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Did you know that Polycystic Ovary Syndrome (PCOS) is one of the most common hormone-related issues affecting women around the world? In the United States alone, PCOS is a leading cause of infertility; yet, according to findings from the 2024 ACOG Annual Meeting, delays in diagnosis and having symptoms brushed off by doctors are still way too common — leaving many women feeling ignored and disappointed when they’re just trying to figure out what’s happening with their bodies.
If you’re a woman of reproductive age, there’s roughly a one-in-ten chance you might be dealing with PCOS — diagnosed or not.
What is PCOS anyway?
PCOS is a complex and often frustrating hormonal disorder. The exact cause remains a bit of a mystery, but research points to a tangled web involving genetic factors, chronic inflammation, and insulin resistance.
When your body experiences an excess of androgens (often referred to as "male hormones" like testosterone), you may see a host of uncomfortable symptoms: think facial hair, stubborn acne, and even hair thinning. Ovulation can also become irregular or stop altogether, making it harder to conceive naturally. For many women, the heartbreak of trying to start a family becomes painfully familiar.
The link between PCOS, nutrition, and fertility
While there’s no one-size-fits-all cure for PCOS, the silver lining is that diet and lifestyle changes can significantly improve symptoms and even increase your chances of getting pregnant. Let’s break down the core areas you need to focus on.
Blood sugar balance: Your fertility’s secret weapon
We can’t talk about PCOS nutrition without discussing the pivotal role of blood sugar. Blood sugar (or glucose) rises when you eat carbs and is supposed to be regulated by the hormone insulin, released by your pancreas. However, if your body starts struggling to respond to insulin (hello, insulin resistance!), you end up with too much glucose and even more insulin floating around your system. And guess what? This insulin resistance is a key player in PCOS.
Insulin resistance triggers your ovaries to make more androgens, like testosterone, exacerbating symptoms like facial hair and weight gain. On top of that, it can mess with ovulation. When you don’t ovulate regularly, getting pregnant becomes a challenge. Plus, blood sugar imbalances may crank up your body’s stress hormone, cortisol, making menstrual cycles even more unpredictable.
How to balance blood sugar with PCOS
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Prioritize protein and healthy fats: Carbs aren’t the enemy, but it’s all about balance. When you eat carbs, pair them with protein (like eggs, lean meats, or tofu) and healthy fats (like avocado or olive oil). This simple hack keeps your blood sugar from spiking too high.
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Choose complex carbs: Rather than cutting carbs entirely (because your body does need them!), go for high-fiber options like whole grains, beans, and veggies. For instance, swap white rice for brown rice or white bread for whole-grain varieties. Fiber slows down the digestion of carbs and helps with more stable glucose levels.
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Mind your portions: Everyone’s carbohydrate tolerance is different. What works for one woman might not work for another. A Registered Dietitian specializing in PCOS can help tailor a plan to your unique needs.
Fighting inflammation: Another piece of the PCOS puzzle
Chronic, low-grade inflammation is unfortunately common in women with PCOS. Inflammation can throw a wrench into your hormonal balance and isn’t ideal when you’re trying to create a welcoming environment for pregnancy. The goal? Minimize inflammation by tweaking your diet to include more anti-inflammatory foods.
Inflammatory foods to limit:
- Processed meats: Hot dogs, bacon, and even certain vegan meat substitutes.
- Sugary drinks: Soda, energy drinks, and even some “healthy” fruit juices.
- Fried foods: Restaurant and fast food fried options are often cooked in inflammatory oils.
- Refined carbs: White bread, pastries, and overly processed snack foods.
- Excess alcohol and sugar: Both can contribute to inflammatory responses.
Anti-inflammatory superfoods to embrace:
- Ginger & turmeric: Both are known for their powerful inflammation-fighting properties. Try adding turmeric to a smoothie or sipping on ginger tea.
- Omega-3 rich foods: Think fatty fish like salmon or plant-based sources like chia seeds. Omega-3s reduce inflammation and support hormone balance.
- Vitamin D sources: Salmon, egg yolks, and fortified foods can all give you a vitamin D boost. Low levels of vitamin D have been linked to inflammation and fertility challenges.
- Berries: These little gems are antioxidant powerhouses, helping combat inflammation.
- Leafy greens and broccoli: Packed with nutrients that help keep inflammation in check.
- Healthy fats: Avocados and extra-virgin olive oil are full of heart-healthy fats that reduce inflammation.
Egg health: Nourishing your fertility with PCOS
Unlike men, who constantly produce new sperm, women are born with all the eggs they’ll ever have. So, if you have PCOS, it’s extra important to nourish your egg health.
Key nutrients for better egg quality:
- CoQ10: This antioxidant helps protect eggs from damage and boosts mitochondrial function, which powers cell activity. You can get it from foods like cabbage and broccoli.
- Vitamins A and E: These support the energy processes in your eggs. Load up on foods like sweet potatoes, salmon, almonds, and sunflower seeds.
- Inositol: This nutrient, found in foods like beans and oranges, can improve insulin sensitivity and support egg health.
- Omega-3 fatty acids: They help form the egg cell membrane and promote proper egg development. Salmon, sardines, and chia seeds are great sources.
- B vitamins & zinc: These are crucial for healthy cell division. Incorporate foods like poultry, quinoa, oysters, and pumpkin seeds.
Addressing the mental health impact of PCOS
PCOS doesn’t just mess with your hormones or your chances of having a baby — it can take a huge toll on your mental health, too. In fact, women with the condition are more likely to experience anxiety, depression, and other mental health challenges. If this sounds familiar, know that you’re not alone, and it’s okay to ask for help. Talking to a therapist or joining a support group where you can connect with other women who “get it” can make a big difference in managing stress.
The truth is, PCOS is complicated and sometimes feels like a rollercoaster you didn’t sign up for. But by taking a holistic approach — balancing your blood sugar, fighting inflammation, nourishing your eggs, and taking care of your mental well-being — you can improve your symptoms and boost your fertility. Remember, It’s a journey, and every woman’s body is different, but hope and healing are absolutely possible.
Cory Levin, MS, RDN is a Registered Dietitian and Women’s Health Expert. A fellow PCOS cyster herself, Cory dealt with severely irregular cycles her entire adult life until she began nourishing her body with the right nutrition, supplements, and exercise routine. In February 2019, she conceived completely naturally and is now a mom to a beautiful little girl. Through her nutrition practice The Women’s Dietitian, she now works exclusively with women to help them conceive, balance their hormones, and put their PCOS into remission. You can find Cory on Instagram here.