Nutrition For PCOS FFHA

Nutrition for Polycystic Ovary Syndrome (PCOS)
Erica Smolinski, MS, RDN, CDN
Overview
Polycystic Ovary Syndrome (PCOS) affects 6% to 18% of reproductive aged women in the United
States. However, the name can be misleading. PCOS is a complex and highly prevalent
reproductive, endocrine, and metabolic disorder.
Patients with PCOS may experience:
reproductive abnormalities
inflammation correlated with insulin resistance
irregular or absent menstrual periods
excess androgens (male hormones such as testosterone)
polycystic ovaries resulting from the hormonal imbalances
hirsutism (male-patterned hair growth)
acne
alopecia (thinning or loss of scalp hair)
Additionally, both reproductive-age and older women with PCOS have an increased risk for
conditions such as:
impaired glucose tolerance
type 2 diabetes mellitus
elevated cholesterol or lipids
increased abdominal adiposity
obesity
hypertension
metabolic syndrome
depression
anxiety
obstructive sleep apnea
nonalcoholic fatty liver disease
endometrial cancer
cardiovascular disease
Ó2022 Foundation for Female Health Awareness

Research suggests that medication alone might not be enough to address PCOS. This is where
individualized, evidenced-based Medical Nutrition Therapy (MNT) obtained from a Registered
Dietitian Nutritionist comes into play.
Symptoms of PCOS
Early diagnosis, intervention, and treatment is key for PCOS patients. So where do you start?
It’s important to recognize common signs and symptoms of PCOS, such as:
Excessive abdominal weight (waist > 35 inches)
Difficulty losing weight despite diet and exercise
Heavy bleeding or frequent periods
Irregular periods or no periods at all
Intense carbohydrate cravings
Hypoglycemic (low sugar) episodes and/or the need to eat frequently
Excessive hair growth on face, chest, stomach, back or toes
Hair loss from head (male pattern)
Acne
Acanthosis nigricans (dark, dry patches of skin)
Interventions for PCOS

Diet Changes
Diet and lifestyle changes are important first-line treatments for PCOS. We know that in
nutrition one size does not fit all. However, nutrition interventions for PCOS can support regular
menstrual function, regulate hormone levels, and improve other symptoms. They can also help
maintain healthy weight and prevent long-term complications.
This can be achieved with:
Individualized diets based on the goal of weight maintenance, weight gain, or weight
loss
o For weight loss, gradual and healthy weight loss is important.
Reducing excess intake of fats and carbohydrates
Eating 4-5 meals/snacks per day
A weight loss of five to ten percent of total body weight over the initial 6 months has been
shown to improve issues associated with PCOS. Types and quality of food should also include
anti-inflammatory foods, such as:

cold-water fish
olive oil
avocados
red wine
dark chocolate
soluble and insoluble fiber, like whole grains, fruits, vegetables, beans, legumes, nuts,
and seeds
pomegranates
onions
garlic
Additionally, it has been shown that zinc deficiencies are related to worsening symptoms.
Dietary sources of zinc include meat, liver, fish, eggs, oysters, nuts, and pumpkin and sesame
seeds.
Supplements
There are three key therapeutic dietary supplements for PCOS: Inositol, Berberine, and L-
Carnitine.
• Inositol - Inositol is a vitamin-like substance. It is found in many plants and animals.

Research shows that taking inositol reduces fasting blood glucose, fasting insulin, total
cholesterol, triglycerides, and testosterone levels. Another study showed myo-inositol is
similarly effective to Metformin for improving fasting insulin, insulin resistance,
androgen levels, and body mass index (BMI), but with a much lower risk for adverse
effects.
• Berberine – Berberine’s lipid-lowering and insulin-resistance improving actions have

been demonstrated in numerous randomized clinical trials. Research shows that
berberine may improve some metabolic characteristics in PCOS patients and insulin
resistance. Berberine seems to improve lipid parameters, including LDL cholesterol and
total cholesterol, when compared with Metformin.
• L-Carnitine - L-carnitine is an amino acid that is produced in the body. L-carnitine helps
the body turn fat into energy. L-Carnitine supplementation reduces body weight, BMI,
waist circumference, and hip circumference when compared with placebo in women
with PCOS. There were also noted improvements in markers of glycemic control and
insulin sensitivity.
Other Therapies
Regular mindful yoga practice can be a useful complementary therapeutic option for people
with PCOS, particularly for improving serum androgen levels. Yoga practices can help with
anxiety and depression as well. Overall, the Academy of Nutrition and Dietetics recommends a
goal of 30 minutes or more of moderate intensity physical activity daily.
There are numerous other therapies and dietary supplements studied for PCOS treatment but
they all have insufficient reliable evidence, and therefore I would proceed with caution.
Additionally, collaboration with a team of healthcare professionals is so important for people
with PCOS. Patients should seek out a multidisciplinary team, including a nutrition professional
and a mental health professional. It is so important to be advocating for yourself on your
journey to healing by requesting copies of your routine lab work to be able to discuss the
results with your doctor. That way you will be able to monitor the effectiveness of your
treatment plan and hard work while educating and empowering yourself along the way!
Take Home Points

PCOS is a highly complex and prevalent reproductive, endocrine, and metabolic disorder
that needs to be detected and treated as early as possible to mitigate long-term
complications
Diet and physical activity should be the first line nutrition intervention for polycystic
ovary syndrome (PCOS). Weight loss of 5% to 10% of total body weight has been shown
to improve both metabolic and reproductive aspects of PCOS.
Physical activity level should be assessed and individualized long-term goals should be
established to accumulate at least 30 minutes or more of moderate-intensity physical
activity on most—preferably all—days of the week, unless medically contraindicated.
Physical activity contributes to weight loss, may decrease abdominal fat, and may help
with maintenance of weight loss

Berberine, Inositol, and L-Carnitine rank highest in the literature as the most effective
therapeutic dietary supplements for PCOS
References
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About the Author
Erica Smolinski, MS, RDN, CDN is a registered dietitian

nutritionist, specializing in integrative and functional nutrition.
Erica received her combined Bachelor and Master of Science
Degree in Dietetics from D’Youville College. She works for Buffalo
Nutrition and Dietetics, PLLC, specializing in gastrointestinal and
pediatric nutrition, out of their Sterling Medical Center office in
Orchard Park, NY. www.buffalo-nutrition-and-dietetics.com
No conflicts of interest to report.

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Nutrition for Polycystic Ovary Syndrome (PCOS)

Erica Smolinski, MS, RDN, CDN

Ó2022 Foundation for Female Health Awareness

Interventions for PCOS

Ó2022 Foundation for Female Health Awareness

• Inositol - Inositol is a vitamin-like substance. It is found in many plants and animals.

• Berberine – Berberine’s lipid-lowering and insulin-resistance improving actions have

Take Home Points

Ó2022 Foundation for Female Health Awareness

Ó2022 Foundation for Female Health Awareness

Ó2022 Foundation for Female Health Awareness

About the Author

Erica Smolinski, MS, RDN, CDN is a registered dietitian

No conflicts of interest to report.

Ó2022 Foundation for Female Health Awareness

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