Lifestyle Modifications for PCOS Backed by Science

PCOS By: Annabelle Shaffer, Dietetics senior at University of Illinois Urbana-Champaign

Polycystic ovary syndrome, or PCOS, is the most common endocrine disorder in women and can cause irregular menstrual cycles, excess body hair, acne, and ovaries with cysts.^{1, 2} PCOS affects 4-18% of women.³ Managing PCOS is vital as it can result in several complications, including infertility, diabetes, metabolic syndrome, and depression.¹

Management of PCOS targets maintaining a healthy weight, improving or correcting hormonal imbalances, and preventing reproductive and metabolic complications.³ Thus, PCOS can be managed through lifestyle interventions, such as diet and exercise.³ Below are several dietary and exercise recommendations that may improve one’s PCOS symptoms.

Moderate weight loss of 5-10% body weight is the first-line treatment in PCOS.⁵ Weight loss results from a calorie deficit and should be gradual, 1-2 pounds per week, and supervised by a Registered Dietitian or physician.
- Weight loss has been shown to improve insulin sensitivity, decrease cardiovascular risk factors, and decrease central adiposity, also known as abdominal fat.⁵
- An international position statement committee reviewed several research studies and found that a restricted calorie diet leads to improved menstrual regularity, fertility, and insulin sensitivity.⁴

A reduced carbohydrate diet, where ~40% calories are from carbohydrates, as compared to a traditional balanced diet of the same calories was found to have a greater improvement in insulin sensitivity.²
- Carbohydrates are found in dairy, fruits, vegetables, and grains. They play an important role in our body and should not be eliminated or significantly reduced. Focus on whole grains, colorful fruits and vegetables, and dairy products.

A low-glycemic diet may improve your insulin sensitivity and menstrual regularity.
- Similar to a reduced carbohydrate diet, a low glycemic diet in comparison to a conventional healthy diet was found to improve insulin sensitivity and increase menstrual regularity.⁶A low glycemic diet focuses on replacing starchy foods, such as white bread or potatoes, with lower starch foods such as whole grains, berries, and beans.⁷

Integrate fitness into your daily routine. Moderate intensity exercise 2-3 times per week is a great place to start.
- In a 3-month study, women with PCOS completed 30 minutes of cycling 3 days a week, in addition to dietary counseling, and results showed moderate weight loss and significant improvements in insulin sensitivity.⁸ A study at Duke University found similar results utilizing moderate-intensity exercise (cycling, walking, elliptical) 3-4 days per week.⁹
- Another study found that women with PCOS who performed 30 minutes of walking 3 days a week experienced increased menses, ovulation, and pregnancy.⁴

It’s important to remember that PCOS can be managed through both lifestyle modifications and traditional medicine. A diet change and incorporating exercise into your daily routine will be challenging, but it can improve your symptoms.

Sources:

1. Polycystic ovary syndrome (PCOS) – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439. Published 2019. Accessed March 9, 2019.
2. Gower B, Chandler-Laney P, Ovalle F et al. Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS. Clin Endocrinol (Oxf). 2013;79(4):550-557. doi:10.1111/cen.12175
3. Moran L, Hutchison S, Norman R, Teede H. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews. 2011. doi:10.1002/14651858.cd007506.pub3
4. Moran L, Pasquali R, Teede H, Hoeger K, Norman R. Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril. 2009;92(6):1966-1982. doi:10.1016/j.fertnstert.2008.09.018
5. Brennan L, Teede H, Skouteris H, Linardon J, Hill B, Moran L. Lifestyle and Behavioral Management of Polycystic Ovary Syndrome. J Womens Health. 2017;26(8):836-848. doi:10.1089/jwh.2016.5792
6. Marsh K, Steinbeck K, Atkinson F, Petocz P, Brand-Miller J. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010;92(1):83-92. doi:10.3945/ajcn.2010.29261
7. 8 principles of low-glycemic eating – Harvard Health. Harvard Health. https://www.health.harvard.edu/healthbeat/8-principles-of-low-glycemic-eating. Published 2019. Accessed March 9, 2019.
8. Vigorito C, Giallauria F, Palomba S et al. Beneficial Effects of a Three-Month Structured Exercise Training Program on Cardiopulmonary Functional Capacity in Young Women with Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology & Metabolism. 2007;92(4):1379-1384. doi:10.1210/jc.2006-2794
9. Brown A, Setji T, Sanders L et al. Effects of Exercise on Lipoprotein Particles in Women with Polycystic Ovary Syndrome. Medicine & Science in Sports & Exercise. 2009;41(3):497-504. doi:10.1249/mss.0b013e31818c6c0c