A Plant Based Diet for PCOS: Everything You Need to Know

What is PCOS?

Polycystic ovarian syndrome (PCOS) is a common hormonal condition affecting 5-15% of women in the reproductive age group, yet many more suffer unknowingly from a lack of diagnosis. The exact cause of PCOS is unknown, but we do know it is linked to a combination of lifestyle, genetic, and environmental factors that contribute to the development.

Since PCOS is a syndrome of symptoms, to be diagnosed, you must meet two of the following criteria:

• Hyperandrogenism confirmed by either: Hirsutism or excess male hormones (testosterone, DHT) tested by blood work
• Missing or irregular periods
• Polycystic ovaries detected by ultrasound

*You do not have to have cysts on your ovaries to have PCOS!*

The Most Common Signs of PCOS Include:

• Irregular Cycles
• Anovulatory Cycles
• Hirsutism (abnormal hair growth)
• Hair Loss on the Head
• Acne
• Infertility
• Mood Disorders
• Weight Gain or difficulty losing weight
• Cysts of the Ovaries
• Sleep Issues
• Fatigue

PCOS is also a metabolic disorder as much as it is an endocrine disorder meaning it can affect lipid levels, blood glucose, and insulin levels increasing your risk for several chronic diseases if not managed. 

Insulin Resistance and PCOS

Up to 85% of women with PCOS have insulin resistance contributing as a main driver to their symptoms. 

What is insulin resistance?

Insulin is a messenger hormone secreted by your pancreas that signals to your cells to utilize the glucose in your blood. With insulin resistance, your cells become unresponsive to the insulin signals causing glucose to build up in your bloodstream. Insulin resistance over time can lead to hyperglycemia and hyperinsulinemia (high blood glucose and high insulin). Both of these conditions drastically increase your risk of developing Type II Diabetes and other metabolic conditions.

It is thought that the high levels of insulin in the bloodstream encourage the ovaries to produce higher levels of androgens leading to the development of PCOS. It is important to note insulin resistance is not the only root cause of PCOS but is by far the most common.

Treatment Approaches for PCOS

Many women are left with the comment to “lose weight” as their only option for PCOS management, sending them down a spiral of diet culture and fad dieting. But I am here to tell you there is so much more to PCOS management than losing weight and restrictive diets!

PCOS is not a one-size-fits-all condition, and management shouldn’t be either. While there is no “cure” for PCOS, there are several lifestyle and diet modifications that can be made to help manage and even reverse your symptoms. These treatment approaches all aim to tackle the root cause of your PCOS, which most often means dealing with insulin resistance.

Some of the most researched and effective treatment tips for PCOS include:

1. Adopting Better Eating Habits:

Eating a healthy, balanced diet significantly impacts your overall health and improves insulin resistance, ultimately helping to improve your symptoms.

2. Implementing a Regular Exercise Routine:

Physical activity helps to balance blood sugar, maintain a healthy weight, and reduce stress levels. Implement daily movement that you enjoy like walking, strength training, yoga, dancing, and pilates.

3. Stress Management:

Chronic stress leads to dysregulation of your HPA axis, which produces and regulates your hormones. This can lead to further hormonal imbalances, increased inflammation, and worsening of symptoms. Find stress management self-care practices that work for you, like walking, reading, journaling, breath work, or talking to a friend.

Can a Plant-Based Diet Improve PCOS Symptoms?

While there is not one diet that will completely cure PCOS, a plant-based diet can be a powerful tool to manage and sometimes reverse PCOS symptoms! There are numerous benefits to plant-based diets. Here are some of the biggest reasons why a plant-based diet may help with PCOS:

High in Fiber

Plant-based diets are higher in fiber because they focus on foods like vegetables, fruits, legumes, beans, nuts, and seeds which are all naturally high in fiber, and avoid animal products that naturally do not have any fiber. Both types of fiber, soluble and insoluble, are only found in plant foods—animal products contain no natural fiber.

Fiber is important for PCOS because it helps to lower insulin levels. Fiber-rich foods are more slowly absorbed into your bloodstream, preventing the sudden spike and crash of blood sugar. Fiber is also necessary for gut health, which many women with PCOS struggle with. Not only does fiber help with insulin resistance, but it also supports healthy bowel movements, lowers blood glucose levels and blood pressure, and can help support a healthy weight.

Healthy Fats

Plant-based diets are also full of monounsaturated and polyunsaturated fats, which include foods like avocados, nuts, seeds, and olive oil. These fats help to slow down the absorption of sugar in the bloodstream, making them beneficial for insulin resistance. Polyunsaturated fats also contain omega 3 fatty acids, which help to reduce inflammation, an underlying cause of insulin resistance and PCOS.

Adopting a plant-based diet also allows you to more easily avoid unhealthy fats known as saturated or trans fats that are most often found in animal products like red meat and full fat dairy. A diet high in saturated fats has been shown to worsen insulin resistance and inflammation, worsening PCOS symptoms.

Advanced Glycation End products (AGEs)

Advanced glycation end products (AGEs) are a group of hormone disrupting compounds formed through a chemical process called glycation. AGEs trigger an inflammatory response in the body, contributing to chronic inflammation. Having high levels of AGEs in the body is linked to ovulation issues in women with PCOS. Additionally, AGEs increase oxidative stress, contributing to hormonal imbalances. Research has shown that reducing AGEs can help counter this, while also improving insulin sensitivity.

AGEs can be in foods that are cooked at high temperatures, especially when using dry heat methods like grilling. Animal-based products, especially meat, have higher AGE content compared to plant-based proteins.

To reduce AGEs in your diet:

• Choose low-AGE cooking methods. Opt for cooking methods that involve lower temperatures and moist heat
• Avoid burned bits of food. Scrape off browned/burned parts on your foods that were cooked with high temperature, dry heat cooking methods.
• Opt for plant-based proteins. Plant-based options tend to have lower levels of AGEs compared to animal-based products, especially when subjected to high-temperature cooking.

Soy Products

Despite what you may hear on social media, research on soy has actually shown it to be beneficial for women with PCOS. Soy products include foods like tofu, soy milk, tempeh, edamame, and miso, which are prominent protein sources in a plant-based diet.

Soy has been shown to reduce metabolic markers like LDL cholesterol, triglyceride, and insulin levels. They have also been proven to reduce androgen levels helping to improve PCOS symptoms.

Weight Management

Plant based foods tend to be higher in fiber and water content and lower in fat content than animal-based foods. Plant foods help us to feel full while eating less calories. Fiber and water don’t have calories and fat has the most calories per gram of all macronutrients. Because of this, the same volume of food from plants is less calories than the same volume of food from animals. While fiber and water are calorie-free, they still take up room in the stomach and contribute to feelings of satiety. This is one of the reasons why plant-based diets are an easier, effective way to lose weight without counting calories.

Protein

Adequate protein intake is extra important with PCOS. This is because, similar to fiber, protein helps to slow the digestion of carbs and prevent spikes and crashes in blood sugar. This, in turn, reduces negative effects of insulin resistance and can help with excess androgens, cravings, and weight management. Plant-based diets do tend to be lower in protein, but they don’t have to be! With intentional planning, a high protein plant based diet is absolutely possible. When choosing protein sources, it’s important to look at food as the whole package that it is and to look at health outcomes of eating that food and not just at single components of it. Plant-based sources of protein come with more fiber, antioxidants, and phytochemicals and less saturated fat, cholesterol, AGE’s, TMAO, and more.

If transitioning to plant-based with PCOS, be sure to prioritize protein with every meal. Plant-based sources of protein include tofu, beans, lentils, tempeh, soy milk, quinoa, protein powder, and more!

Reduced Risk of Chronic Disease

Plant based diets have been shown to reduce risk for heart disease, type 2 diabetes, and cancer; all of which women with PCOS are at higher risk of getting. And animal based foods like red and processed meat have been shown to increase risk for these conditions.

Supplements

It is usually recommended to take a vitamin B12 and vitamin D supplement when following to a plant-based diet. These deficiencies are very common amongst women with PCOS.

Some people, who live in warmer climates, may get enough vitamin D from the sun. However, for those of us who live in colder climates or stay indoors most of the day, taking a supplement may be warranted.

Vitamin B12 is not made by animals or plants, it is made by bacteria in the soil. Most livestock are given B12 supplements. 90% of B12 supplements produced in the world are actually fed to livestock. However, instead of filtering our nutrients through animal’s bodies by supplementing animals and then eating them, we can just take the supplement directly ourselves.

You can ask your doctor to check your vitamin D and vitamin B12 levels. Be sure to get regular lab work done to ensure you are not deficient in important nutrients. If you need help meeting your nutrient needs with food and figuring out what nutrient supplements you need to fill the gaps, I recommend working with a registered dietitian.

Tips for Transitioning to a Plant-Based Diet

Making the switch to a plant-based diet is all about going at your own pace. For many people, going plant based “cold turkey” is not sustainable. Start gradually by adding just one plant-based meal to your day. If once a day is too much, try it out just once a week. No need to rush, slow and steady wins the race.

Experiment with a variety of fruits, veggies, grains, and legumes. Plant-based doesn’t mean boring! You’ll be amazed at the flavors and textures awaiting your taste buds. Going plant-based doesn’t have to mean giving up your favorite meals. Learn how to make your favorite meals plant-based, nowadays there’s a plant-based alternative for almost everything. The secret to success lies in making this transition enjoyable, balanced, and customized to your unique tastes.

Remember, this journey is as unique as you are.

If you want to master a plant-based transition without stressing about what to cook, worrying that you’re missing key nutrients, or wondering if you’re taking the right supplements, I’m here to help. Apply to work with me in my Thrive with PCOS Program.

Do I Have to Go Plant Based with PCOS?

While there are many benefits of going plant-based to help manage PCOS symptoms, this diet is not the only way you can help your PCOS! As a PCOS dietitian, I would still recommend focusing on a plant-forward diet if you don’t choose to go completely plant-based. This means focusing on a diversity of fruits, vegetables, whole grains, beans, legumes, nuts, and seeds in your diet. This way, you’re not missing out on all the benefits of plant-based foods in addition to the animal products you want to include.

*While I specialize in plant-based diets, you do not have to be vegan or vegetarian to work with me in my Thrive with PCOS program!*

The Takeaways: Plant-based Diet for PCOS

What you put into your body is a direct correlation with how you feel physically and mentally, as well as how your cells, hormones, and organ systems can function. You can’t expect your body to run optimally without fueling it with the proper nutrients, vitamins, and minerals it needs to function! With PCOS, your body is extra sensitive to what you fuel it with because of the complexities of insulin resistance, inflammation, and hormonal imbalances that characterize the disorder.

Managing PCOS can be extremely challenging, but nutrition and lifestyle changes have been shown to significantly help to improve symptoms. Every little plant-based victory is a step towards feeling your best. So let’s celebrate every colorful, nourishing choice.

Here’s to the power of plants and a vibrant, healthier you!