A version of this article originally appears on the Trellis blog here.
When you’ve been diagnosed with PCOS, maintaining a healthy diet to manage your cycle can feel like a constant guessing game. And if you’ve been on the pill for years like many of us (raises hand), it can be even harder to understand what’s going on with your hormones and get them under control.
Yep, we were all there in Sex Ed, learning how not to get pregnant. But if you know you do want children one day and you have PCOS, regulating your cycle with diet is super important, especially if you’re considering freezing your eggs for the future or undergoing IVF. You’ll want to make sure those eggs of yours, once retrieved, are in tip-top shape to make the process all worthwhile, right?
If that question feels daunting and anxiety-provoking, we hear you. PCOS is v. frustrating, and is often accompanied by symptoms that can feel totally un-sexy, like facial/body hair growth, acne, and weight fluctuation. Thankfully, there are amazing OBGYNs, REs and medication out there than can help keep your PCOS under control. But certain changes to your diet can also really mitigate your PCOS symptoms and improve your egg health.
So basically, you’re about to tell me to eat kale for breakfast, lunch, and dinner, right?…is what we imagine you’re probably thinking. But not so fast. Read on, friends.
Back to the basics of PCOS
If you’re curious about diets to balance PCOS, you’re definitely not alone. 1 in 10 women of childbearing age have PCOS, and 90% of anovulation cases are caused by PCOS.
Let’s take a step back to understand what the heck is even going on with your body when you have PCOS and how diet can play a role. According to Cory Levin MS, RDN (otherwise known as The Women’s Dietitian), it’s really about balancing blood sugar. When your blood sugar is all over the place, it triggers a few responses that can send your fertility into a tailspin (helloooo, crazy cycles):
- Your ovaries begin to pump out more testosterone, which can be responsible for those extra fun PCOS symptoms we mentioned above.
- Your body halts reproductive hormone production, leading to improper (or non-existent) ovulation.
- An increase in cortisol (your “stress hormone”) also contributes to cycle irregularities.
So there’s a pretty significant connection between what we’re eating, our blood sugar balance, and healthy ovulation.
“The biggest goal of nutrition for fertility with women with PCOS is getting them to actually ovulate,” says Levin. Women with PCOS tend to have a higher AMH (a measurement of ovarian reserve, or egg count), but while they’ve got lots of eggs, they can be underdeveloped or not mature enough to ovulate.
In other words, in order to manage PCOS symptoms, get your cycles on track and achieve ovulation, making changes to your diet and lifestyle that might improve egg quality is key.
All carbs are not created equal
Since PCOS management is all about balancing blood sugar (are you sensing a theme here?!), you’re probably thinking that carbs are the enemy and keto is life. According to Levin, however, that’s (a) extremely unreasonable (c’mon, we all love our pizza every once in a while) and (b) just super hard and too restrictive. Our bodies need a certain amount of carbs in order to keep our vital organs running. The key is to understand which carbs and how much is too much.
“Every woman with PCOS has her own unique carbohydrate tolerance, or the number of carbs she can eat in a day that doesn’t exacerbate her PCOS symptoms,” notes Levin. Your carb tolerance can be a pain in the butt to pinpoint and may take some trial and error, so don’t get discouraged. Our advice? Chat with a registered dietitian who specializes in nutrition and PCOS to help figure out your exact needs to maintain a healthy hormonal balance.
Levin recommends skipping the naked carbs and instead pairing carbs with other foods that negate the blood sugar spike that accompanies them. For example, instead of eating a full piece of fruit, have half the fruit plus nuts or nut butter, which contain protein and fat to negate that blood sugar spike you might experience otherwise.
In addition to focusing on proteins and fats to balance carbs, you should also aim to increase your fiber intake. This can come in the form of vegetables, beans, nuts and seeds, as well as fruit and whole grains in moderation.
Fight that inflammation
Another factor to keep in mind when it comes to eating for PCOS: women with PCOS are in a chronic state of low-grade inflammation. So ditching more inflammatory foods as much as possible is actually pretty important. According to Levin, you’ll want to cut back on:
- Sugary drinks: soda, juices, energy drinks
- Fried foods: especially those from restaurants often cooked in pro-inflammatory omega-6 rich-oils
- Bread and pasta
- Processed snacks: chips, cookies, and pastries, often with preservatives to maintain shelf life
- Processed meats: yep, including veggie and vegan “meats,” too!
If this list of what not to eat makes you just a little bit sad…honestly, we don’t blame you. It can be really tough to get on the healthy train, but it can be totally worth it once your hormones are thriving and you begin to ovulate on schedule. And here’s the good news: there are lots of awesome things you can eat that really help mitigate inflammation in the body. Like:
- Fatty fish: salmon, tuna, herring, mackerel, sardines, and anchovies (all rich in omega 3 fatty acids!)
- Nuts and seeds: walnuts, chia seeds, flax seeds
- Ginger and tumeric roots
- Foods rich in vitamin D: egg yolks, fatty fish (again), dairy milk
NOTE: plant-based forms of omega 3s are not as readily absorbed by the body, so consult with a registered dietitian if you need to up your omega 3 intake and need to think outside the box.
And for tons of PCOS-friendly recipe inspo, make sure to follow Levin on Instagram (@thewomensdietitian). You can thank us later.
Your pocket guide to eating for egg quality
If you’ve made it this far, you get a gold star. You’re already a pro at balancing your blood sugar and fighting inflammation. Now we move onto the grand finale. Here’s the ultimate checklist of vitamins and nutrients you should consider that contribute to egg quality:
- coQ10: These can come in the form of supplements or worked into your diet. Think (shocker!) fatty fish, legumes, nuts and seeds, spinach, cauliflower, and oranges.
- Vitamin A: As a good rule of thumb, most orange and yellow veggies and fruits provide a good amount of Vitamin A, as do egg yolks.
- Vitamin E: This includes nuts and seeds, like almonds, peanuts, hazelnuts, and sesame seeds.
- Inositol: Beans, leafy greens, and nuts all contain a good amount of inositol.
- Omega 3 fatty acids: You know the deal with this one…keep it up with the fatty fish!
- B vitamins: This includes poultry, red meats, eggs, and dark, leafy veggies.
- Zinc: Oysters and legumes, like lentils and chickpeas, are good sources of zinc.
Summing it all up
According to Levin, the maturation cycle for each individual egg is 90 days. During this time, your eggs are all affected by healthy or unhealthy influences. If you have PCOS and are considering egg freezing, try chatting with a nutritionist. They’ll not only help you calm down those precious hormones of yours, but they’ll also help you get the most bang for your buck for your upcoming cycle.
Bottom line? There’s no time like the present to be mindful of nutrition as it relates to your hormones. And that rule applies to all of us—with or without PCOS.