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Women's Health
lean pcos
One in 10 women suffers from a hormone disorder known as Polycystic Ovarian Syndrome (PCOS).  Although most women with PCOS are overweight, about 20% of women with PCOS are normal weight and some are even underweight. This type of PCOS is called lean PCOS. If this is you, you know the struggles that can come with this condition.

In this article, we describe some of the symptoms of lean PCOS and certain dietary supplements that may be helpful.  In the coming weeks, we will be sharing another article about diet and lifestyle approaches to managing lean PCOS.

Symptoms of Lean PCOS

At the 2016 PCOS Awareness Symposium, Dr. Fiona McCulloch presented “Lean PCOS: Beyond Weight loss.”  In her talk, she explains that about 75% of women with lean PCOS are insulin resistant, even though they may have normal fasting blood sugar levels and HbA1c levels. Up to 50% of women with lean PCOS may experience reactive hypoglycemia. Reactive hypoglycemia is a drop in blood sugar about 1 ½ to 5 hours after eating.  This drop can result in symptoms such as fatigue, dizziness, lightheadedness and increased hunger.

Many women with lean PCOS also experience irregular or absent periods, and symptoms related to high androgen levels, such as excess body or facial hair and acne. Although you may feel a bit discouraged, there are a few strategies to help keep these symptoms under control.

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Dietary Supplements for Lean PCOS

In addition to good nutrition and exercise, certain nutritional supplements may help you manage your symptoms of PCOS. (Look for a future blog article discussing diet and lifestyle approaches for managing lean PCOS.)

Studies show that inositols, vitamin D, and omega-3 fatty acids may help normalize menstrual cycles and decrease insulin resistance, which may help manage acne and abnormal hair growth. Here are some details about how these can help.

Inositols

Inositols are produced by the body and are also found naturally in grains, fruits, beans, and nuts. There are different forms of inositols, but the two types that are beneficial for women with PCOS are myo-inositol and D-chiro-inositol.

In our body, myo-inositol and D-chiro-inositol naturally occur in a ratio of 40 to 1. Research has shown that when women with PCOS take a combination of these inositols they experience more benefits than taking either form alone.

Insulin resistance, excess facial hair, and acne.

Insulin resistance is well recognized among women with PCOS. Although it’s quite common in overweight women, it can also occur in lean women with PCOS.

Hyperandrogenism (high levels of male hormones such as testosterone) is linked to insulin resistance and PCOS. Studies have shown that inositols can reduce insulin resistance and in turn, decrease testosterone and other hormone levels, which may improve acne and reduce abnormal hair growth.

Irregular periods and inositols.

Overall, PCOS is the most common cause of menstrual disorders. In a 2016 study, 70% of the participants taking inositol for 16 weeks saw the return of regular menstrual cycles. Taking an inositol supplement may help women with lean PCOS regulate menstruation and improve fertility.

Vitamin D

Vitamin D is a fat-soluble vitamin that has many roles in our bodies. Insufficiency of vitamin D affects up to half of the population, and according to Amy Medling, PCOS Diva, three out of four women with PCOS may be deficient in vitamin D.

Angela Grassi, MS, RDN, LDN of PCOS Nutrition Center describes the importance of vitamin D for women with PCOS, including roles in glucose metabolism, inflammation, and fertility. In addition, studies have shown that vitamin D supplementation decreases total testosterone levels and improves menstrual irregularities.

Although we can get some vitamin D in our diet, there are few foods that naturally contain meaningful amounts. For example, 3 ounces of canned tuna fish supplies about 150 IU of vitamin D.  Most women with PCOS will need to take a vitamin D supplement. Supplementing with vitamin D ensures you are getting the vitamin D they need. Ask your healthcare professional to test your vitamin D level and, if necessary, recommend a vitamin D supplement.

Omega-3 Fatty Acids

Research has shown that omega-3 fish oils offer many benefits to women with PCOS, including reducing testosterone levels and helping regulate menstrual cycles.

You can get the omega-3 fatty acids you need by eating fatty fish more than twice a week. However,  if you don’t eat fish that often, you will benefit from taking a fish oil supplement.  Studies suggest that supplementing with 1,500 mg of omega-3 fatty acids daily may improve insulin resistance and supplements of 2,000 mg of omega-3 fatty acids improve menstrual regularity.


Although dealing with PCOS can be challenging, it is worthwhile to consider doing all you can to alleviate your symptoms. Consider a supplement of omega-3 fatty acids, vitamin D, and inositols to help you look and feel your best.

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