Losing Weight With PCOS
Polycystic Ovarian Syndrome (PCOS) is a condition that has a strong impact on a woman’s fertility, and affects between 5% to 10% of women of child bearing age. Because a woman’s with PCOS may not produce enough eggs, PCOS can be associated with infertility. Research has found that 50-70% of all cases of infertility are associated with PCOS (Zhang et al, 2019). Women in developed countries (‘merica!) tend to suffer from PCOS more often than women from third world countries.
How to Reverse PCOS
There are no treatment options for PCOS, but lifestyle modifications are highly recommended to reverse many of the complications associated with the disease.
Most cases of PCOS are not genetic, but hormonal in nature. Increased levels of androgenic hormones like testosterone can lead to suppression of ovulation. Both men and women produce testosterone, but men produce around 10x more testosterone than women.
Hallmarks of PCOS
During normal ovulation, the ovarian follicle swells and “ripens” to release an egg. In women with PCOS, suppressed ovulation means that the follicle may swell and ripen but never release an egg. This can lead to multiple cysts over time. These cysts are a hallmark of PCOS.
Other consequences of the higher levels of androgens include:
- increased risk of obesity
- increased risk of heart disease
- increased risk of diabetes
- increased risk of having more facial hair.
Interestingly, lower carbohydrate diets may help overweight women with PCOS. A recent study of 11 non diabetic, overweight women with PCOS who had an average age of 33 was conducted. The study compared a ‘standard’ diet with 56% carbohydrates and 16% protein, with a lower carb diet of 43% carbohydrate and 15% protein. The fat component of the lower carb diet was a lot higher than the standard diet, by 14%. The fat content of the low carb diet was almost evenly split between polyunsaturated fatty acids and monounsaturated fatty acids. The fat content of the standard diet was almost evenly split between the two types of fatty acids, but was slightly higher (by 3%) in the monounsaturated variety.
A third diet, one high in both carbohydrates and monounsaturated fatty acids, was also compared. The study participants only followed each diet for 16 days. They had a 3 week break between each diet, and tried all 3.
Because production of the androgen hormones are influenced by the presence of the hormone insulin, the researchers were interested in finding out whether a low carb diet could reduce the amount of insulin circulating in the body. They believed this would have an indirectly positive effect on PCOS.
The results of this study found that while circulating insulin was not significantly affected by the lower carb diet, cholesterol, fasting insulin levels, free fatty acids, and their response to insulin were positively affected. The fact that their response to insulin improved is an indicator of the possible benefit eating less carbs.
The authors of the study state: “Because elevated insulin is thought to contribute to the endocrine abnormalities in PCOS, a reduction in insulin would be expected to ultimately result in an improved endocrine profile.”
They go on to say that these improvements indicate that using a low carb type diet, with a lower calorie intake, would probably benefit overweight women who suffer from PCOS.
More Research in Favor of PCOS
Marsh et al (2010) demonstrated that a low carbohydrate diet both decreased body weight and also treated infertility. That’s a win-win in my book! Both Zhang and Marsh used a diet that was 45% carbohydrate. For a standard 2000 calorie a day diet, this means that roughly 900 calories, or 225 grams of carbohydrates, were clinically effective for both weight loss and also to reverse infertility.
To that, I say “damn”.
That’s still a lot of carbs.
Primal guru Mark Sisson recommends staying under 150 grams of carbohydrates each day if one is wanting to lose weight.
Weight loss expert and physician Dr. Ted Naiman says that the liver and muscles can hold up to 100 grams of sugar at a time, so in order to lose weight, one should stay under 100 grams of carbohydrates each day.
PCOS and Alcohol
But I like a snippet I read from an obscure book by Robert Cameron written in the 1960s called The Drinking Man’s Diet. The author of the book (not a doctor, just a formerly chubby guy) relays the story of his chance meeting with a slim female professor who told him that to lose weight, he needed to stay under 60 grams of carbohydrates a day.
Moral of the story- if you’re into booze, keep your sugary drinks to a minimum and eat mostly meat. Cameron lived to the ripe age of 98, enjoying martinis and ribeyes until the last day.
If you’re struggling with PCOS, it’s a really good idea to lower the carbs. Alcohol can make the carbs add up really quickly, so stick to dry wines or vodka. Better yet, take a break. My drink of choice these days is soda water with lime and a cherry. I’m 260 days AF/AF and feeling pretty good. My insulin levels tend to be somewhat elevated myself, so I’m mindful of both carbs and sugar. And for me, cutting out alcohol completely has slowed down my trail mix-chocolate chip-cramp free energy bites-chips and salsa-potato chips-whatever the F is in the pantry-night runs.
Need help with a suggested meal plan that’s lower in carbs? Check out my Protein Power Reset. It’s helping women lose weight, sleep deeper, and dial in their moods. You can go through it at your own leisure, and I’m offering it to you for 50% off with coupon code FITTYFALL (already applied for you!).
If you need further help and want to test your androgenic hormones and then some, let’s run the DUTCH test. You can grab that mini package here.
So to sum it up, you can reduce your PCOS symptoms by cutting carbs down to between 60-150 a day. Stick with whole foods preferably, and don’t neglect the sun, epsom salt baths, breathwork, or hydration. You’ll be on your way to a flatter belly in no time 😉