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Women's Health
Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder affecting approximately 7 million women and teenage girls in the United States. Chances are, you or someone you know is dealing with PCOS.

Symptoms vary from woman to woman making a PCOS diagnoses difficult.  Less than 50% of all women with PCOS are correctly diagnosed. According to a recent study, it can take more than two years to receive a diagnosis of PCOS.

Many, but not all, women with PCOS experience weight gain or have a hard time losing weight. Other women may experience facial hair growth, acne and lack of menstrual cycles due to elevated testosterone levels. Insulin resistance is another common side effect that many women with PCOS experience. Insulin is a hormone that allows our cells to use glucose (sugar) to produce energy. When insulin resistance occurs, cells lose their ability to respond normally to insulin. The result is more and more insulin is produced. Insulin resistance can lead to diabetes.

If you are a woman dealing with PCOS, the good news is there is hope. While there is no cure for PCOS, making a few lifestyle changes can help you manage the disease. It can also reduce your risk developing other health concerns such as diabetes and heart disease.

In this article, we will share five lifestyle strategies for dealing with PCOS.  As always, please check with your healthcare provider before making any changes.

1. Stop believing in crazy PCOS diets.

The internet, and probably your well-meaning family and friends, are an endless resource of nutrition information that promises a fast, easy and effortless way to be the best you can be! In reality, though, any recommendation that appears to be fast, easy and effortless is usually anything but.

Choose to make long term sustainable lifestyle changes rather than trying a short term PCOS diet that promises weight loss. We have all heard the stories of a woman who attained her weight loss goals in a few weeks, only to end up regaining all the weight back after she stopped following the diet.

Don’t let that be you.

Research has shown that making a few lifestyle changes is more successful for maintaining weight loss, than following a short term fad diet. An eating pattern for life should be the one that is realistic for you and sustainable for the long term; not a quick fix.

Yes, making changes to your lifestyle can be hard at first, but it is well worth the effort. Enjoy a rich variety of whole foods in moderation. Eat fewer highly processed foods (you know the ones that have a list of ingredients you cannot pronounce). And lastly be kind to yourself. Changing your lifestyle can be challenging, but it is not impossible.

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2. Choose low-glycemic index foods.

Hey wait, didn’t I just say no crazy PCOS diets? The glycemic index (GI) is not a PCOS diet. It is a system of measuring how much a carbohydrate-containing food increases your blood sugar and insulin levels. This measurement can be critical to those women with PCOS who experience insulin resistance.

The glycemic index system rank foods on a scale from 1-100.  Foods that have a low glycemic index (less than 55) result in a slower rise in blood sugar levels. Eating low GI foods also results in less insulin secretion by your body.

Studies have shown improved insulin sensitivity and more regular menstrual cycles in women with PCOS who incorporate low glycemic index foods into their daily lifestyle.

Add a few low glycemic index foods such as beans, legumes, fresh fruits, 100% whole-grain breads, oatmeal, quinoa, and non-starchy vegetables into your daily meals. Replace some of those highly processed carbohydrates you may eat, such as cookies, white rice, and ready prepared breakfast cereals, with these low glycemic index foods. High glycemic foods will not improve your insulin sensitivity.

Choosing low glycemic index foods will not only help you manage your PCOS but will also have many other healthful benefits. Low glycemic index foods are good sources of fiber, vitamins, minerals and other important nutrients. All of which will contribute to a healthier you!

3. If you have PCOS, workout.

Being physically active every day is one of the most helpful things you can do to help manage your PCOS. Research has shown that exercise can help to reduce insulin resistance and inflammation in women with PCOS. Check with your doctor first, but once you have the go-ahead, make a plan and get moving!

Include a combination of both cardiovascular exercise and muscle-strength training exercise. There have been studies that suggest shorter intense workouts may be best for managing PCOS than moderate exercise. However, any exercise is good.  If you are just starting to become active, aim for 30 minutes of moderate activity most days of the week. Moderate activities include brisk walking, jogging, cycling, and dancing.

Don’t forget to include some strength-training exercises at least 2-3 times a week. According to PCOS expert Fiona McCulloch, author of “8 Steps to Reverse Your PCOS”, any exercise is helpful, but the more muscle mass or lean muscle you have, the more insulin sensitive you will be. This is especially important to those women who have insulin resistance. Examples of strength-training exercises include lifting weights, Pilates, and yoga.

The most important thing is to make sure you move every day!  There are lots of different types of exercises you can do; you just need to find the activity that works best for you.  Whether it is going for a walk, taking a Zumba class, or bouncing on a rebounder at home, do what you enjoy! Most of all make sure you do it!

4. Add nutritional supplements for PCOS.

In addition to eating a healthy diet and moving, there is research to suggest that certain nutritional supplements for PCOS may also be helpful.

Buy supplements that have been independently tested and certified by a non-profit program such as NSF® International or USP®. These programs test supplements for content accuracy, purity, and freedom from contaminants.

An NSF or USP seal assures you that the product you have contains exactly what it says on the label. It also verifies that the product will break down in your body correctly. Also, certification assures you that your product does not contain any contaminants or anything that should not be there. Certification verifies that the product was manufactured following current Good Manufacturing Practices (GMP) in a GMP-certified facility.

Supplements are one component of an ongoing program of care. Discuss what supplements you take with your healthcare provider.

Inositols

Studies have shown that inositols can reduce insulin resistance, decrease testosterone levels, and also help improve triglycerides levels and blood pressure in women with PCOS. Inositols have also been shown to reduce cardiovascular risk and promote egg quality in women trying to become pregnant.

Inositol is a nutrient found naturally in fruits, beans, grains, and nuts and it is also produced by the body. As Angela Grassi, registered dietitian and founder of the PCOS Nutrition Center, explains there are nine different forms of inositols, but the two types that have shown benefit for women with PCOS are myo-inositol and D-chiro-inositol.

Research has shown that when women with PCOS take a combination of these two forms of inositols, in the body’s naturally occurring ratio of 40 to 1, they experience more benefits than taking either form alone. Participants received a recommended dose of inositol powder that provided a combination of both inositols (2,000 mg of myo-inositol plus 50 mg of D-chiro-inositol, taken twice a day).

Speak to your healthcare provider and ask if inositols would be right for you.

Omega-3 Fatty Acids

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

Omega-3 fatty acids are essential polyunsaturated fats. They cannot be manufactured by the body and must be consumed through food or supplements. Three types of omega-3s include ALA (alpha-linolenic acid), EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid). The benefits of EPA and DHA are in the news often. These omega-3 fatty acid are naturally found in fatty fish such as salmon, herring, sardines, tuna, trout, and mackerel.

Get the omega-3 fatty acids you need by eating fatty fish more than twice a week. If you do not eat fish that often, you will benefit from taking a fish oil supplement.  Research studies suggest that supplementing 1200 mg of omega 3 fatty acids daily may be beneficial.

Vitamin B12

Many women with PCOS may be prescribed the insulin-sensitizer medication metformin. Metformin is a medicine that makes the body more sensitive to insulin. This medication helps lower high blood glucose (sugar) levels, insulin levels, and testosterone levels. Metformin may also help improve menstrual patterns.

Research has shown that long-term use of metformin can decrease levels of vitamin B12 in the body. Vitamin B12 is a vitamin that plays a significant role in the normal functioning of your brain and nervous system and the formation of your blood cells. A deficiency of vitamin B12 can cause anemia, affect energy levels and mood, and cause neurological and nerve damage.

The recommended daily allowance for vitamin B12 for adult women is 2.4 mcg. This recommendation increases to 2.6 mcg during pregnancy and increases again to 2.8 mcg while breastfeeding.

If you are taking metformin, get your vitamin B12 level checked by your healthcare provided annually, and discuss the amount of vitamin B12 supplement you should take.

Vitamin D

About one-third of Americans may have insufficient vitamin D levels for various reasons. According to an article by Amy Medling, PCOS Diva, three out of four women with PCOS may be deficient in vitamin D.

Vitamin D is a fat-soluble vitamin that has several important roles in our bodies. For women with PCOS having low levels of vitamin D is associated with insulin resistance, metabolic issues, and menstrual irregularities.

Vitamin D is produced in our skin cells in response to exposure to the ultraviolet (UV) rays in sunlight. Given enough sun exposure, our bodies will make all the vitamin D we need. However, most of us do not get enough sun exposure to maintain adequate levels of vitamin D.

We can also get vitamin D in our diet, however, there are few foods that naturally contain meaningful amounts of vitamin D.  For example, drinking a quart of vitamin D fortified milk each day only provides around 400 IU of vitamin D.  This amount is much lower than the amount needed to ensure ideal blood levels of vitamin D. To achieve adequate vitamin D levels, most women with PCOS will need to take a vitamin D supplement.

There is not complete agreement on the optimal daily dose of vitamin D. The current Recommended Dietary Allowance (RDA) set by the Institute of Medicine’s Food and Nutrition Board is 600–800 IU per day, depending on age. Vitamin D experts consider the RDA to be conservative and recommend higher intakes for most adults, particularly those who have low vitamin D levels.

The daily dosage of vitamin D you need will depend on several factors. The most important factor when determining vitamin D dosage is your current vitamin D blood level. Speak to your doctor to determine how much vitamin D you need.

5. Embrace support in dealing with PCOS.

Remember you are not alone. At least 7 million women in the USA have PCOS, never mind the rest of the world. There is a good chance that at least one person you know also has PCOS.

Do not be embarrassed about the symptoms you are experiencing.  You are not “weird” or “abnormal.” I encourage you to share your struggles, as there are many other women out there that are feeling the same way as you. These women would love to find the support of another person that understands what they are going through.

Consider attending the annual PCOS Challenge Symposium. Not only will you be among hundreds of women with PCOS who understand what you are experiencing, but the symposium also offers many resources all in one place to help you manage your PCOS.

There are many different online websites providing various support and information ranging from podcasts by PCOS Diva, nutritional advice by PCOS Nutrition Center, and emotional support (PCOS Diet Support & Surviving Shelby).


Yes, the reality is that dealing with PCOS can often be personal and embarrassing. But you are not alone.  Be kind to yourself. Use this guide to help you make steps towards a healthier lifestyle today!

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