Managing PCOS involves considering various aspects of your lifestyle, and it can definitely feel overwhelming. While it’s impossible to cover everything in one article, we’re here to help you create a personalized PCOS meal plan, setting you up for success with nutrition and supporting your overall well-being.
Before diving into meal planning, let’s first go over some key basics of PCOS.
What is PCOS?
Polycystic Ovarian Syndrome (commonly abbreviated to PCOS) is a common hormonal condition that affects between 4-20% of women in the United States (1).Getting a diagnosis can be challenging, and knowing what to do once you have one can be even more difficult, despite the condition having been recognized for hundreds of years.
If you or someone you know is dealing with PCOS, you’ve come to the right place. Welcome!
In this article, we will cover:
- Challenges for diagnosing PCOS
- The types of PCOS
- How food can be a powerful tool in healing
- What to focus on when you create a PCOS Meal Plan and how to build your plate.
Challenges for Diagnosing PCOS
Anyone with PCOS understands the personal struggle with getting a diagnosis. It’s frustrating, sometimes painful, and honestly, takes a long time.
In fact, in the largest study done on PCOS diagnostic experiences revealed that at least one-third of women experience 2 or more years and seeing 3 or more health professions before receiving a diagnosis (2).
If Polycystic Ovarian Syndrome is so prevalent, why is it so difficult to diagnosis?
The answer has multiple layers.
First, obtaining accurate data on the prevalence of PCOS and its phenotypes is very challenging. When conducting research on PCOS, there are many variables to consider, such as differences in diagnostic criteria, other health factors, socioeconomic status, awareness, access to healthcare, and geographic location.
A further limitation lies in the ongoing use of outdated diagnostic criteria. In the 1990s, the National Library of Medicine (NIH) hosted a conference on PCOS, where they established formal diagnostic criteria. These criteria were later revised in 2003 and are now known as the Rotterdam criteria (3).
4 Types of PCOS
There are four types (phenotypes) of PCOS: Adrenal, Post-Pill, Insulin-Resistant, and Non-Insulin Resistant. While they greatly overlap in symptoms and qualities, specific traits distinguish them. Knowing and understanding the kind of PCOS you have can make finding a successful treatment much easier.
Adrenal PCOS
Adrenal PCOS refers to elevated adrenal androgens such as DHEAS (dehydroepiandrosterone sulfate – yes, that’s a mouthful) while testosterone levels stay normal. The adrenal glands primarily produce DHEAS.
This form usually results from chronic stress. Individuals who experience this sort of PCOS may struggle with anxiety, work in high stress environments, experience stress in their day-to-day lives, and may (but not always) have a lean physique.
Symptoms may include:
- Irregular or absent periods
- Infertility
- Increased insulin resistance
- Acne
- Weight gain
- Hirsutism (abnormal or excessive hair growth on the face and body)
Post-Pill PCOS
Post-pill PCOS refers to the after-effects of hormonal birth control.
Birth control suppresses ovulation, and over time, your body begins to understand that as the new norm. After stopping birth control, it takes time for your body to readjust. For some people, ovulation will resume shortly after stopping birth control, while for others, it may take months or even years.
It’s important to note that many conventional OB/GYN doctors don’t widely recognize this type of PCOS. Stopping birth control doesn’t guarantee that you will develop PCOS.
If you didn’t have regular periods before starting birth control, you may have a different form of PCOS.
If you have questions or concerns about the side effects of birth control or are thinking about stopping, talk to a trusted healthcare professional.
Insulin-Resistant PCOS
Insulin-resistant PCOS is considered the “classic” type of PCOS and is the most common (4). With this form, high insulin and leptin levels (a hormone that regulates appetite) hinders ovulation, causing the ovaries to produce excess testosterone.
Insulin gets released when you eat, helping your body absorb sugar or protein into your cells (5)
If you consume excess sugar or protein without balancing your meals with fat or fiber, insulin levels may spike, potentially causing insulin resistance. This, in turn, leads to hormonal imbalances, including testosterone, estrogen, and progesterone
Symptoms may include:
- Pre-diabetic or diabetes diagnosis
- Abnormal glucose tolerance test
- Elevated LH (luteinizing hormone)
Non-Insulin Resistant PCOS (Lean/Inflammatory PCOS)
Inflammation in the body may result from various factors including stress, environmental toxins, and inflammatory foods. This interferes with ovulation, disrupting hormones, and stimulating adrenal androgens.
Non-Insulin Resistant PCOS is also known as Lean PCOS because people with this condition may have a normal weight, unlike those with other forms of PCOS.
Identifying the inflammatory triggers that cause irregular menstrual cycles and hormonal imbalances is crucial for managing this type of PCOS.
Symptoms may include:
- Irregular menstrual cycles
- Headache
- Joint Pain
- Acne
- Thinning hair
- Skin tags
- Lab Tests that may indicate a vitamin D deficiency, abnormal blood count, and thyroid antibodies.
This list is not exhaustive. If you suspect that you have Inflammatory PCOS, please contact your provider for testing and a diagnosis.
Causes
You’ve probably asked yourself, “What causes PCOS?”.
Like you, scientists and researchers have wondered about this too. While there is not one singular cause, here are some of the known contributors to PCOS:
- Genetic Predispositions
- Environmental toxins (6)
- Chronic Stress
- Weight
- Birth Control
- Diet
- Sleep disruption
It’s important to remember that while many of these variables might be out of your direct control, there are still many things you can do to reduce symptoms or even heal the condition entirely.
Food as a Tool for Healing
Navigating food for PCOS can feel really daunting and complicated. Let’s break it down.
Your body consists of a complex system of cells and molecules that act like little energy and message carriers. They deliver messages in the form of food (energy) and in response, your body dispatches hormones.
Think of these cells like little mailmen! With PCOS, your mailman keeps delivering an “ATTENTION!” notice to the wrong address.
Your body reads these messages and raises testosterone and insulin in response. Over time, this creates a lot of mixed messages!
So, what’s the solution? Great question. While this is a complex issue that requires attention to exercise, sleep, environment, and stress, your nutrition plays a MAJOR role in healing. If we can start sending the right messages to your body, it will adjust accordingly! That’s why creating the right PCOS meal plan is so important.
PCOS Meal Plan: How to Balance Your Plate
You may feel overwhelmed when you start making nutrition and lifestyle changes. To avoid overwhelm start small and build new habits over time.
You might be asking yourself “what should my plate look like?”. You will balance your plate with protein, healthy fat, and fibrous carbs (your three new besties!). Balancing your plate will ensure you are getting all the essential nutrients for day-to-day life while improving PCOS and reducing risk of other chronic diseases.
Power Up with Protein
Protein is a complex molecule made up of amino acids that your body needs for function. It replenishes cells, provides long-lasting energy, and helps promote feelings of fullness, which aids in managing weight.
Here is a non-exhaustive list of foods containing Protein you can add to your PCOS meal plan:
Fat Facts: Fuel, Flavor and Function
Healthy fat is a nutrient used in the body for many different functions including building cell membranes, nerve tissue, supporting hormones, absorbing nutrients, and providing energy. There are three main types of Fat:
Unsaturated Fats
The nitty-gritty explanation is that it’s a molecule that contains at least one double bond within its fatty acid chain. For those who weren’t subjected to an Organic Chemistry course, these fats generally have a looser structure and are typically liquid at room temperature.
Monounsaturated Fat includes sources such as avocados, olive oil, and olives to promote heart health and improve cholesterol levels.
Polyunsaturated Fat includes foods like fatty fish (salmon, mackerel), flaxseeds, chia seeds, and tofu for their omega-3 and omega-6 fatty acids, which support brain function and reduce inflammation.
Saturated Fats
Saturated fats are solid at room temperature and are found most often in animal products like beef, pork, milk, and cheese. For our Chemists: this is a type of fat where all the fatty acid chains have single bonds between carbon atoms.
Trans Fats
Trans Fats are made when liquid oils are turned into solids like shortening or margarine. These are also known as partially hydrogenated oils (PHOs) and have been banned by the United States Food and Drug Administration as additives used by food manufacturers.
Choosing the Right Fat for your PCOS Meal Plan
It is generally recognized that Monosaturated and Polyunsaturated fats are considered the healthiest and provide the most nutritional benefits.
While Saturated fat has previously been considered “bad” or “unhealthy”, new research suggests that it is not as detrimental as previously thought. In two studies recently published, showed that there was no significant evidence to suggest that saturated fat is associated with an increased risk of cardiovascular disease (7).
While there is conflicting evidence for whether or not saturated fats have adverse effects on the body, it is important to remember that not all saturated fats are created equal. For example, saturated fat from fast food, fried foods, or sugar goods are likely to have a different effect on the body than consuming dairy or grass-fed meat.
Be sure to include a variety of fat into your meal plan.
Here is a non-exhaustive list of foods with Fat:
Carbohydrates and Fiber: The Dynamic Duo
Carbohydrates (commonly referred to as carbs) break down into glucose (blood sugar), providing energy for cells, tissues, and organs.
Fiber is an important nutrient found in carbohydrates, that supports digestive health. It helps improve bowel movements, regulates blood sugar, lowers cholesterol, and plays a vital role in preventing disease. There are two kinds of Fiber: soluble and in-soluble.
Soluble fiber tends to dissolve in water and helps to reduce elevated cholesterol levels and improve blood sugar regulation.
Insoluble fiber does not dissolve in water and tends to stay together when it travels through the digestive system. It plays a vital role in reducing constipation.
Here is a non-exhaustive list of foods with Fiber:
Myth Busting: Fear of Fat and Carbs
In previous decades, the general consensus was that fat was “bad.” However, we now know that healthy fats are essential for your body.
During the 20th century, trans fats were used by many food makers from commercial cookies to fast food. Trans fats are manufactured fats that contribute to inflammation, heart disease, stroke, and other harmful health conditions. Scary right?! Luckily, trans fats are now banned in the U.S and many other countries
Now, we know that monosaturated and polyunsaturated fats are not only safe to eat but contribute positively to lowering inflammation, blood clotting, cell rebuilding, and nerves.
Similarly, carbohydrates often get a bad reputation. People often see carbs as the cause of excessive weight gain. While overconsumption of any nutrient can cause weight gain, carbs are an essential source of energy and often contain other beneficial qualities.
Basically, there is a balance to all things! If you would like to explore how much of each nutrient you should be consuming, a local dietitian would be a great resource! Make sure to incorporate a range of fats into your PCOS meal plan.
Whole Foods – Your PCOS Meal Plan Power House
Whole foods are those closest to their original state, meaning they undergo little to no processing and retain their natural fiber, vitamins, minerals, and beneficial compounds.
For example, an apple is considered a whole food, whereas applesauce, though still derived from apples, has likely been processed with added sugars or preservatives and has lost some of its fiber. Similarly, an orange provides fiber and essential nutrients in its natural form, whereas orange juice, especially when processed, often lacks fiber and may contain added sugars.
Eating whole foods ensures that you are getting the full benefits of the item. These foods are rich in fiber, which supports digestion and gut health, and they contain a balance of macronutrients and micronutrients that work together to nourish the body.
When foods are processed, they often lose some of their essential components, making them less nutritionally complete. To put it in a fun analogy: Imagine receiving a gift card—you wouldn’t want to use just half of it and throw the rest away! Adding whole foods to your PCOS meal plan is a great way to optimize nutrition!
Anti-inflammatory Foods List
Anti-inflammatory foods contain important vitamins, minerals, and antioxidants. Antioxidants help your body fight off harmful free radicals.
Here is a non-exhaustive anti-inflammatory food list:
Alcohol and PCOS
Alcohol comes in many different forms and can be a complex issue. Generally, alcohol has no positive effects on the body.
In a recent study on moderate alcohol consumption in females, researchers found that alcohol lowers progesterone levels (8). Certain alcoholic beverages contain high sugar levels, which can spike blood sugar, especially when consumed without food.
As PCOS is predominantly a Progesterone, Testosterone, and Blood Sugar issue, limited alcohol consumption or abstaining from alcohol all together is recommended.
If you are concerned about your alcohol intake, please contact a trusted healthcare provider.
Conclusion
Nutrition plays a major role in balancing hormones and supports the recovery of conditions like PCOS. A PCOS friendly meal plan is a great start! PCOS can be challenging to navigate, but with the right tools and support, it is highly treatable. For additional support and information, speak with a health professional or make an appointment with our Registered Dietitian.