Nearly 70% of women with PCOS seek complementary and alternative medicine as an option for care [1]. This article aims to shed light on the natural management of PCOS through dietary and lifestyle interventions, which may be considered as a stand-alone therapy or to complement current conventional medical therapy.
What is PCOS?
Polycystic Ovarian Syndrome (PCOS) is a prevalent endocrine and metabolic disorder that affects up to 22% of women of reproductive age across various ethnicities and backgrounds [1]. Characterized by a complex array of signs and symptoms, PCOS presents a significant challenge for women and healthcare providers alike. Of note, only a medical provider can provide the diagnosis of PCOS, which is determined by meeting certain criteria known as the modified Rotterdam criteria [1].
Contributing Factors to the Development of PCOS:
PCOS is a multifaceted condition, often presenting differently from woman to woman.
The exact cause of PCOS remains unclear, but several factors are believed to contribute to its development, including [2]:
Poor diet and lifestyle factors (i.e., Standard American Diet and sedentary lifestyle)
Insulin resistance
Chronic inflammation
Obesity
Exposure to environmental toxins
Mental-Emotional Stress
Mitochondrial dysfunction and oxidative stress
Common Symptoms of PCOS
Women with PCOS may experience a variety of symptoms, including, but not limited to [1]:
Irregular menstrual cycles that are generally longer in frequency and duration
Excess hair growth (hirsutism)
Acne
Weight gain or inability to lose weight
Pelvic pain
PMS
Changes in moods
Infertility
These symptoms are primarily driven by hormonal imbalances, particularly elevated levels of testosterone and insulin and an imbalance between luteinizing hormone (LH) and follicle-stimulating hormone (FSH), though other hormones like estradiol, progesterone, and anti-Mullerian hormone can also be imbalanced [1].
Traditional Approaches to Managing PCOS
Women with PCOS may be treated by their physician with medications such as oral contraceptives to reduce excess testosterone, insulin-lowering medications, and medications that can stimulate ovulation if it is not occurring. However, these options may not fully or adequately address all a woman is experiencing.
Natural Approaches to Managing PCOS
Diet and Nutrition
Diet plays a crucial role in managing PCOS, particularly in addressing insulin resistance and chronic inflammation, which are central to the condition. Research has shown that certain dietary patterns, such as the Mediterranean diet and the Ketogenic diet, can be beneficial in managing PCOS symptoms [2].
The Mediterranean diet, rich in fruits, vegetables, whole grains, lean proteins, and healthy fats like olive oil, is known for its anti-inflammatory properties. This diet has been shown to improve insulin sensitivity and reduce the risk of cardiovascular disease, while also assisting in female reproductive health, such as improving ovulation and supporting a healthy menstrual cycle [2,3]. The ketogenic diet, which is high in fats and low in carbohydrates, has also demonstrated benefits in improving insulin sensitivity and promoting weight loss in women with PCOS [2,4].
Women should focus on incorporating anti-inflammatory foods, such as leafy greens, berries, and omega-3 fatty acids (found in fatty fish), and avoiding high-glycemic foods that can spike blood sugar levels. Essential nutrients like magnesium, inositol, and vitamin D are also important in supporting insulin sensitivity and hormone balance.
Tailoring diet and nutrition are key in managing PCOS, which is where working with a skilled nutritionist could be most beneficial. When embarking on a ketogenic diet, consider working with a Certified Ketogenic Nutrition Specialist (like me!) to ensure this dietary pattern is well-formulated and sustainable. I like to say, there is the “social media keto diet” that might appear to be all the rage and then there is a “well-formulated keto diet” that is backed by science.
Herbal and Nutritional Supplements
In addition to dietary changes, certain herbal and nutritional supplements can offer support in managing PCOS symptoms. Myo-inositol, a naturally occurring compound found in fruits and beans, has been shown to improve insulin sensitivity and promote ovulation in women with PCOS [5]. It can also be found in supplemental form.
Maca, particularly specific phenotypes (colors) found in a product called FemmenessencePRO Harmony,* has gained attention for its ability to support hormone balance by nourishing the hypothalamic-pituitary-thyroid-adrenal-ovarian (HPTAO) axis. Unlike conventional medications that can introduce exogenous hormones into the body, FemmenessencePRO Harmony supports the body's natural hormone production. Studies have shown that using the right maca phenotype for a given health concern is paramount since each color demonstrates specific benefits for specific conditions [6].
I had the honor of being a co-author on a case report detailing the effectiveness of using FemmenessencePRO Harmony for a woman diagnosed with PCOS. She experienced multiple improvements in her menstrual cycle, hormone profile, and symptoms in as little as three months.
When selecting maca supplements, choosing high-quality, research-backed products is crucial to avoid potential negative effects and ensure efficacy. I had the pleasure of working with an amazing team on a review paper that highlights this importance called, "Not all Maca is Created Equal: A Review of Colors, Nutrition, Phytochemicals, and Clinical Uses".
Exercise and Physical Activity
Regular physical activity is another essential component in managing PCOS. Exercise helps improve insulin sensitivity, reduce inflammation, and promote weight loss, which are critical in managing PCOS symptoms. Aerobic exercises like walking, swimming, and cycling benefit cardiovascular health and can help lower insulin levels. High-intensity interval training (HIIT) has also been particularly effective in improving insulin sensitivity and reducing body fat in women with PCOS [7,8].
Resistance training, including the use of weights and resistance bands, helps build muscle mass, which in turn improves metabolism and aids in glucose regulation. Studies have shown that resistance training can also help lower testosterone levels, thereby reducing symptoms like hirsutism and acne [9].
Stress Management
Chronic stress can exacerbate PCOS symptoms by increasing levels of cortisol, a stress hormone that can interfere with insulin function and worsen hormonal imbalances. Incorporating stress management techniques such as yoga, meditation, and mindfulness practices can help reduce cortisol levels and improve overall well-being.
Sleep
Sleep is another critical factor in managing PCOS. Women with PCOS are twice as likely to experience sleep disturbances, which can further disrupt hormone balance [10]. Establishing good sleep hygiene, such as maintaining a regular sleep schedule and creating a calming bedtime routine, can help improve sleep quality. In some cases, supplements like chamomile, lavender, valerian, L-theanine, and/or melatonin may be beneficial. Work with one of our talented nutritionists to determine the right choice for you.
Conclusion
Polycystic Ovarian Syndrome is a multifactorial condition that requires a comprehensive and individualized approach to management. By understanding the root causes and symptoms of PCOS, women can take proactive steps to manage the condition naturally through diet, exercise, stress management, and the use of targeted supplements.
Working with a healthcare provider who understands PCOS is essential in developing a personalized management plan. By taking a natural approach, alone or in combination with conventional therapies, women with PCOS can improve their quality of life.
Learn More
To learn more about our nutritional services and how we can help you manage PCOS or other hormonal imbalances, visit the Ross Nutrition Team website. Our experts are here to guide you through personalized nutrition plans tailored to your specific needs.
Disclaimers:
Information provided in this article is for informational purposes only and is not intended to serve as a replacement for the care provided by medical doctors, psychologists, psychiatrists, or other healthcare providers.
Supplements: Before beginning new supplements, check with your healthcare and medical providers. The FDA has not evaluated any data regarding supplements. These products are not intended to diagnose, treat, cure, or prevent any disease.
Exercise: Individuals should always consult with an appropriate provider before beginning a new exercise routine.
*Dr. Kim Ross is an independent contractor of Symphony Natural Health, the manufacturer of FemmenessencePRO Harmony (also known as Femmenessence MacaHarmony), providing medical, evidence-led content for consumers and healthcare professionals.
References
1. Hayes S, Manongi S, Ross K. Concentrated Gelatinized Proprietary Phenotype Formulation of Lepidium peruvianum (maca) Positively Impacts Polycystic Ovarian Syndrome (PCOS), Premenstrual Syndrome (PMS), Dysmenorrhea, and Hormone Levels for Fertility Optimization: A Case Report. Obstetrics & Gynecology: Open Access. 2024 Jan 5;8(1).
2. Di Lorenzo M, Cacciapuoti N, Lonardo MS, Nasti G, Gautiero C, Belfiore A, et al. Pathophysiology and Nutritional Approaches in Polycystic Ovary Syndrome (PCOS): A Comprehensive Review. Current Nutrition Reports. 2023.
3. Barrea L, Verde L, Annunziata G, Camajani E, Caprio M, Sojat AS, et al. Role of Mediterranean diet in endocrine diseases: a joint overview by the endocrinologist and the nutritionist. J Endocrinol Invest. 2023 Sep 11;47(1):17–33.
4. Xing N nan, Ren F, Yang H. Effects of ketogenic diet on weight loss parameters among obese or overweight patients with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trails. Food Nutr Res. 2024 Mar 12;68.
5. Moretti C, Bonomi M, Dionese P, Federici S, Fulghesu AM, Giannelli J, et al. Inositols and female reproduction disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)—Women’s Endocrinology. J Endocrinol Invest. 2024 Jul 15;47(9):2111–41.
6. Minich DM, Ross K, Frame J, Fahoum M, Warner W, Meissner HO. Not All Maca Is Created Equal: A Review of Colors, Nutrition, Phytochemicals, and Clinical Uses. Nutrients. 2024 Feb 14;16(4):530.
7. Shele G, Genkil J, Speelman D. A systematic review of the effects of exercise on hormones in women with polycystic ovary syndrome. Vol. 5, Journal of Functional Morphology and Kinesiology. 2020.
8. Ryan BJ, Schleh MW, Ahn C, Ludzki AC, Gillen JB, Varshney P, et al. Moderate-Intensity Exercise and High-Intensity Interval Training Affect Insulin Sensitivity Similarly in Obese Adults. Journal of Clinical Endocrinology and Metabolism. 2020;105(8).
9. Kite C, Parkes E, Taylor SR, Davies RW, Lagojda L, Brown JE, et al. Time to Load Up–Resistance Training Can Improve the Health of Women with Polycystic Ovary Syndrome (PCOS): A Scoping Review. Medical Sciences. 2022;10(4).
10.Moran LJ, March WA, Whitrow MJ, Giles LC, Davies MJ, Moore VM. Sleep disturbances in a community-based sample of women with polycystic ovary syndrome. Human Reproduction. 2015;30(2).