While working in my clinic I have come across many women with PCOS (polycystic ovarian syndrome). PCOS is a hormonal condition. 'Polycystic' translates to 'many cysts'. But this doesn't necessarily mean that PCOS women have cysts on their ovaries but rather many partially formed follicles on the ovaries, which each contain an egg. These follicles rarely grow to maturity or produce eggs that can be fertilised. The important thing to understand is that you can have polycystic ovaries and not have PCOS. Confusing right?
To have PCOS you must have elevated androgens, physical symptoms (more on this below), menstrual irregularities and excess follicles on the ovaries (as i mention above).
There's actually four main types of PCOS.
1. Insulin resistant PCOS
2. Pill-induced PCOS
3. Inflammatory PCOS
4. 'Hidden' or uncategorised PCOS
Lara Briden talks about these in detail and I will elaborate on them in future. But today I wanted to talk to you guys about Insulin resistant PCOS because it's definitely the most common presentation I have seen in clinic and with my peers.
What is insulin resistant PCOS?
Insulin resistant PCOS occurs when women have high insulin levels, often resulting from a combination of genetic, diet and lifestyle factors. When women have increased insulin (and leptin) in the body this can interrupt a females natural ovulatory cycle. You see when insulin rises, so do androgens (male sex hormones), like testosterone. All women have testosterone but the amount we have impacts hormonal functions. Too much can throw things right out of whack.
Symptoms of insulin resistant PCOS
Hair loss or hair thinning around the hairline
Facial hair or abnormal amounts of dark body hair (known as hirsutism)
Difficulty losing weight/always carrying excess weight
Abnormal, irregular or no menstruation
Tendency towards depression and/or low mood
Acne or oily skin
Pelvic pain (throughout and in between menstruation)
If you are concerned that this may be you then definitely get in touch with me and book an appointment or contact your local naturopath/holistic nutritionist/GP for further testing.
How to eat when you have PCOS
The key here is to stop the insulin spiking at all costs.
So this sadly means cutting out all sugar including 'natural' sugars (coconut, rice malt syrup, rapadura, panella), refined sugars (raw sugar, white sugar, icing sugar, and all the other types found in baked goods and sweetened drinks). You'll also need to avoid high fructose fruits like banana, apple, pineapple, ripe pears etc. Instead stick with one portion of mixed berries a day, if you feel you need it.
Eat more good fats.
I know for some this totally goes against what you think you need to do to lose weight or be healthy. But I promise that eating natural sources of unprocessed polyunsaturated, monounsaturated and saturated fats will not only keep you satiated and away from the sugar, it will also support hormonal production required for the creation of sex hormones and stabilise blood sugar to avoid those insulin spikes.
Avocado in salads and on seeded bread.
Coconut yoghurt with some low fructose berries.
A small handful of unsalted macadamia nuts.
Walnuts scattered through a salad or on top of roast veg.
Nut butters spread on seeded bread or just a teaspoon to snack on.
Grass fed, organic butter, used for cooking.
Pepitas, sprinkled over salads.
Coconut butter, added to a hot cacao or raw treats (in moderation!)
Coconut oil, for cooking and added to soups and smoothies.
A CAVEAT: This is not a license to eat a tub of Pic's peanut butter in one sitting while watching The Bachelor - though that would be nice. This is simply an invitation to opt for a high fat snack rather than a high sugar one and see how you feel.
Cut back on refined carbs.
I hate to be that person. In fact a few years ago, I would have happily eaten toast for brekky every day (even the healthy stuff). The truth is when eating carby foods, even when #organic #vegan #glutenfree you will still experience a rise in blood sugar resulting in increased insulin. Bummer, I know.
To combat the lack of carbs:
Fill up on veggies. Add at least 2-3 cups of sautéed green veg to your plate.
Enjoy sweet potato (in small amounts) for your carby hit.
Go for 'meatier' veggies like field mushroom and eggplant to satisfy the need for bulk in your meal.
Make seed crackers as they're full of yummy fats and low in carbs.
Eliminate dairy and soy.
There's no hard and fast rule when it comes to these but I highly recommend my patients eliminate these foods for at least 6 weeks and then we can analyse their symptoms. Studies are showing that eliminating or reducing dairy can help reduce incidences of acne related to PCOS.
Why soy though? Soy contains phytoestrogens which are plant-derived xenoestrogens - oestrogens not generated within the endocrine system but consumed by eating phytoestrogenic plants. The problem with these phyto-oestrogen's is that they mimic oestrogen and confuse the bodies endocrine (hormonal system). So when we're working to balance these hormones the last thing you want to do is add some additional ones to the mix!
Eat adequate amounts of protein.
Protein will keep you satiated, help balance blood sugar levels and is a super important macronutrient required for so many key functions in the body. In clinic I've found that women with hormonal issues are not eating enough protein in their diet. As soon as we make changes they start to feel like their energy increases and stabilises, their weight shifts and they have a clearer head. Eating a portion of protein at every main meal and a small amount with snacks is ideal.
Great sources of protein are:
So there you go my lovely friends, here is just a starting point for you. But I cannot stress enough how important it is that you cater you nutrition to you as an individual. If this means seeking out the help of a professional so you have a bespoke plan then do that. My advice is simply a guideline. I hope it helps you start to make significant change.
If you have PCOS how have you managed it? Do you struggle with your diet? I would LOVE to hear your stories below so that we can all learn about this condition.