How to manage PCOS symptoms through diet and exercises - and which foods to eat or avoid

• Diet can help manage PCOS symptoms like weight gain, infertility, and hormone irregularities.
• If you have PCOS, try a low-carbohydrate diet rich in whole foods and healthy fats.
• People with PCOS should avoid refined grains, processed foods, and added sugars.

Diet is vital in managing symptoms for people with polycystic ovary syndrome (PCOS), a hormonal disorder found in women of reproductive age. That's because what you eat can help you stabilize insulin levels, restore a regular period, and lose weight.

Many of the symptoms associated with PCOS - including ovarian cysts, infertility, acne, and excessive hair growth - are due to unusually high levels of a hormone called androgen. Androgens are more prevalent in men, but will naturally show up in trace amounts in women.

While the exact cause of PCOS is not known, elevated levels of androgen can be a result of insulin resistance. This is when the body produces too much insulin - similar to diabetes - and cannot use it effectively. In fact, more than half of people with PCOS will develop type 2 diabetes by age 40.

Most women with PCOS are insulin resistant, which increases androgen levels and exacerbates symptoms. There is no cure for PCOS, but treatments, such as diet or exercise, can manage symptoms. Here is what you need to know about how diet affects PCOS.

Foods to eat and avoid with PCOS

People with PCOS should opt for low-glycemic foods, says Emmaline Rasmussen, RD, a dietitian at NorthShore University HealthSystem. This will keep blood sugar and insulin levels from spiking, thereby reducing PCOS symptoms.

Medical term: The glycemic index ranks foods by how their carbohydrates impact blood sugar levels. Low-glycemic foods have less of an effect on blood sugar levels.

A 2012 study found overweight and obese women with PCOS who ate a high protein, low glycemic index diet significantly reduced androgen levels and body weight, both of which decrease PCOS symptoms, compared to a conventional diet. Meanwhile, a 2016 study found a moderately lower-carb diet (43% of their daily caloric intake was carbohydrates) reduced insulin levels in people with PCOS more than those on a standard diet.

Here are some foods to eat and foods to avoid when you have PCOS:

Managing weight through diet can also help with infertility, a symptom of PCOS, says Samantha Schon, MD, an assistant professor in the Department of Obstetrics and Gynecology at Michigan Medicine. Losing just 5% of body weight, through diet and exercise, can often be enough to resume regular ovulation and increase fertility according to Schon.

What the research says: A 2010 study found women with PCOS on a low-glycemic diet had a more regular menstrual cycle compared to those on a conventional diet. Another small 2003 study found overweight patients with PCOS who followed a low-calorie diet saw an improvement in menstrual cycle regularity and an increase in chances of pregnancy.

How to lose weight with PCOS

Up to 80% of people with PCOS in the United States are overweight or obese.

People with PCOS gain weight easily due to elevated insulin levels, says Rasmussen. Consistently elevated insulin levels mean the body is unable to break down stored fat for energy, making it difficult to lose weight.

Even small amounts of weight loss in people with PCOS can:

• Reduce insulin resistance
• Restore ovulation
• Improve mental health
• Improve fertility

There is no one diet for PCOS that can guarantee weight loss, says Schon. Some patients might have great success with certain diets, such as the Mediterranean diet or a low-carb diet, but it really depends on what works best for the individual.

While low-glycemic foods are a great option, Schon recommends seeing a reproductive endocrinologist or a dietitian specialized in PCOS to understand what type of diet works best for you. They can also help you determine proper portion sizes for your nutritional needs.

What the research says: A small 2018 study found patients with PCOS on a low-carbohydrate, keto diet lost as much as 36 lbs and resumed regular menstruation over the course of six months. Another small 2005 study found for women with PCOS, the keto diet led to significant improvement in insulin levels, androgens, and weight loss over the course of 24 weeks.

Exercise is also important in reducing the symptoms of PCOS and can help with weight loss, says Rasmussen. She recommends weight-lifting and low-intensity, steady exercises, like a light jog or speed walking.

Important: Rasmussen suggests leaving out high-intensity training until your hormones are better under control since high-impact exercise can have a mild androgen boosting effect.

Insider's takeaway

Diet is an important part of symptom management in people with PCOS. Eating a low-glycemic diet rich in healthy fats, whole grains, and non-starchy vegetables can regulate periods, improve fertility, and prevent weight gain.

A healthy diet alongside low-impact exercise may help people with PCOS lose weight as well, which can further manage symptoms. But not everyone's PCOS will see the same results, so speak with a doctor or healthcare professional about what may work best for you.