What is PCOS/PMOS?
PCOS, renamed to PMOS, is a common hormone condition that describes a number of symptoms. These symptoms include irregular periods, excessive hair growth on the face and body, oily skin and acne, thinning hair and hair loss (from the scalp), weight gain and difficulty conceiving.
This hormone condition is thought to affect between one in 10 and one in eight people in the UK, and while the cause is not definitively known, the condition is related to abnormal hormone levels and is thought to be hereditary.
PCOS/PMOS can affect hormone balance, metabolism, fertility, and emotional well-being.
In this video, Dietitian Monika Bettney explains how polycystic ovary syndrome (PCOS) can affect us and how working with a nutrition professional can help.
Symptoms of polycystic ovary syndrome
Those with ovaries will commonly begin to notice symptoms of polycystic ovary syndrome between their late teens and early 20s. Not all the PCOS symptoms will occur in everyone with PCOS. For example, some may experience extremely irregular periods, whereas others may have normal cycles but find excess body hair.
Some people may experience mild symptoms, while others may experience several. These can include:
- absent or irregular periods
- acne, usually on the face
- thinning hair
- excess body hair on the face, forearms, lower legs, around the nipples and lower abdomen
- weight gain
- miscarriage. Those with PCOS usually have a raised level of the luteinising hormone. Those with high luteinising levels may have an increased risk of miscarriage.
Long-term risks of PCOS
Polycystic ovary syndrome can, over time, increase the risks of developing health problems later in life. PCOS is also a common cause of infertility, with many discovering the condition when trying to conceive.
Those with PCOS are at an increased risk of developing:
- type 2 diabetes
- sleep apnoea
- high blood pressure
- high cholesterol
- mood swings
- depression
Diagnosing PCOS
PCOS is usually diagnosed by your GP or healthcare provider. They will carry out blood tests at a suitable time during the menstrual cycle to determine whether or not you are affected.
Once the diagnosis has been made, options for management can then be discussed. If treatment is needed, your GP or specialist may prescribe you medication and/or may recommend certain lifestyle changes.
For more complicated cases, you may be referred to a professional specialising in female reproductive health, such as a gynaecologist or endocrinologist.
A PCOS diet
While there’s no current cure for PCOS, symptoms can be effectively treated and managed. A healthy, balanced diet may help manage some PCOS/PMOS symptoms and support weight management, helping to regulate insulin levels.
Finding the right diet to manage symptoms of PCOS can be a complex process and needs to be tailored to each person’s symptoms and lifestyle. Contacting a qualified nutrition professional can help you understand and manage helpful dietary and lifestyle changes.
How can a nutrition professional help you?
Whilst some people will feel comfortable devising their own nutrition and fitness programme, others may need extra support. Those who feel they don’t have the necessary knowledge and experience may benefit from consulting a nutrition professional.
If you do decide to seek professional support, your practitioner will usually begin by gathering information about your current diet and lifestyle. This is so they can build a realistic, effective nutrition programme, including a tailored diet for PCOS, unique for you. This may involve providing a food diary. You may be asked to record everything you have consumed over a period of time before or during the sessions, with details of your moods and menstrual cycle included.
At this early stage, you will also have the opportunity to discuss any dietary requirements or related health conditions that will need to be considered when creating your PCOS diet.
While nutritional support cannot eradicate PCOS, it can provide you with support for simple changes to eating and exercise patterns. Nutrition professionals will explain how these changes may help alleviate symptoms of PCOS and help manage the condition.
When consulting a nutrition professional, remember they are not just there to give you a kick-start to weight-loss. They are also there to monitor your progress and to provide ongoing motivation, support and advice.
Does your weight make a difference?
Weight gain is one of the most common side effects of PCOS. Whilst those with PCOS must seek professional medical advice and treatment for the condition, a nutrition professional could provide individuals with extra support if they are struggling to manage their PCOS diet independently.
According to the NHS, individuals losing just 5% of their body weight will experience an improvement in symptoms of polycystic ovary syndrome.
Following a low GI (glycaemic index) diet
The glycaemic index is a way to monitor how quickly blood glucose rises after eating carbohydrates. Foods with a low GI can cause your blood levels to rise slowly, and it’s thought that these help reduce the symptoms of PCOS.
Low GI foods can improve and help balance insulin levels; those with PCOS are often resistant to the effects of insulin, therefore, they have more insulin in their blood. Higher insulin levels can also increase testosterone production. The increase in both insulin and testosterone upsets the natural hormone balance in the body, which can cause symptoms to flare up.
Those with the condition may find replacing high-GI foods effective, even if they do not need to lose weight. It has also been found that when combined with weight-loss, a low GI diet can help regulate the menstrual cycle.
As well as the potential to help ease some of the symptoms worsened by being overweight, a balanced, nutritious diet can also help to reduce the risk of developing diabetes and heart disease, as well as improve overall health and well-being.
Foods typically included in a PCOS diet
Healthy fats
Unsaturated fats are essential in managing the symptoms of polycystic ovary syndrome. Essential fatty acids (EFAs) are vital in a PCOS diet as they help maintain the cell wall, which absorbs the nutrients we need. EFAs also help to rebalance hormones, manage weight and support fertility. ‘Healthy’ fats can include oily fish (salmon or mackerel), avocado and olive oil.
Magnesium-rich foods are also important to include, as a deficiency in magnesium has recently been linked with an increased risk of insulin resistance. Dark, leafy greens, nuts and seeds can help provide you with the mineral.
Organic meat
Choosing lean sources of protein may help support a balanced diet for PCOS. This can include foods such as fish, eggs, beans, lentils, tofu, nuts, seeds, and lean meat. Some people choose minimally processed or higher-welfare food options as part of a balanced diet. However, there is no single diet that works for everyone with PCOS, and nutritional needs can vary from person to person.
In addition to organic meat, organic dairy products, best in the form of live, natural yoghurt (rather than cheese or milk), are advised as it contains bacteria beneficial in a diet for PCOS.
Fruit
Fruit is rich in fibre and is a good source of essential vitamins and minerals. Whilst some are reluctant to add fruits into their PCOS diet due to the sugar content when eaten, in the correct portions and as a whole, fresh fruit (as opposed to dried or juiced) can be an extremely healthy alternative to ready-made, high-sugar snacks. Fruit is vital in providing the body with the nutrients needed to combat the symptoms of PCOS.
Fruits with a low GI include cherries, plums, apricots, prunes and grapes.
If you are concerned about the rise in blood sugar and insulin levels caused by fruit, enjoy a handful of seeds or nuts as a side snack - the protein in the seeds can help regulate the rising glucose levels. Aim for two to three portions of fruit per day and increase your vegetable intake for fibre, minerals and antioxidants.
Chromium is an important mineral involved in regulating blood sugar and insulin levels. This can sometimes be low in a highly refined diet; opting for more complex carbohydrates, such as whole grains, broccoli and nuts can help to provide this.
Pregnancy
If you are trying to get pregnant, it is particularly important to consider whether you are getting the right amount of nutrients in your PCOS diet. For support and advice on following a healthy PCOS diet for pregnancy, please consult your GP or a suitably qualified professional.
It has been found that the sex hormone-binding globulin (SHBG) is usually low in those with PCOS. Lignans, found in flax and sesame seeds, chickpeas and carrots, are reported to increase this.
Due to the underlying hormonal imbalances, it is important to have the right proportion of different food groups at every meal. This should include a balance of protein fibre, healthy fats and whole grain carbohydrates.
- Rania Salman, Registered Dietitian, PgDip (Merit), BSc (Honours), MBDA
PCOS treatment
There is a range of treatment options available to help manage the symptoms of PCOS. Treatment will depend on a person’s symptoms, health concerns, and whether they are trying to conceive.
Support may include lifestyle and dietary changes, medication to help manage hormone-related symptoms, and fertility support where needed. Some people may also be offered treatment to help manage insulin resistance or regulate menstrual cycles. In certain cases, minor surgical procedures may be discussed as part of fertility treatment.
If you are concerned about symptoms of PCOS/PMOS, speak to your GP or healthcare professional about the most suitable support options for you.
Frequently asked questions about PCOS/PMOS
Can diet help manage PCOS symptoms?
While there is no cure for PCOS/PMOS, some people find that dietary and lifestyle changes can help manage symptoms. A balanced diet may help support hormone balance, blood sugar regulation, energy levels, and weight management.
Is PCOS the same as PMOS?
Polycystic ovary syndrome (PCOS) is increasingly being referred to as polyendocrine metabolic ovarian syndrome (PMOS). The newer term aims to better reflect the wider hormonal and metabolic effects of the condition.
Is PCOS linked to insulin resistance?
Yes, insulin resistance is commonly associated with PCOS/PMOS. This means the body may struggle to use insulin effectively, which can affect hormone levels and metabolism.
