Polycystic ovary syndrome (PCOS) is a complex hormonal disorder that can manifest differently in different women.
There is generally hyperandrogenism (an excess of certain hormones), which makes ovulation more difficult, leads to irregular cycles, and excessive hair growth. It is sometimes associated with insulin resistance that promotes localized weight gain around the abdomen.
Several mechanisms are interconnected in the onset of PCOS: hormonal disturbances, metabolic dysregulation, low-grade inflammation…
But rest assured, you can act to reduce symptoms and improve the hormonal environment, notably through your diet. Several studies including this one show a significant effect of lifestyle and dietary changes.
I help women move toward eating that feels good for them, and I’ll explain which foods to favor and which foods and habits to avoid, to support your hormones, energy, and fertility.
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The pillars of a PCOS diet
Basic rules (that apply to everyone)
I encourage you to have complete and balanced meals, made up of starchy foods, vegetables, and a source of protein and healthy fats. This combination isn’t trivial; it helps stabilize blood sugar, prolong satiety, and prevent cravings that can disrupt hormonal balance.
Foods to favor are derived from or follow the principles of the Mediterranean diet, a dietary model that may have a therapeutic role in PCOS according to this study.
Also take the time to eat mindfully and chew slowly. Digestion begins in the mouth – good chewing improves nutrient absorption, reduces bloating, and promotes better appetite regulation.
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Include antioxidant and anti-inflammatory foods
Oxidative stress and/or low-grade inflammation are common in PCOS.
The antioxidant and anti-inflammatory compounds (good news, many compounds have both roles!) can help reduce inflammation, improve insulin sensitivity, protect oocytes, and regulate hormones. Focus on:
- colorful fruits and vegetables: berries (red and black), citrus fruits, leafy greens, cruciferous vegetables, carrots, tomatoes
- spices and aromatic herbs: turmeric, ginger, cinnamon, rosemary, thyme, curry
- nuts and seeds: fresh if possible, or soaked and peeled
- small fatty fish: sardines, mackerel, herring, anchovies
- high-quality vegetable oils such as first cold-pressed extra virgin olive oil
For beverages, I recommend replacing coffee with green tea and cocoa, and favoring herbal infusions.
Choose high-quality proteins
Don’t forget to consume protein at breakfast. It helps maintain muscle mass, satisfy hunger, and stabilize blood sugar. Here are examples of quality protein sources:
- eggs preferably free-range, organic, or from labels such as Label Rouge or Bleu Blanc Coeur
- poultry
- fish and especially the small oily fish already mentioned
- legumes such as lentils, chickpeas, red beans…
- tofu and other fermented soy-based products
- dairy products: cheeses, Greek yogurt, skyr…
- nuts and seeds
Take care of your microbiome
The gut microbiota modulates hormones, inflammation, and insulin sensitivity. Neglecting it deprives us of a valuable aid in regulating our hormones and reducing PCOS symptoms.
Thus, I recommend favoring foods that support your microbiota.
Fermented foods such as white cabbage and other lacto-fermented vegetables, kefir, kombucha, yogurt, miso… are powerful allies. The same goes for prebiotic fibers found in vegetables and fruits in general.
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Dietary supplements to accompany a balanced diet
PCOS is complex and multifactorial, and a single element cannot replace a comprehensive approach. Every small step counts, and it’s the consistency of your efforts regarding diet, physical activity, and lifestyle that will produce the greatest long-term results.
Avoid relying on a single ‘miracle’ food or dietary supplement. Some supplements, as a complement to the principles I have just outlined, can nevertheless support the body:
- Inositol (myo- and D-chiro-): improves insulin sensitivity and promotes ovulation
- Magnesium and vitamin D: support hormonal regulation and stress management
- Omega-3: anti-inflammatory effects and beneficial for metabolism
- Zinc or chromium: useful for the skin, blood sugar, and hormone production
Foods and habits to avoid with PCOS
Ultra-processed foods and added sugars
One of the mechanisms commonly seen in PCOS is insulin resistance: sugar from the diet is less well handled by the body, causing significant blood sugar fluctuations and sometimes higher blood glucose levels that stimulate androgen production.
To maintain stable blood sugar, I strongly recommend avoiding:
- ultra-processed products: prepared meals, sweet or savory snack items, breakfast cereals…
- added sugars: flavored yogurts, pastries and confectionery, sugary drinks.
Unhealthy fats
Trans fats and refined oils (fried foods, margarine, snacks, ready-made meals) promote inflammation, often already present in PCOS. It’s not about eliminating all fats, but about choosing the right fats, which I mentioned earlier.
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Skipping meals, doing intermittent fasting in the morning
Skipping one of the main meals can cause blood sugar fluctuations and trigger compensatory eating at the next meal. It also leads to fatigue and greater blood sugar dysregulation.
That’s why you shouldn’t skip breakfast: in the morning, our hormones need fat and protein to function. It’s essential to eat a ‘savory’ breakfast!
It’s better to have three balanced meals a day, with snacks if needed, and to listen to hunger cues without depriving yourself. If you’re used to skipping breakfast, I encourage you to reintroduce it gradually and focus on savory options with good proteins and healthy fats: eggs, avocado, cheese, seeds and nuts, whole-grain or sourdough bread.
Reducing or eliminating carbohydrates
If you’re diagnosed with insulin resistance, it’s tempting to reduce or even eliminate sources of carbohydrates. However, carbohydrates are an essential fuel for our body, and removing them or drastically reducing them promotes cravings.
Instead, choose carbohydrate sources that minimally raise blood glucose: whole grains, legumes, sweet potato, quinoa, whole-grain or sourdough bread…
Neglecting sleep, stress management, and physical activity
Insufficient sleep as well as chronic stress promote the development of insulin resistance. It is therefore essential to take care of your sleep and stress daily. Not just for hormones, but also for overall well-being and to reduce the risk of disease.
Furthermore, physical activity, which supports metabolism and also helps manage sleep and stress, is a key ally in the management of PCOS.
Sources and scientific studies
Szczuko M, Kikut J, Szczuko U, Szydłowska I, Nawrocka-Rutkowska J, Ziętek M, Verbanac D, Saso L. 2021. Nutrition Strategy and Life Style in Polycystic Ovary Syndrome-Narrative Review
Di Lorenzo M, Cacciapuoti N, Lonardo MS, Nasti G, Gautiero C, Belfiore A, Guida B, Chiurazzi M. 2023. Pathophysiology and Nutritional Approaches in Polycystic Ovary Syndrome (PCOS): A Comprehensive Review
