Most women treat PCOS with medication. Usually they do so with birth control pills or with blood sugar regulating meds. However, neither of these options ever solve PCOS.
Drugs may cover up symptoms of PCOS in the short-term, but they are completely ineffective for long-term healing.
But there is one secret key to effective change.
It is a PCOS diet.
Here’s why, how, and what to do about it.
The PCOS Diet: Why
PCOS (read my introductory post “what is PCOS” here) stands for poly cystic ovarian syndrome. It is the condition of having multiple small cysts on the ovaries. It is usually accompanied by elevated male sex hormone levels and irregular menstrual cycles.
Markers of PCOS include acne, oily skin, facial hair, balding, difficulty losing weight, low libido, and missed menstrual cycles and infertility. Not every woman who suffers from PCOS has all of these symptoms, but all have at least a few.
These symptoms are not a result of the cysts on the ovaries themselves. Rather, they are a result of a hormone imbalance in which male hormones are elevated over female hormones.
When doctors proscribe medication for PCOS, they typically have two options:
One is birth control pills. These pills contain progesterone and (usually) estrogen in them. These pills help control the symptoms of PCOS because they increase progesterone and estrogen levels in the blood. Doing so helps restore proper balance between male and sex hormones. The problem with taking these pills is that the underlying hormone imbalance continues to exist. Once you come off of the pill, the chances are close to certain that your PCOS symptoms will come back.
Another is blood sugar regulation. The primary pill used for this is metformin, which I have written about at length here. Metformin sometimes helps (though not always, not all PCOS cases are the same). Even in cases in which it does help, however, it does not heal the underlying problem.
The important thing to know about PCOS is that it is caused by an underlying health condition. If you take medications that cover up symptoms, you are still left with the underlying health problem. In many cases of PCOS (though not all) this is an insulin problem, and may also be a gut problem, or a thyroid problem. All of these problems can cause many other symptoms and diseases in the long-run. In fact it is almost certainly guaranteed to.
The only way to be free of all of these health problems is to make the dietary changes necessary to correct hormone imbalance and heal underlying health conditions.
The PCOS diet: How
PCOS is far more complicated than most medical professionals and websites would have us believe. They tell us that PCOS is only a problem of high testosterone and insulin levels.
But PCOS is caused by so many more things! It is also caused by hypothyroidism, by leaky gut, by birth control pill usage, by inflammation…. all of which are problems that can be overcome with dietary changes.
The PCOS diet I describe here helps account for all of those things. I will mention below which specific aspects of the diet are more helpful for different underlying conditions – though all of the points of advice are helpful to know about.
The more you know about your PCOS and what has caused it, the better. That way you can better tailor your diet and healing plan to your needs. I wrote a manual exactly on how to figure out your PCOS that you can read about here. You can also check out this post on PCOS treatment options.
The PCOS Diet: Foods to Eliminate or Limit
From a physical standpoint, it may be best to completely eliminate the following foods from your diet. However, I recognize that this is not necessarily feasible, especially if you have an ambivalent relationship with food and think that an overly-restrictive diet will do you more harm in the long-run.
Restriction, after all, is the primary cause of overeating.
So I advise you to consider these guidelines as firm guidelines you choose. Choose to focus on the healthy foods and to avoid the less healthy foods. Don’t force or punish yourself. Make it a choice – and it will be all the easier to adhere. You may choose (for any number of reasons) to deviate from the guidelines from time to time. Just know also that it’s best to focus on the healthy foods as much as possible.
Perhaps it goes without saying, but this is so important I will say it anyway:
Foods that come in colorful bags and boxes have most likely been “manufactured” to some extent, and contain any number of unhealthy compounds. Trans fats and partially hydrogenated oils may be some of the worst, though all the added sugar in processed foods gives them a run for their money.
Foods that you wouldn’t even expect to be bad are often full of things that aren’t good for you. Breakfast cereals, for example, are usually fortified with folic acid. This was intended to be helpful for pregnant women – but it now instead has been linked to several forms of cancer.
If you instead eat one serving of spinach every day, you would get your daily requirement for folate which is far healthier for you than the chemical altnerative folic acid made in laboratories.
Take a look at the ingredients in whole wheat bread. In addition to being full of gluten and other harmful wheat proteins, for most brands, there is a high amount of sugar and even partially hydrogenated soybean oil in the bread.
Processed foods cause PCOS because they cause nutrient deficiencies and inflammation. They mess up metabolism and make it hard for the body to healthfully detox and metabolize food. Removing them from the diet can do wonders for women with PCOS.
I am a perfectly good fan of fruit, potatoes, starches, and other natural plant carbohydrates. Sugar, on the other hand, in sweets, in soda, in sauces, and in just about everything else from restaurants or packages in grocery stores, is incredibly bad for women with PCOS.
Sugar causes insulin levels to spike, and insulin causes the ovaries to produce testosterone. Therefore many women find that there is a direct relationship between how much sugar they eat and how bad their PCOS symptoms are at any given point in time.
Sugar is not the only thing that can cause insulin levels to go haywire. Having inflammation or IBS or other gut problem can also cause dysregulated insulin levels. But sugar is most definitely one big potential bad guy that should be eliminated (as much as possible).
What’s a seed oil? A seed oil is probably the oil 95% of the food you have eaten in your life has been cooked with, especially if you often eat at restaurants.
Seed oils are used in processed foods and by restaurants because they are cheap nd don’t have a unique flavor, which makes them easy to use in any food product.
Seed oils include vegetable oil, soybean oil, canola oil, rapeseed oil, sunflower oil, safflower oil, and all other oils that come from seeds or nuts.
They are unhealthy because they are composed primarily of omega 6 fats, which cause inflammation. Inflammation is one of the primary causes of insulin problems, hormone imbalance, and PCOS.
Unlike most bloggers in the paleosphere, I don’t think it’s necessary for everybody to give up grain products 100%.
However – if you have a gut issue, an insulin issue, or most especially an autoimmune disease like Hashimoto’s Thyroiditis like many women with PCOS do have, you probably do need to eliminate grains at least for a while.
And even for those of us who do not have any of those conditions, grains are still not optimal. The proteins in grains (gluten is one but not the only one) can be harmful to the gut lining. Certain molecules in grains bind with nutrients in the gut and carry them out of the body with excretion. They should not be the staple of anyone’s diet.
Consider eliminating grains for at least a few weeks and see if that helps you! Some women I have worked with have found that eliminating grains was the most important thing they did for their healing. (Though others of course had different problems and needs.)
By grains I mean all bread products, pasta, breakfast cereal, bagels, sandwiches, pizza, etc. Grain-type things that are okay in my book are rice, quinoa, and occasionally corn and oats (though be sure they are gluten free).
Dairy is complicated. Some women need to remove it for PCOS and others do not. This is another food, like grains, that I recommend experimenting with. Remove all dairy – milk, yogurt, cheese, cream, and butter (though ghee is fine since it is clarified!) – for at least 3 weeks and monitor if you experience any changes in your symptoms.
Some women need to eliminate dairy because of its harmful effects on the gut. Others find that doing so helps with symptoms of PCOS like acne because dairy is simply a food that has a lot of male-type hormones in it.
If you have an autoimmune disease or IBS….
If you have an autoimmune disease like Hashimoto’s Thyroiditis or Irritable Bowel Syndrome (or other gut issue) which can all contribute to PCOS, I recommend considering eliminating legumes like beans and peas, nuts, and also the nightshade vegetables tomatoes, potatoes, eggplant, and pepper.
Your best bet as a guide in doing so is Dr Sarah Ballantyne, who’s written the book on autoimmunity and diet. You can find the book here.
The PCOS Diet: Foods to focus on
That may seem like a lot of food to eliminate! No processed foods, no oils, no sugar…. well, really all this eliminates is processed food! (If you get smart at reading labels you can still include some foods that come in bags and boxes… I talk about how to do so in this book.)
All that’s left having been eliminated for sure is grains, and possibly, though not necessarily, dairy.
Then you are left with a literal bounty of fresh fruits and vegetables, healthy cooking fats like olive and coconut oil, and all the animal products you might ever want, from eggs to ribs to bacon and back.
Vegetables are awesome. All of them. They are rich in B vitamins, vitamin E, vitamin C, and many other antioxidants.
Try to have at least one serving of greens like kale, spinach, chard, or broccoli every day. More often than not, cook the greens, as this reduces a potential threat they might pose to your thyroid gland.
Starchy vegetables like potatoes, sweet potatoes, yams, cassava and taro are great choices for meeting your carbohydrate needs (which I consider to be at least 100 grams a day).
Women who struggle with insulin and who are type I PCOS may not want to have a TON of starch, but they should still have at least some carbohydrate – at least 100 grams a day! Women who are type II PCOS and struggle with low hormone levels may instead want to have a LOT of carobhydrate, somewhere around 2 or even 300 grams a day.
Fruit is also awesome! Fruit is also full of antioxidants and vitamins. As with starches, women who struggle with insulin and who are type I PCOS may not want to have a TON of fruit, but they should still have at least some carbohydrate!
I especially love berries, cherries, and other dark fruits like plums for great antioxidant content. Antioxidants improve detox and lower inflammation, which is crucial for overcoming PCOS.
Eggs are super healthy super foods! They contain all of the building blocks for a single organism in them… so they contain a lot of nutrients we can’t really get anywhere else!
In particular, eggs are rich in choline, which supports liver health, helps lower triglyceride levels, and which can help reduce inflammation and metabolic dysfunction.
For women with all types of PCOS I recommend trying to eat two eggs (and the YOLKS, which are the parts with all the nutrients in them) a day.
Seafood, particularly wild caught fatty fish like salmon (a great salmon snack here!) or trout, is great for women with PCOS. Not only does seafood contain high levels of good vitamins like vitamin D and iodine, but it is also the only rich source of the super healthy omega 3 fatty acids EPA and DHA in the diet.
Aim for one pound of fatty fish like salmon every week. If you cannot get that, consider taking this cod liver oil supplement. This is the highest quality and most nutrient dense fish oil available in the world today (not exaggerating).
Seaweed is awesome for PCOS because it contains lots of trace minerals in it, including iodine and selenium, which are great for supporting thyroid function.
For the sake of thyroid health, be sure that if you eat seaweed (here’s a super tasty paleo-approved seaweed snack) or supplement with kelp to eat about 10 brazil nuts (raw organic here) a week, since those are high in selenium and the seaweed is higher in iodine. It is crucial to get both iodine and selenium in the diet as the thyroid needs both in order to function optimally.
Organ meats are some of the healthiest foods around! Did you know that liver contains 20,000 times the vitamin A of the normal vitamin A “superfoods” carrots? It does!
Aim for about one pound of liver consumption a month. If you don’t like liver (but you should, it’s amazing), try 10 capsules of this grass-fed desiccated liver supplement.
Grass-fed animal products
Grass-fed cows, bison, pork, and other animals are great sources of protein and fat, rich in the B vitamins you need to support detox.
Butter from grass fed cows is also great -particularly ghee, which tastes like butter but is safe for everyone (even those of us with autoimmune diseases) to eat.
Great plant fats: Avocado, Olive oil, Coconut Oil, Palm Oil
Olive oil is an amazing plant fat. It is great at low temperatures (but can go bad and be unhealthy at high temperatures), so use your olive oil mostly for cool foods like salads.
Avocadoes are super healthy and high in vitamin E, which can help promote progesterone production, so this is a definite must for women who like their taste buds and have PCOS. 🙂
Coconut oil is anti-microbial and great for fat-burning, as its a fat with a special molecular shape. I already mentioned that this is my favorite coconut oil. It’s great and super healthy for cooking, and fabulous in both sweet and savory dishes.
Red palm oil is another option that is good for high heat cooking if you do not particularly love the taste of coconut oil. Here is the tastiest, in my opinion.
Fermented foods are great for PCOS because they are excellent ways to help support gut flora health, which is crucial for overcoming insulin resistance, cooling inflammation and balancing hormone levels.
Here are some of my favorite fermented foods and great links to get them online: kimchi (korean fermented cabbage), kombucha (fermented tea-careful though because it has caffeine!), and coconut-based yogurt.
The PCOS Diet: How to Eat it
Having a list of foods is all well and good, but you are probably wondering at this point how much and when you should be eating these foods.
Unfortunately, the answer to that question vaires based on which type of PCOS you have. For example, in the manual I wrote (check it out here) on overcoming PCOS, I recommend different amounts of carbohydrate for type I or type II PCOS. I also recommend different meal timing. For type I PCOS, I recommend eating in 3 meals, or perhaps 4 including a snack, every day. For type II PCOS, it is often helpful to eat more frequently than that.
In general, however, here are some good guidelines to follow:
A healthy protein level for women with PCOS is between 50 and 100 grams of protein every day. This is the equivalent of 2-4 cans of fish a day (for sizing purposes), which is also roughly about 3 palm-sized servings of meat a day, 0.5-1.0 pounds of meat, or 8-16 oz of meat.
Many women with PCOS – there are no good numbers out there, though in my best estimate is perhaps between 40 and 50% – have a tendency to have elevated homocysteine levels, as a result of carrying the MTHFR gene mutation. Homocysteine is a by-product of protein metabolism, as well as the body’s detox processes. One of the best things you can do to help keep homocysteine levels in check is eat a moderate protein diet. More than 100 grams/day is probably not optimal for a woman carrying the MTHFR mutation.
(Another thing you can do is take a high quality methylated B vitamin supplement. This methylcobalamin (B12) is good. This methylcobalamin with 5-MTHF is even better for some because the 5 MTHF even better helps support the body’s detox methylation pathway. Always start with a low dose and take it in the mornings since B vitamins can be energizing!)
Plenty of healthy fats
It is optimal to eat at least 36 grams of fat each day, which is about 12 grams of fat per meal (or approximately 100 fat calories). Fat is important for helping the body absorb nutrients, as well as serving as a building block of fatty tissues in the body, like the brain. It also helps keep blood sugar levels stable, which is important for keeping insulin (and therefore testosterone) levels in control.
Aim for one tablespoon of fat at very minimum with every meal.
Plenty of fiber
There is no need to supplement with fiber, or to try to eat high fiber cereals. A diet rich in vegetables and fruits will having plenty of its own natural fiber to give you.
Fiber is great for PCOS because it helps moderate blood sugar responses to meals (it slows down absorption in the intestines), and also because it helps feed gut flora, and also because it helps the body keep digestion moving along at a healthy pace.
At least 100 grams of carbohydrate a day
Some women (usually those who are overweight and/or have insulin resistance issues) find that a lower carbohydrate diet helps manage their PCOS. In this case, they should eat carbohydrate on the lower end, but probably not go much below 100 grams a day. I see far too many women suffer ill effects from a low carbohydrate diet to advocate a very low carb diet for any significant length of time.
Other women should definitely try to stay above 100 grams of carbohydrates like fruit and starchy vegetables every day.
For a lot of people in the paleosphere, 100 grams sounds like a lot. But that’s really just 1/2 a sweet potato or one apple with every meal – a much lower carbohydrate intake than the general population eats.
And I personally eat approximately 250-300 grams of carbohydrate each day – so you are probably lower than I am in carbs!
The PCOS Diet: Healing naturally and flexibly
I have not laid out a specific diet plan. I have not given you meal times or necessary serving sizes.
Rather, I have listed foods that are important to avoid, and foods that are important to focus on, and some rough guidelines for making sure you get enough of the things you need. After you meet these minimum requirements, you can fill in the rest with whatever your heart desires.
(I go into my theory of meal sizes and macronutrient ratios a lot more in my guide to female weight loss if you’re interested!)
This diet is a very nourishing one. Choose a variety of foods from the vegetables and fruits, healthy animal products and healthy fats I list, and you will be eating a diet that is highly nourishing, that reduces inflammation, and that helps support hormone balance.
The best part about it all is that it is long-term, and long-lasting. Medications cannot do that for you. Medications are like band-aids. they might cover up PCOS, but they do not solve it.
The diet I describe here, which I have used personally and used with countless clients all over the world, has literally saved so many of our lives. It gave me my libido back. It cleared my skin. It gave me my fertility back.
The PCOS diet really is a secret to healing – so many women are still missing out on it. So many women still don’t know the amazing effects these easy, natural dietary changes can have on their lives.
The PCOS diet is an incredible tool for overcoming PCOS for good, especially if you’ve figured out your own type of PCOS and what caused it.
You can also check out other posts on PCOS. My favorites are:
And what about you? Have you tried your own version of a PCOS diet? What works for you? What doesn’t? What do you think of my version of the PCOS diet?
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