Rohini Bajekal explains how opting for a plant-based diet can help alleviate the common symptoms of PCOS.
PolycysticOvarian Syndrome, known as PCOS, is the most common hormonal disorder worldwide, affecting at least one in 10 women and people assigned female at birth (AFAB).
It is a complex condition that affects a woman’s hormone levels and the way the ovaries function, resulting in a wide range of reproductive, metabolic and psychological symptoms that affect women differently.
PCOS is the number one cause of infertility yet three in four of those with PCOS remain undiagnosed because of the complex nature of the condition.
Common symptoms include irregular or absent periods1, acne, excess facial and body hair, scalp hair loss, anxiety, sleep disturbances, disordered eating, excess weight gain and insulin resistance, all of which have a negative impact on quality of life.
Lifestyle changes that ease PCOS symptoms
This disorder is heavily influenced by lifestyle — how we eat, sleep, move, stress, interact with others and so on. While national and international guidelines recommend lifestyle changes as the first line of treatment for PCOS2, even before medication, women with PCOS often receive little advice around their diet and lifestyle.
While there is no ‘cure’, making positive lifestyle changes – especially through nutrition and exercise3 – can go a long way in managing PCOS and its symptoms, both in the short term and longer term.
Although PCOS is often oversimplified as a fertility issue, PCOS and its complications are woefully under-represented in scientific research, the media and mainstream conversations.
The condition is poorly understood and the exact cause is unknown, although there are genetic factors4. Insulin resistance, a condition in which our cells become resistant to the action of the hormone insulin, appears to be the main mechanism in driving PCOS and many of its symptoms5.
Making positive lifestyle changes like eating a health plant-based diet and exercising help manage PCOS and its symptoms regularly. Photo © netus via Adobe Stock
Healthy eating to manage the symptoms of PCOS
Approximately 20 per cent of those with PCOS have ‘lean PCOS’, meaning they have a so-called ‘healthy’ BMI yet still struggle with the symptoms of PCOS. While excess body weight is a common cause of insulin resistance, lean people with PCOS can also be insulin resistant6.
Rather than pursuing weight loss as the only goal, especially given that people with PCOS are at a higher risk of eating disorders7, it is helpful to focus on sustainable lifestyle changes and an overall healthy plant-based dietary pattern.
Eating a plant-based diet that is rich in fibre helps promote healthy gut bacteria8, reduces inflammation9 and oxidative stress10, normalises blood sugars11, and lowers insulin resistance.
As seen in type 2 diabetes, a whole food plant-based diet can be an excellent tool in tackling insulin resistance and preventing blood sugar spikes, as well as in promoting a healthy weight.
For vegans with PCOS, aim to include minimally processed whole grains, such as brown rice, quinoa, barley and oats, and up your intake of plant protein. This means including plenty of beans, lentils, tofu, tempeh, edamame beans and peas in your daily diet.
Eating a fibre-rich plant-based diet helps promote healthy gut bacteria, reduces inflammation and oxidative stress, normalises blood sugars, and lowers insulin resistance. Photo © Alexandr via Adobe Stock
The benefits of soya for PCOS
Soya foods are naturally rich in isoflavones, compounds that have oestrogen-like effects, as well as being a great source of iron, potassium, B vitamins, and a good source of protein.
When consumed regularly, minimally processed soya foods (such as tofu and edamame) have been consistently shown to help with the symptoms of PCOS and improve many of the metabolic markers seen in the condition.
Whole fresh fruit and vegetables, especially berries and dark leafy greens, herbs and spices and a daily handful of nuts and seeds all increase the diversity of plants in your diet. It’s also important to take a reliable B12 supplement when on a plant-based diet.
Vitamin D deficiency is also common in PCOS12, and there is some evidence that vitamin D supplementation may improve reproductive function and insulin sensitivity. Other supplements that may be helpful in certain cases include inositol, chromium, magnesium and an algae-derived DHA/ EPA omega-3 supplement.
Consuming higher amounts of saturated fat, found in red and processed meats, dairy, eggs, coconut oil and ultraprocessed foods can accentuate levels of oxidative stress and inflammation in people with PCOS13. Use salt, oil, and sugar for flavouring purposes rather than overconsuming them and try to make water your drink of choice.
Limit barbecued and fried foods and ultra-processed foods that are high in tissue-damaging advanced glycation end products (AGEs) that are linked to fertility issues, heart disease and PCOS.
When consumed regularly, minimally processed soya foods (such as tofu and edamame) have been consistently shown to help with the symptoms of PCOS. Photo © naito29 via Adobe Stock
Given the higher risk of long-term conditions if you have PCOS, such as gestational diabetes, metabolic syndrome, increased cardiovascular risk factors, type 2 diabetes and womb cancer, making dietary changes early is advisable.
While plant-based nutrition can help to significantly reduce the symptoms of PCOS, it is important to focus on the other pillars of a healthy lifestyle in order to successfully manage the condition. These include the following:
- Move your body regularly, ideally in a form you enjoy. This is especially helpful after a meal – a short brisk walk for 15 minutes can help curb blood sugar peaks. Resistance training is particularly helpful for improving body composition and reducing androgen excess in PCOS.
- Prioritise a regular sleep routine and aim to get seven to nine hours restorative sleep every day.
- Avoid tobacco and excess alcohol and caffeine.
- Consider mindfulness, meditation, psychotherapy, yoga or any other relaxing activity that helps to manage stress levels.
- Spend time with your support network, such as your close friends and family
Harness the power of plants and improve your thyroid health with a plant-based diet.
Featured image credit: Jo Panuwat D via Adobe Stock
- Witchel SF, Oberfield SE, Peña AS. (2019) Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls. J Endocr Soc. Jun 14;3(8):1545-1573.
- Lim SS, Hutchison SK, Van Ryswyk E, Norman RJ, Teede HJ, Moran LJ. (2019) Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. Mar 28;3(3):CD007506.
- Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I, Brown JE. (2019) Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis. Syst Rev. Feb 12;8(1):51.
- Khan MJ, Ullah A, Basit S. (2019) Genetic Basis of Polycystic Ovary Syndrome (PCOS): Current Perspectives. Appl Clin Genet. Dec 24;12:249-260.
- Samantha Cassar, Marie L. Misso, William G. Hopkins, Christopher S. Shaw, Helena J. Teede, Nigel K. Stepto, Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic–hyperinsulinaemic clamp studies, Human Reproduction, Volume 31, Issue 11, 21 November 2016, Pages 2619–2631.
- Toosy S, Sodi R, Pappachan JM. (2018) Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. J Diabetes Metab Disord. Nov 13;17(2):277-285.
- Bernadett M, Szemán-N A. (2016) Prevalence of eating disorders among women with polycystic ovary syndrome. Psychiatr Hung. 31(2):136-45. Hungarian. PMID: 27244869.
- Tomova A, Bukovsky I, Rembert E, Yonas W, Alwarith J, Barnard ND, Kahleova H. (2019) The Effects of Vegetarian and Vegan Diets on Gut Microbiota. Front Nutr. Apr 17;6:47.
- Menzel J, Jabakhanji A, Biemann R, Mai K, Abraham K, Weikert C. (2020) Systematic review and meta-analysis of the associations of vegan and vegetarian diets with inflammatory biomarkers. Sci Rep. Dec 10;10(1):21736.
- Malinska H, Klementová M, Kudlackova M, Veleba J, Hoskova E, Oliyarnyk O, Markova I, Thieme L, Hill M, Pelikanova T, Kahleova H. (2021) A plant-based meal reduces postprandial oxidative and dicarbonyl stress in men with diabetes or obesity compared with an energy- and macronutrient-matched conventional meal in a randomized crossover study. Nutr Metab (Lond). Sep 10;18(1):84.
- McMacken M, Shah S. (2017) A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. May;14(5):342-354.
- Manzar N, Khan SA, Fatima N, Nisa MU, Ahmad MH, Afzal MI, Saeed HFU, Imran M, Anjum FM, Arshad MS. (2021) Exploring the prophylactic role of soy isoflavones against polycystic ovarian syndrome. Food Sci Nutr. Jul 9;9(9):4738-4744.
González F, Considine RV, Abdelhadi OA, Acton AJ. (2019) Oxidative Stress in Response to Saturated Fat Ingestion Is Linked to Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome. J Clin Endocrinol Metab. Nov 1;104(11):5360-5371.