Hormones are chemical messengers that have a huge impact on our bodies, affecting mood, fertility, and even metabolism.

But did you know that your metabolism can also affect your hormones and vice versa?

PCOS and the metabolic component

While PCOS can never be cured totally, managing your diet can significantly help the severity of symptoms. Here is how….

Polycystic Ovary Syndrome or PCOS is a hormonal imbalance in women corresponding to low-grade inflammation, insulin and testosterone imbalances. Symptoms are wide-ranging and therefore sometimes difficult to diagnose by practitioners looking specifically for cystic ovaries. There may be no cysts despite these other symptoms being present: 

• Mood swings, depression and anxiety 
• Male-pattern hair growth, on the face, chin or breasts, back and buttocks
• Hair loss or hair thinning
• Acne, oily skin or changes like skin tags and mole growth
• Weight management issues, gaining weight and difficulty shifting weight
• Irregular cycles and longer cycles of over 32 days
• Heavier, painful periods OR very light periods
• Difficulty getting pregnant, irregular ovulation 

According to OASH, PCOS affects about 1 in 10 women and is the most common hormonal disorder among women of reproductive age. It can have serious long-term impacts on family planning, women's health and quality of life. Women with PCOS are often at risk of infertility. According to this study, PCOS represents 80% of anovulatory infertility cases, making it the most common source of infertility in women worldwide. But, why is that? 

The short answer is, we don’t definitively know, however, some researchers, like renowned scientist and pathophysiology professor Dr. Benjamin Bikman are linking it to insulin resistance. In his eye-opening book “Why We Get Sick” he explores why insulin resistance has become so prevalent and why it matters. People more commonly link insulin resistance with being overweight, obese or diabetic, however insulin resistance also presents in healthy-range BMI women suffering from PCOS.

Dr. Bikman recently tweeted, "Even normal-weight females with PCOS are insulin resistant relative to non-PCOS females. The insulin inhibits ovarian estrogen production, resulting in elevated androgens (which disrupts ovulation).” 

While this condition can never totally be cured, there are ways to mitigate and manage its symptoms. The impact of dietary and lifestyle changes on insulin resistance can be profound, and as a result, women may find significant relief from their PCOS symptoms. 

Avoiding trans fats, eating whole foods and a ketogenic diet. 

Your favourite plant-based milk may be impacting your PCOS…

Data suggests that a diet that is high in trans fats, carbohydrates and sugars affects PCOS in a negative way, while those that are rich in dietary fibre, omega-3 fatty acids, grass-fed or natural diet animal-based protein and several types of plant-based protein, vitamins and minerals, impact PCOS symptoms positively. 

These trans fats may be lurking in seemingly harmless “healthy” foods like your favourite plant-based milk alternatives such as oat and foamable soy milk. They often contain processed seed and vegetable oils like rapeseed, canola and sunflower used to thicken and give body. To put this in perspective,  if you drink 3-4 lattes or cappuccinos a week made with these dairy alternatives containing processed oils, you may be unwittingly ingesting over a litre of these inflammatory trans fats in a month! That’s a lot and sure to make a dent in your body’s already taxed inflammatory response to PCOS. 

Check the labels of your vegan milk alternative and opt for ones that don’t contain seed or vegetable oils or specifically state “cold-pressed”. If drinking dairy, opt for organic and grass-fed which won’t contain antibiotics and synthetic hormones that can affect your hormonal system.

There is now evidence that a whole food, non-processed ketogenic diet can improve symptoms by improving insulin resistance and reducing inflammation, such as this 2005 study where a low-carbohydrate ketogenic diet led to significant improvement in weight, testosterone levels, fertility indicators and fasting insulin in women with obesity and PCOS over a 24 week period.  

Whether you choose to go full keto or just make some healthier swaps, diet is important. In PCOS experts  Dr. Walter Futterweit’s guidebook on PCOS and Naturopath Doctor Fiona McCulloch’s 8 Steps to Reverse Your PCOS, a core pillar of improving PCOS is a balanced diet. As Dr. McCulloch sees it, this includes healing your gut, perhaps even a period of elimination to allow your system a rest and reset, and eating healthy. Whatever you choose, some great ground rules are as follows: 

• Get sufficient protein! It helps alleviate blood sugar crashes and cravings for sugar 
• Eat whole, natural foods. The less processed, the better with plenty of greens
• Opt for healthy fats, avocadoes, cold-pressed olive oil, grass-fed ghee and tallow
• Keep sugar and glucose levels in check, opting for whole fruit for dessert and always try to buffer sugar consumption by eating it with a protein source or ideally 15-20 minutes after consuming protein and fats, rather than alone or on an empty stomach. 

Here are a few things to help alleviate your PCOS that are easily done; 

Cinnamon and Spearmint

You can also try introducing natural ingredients to your meals like adding cinnamon and spearmint tea. Cinnamon does not only reduce insulin resistance, but it also aids in fertility issues brought about by PCOS. You can also try drinking spearmint tea to help mitigate PCOS symptoms, as this study suggests, it has a positive result on androgen hormones in women with PCOS.

Eat Regularly

Scheduled meals can help improve insulin resistance.

There is a difference between intermittent fasting, which may help insulin resistance if practised a few days per week (ideally not the week of your period or just before) and inconsistent or poor eating patterns. A poor breakfast high in sugar and carbohydrates (coffee with sugar and a croissant for example) that are not buffered by sufficient protein or healthy fats, having a coffee with sugar or creamer of any kind, skipping meals or eating a poor or very late lunch causes blood sugar spikes and drops.  

Random snacking with insufficient protein, or eating meals dominant in carbohydrates and poor in healthy fats can do a number on your insulin sensitivity and make your PCOS worse with unstable blood sugar and energy crashes. These affect you day to day but also stack up with an inflammatory response that aggravates your PCOS. 

This type of eating is counterproductive for maintaining normal hormone levels and may aggravate insulin resistance and worsen PCOS symptoms. In improving insulin resistance, scheduling when you eat matters. Eating more balanced and regularly is encouraged. By doing this, you’re making sure that your blood sugar levels remain steady and controlled for sustained energy and helping to improve your PCOS symptoms. 

Exercising Helps

Get moving, but skip the high-intensity interval (HIIT) training! 

Women with PCOS are typically at risk of other diseases like cardiovascular diseases and mental health conditions. According to this study, exercising helps mitigate these risks by helping improve insulin sensitivity and decrease hyperinsulinemia. Exercise also helps improve the psychological well-being of women with PCOS. 

However, when exercising, it is important to avoid high-intensity interval training or HIIT. HIIT consists of short exercises with several bursts of intense activity. While generally speaking, this is an effective method of weight loss and conditioning, for women with PCOS, this can be detrimental. Repeated intense activities can increase the levels of cortisol, the stress hormone, which makes PCOS symptoms worse and is counterproductive to shifting weight in women with already elevated cortisol levels. 

The good thing about learning to manage your PCOS is that you can start in your own kitchen. There are little things you can adjust within your diet and lifestyle that will make a world of a difference in managing your hormone levels. 

HORMONAL & PROUD

Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum — and practically every stage of life, the SABI aims to change the narrative around our hormones from one of taboo, embarrassment and loneliness, to awareness and even pride. Much more than a wellness brand, SABI offers a carefully crafted line of products to carry you through your hormonal journey; a set of rituals, supportive tools, and ancient herbal remedies that have been tested time and again by women and now, backed by medicine. SABI is a blend of science and nature conceived by women who have experienced the joys and deep implications of bringing a child into the world, the pains of a heavy and difficult period, miscarriage and difficulty conceiving

Here is an invitation to get to know your body and its cycles better and to really understand what is going on inside. Learn to use your hormonal cycle to your advantage no matter your stage of life, and know that you can always support and balance your hormone levels. Look for the right sources of information, know that there is help, and know that you’re supported.

ABOUT NIKKA

Nikka is a copywriter and Associate Creative Director by day and singer-songwriter by night, based in Manila, Philippines. From creating commercials under an agency, she transitioned to independently collaborating with different people within the music community, as well as organisations in the area of social development, and now entering the beauty and wellness space with the SABI. Walking her dog + food trips + film photography are her favourite pastimes.

SOURCES

1. National Institute of Diabetes and Digestive and Kidney Diseases. Insulin Resistance & Prediabetes. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance 
2. Skiadas, C. (2022). Treating PCOS with Nutrition: 9 Tips for a Healthy Diet. https://www.lancastergeneralhealth.org/health-hub-home/2022/october/treating-pcos-with-nutrition-9-tips-for-a-healthy-diet 
3. Fallabel, C. (2022). Insulin Resistance Diet for Diabetes – What to Eat & What to Avoid. https://diabetesstrong.com/insulin-resistance-diet-for-diabetes/#:~:text=Highly%20processed%20foods%20with%20simple,bacon%2C%20cheese%2C%20and%20butter 
4. OASH. (2021). Polycystic ovary syndrome. https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome#:~:text=Who%20gets%20PCOS%3F,at%20any%20age%20after%20puberty. 
5. Melo, A. S., Ferriani, R. A., & Navarro, P. A. (2015). Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics (Sao Paulo, Brazil), 70(11), 765–769. https://doi.org/10.6061/clinics/2015(11)09 
6. Skoracka, K., Ratajczak, A. E., Rychter, A. M., Dobrowolska, A., & Krela-Kaźmierczak, I. (2021). Female Fertility and the Nutritional Approach: The Most Essential Aspects. Advances in nutrition (Bethesda, Md.), 12(6), 2372–2386. https://doi.org/10.1093/advances/nmab068 
7. Moradi, S., Hojjati Kermani, M. A., Bagheri, R., Mohammadi, H., Jayedi, A., Lane, M. M., Asbaghi, O., Mehrabani, S., & Suzuki, K. (2021). Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis. Nutrients, 13(12), 4410. https://doi.org/10.3390/nu13124410 
8. PCOS: Cinnamon and 4 other possible ways to minimize your symptoms. https://overlakeobgyn.com/pcos-cinnamon-and-4-other-possible-ways-to-minimize-your-symptoms/#:~:text=Like%20we%20mentioned%20above%2C%20cinnamon,who%20were%20given%20the%20placebo 
9. Grant P. (2010). Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Phytotherapy research : PTR, 24(2), 186–188. https://doi.org/10.1002/ptr.2900 
10. Galan, N. (2021). Why Protein Is Important in a PCOS Diet. https://www.verywellhealth.com/all-about-protein-2616481 
11. Ramallo, F. PCOS and Sugar: Every Single Thing You Want to Know. https://allarahealth.com/pcos-and-sugar-every-single-thing-you-want-to-know/#:~:text=Sugar%20cravings%20can%20be%20caused,high%20levels%20of%20circulating%20insulin. 
12. Panth, N., Gavarkovs, A., Tamez, M., & Mattei, J. (2018). The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States. Frontiers in public health, 6, 211. https://doi.org/10.3389/fpubh.2018.00211 
13. When To Eat To Support Your PCOS And Why Meal Timing Matters. https://jilliangreaves.com/blog/2021/12/4/when-to-eat-to-support-your-pcos-and-why-meal-timing-matters 
14. Woodward, A., Klonizakis, M., & Broom, D. (2020). Exercise and Polycystic Ovary Syndrome. Advances in experimental medicine and biology, 1228, 123–136. https://doi.org/10.1007/978-981-15-1792-1_8 
15. Sharma, P. (2022). Is HIIT Really the Worst Exercise for PCOS? Here's What Science Has to Say! https://phablecare.com/health-guide/pcos/worst-exercise-for-pcos