PCOS Uncovered: The Link Between Hormones, Insulin, and Your Health

Meghna Pandey
Sep 11, 2024
4 min read

Updated: Sep 17, 2024

What is PCOS?

A hormonal disorder affecting women and people AFAB.
Irregular periods, excess hair growth, acne, and infertility are common symptoms.
Increases risk of diabetes, high blood pressure, high cholesterol, and heart disease.

Types of PCOS

Insulin resistance: Most common, linked to cells resisting insulin. Symptoms include weight gain, sugar cravings, and fatigue.
Adrenal: Occurs during high stress, marked by high cortisol and DHEA levels.
Inflammatory: Results from chronic inflammation caused by poor diet and lifestyle.
Post-pill: Occurs after stopping birth control pills due to artificial progesterone.

Symptoms

Heavy, long, intermittent, or absent periods
Infertility
Acne or oily skin
Excess hair growth
Male-pattern baldness or hair thinning
Weight gain, especially around the belly

Causes

Exact cause unknown, likely a mix of genetics and environment.
High levels of male hormones, insulin resistance, and inflammation are linked to excess androgen production.

Diagnosis

Discussing symptoms and medical history
Physical exam
Blood tests to check hormone and glucose levels
Pelvic ultrasound

Treatment

No cure, but symptoms can be managed through lifestyle changes and meds.
Lifestyle changes include:
- Maintaining a healthy weight
- Regular exercise
- Balanced diet low in sugar and refined carbs
- Stress management techniques

Nutrition Guidelines

Aim for weight loss, even 10% reduction helps.
Balanced carb intake throughout the day.
Don't skip meals.
Gradually increase intake of high-fibre carbohydrate foods.
Emphasise lean protein foods.
Consume healthy fats in moderation.
Include low-fat dairy foods.
Consider supplements like vitamin D and omega-3s.

Exercise

Exercise helps with weight loss, reducing testosterone levels, and improving insulin resistance.
Aim for at least 120 minutes of vigorous-intensity exercise each week.
Aerobic and resistance training can be beneficial.

Living with PCOS

PCOS is a lifelong condition, but with the right treatment and lifestyle changes, you can manage your symptoms and reduce your risk of long-term health complications.

Detailed Nutrition Guidelines in PCOS (Polycystic Ovary Syndrome)

The following diet recommendations have proven successful in treatment:

1. Weight Loss: even a 10% reduction in body weight will decrease insulin resistance. Try not to eat less than 1400 kcal/day.

2. Balanced carbohydrate intake throughout the day. Eat three meals with 45 grams/meal and two to three snacks of 15/20 grams each. (1400 kcal = 170 grams carbohydrate). (Individuals who are very active or vegetarian may need at least 60 grams of carbohydrate/meal).

3. Do not skip meals. Try not to let more than four to five hours go between meals/snacks to maintain stable blood sugars and diminish extreme hunger.

4. Gradually increase intake of high fibre carbohydrate foods, aiming for 30 to 35 grams/day, or 15 grams/1000 kcal.

5. Emphasise lean protein foods at 15 to 20% of total calories. (1400 kcal = 60 grams protein) Try to include protein with most meals and snacks.

6. Consume about 25 to 30% of calories as fat – emphasising low saturated fat foods and increased monounsaturated and omega-3 fatty acid food choices. Avoid foods containing trans fats.

7. Include two to three servings of low-fat dairy foods per day, such as skim or 1% milk, yoghourt, lite cheese, cottage cheese, paneer, tofu etc.

8. Some phyto-nutrients might improve insulin resistance.

Caissia cinnamon (1 to 2 tsp/day of the spice); low fat dairy foods; nuts especially walnuts; orange and leafy green vegetables such as spinach or kale; carrots, yams and sweet potatoes.

9. Vitamin D deficiency has been associated with insulin resistance and reduced pancreatic beta cell function. Supplementation with Vitamin D3 (cholecalciferol) may Control portions, especially from restaurants or fast-food places.

Most restaurant portions are 50% more than needed. Ask for the “to go” container when the meal arrives and put aside part of the meal.

High Fiber carbohydrate foods include: whole grain breads, whole wheat pasta, brown rice and varieties of millets, high fiber cereals, oats, barley, legumes (peas, beans and lentils), corn, bran, seeds, nuts; fresh and dried fruit and most vegetables.

B12 absorption may be affected by long term use of metformin. A multi-vitamin supplement with B12 is recommended, especially for strict vegetarians if doctors prescribed.

Monounsaturated fat containing food choices include: avocado, canola, olive and peanut oils; olives, nuts such as almonds, cashews, peanuts and chana, sesame oil, seeds and paste.

Omega-3 fatty acid (specifically EPA and DHA) containing food choices include: cold water fish such as salmon, mackerel, tuna, sardines and herring. Two to three servings of fatty fish/week will provide the 220 mg each of EPA and DHA that is recommended. Omega-3 eggs from free range chickens. Fish oil supplements containing 220 mg each of EPA and DHA per day. Typically, a 1000 mg fish oil capsule contains 180 mg EPA and 120 mg DHA.

Flax seed is high in ALA which is normally converted to EPA and DHA. However, people with insulin resistance may not efficiently make this conversion, so flax seed supplementation may not be beneficial.

Limit foods containing trans fatty acids, especially deep-fried restaurant foods and commercial products not labeled trans free.

Lean protein food choices include: Fish and shellfish; egg whites, egg substitutes, free-range eggs, skim and 1% milk, soy milk, low-fat yogurts, cottage cheese, paneer and low-fat cheese. Dried beans, lentils, peas, and hummus, soy products such as veggie burgers and meat substitutes, tofu. Nuts and seeds are higher in fat but contain healthy monounsaturated fats. be beneficial. Consider taking vitamin D3 supplement with the help of your doctor prescription, if you are vitamin D deficient.