How to Manage PCOS Naturally

Balance hormones and restore your menstrual cycle

Polycystic Ovary Syndrome (PCOS) is a common hormonal and metabolic condition that affects how a woman’s ovaries function

Women with PCOS have abnormalities in the way their bodies process certain hormones (testosterone and oestrogen) which can negatively impact ovulation and cause an irregular menstrual cycle. Other characteristics of PCOS include cysts on the ovaries, extra hair growth and insulin resistance.

Learn what causes PCOS, the signs and symptoms to look out for and how to manage PCOS naturally through diet and lifestyle.

What causes PCOS?

The exact cause of PCOS is unknown; however, it is thought to be triggered by multiple factors including the abnormal functioning of the hypothalamic-pituitary-ovarian (HPO) axis. This is a tightly controlled system that regulates hormones in the body. The HPO axis is governed by the hypothalamus and the pituitary (two glands in the brain) and the ovaries. When this axis is disrupted, it can lead to hormonal imbalance.

When someone has PCOS, they tend to have increased androgens (mainly testosterone) and luteinising hormone (LH) – this is the hormone that triggers the ovaries to release an egg and helps control the menstrual cycle. High levels of androgens can prevent ovulation from occurring.

High insulin levels and insulin resistance are also linked to PCOS. Insulin is a hormone secreted by the pancreas that helps to regulate and store glucose in the body. It helps cells take in glucose to be used for energy. When cells have sufficient glucose (sugar), insulin sends a message to the liver to take in and store excess glucose to remove it from the bloodstream. Insulin resistance occurs when cells don’t respond well to insulin and cannot take in glucose, resulting in increased blood sugar levels. Over time this can lead to weight gain, obesity, high blood pressure and type 2 diabetes.

There is a strong causal link between PCOS and a poor diet and sedentary lifestyle. Lack of exercise and a diet that is high in sugar, refined carbohydrates (pasta, bread, pastries, pizza) and junk food with a lack of essential nutrients can cause abnormal hormonal and metabolic function. Poor diet can also increase insulin levels and your risk of insulin resistance.

Other causes of PCOS include ovarian dysfunction and adrenal dysfunction. Both of these conditions affect androgen and oestrogen production and metabolism.

How to know if you have PCOS

Testing for PCOS usually involves a series of blood tests and an ovarian ultrasound (to check for cysts on the ovaries).

Blood tests include:

• Testosterone and androgen levels (to see if they are raised)
• Oestrogen levels
• Prolactin levels (this hormone plays a role in ovulation)
• Blood glucose and fasting insulin (to check for insulin resistance and raised blood sugar levels)
• Fasting cholesterol and triglycerides (abnormal blood lipid levels are common in PCOS)

When a woman is diagnosed with PCOS, she is normally prescribed Metformin (a type 2 diabetes drug) for insulin resistance and the oral contraceptive pill (OCP) to address acne and excessive hair growth. Common side effects of Metformin include heartburn, stomach pain, nausea, vomitting, bloating and changeable bowel motions. Some women may also be given anti-androgenic drugs in severe cases of hirsutism (excessive hair growth).

Change your diet and lifestyle to combat PCOS

Diet and lifestyle play a huge role in the management of PCOS, helping to keep weight in check and insulin levels regulated.

• Eat a predominantly plant-based diet and increase your intake of fresh, organic vegetables, especially the brassica vegetables (broccoli, Brussels sprouts, cauliflower, cabbage, kale) as they are excellent for clearing excessive oestrogen and restoring hormonal balance.
• Stick to three meals per day and avoid snacking in between.
• Cut out sugar and refined carbohydrates (bread, pasta, pastries, pizza). Opt for low glycaemic index (GI) foods instead, such as leafy green vegetables, carrots, peas, berries, nuts, seeds, legumes and wholegrain rice. Keeping your blood sugar levels balanced is essential when you have PCOS.
• Increase your fibre intake by eating more vegetables, fruit, whole grains (brown rice, quinoa, oats), seeds and nuts. Fibre is key for maintaining healthy blood sugar levels and preventing insulin resistance. It also promotes healthy digestion and keeps bowel movements regular which is important for hormonal balance and detoxing metabolised oestrogen out of the body (to prevent it being reabsorbed).
• Include quality protein at every meal. Protein helps anchor blood sugar levels, prevent post-meal sugar spikes and keep you fuller for longer (preventing you from overeating). Good sources of protein include nuts, seeds, beans, lentils, quinoa and chickpeas.
• Intermittent fasting (where you only consumer food during specific times in a 24-hour period) can be very helpful for women with PCOS. Fasting can improve insulin sensitivity, promote new cell growth, reduce inflammation and increase weight loss/ fat burning capability.
• Avoid coffee and alcohol. Not only are they inflammatory for the body, they also rob you of essential nutrients. Caffeine negatively impacts insulin levels and blood sugar regulation. Alcohol can dysregulate hormone production and also contributes to weight gain due to its sugar content.
• Add cinnamon and fenugreek to your food as these herbs have powerful medicinal properties that can boost weight loss by increasing fat burning capability and balancing blood sugar levels. 
• Increase your intake of B vitamins, vitamin D, calcium and magnesium as these nutrients play an important role in hormone regulation. Magnesium and B6 also help maintain healthy blood sugar levels. Foods that are rich in magnesium include leafy green vegetables (spinach, kale), avocado, almonds, pumpkin seeds and kidney beans. Wheatgerm, bananas, oats and sweet potatoes provide a good source of B6. Learn more about the health benefits of magnesium.
• Include healthy fats (omega-3) in your diet (nuts, flaxseed oil, avocado, extra virgin olive oil) as fats are essential for sex for hormone production, especially oestrogen and progesterone. All sex hormones are made from fats.
• Exercise is so important if you have PCOS. Exercising regularly helps burn excess calories and fat and regulate hormone production. It also helps build muscle mass which can reduce insulin resistance. Listen to CNM’s podcast episode on how to exercise properly.
• Reduce stress levels as stress wreaks havoc with your hormones and eating habits. When your stress response is triggered, your body prioritises the production of the stress hormone cortisol, instead of producing sex hormones (oestrogen and progesterone). Learn how to relieve stress naturally.
• Adopt a healthy sleep routine. Lack of sleep affects your body in a similar way to stress, stimulating your body to produce extra cortisol. Ensure you relax before bedtime and limit screen time – stop checking emails before you turn the lights out. Sleepy herbal teas like Chamomile, Lavender and Valerian can also be helpful.

The natural approach to PCOS

In most cases, PCOS can be dramatically improved by adopting a strict, healthy diet and lifestyle. Eating a whole food, nutrient-dense, low sugar diet is key for maintaining blood sugar balance and reducing insulin resistance. Avoid alcohol, caffeine and refined carbohydrates/ grains and start exercising daily, improve your sleep and reduce stress.

To learn more about nutrition and hormone health, take a look at CNM’s Nutrition for Everyday Living Short course which is available online and in-class.

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