PCOS—polycystic ovary syndrome—is one of the most common hormonal disorders for women. In fact, five to 10 percent of women have PCOS, although one in five may have polycystic ovaries (me included!).*
But when you've been diagnosed with the syndrome, no matter how severe your symptoms, from excess hair to spots, irregular or absent periods and weight gain, it can be really hard to know what to do next.
First, it's important to remember that although PCOS is related to our hormone levels and insulin production, it's not your "fault" if you have it. The symptoms can sometimes, however, be managed and hopefully improved through diet and exercise.
PCOS and weight loss/gain is also a bit of a catch 22—it can be linked to insulin resistance, which can lead to weight gain; and then, because excess body fat causes the body to produce even more insulin, this can make PCOS symptoms worse—creating a vicious cycle.
But information online is totally overwhelming when it comes to PCOS and lifestyle—is losing weight the answer? Should you totally ditch all foods that raise your blood sugar? Will exercise help?
If you are overweight, with a BMI of over 25, The London Clinic advises that "even a small reduction in weight can significantly improve symptoms—including a low mood or depression (which is often a symptom of PCOS).", Consultant Gynaecological Surgeon at
"Generally, you want to focus on 'being healthy'—so try to consume lots of fruit and veg, avoid high GI (glycemic index) food, take regular meals so your blood sugar levels aren't going up and down too much, try to do 30 minutes of exercise a day, and stop smoking."
"Polycystic ovarian syndrome is your body's way of saying you can't handle high sugar levels—so your diet is a chance to really change things—and this can help you in your later life, pre-menopause and before and during pregnancy. By keeping your weight stable, your pregnancy is likely to be more straightforward health wise."
Daria Tiesler, a Registered Nutritional Therapist, Personal Trainer and Performance Coach at Ultimate Performance Mayfair, regularly trains clients with PCOS, and agrees that diet and exercise can really help with managing the condition.
Here are seven ways she advises her clients to overhaul their lifestyle:
1. Focus on nutrition, not diet
Daria advises veering away from fad diets, and eating with a focus to fueling your body, managing stress, and balancing your hormones. For her clients, the key is to address insulin resistance and to reduce cortisol (stress hormone) levels by packing their diet with anti-inflammatory foods.
On her shopping list are lots of leafy green vegetables, blueberries, and pineapples; a focus on whole foods and sources of protein like fish, eggs, and chicken breast; and good fats like nuts and avocado.
Daria's also a big fan of spices like turmeric, cinnamon, fenugreek, and ginger, which are anti-inflammatory and believed to help with insulin resistance.
One of Daria's favorite foods for balancing hormones is flaxseed which is rich in fiber and Omega 3s. She tells her clients to eat two tablespoons per day on salads, or sprinkled on porridge or in smoothies.
2. Cut out the crap
Reducing foods in your diet that cause spikes in blood sugar is crucial to managing your PCOS. This means opting for wholegrain sources of carbohydrates over anything with a high glycemic index.
Daria advises reducing your consumption of white pasta, white rice, and anything super-processed (including processed meats).
Daria also suggests swapping fruit drinks and smoothies for whole fruit, because they contain more fiber, which is vital for a healthy gut. "Most of the ladies I train have problems with gut function," Daria says. Fruits low in fructose are best, like grapefruits, clementines, lime, lemon, raspberries, blackberries, and strawberries.
3. Try and balance your blood sugar throughout the day
"Start with breakfast," Daria says "Don't leave home with an empty stomach and then grab a sandwich at 12. So many of my clients skip breakfast or have coffee and a croissant - and their bodies struggle to process it."
Try something like eggs, salmon and spinach; or a smoothie with vegan protein, a blend of berries, cinnamon, and avocado. Just make sure whatever you're eating stabilizes your blood sugar by including protein and fats as well as low GI carbs.
4. Don't fear fats
Many of Daria's clients with PCOS are scared of fats because they don't want to put on weight; but increasing healthy fats in your diet is a great way to keep you satiated, and can help your body absorb vitamins A, D, E, and K and help with healthy female hormone levels.
Just as a reminder, healthy fats mean foods like avocado, salmon, mackerel, sardines, and olive oil (free range or organic if possible).
5. Or carbs
Reducing or " cutting" out processed and high GI carbs is beneficial for anyone with PCOS , but because everyone is different, we need to personalize the amount of complex carbohydrates from fruits, vegetables, and pulses—and there is no need to ditch them entirely. Those foods are a great source of phytonutrients, vitamins, and minerals as well as fiber.
Daria recommends experimenting—try removing the processed carbs from your diet, while keeping whole foods, like pulses, lentils, and beans in there and seeing how you feel. At the end of the day, a bit of trial and error might be needed to find what works for you.
"I try a macronutrient split of around 20 percent complex carbs, 40 percent protein and 40 percent fat for my clients," Daria says. "But I switch it around and get constant feedback from them as to whether it's working or not."
6. Look out for "hormonal disrupters"
In a body that's struggling to balance hormones, the last thing you need are factors in your life that cause more hormonal imbalances, like stress and lack of sleep. Daria advises avoiding "hormonal disrupters" like plastic bottles and containers that contain BPAs, but also looking at the bigger picture of how stressed out you are day today.
"Review the stress in your life—I train eight to ten girls at any one time with PCOS, and many of them are super strong on the outside, but totally stressed on the inside," Daria says.
"Make sure you are getting enough sleep, and good quality sleep, too. I also recommend journaling or breathing techniques to help with relaxation."
Daria advises avoiding stimulants, aka coffee, after 2 p.m., and swapping it for spearmint tea and green tea. Mainly because a high caffeine intake is going to give you the energy crashes you're trying to avoid and can affect the quality of your sleep, but also because coffee removes magnesium from the body—and magnesium helps the body metabolize carbs, so it's pretty vital.
7. Hit the weights—but don't stress your body out
Daria is a huge advocate for resistance training with weights for women with PCOS. "My first goal with my clients is to manage their insulin resistance—my second is to increase their muscle mass," says Daria, "because the more muscle mass you have means you can better metabolize glucose and can handle carbs better."
Daria uses a mix of weight training with HIIT (high intensity interval training) and LISS (low intensity steady state cardio, like walking) on her clients. But the key is to make sure whatever exercise you're doing is not too stressful on the body—because over-exercising is not good for your hormonal balance, either.
Often clients will come to Daria and they have previously been doing lots and lots of cardio, along with prolonged low calorie and low fat diets, which she would change to 2-3 weight training sessions a week for around 45-60 mins, coupled with some swimming, walking or yoga.
Of course, every body tolerates exercise differently, so for women who are better with stress management, Daria also uses HIIT workouts.
Also, Daria notes to not become too obsessed with the number on the scale—many of her clients won't lose huge amounts of weight doing resistance training, but they will become fitter and totally change their body composition, which has a knock-on effect on their health.
* It's important to distinguish between having PCOS and having polycystic ovaries. Mr. John Butler, Consultant Gynaecological Surgeon at The London Clinic says: "Polycystic ovaries (PCO) refers to the ultrasound appearance of multiple cysts on the ovaries which is common and normal; whereas polycystic ovarian syndrome (PCOS) is a condition affecting some women with PCO who may have irregular periods, and hormone imbalance associated with excess hair growth, skin changes including acne, or weight gain.”
This article originally appeared on Cosmopolitan.com/uk. Minor edits have been made by the Cosmo.ph editors.