Polycystic Ovarian Syndrome: what it is & what to do if you have it.
This is a long one ladies! Grab a cup of coffee or tea and enjoy!
Polycystic Ovarian Syndrome (PCOS) is a complex condition and has an array of unpleasant symptoms affecting more than just reproduction. It is a metabolic condition that is rooted in insulin resistance and metabolic dysregulation.
The problem is that women often have some aspects of the condition but not others, making our current classification, treatment, and nutrition recommendations confusing at best and frustrating for many women with PCOS – or those thinking they may have it.
Hormonal disruptions include elevated LH (luteinizing hormone), elevated testosterone (or other androgens like androstenedione, DHT, or DHEA-S), elevated prolactin, abnormal cortisol levels, low progesterone, low estrogen, estrogen dominance, and insulin resistance (ranging from mild to severe) can all be present.
Women may have acne, unwanted hair growth, trouble ovulating, and struggle with fertility. And some women have multiple, small, dysfunctional cysts on their ovaries.
Some women have all these findings, others have only a few. Some women get a period, others do not. Some women struggle to get pregnant; others have little to no issue here. Some women have beautiful skin, others regularly deal with breakouts. Some are losing hair on their head and having to tweeze, wax, thread, laser or shave rogue hairs elsewhere on their body. And some women are overweight or struggle to lose body fat, while others do not.
Because there are so many variances in this condition, you can see where this has led to a lot of trouble with “PCOS nutrition” that is one size fits all. A hallmark of PCOS is blood sugar control and insulin resistance, but with varying severity.
BLOOD SUGAR STABILITY TIPS AND TRICKS
Eat regular meals - I want you to focus on consuming 3 meals a day with 2 snacks if needed. The key to transitioning to 3 meals instead of eating every 1.5-2 hours is eating big enough serving sizes and eating enough protein and fat.
Meal staging: The way that you eat your meal matter. Starting your meals with fiber (vegetables), protein, and lastly consuming starches/carbohydrate sources can reduce the impact of your meal on your blood sugar by up to 75%.
Based your meals on protein, fat, and vegetables – This means having about a palm-size portion of meat (or about 4-5 ounces) at every meal, 1-2 thumb-size portions of healthy fat (ghee, olive oil, avocado oil, having a fattier cut of meat that naturally contains fat, nuts, seeds, etc.), lots of fiber-rich vegetables (cruciferous vegetables are great for detoxing hormones: broccoli, cauliflower, Brussel sprouts, kale, etc.). If you are going to consume carbohydrates try for high-fiber, whole food options (keep to about one serving) like fruit, brown rice, quinoa, squashes, plantain chips, oatmeal, cassava chips, etc.
Sample Meals
Breakfast:
Breakfast hash (with or without eggs with additional protein such as chicken or turkey sausage, ham, salmon, turkey bacon) with seasonal vegetables (whatever you would like – peppers, mushrooms, onions, squash, zucchini, chard, spinach, etc.) and a starch (sweet potatoes, potatoes, beets, squash: acorn/butternut)
Breakfast tacos (with or without eggs with additional protein such as chicken or turkey sausage, ham, turkey bacon) with quinoa or cassava tortillas with avocado and arugula.
Loaded avocado toast: GF bread with avocado, chicken/turkey sausage topped with sprouts.
Grain-free breakfast sandwich: Gluten-free bread with dairy-free cream cheese (Kite Hill) or avocado with ham and greens.
“Bagel” and lox: Trader Joe’s gluten-free bagel with dairy-free cream cheese (Kite Hill) with salmon
Loaded eggs: Scrambled eggs with vegetables with a side of berries
Chia pudding mixed with protein powder and berries and nuts.
Smoothie bowl (instead of a smoothie): Collagen + greens + add in powders + ½ banana topped with berries and flaked coconut
Yogurt bowl (dairy-free): Sigg’s dairy-free yogurt or Kite Hill’s unsweetened Greek yogurt with 1 serving of collagen + berries.
Lunch:
Leftovers
Salad + 4-5 ounces of turkey and 2 tbsp. of olive oil and vinegar + ½ cup of quinoa or beans.
Adult Lunchables: Lunch meat, canned tuna, or protein leftovers (4-5 ounces) + vegetables (baby carrots, snap peas, pre-chopped vegetables) + healthy fat (avocado oil mayo, olives, nut butter (1 tbsp.), avocado oil, olive oil, dressing, etc.) + starchy carbohydrate (plantain chips, Simple Mills crackers, fruit, etc.)
Dinner: Keep it simple with 4-5 ounces of protein, a handful or two of vegetables, and a high fiber starch like sweet potatoes, quinoa, brown rice, plantains, fruit, etc. (see additional handouts for carbohydrate options). Keep things interesting with different dressings, sauces, and spices (Primal Kitchen, Tessamae’s. and Sir Kingston are great unsweetened options with healthy fats).
Snacks:
- Guacamole + carrots + CHOMPER meat sticks (found at Natural Grocers/Pilgrims)
- Nuts and seeds
- Boiled eggs
- Tuna
- Fruit with almond butter or peanut butter
TIPS FOR MANAGING PCOS
#1. Make yourself a priority! You’re probably thinking, “I don’t have time” to make myself a priority, but it’s time to find the time. Change your mindset. It’s time to start taking care of YOU! Focus on one tip at a time, so you won’t feel overwhelmed.
#2. Plan your meals & snacks. This will take a little work, but it is the key to eating healthier! Plan a few meals for the week. Put together a shopping list so you’ll be prepared once you get to the store. Include plenty of proteins (fish, canned salmon, eggs, lean beef), vegetables, fruit, and whole grains. Portion the protein into single servings and freeze. This will defrost more quickly so you can make a fast dinner. Frozen vegetables are a good backup in case your fresh veggies go bad!
#3. Stock up your “PCOS- Friendly Kitchen.” Take a thorough look in your kitchen and clean house! This means getting the sugary, processed, or trigger foods out of the kitchen and replacing them with some healthier options.
#4. Cook meals on weekends so you’ll have options for the beginning of the week.
#5. Cook extra food for dinner and freeze leftovers in individual containers for an easy meal later.
#6. Take advantage of supermarket pre-washed salad greens and veggies that have already been sliced, diced, or spiralized. I’m also a fan of frozen veggies – they’ve come a long way from frozen peas and corn! You can even find frozen cauliflower rice.
#7. Invest in a crockpot. Throw a few ingredients in, and you’ll have dinner ready when you get home.
#8. Eat breakfast at home or pack it to bring to work. Most breakfasts on the run choices are loaded with carbs. Studies have shown that a high-protein breakfast can help control cravings later in the day. Some healthy choices include eggs, nut butter on an apple, steel-cut oats with nuts and seeds, a protein shake made with your favorite protein powder, almond milk, ground flaxseeds, spinach, and berries.
#9. Don’t let too much time go between meals. Pay attention to your schedule and try not to let more than 4-5 hours at the most go by between meals or snacks. Getting over-hungry will only backfire and lead to overeating at the next meal as well as exacerbate carb cravings.
#10. Bring snacks for during the day. Some of the snacks I recommend are nuts (buy mini bags or make your own), healthy jerky, nut butter on ½ apple, hummus + veggies, and mini guacamole + veggies. Keep them in your office and non-perishable ones in your car or bag.
#11. Bring lunch from home. Add leftover protein and vegetables to greens to make a tasty salad. Limit the carbs (chickpeas, quinoa, sweet potato, brown rice) to ½ cup.
#12. Survey your surrounding take-out options. There will be days that you just don’t have time to cook and need a backup. While most take-out food is not ideal, you can probably find something that is moderately healthy.
Examples:
Chinese: Protein + veg + sauce on side + ½ cup brown rice
Sushi: one roll with brown rice + sashimi + miso soup
Lettuce-wrapped burger with a side salad
Unwich: Lettuce-wrapped sandwich
Burrito bowl with limited beans and rice with extra protein and vegetables.
Many people with hectic schedules eat out or order in at least once a day. Often, restaurants list the nutritional content of menu items online. Preview the menus of local places so you will know what to order ahead of time.
LIFESTYLE SUPPORT
Prioritize sleep: Sleep is extremely important to regulate insulin and cortisol (our main stress hormone). When someone consistently gets less than 7-8 hours of sleep it can dramatically influence insulin sensitivity and increase insulin resistance. Going to bed and getting up at relatively the same time helps improve the quality of sleep. Proper sleep hygiene is to reduce screen time 1-2 hours before bed to promote more restorative sleep.
Movement: Adding in regular movement can be helpful to increase insulin sensitivity because it makes your body more sensitive to insulin post workout and increases lean muscle mass. Increasing lean muscle mass increases basal metabolic rate (the number of calories burned while at rest) and increases insulin sensitivity overall. The best forms of movement for women with PCOS are resistant or strength training and low-moderate cardiovascular activities like walking, hiking, yoga, and pilates.
Manage stress: Managing cortisol levels and stress is imperative to managing your PCOS and PCOS-like symptoms. Stress can be psychological and physiological. Stressors could be lack of sleep, nutrient deficiencies, over-exercising, blood sugar imbalances, emotional stress, chronic infections, etc. Some of my favorite stress management techniques to help you manage and become more resilient to stressors are:
Meditation: To get started, utilize free apps like Calm and Headspace.
Deep breathing/Box Breathing/Diaphragmatic breathing.
Spending time in nature.
Movement (in any form)
Art
SUPPLEMENTS SUPPORT
Berberine: Supports insulin sensitivity and is an anti-microbial herb. The dose varies from 500 mg – 2,000 mg and needs to be taken with meals. It can cause some digestive distress (nausea and loose stools).
Inositol: Increases insulin sensitivity and hormonal regulation to support regular ovulation. The dose is patient dependent.
Saw Palmetto: Support regulation of excess androgens. The dose is patient dependent.
Zinc: Helps with hormonal regulation and decreases excess androgens. Dose from 25-50 mg. Can cause nausea if not taken with food.
Magnesium: Helps increase insulin sensitivity. Dose range from 400 mg-800 mg at night before bed. Can cause loose stools.
