Just diagnosed with polycystic ovary syndrome (PCOS) and not sure where to start? We’re here for you! While PCOS is one of the most common endocrine disorders for women of reproductive age, integrative treatment options are not well understood. This often makes women with PCOS fearful about the future of their hormonal health and fertility.

The good news? By exploring and addressing the root causes of PCOS, we can help to re-balance your hormones before fertility and/or other hormonal issues become a concern. 

Insulin resistance, inflammation, gut health, adrenal function, and detoxification are all common areas we explore for women with PCOS—and proper nutrition is essential for addressing each of these areas. Since PCOS truly has a spectrum of symptoms, every person’s nutritional strategy will look different. That’s why we encourage you to work with an integrative and functional provider to identify an approach that addresses your specific needs. But in the meantime, we can help with a few recommendations that give a general overview of a nutritional approach to manage PCOS.  

Step 1: Address Insulin Resistance & Inflammation

Roughly 30% of lean women and 70% of overweight and obese women with PCOS have insulin resistance (IR). IR is accompanied by higher circulating levels of insulin, which causes an increase in testosterone and estrogen production. These elevated levels contribute to many of the symptoms of PCOS, including cystic acne, male pattern baldness, abnormal hair growth (hirsutism), heavy periods, breast tenderness, irregular ovulation, and “cystic” ovaries. IR also impacts metabolism and contributes to excess weight around the abdomen (known as visceral fat) and a difficulty maintaining and/or losing weight. 

Stress, lack of sleep, chronic inflammation, gut imbalances, and poor nutrition can all contribute to insulin resistance. By focusing on a balanced, whole food, plant-centered diet and targeted lifestyle changes, we can reduce insulin resistance and lower inflammation. 

Action Steps

1. Aim for 2 cups of veggies at each meal (1 cup non-starchy veg + 1 cup leafy greens) 
2. Include a palm size (3-4 oz) protein source at every meal
3. Focus on high fiber carbohydrates at meals (½ cup per meal): squash, sweet potato, wild rice, brown rice, quinoa, legumes
4. Include healthy fats at each meal: avocado, olive oil, nuts/seeds, olives 

Should I go low-carb? The answer: It depends. While we always recommend a low glycemic/high fiber diet, the amount of carbohydrates your body needs will depend on multiple factors—the extent of insulin resistance, adrenal function, and hormone balance. Not having enough carbohydrates can negatively impact adrenal function, hormone health, and microbiome balance. 

What type of protein should I choose? Having enough and the right quality of protein improves glycemic response, lowers androgen levels (i.e. testosterone), and supports ovulation. Choose fish as your primary animal-based protein source and include legumes 2 to 4 times per week. Limit red meat to 1 time per week, as red meat has been associated with insulin resistance, inflammation, and anovulation in women with PCOS. 

Step 2: Support Gut Health 

Our digestive tract is how we excrete excess hormones. Having a diverse microbiome and optimal digestive function is essential for hormone balance. Individuals with PCOS tend to have reduced microbial diversity and an increase in bacteria that are associated with inflammation and obesity. “Leaky gut” or intestinal permeability has also been associated with inflammation and increased oxidation.

Action Steps

1. Make sure you are having a daily bowel movement. If not → increase your fiber and fluids.
2. Include probiotics at least 1 time per day (raw fermented sauerkraut, kimchi, pickled veggies, yogurt).
3. Explore food sensitivities. Dairy and gluten are both associated with increased intestinal inflammation and intestinal permeability in certain individuals. 

Step 3: Nourish Your Adrenals 

The effects of stress on hormonal dysregulation, adrenal function, and blood sugar balance are well established. Excess stress contributes to adrenal dysregulation and increased production of cortisol and DHEA. DHEA is elevated in about 50% of women with PCOS—excess DHEA can be converted into androgens (i.e. testosterone and its metabolites), contributing to further hormonal dysregulation. 

Action Steps

1. Get at least 7 to 8 hours of sleep per night. Shut off all electronics 1 hour before bedtime. 
2. Choose restorative, calming movement. Over-exercise can be an additional stressor on the adrenal glands. 
3. Establish a daily stress-reducing practice that includes meditation, deep breathing, or journaling. 
4. Keep blood sugar balanced by always pairing carbohydrate foods with protein/fat at meals and snacks. 

Interested in more ways to address PCOS? Connect with our team for a complimentary 15 minute call to see how we can help you find the root causes of your PCOS.

Dr. Cassie Wilder

Dr. Cassie Wilder is a registered Naturopathic Medical Doctor (NMD) and founder of MIMC. Her passion is empowering her patients through education, understanding, and support through their healing journey. After graduating from Iowa State University with a Bachelors of Science in Kinesiology and Health, Dr. Wilder earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine & Health Sciences, a fully accredited and nationally recognized institution in Phoenix, AZ. During her clinical training, she received extensive hands-on training with many leading experts in the field of functional medicine and developed a passion for treating hormonal imbalances, thyroid disorders, cardiovascular concerns, and adrenal fatigue.