beans, and lentils.
- Whole grain carbohydrates, including brown rice, quinoa, and barley.
- Healthy fats, like avocado, olive oil, and nuts.
- A colorful variety of fruits and vegetables.
- Probiotic-rich foods, like cultured yogurt, sauerkraut, and kimchi.
Foods to Limit
Certain foods can increase inflammation and insulin resistance, making it harder to manage PCOS. These include:
- Added sugars and high fructose corn syrup.
- Refined carbohydrates, like white flour.
- Saturated fat and trans fat, found in processed meats, fried foods, and chips.
- Ultra-processed foods, like soda and fast food.
While conclusive evidence on the impact of alcohol and caffeine on female fertility is lacking, you may want to start limiting these while trying to conceive since there are specific guidelines in place if you become pregnant.
More Tips for Boosting Fertility
In addition to dietary changes, there are other lifestyle factors to consider for improving fertility, like:
- Quitting smoking.
- Exercising regularly.
- Getting adequate sleep.
- Managing stress levels.
- Talking to your doctor about supplements like CoQ10, vitamin D, fish oil, inositol, and chromium.
When To See a Doctor For PCOS-Related Infertility?
Experts advise talking to your doctor if you’ve been trying to conceive for one year and have not gotten pregnant (six months if you’re over 35). However, if you have symptoms of PCOS and are trying to conceive, don’t wait to bring up your concerns with your doctor.
PCOS is commonly underdiagnosed– it typically takes over a year to get a diagnosis once a person seeks initial care. This is because the symptoms of PCOS often overlap with other conditions, making it hard to identify the root cause.
This can be incredibly frustrating for the patient because they are living with the progressing health impacts of PCOS throughout this time, like weight gain and infertility.
A doctor can prescribe medications and other treatments to address infertility in the context of PCOS. Medical treatment aims to stimulate ovulation, regulate hormone levels, and improve insulin resistance.
Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that can result in elevated levels of androgen hormones, irregular menstrual cycles, and cysts forming on the ovaries. It can lead to many health concerns when untreated, including infertility, insulin resistance, and weight gain.
In addition to working with your doctor on medical treatment options, you can optimize your diet by focusing on a low glycemic, anti-inflammatory diet rich in lean proteins, whole grains, healthy fats, fruits, and vegetables.
Manage stress levels, prioritize sleep and regular exercise, and quit smoking (if you smoke) to boost your fertility.
How a Dietitian Can Help
A PCOS registered dietitian can walk you through how to optimize your fertility and offer guidance on supplements and other lifestyle changes.
Consider establishing care with a Nourish registered dietitian for convenient access to expert advice about diet and PCOS. With online appointments and insurance coverage, you’ll get the support you need.
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