Polycystic ovary syndrome (PCOS) affects an estimated 1 in 10 women of childbearing age worldwide. We know the predominant symptoms of the hormonal disorder range from irregular menstrual cycles to thinning hair to weight gain and even infertility. But did you know that many women with PCOS report an increase in food cravings?

Research backs this up: a high proportion of women with the endocrine disorder exhibit clinically significant binge eating behavior and food cravings-trait scores. Women with PCOS who are obese present with significantly higher scores regarding food cravings than women with PCOS who are lean.

With no exact cure available yet to those suffering, managing PCOS symptoms through targeted diet and lifestyle change is key. Healthy weight management can lower risk of food cravings and binge eating behaviors as well as more serious complications associated with PCOS, such as diabetes, heart disease and stroke.

What is PCOS?

With PCOS, the ovaries produce an abnormal amount of androgens, which are male sex hormones that are usually present in women in small amounts, according to Johns Hopkins Medicine.

The exact cause of PCOS is unknown but researchers believe that the onset is related to genetic and environmental elements as well as the following factors:

  • High levels of androgens: excess production in the ovaries and/or adrenal glands can contribute to symptoms such as acne, unwanted or thinning hair, and irregular periods.
  • Insulin resistance: in PCOS, the body may become less sensitive to insulin and lead to high blood glucose levels. This cascade can contribute to weight gain and even higher levels of androgen production.
  • A polycystic ovary: a cyst on at least one of the ovaries

Some women present with only one of the above factors, while others may experience two or all three. Understanding the functional changes of a client’s PCOS symptoms is important when matching the appropriate protocol and lifestyle modifications to rebalance the body.

RELATED: How I Changed My Diet to Manage PCOS and Finally Feel Better

PCOS and Food Cravings

Clients who develop insulin resistance may experience intense food cravings—especially for refined carbs such as white bread, pasta and pastries. These cravings may lead to overeating, weight gain and additional complications triggered by PCOS (irregular periods, infertility, diabetes). Having a management plan specific to food cravings may be valuable for clients experiencing these symptoms.

Strategies for Reducing PCOS-Related Food Cravings

They include:

  • Food timing: suggest eating every 3-4 hours to regulate blood sugar and keep cravings at bay. Encourage eating a combination of protein, healthy fats and fiber.
  • Remove triggers: work with your client to cut down on foods that contribute to more intense cravings (processed/packaged foods and artificial sweeteners above all).
  • Replace triggers with healthier alternatives: when sugar cravings hit, try using spices such as cinnamon and nutmeg which can be helpful in curbing a sweet craving. Sipping unsweetened herbal teas is also a great strategy that will have negligible effects on blood sugar. You can also try incorporating cashews and pecans as they are “sweet” nuts, and the fat and protein will help with satiety too.

RELATED: Sugar Cravings: 4 Reasons They Happen and How to Stop Them

PCOS and Pregnancy

PCOS is one of the most common causes of female infertility, affecting as many as 5 million U.S. women of reproductive age. Excess androgens or the presence of a polycystic ovary lead to disruptions in proper ovarian functioning and make it more difficult for women with PCOS to become pregnant. Some women may not even realize they have PCOS until they are trying to conceive.

For pregnant women with PCOS, there is an increased risk of complications. This includes:

Preeclampsia: a condition characterized by high blood pressure during pregnancy, and
Gestational diabetes: a type of diabetes that develops during pregnancy in women who don’t already have it.

Both of these conditions can lead to potential risks for the baby, including premature birth, excessive birth weight and miscarriage.

Strategies for a healthy pregnancy

Strategies to manage symptoms and maintain a healthy pregnancy are similar to most PCOS protocols:

  • Managing a healthy weight — even a 5% to 10% loss in weight has been shown to significantly increase the chance of becoming pregnant.
  • A plant-based, low-glycemic diet
  • Regular exercise

In certain cases, doctors may prescribe fertility medications to help with ovulation or suggest a surgery to remove tissue that produces excess male hormones in the ovaries. In vitro fertilization (IVF) is also common for women with PCOS, although this option is expensive and usually considered when all other lifestyle interventions have been unsuccessful.

PCOS and Insulin Resistance: Newest Findings

The connection between PCOS and insulin resistance has been well-established and widely recognized. More recently, it’s been found that in addition to insulin sensitivity, women with PCOS may have unbalanced adipokines, which are cell-signaling molecules produced in fat tissue. Adipokines include leptin and visfatin, two hormones involved in regulating body weight and blood glucose.

The following lifestyle modifications can help counter insulin sensitivity and adipokine secretion, leading to better metabolic health and reproductive outcomes.

5 Ways to Improve Metabolic Health

Living with PCOS doesn’t have to mean experiencing metabolic disorders or food cravings. Luckily, there are many tools we can employ to help alleviate and even reverse the symptoms of PCOS in women. Here are five diet and lifestyle modifications proven effective.

Adopt a low-glycemic diet

With insulin resistance affecting up to 70% of women with PCOS, keeping blood sugar in check with low-glycemic foods is highly important to stabilizing glucose levels. Foods to incorporate include: whole grains, non-starchy vegetables, low-sugar fruits like berries, legumes, dairy, lean proteins and healthy oils.

RELATED: Managing Blood Sugar: Nutritious,Tasty Snacks and Breakfast Ideas

Make breakfast a priority

Starting the day with a balanced, low-glycemic breakfast can lead to better blood sugar stabilization throughout the day.

Reduce chronic stress

In women with PCOS, chronic stress can make symptoms worse by further increasing blood sugar levels via an excess production of cortisol. Quality nutrition, sleep and exercise can all help to lower levels of your body’s main stress hormone.

Supplement with Vitamin D

Studies have found that supplementing with vitamin D may contribute to better PCOS management if serum levels are low. Consult with a physician before making recommendations around specific supplement recommendations.

Supplement with berberine

Berberine, an organic compound extracted from herbs like tree turmeric, goldenseal and barberry, has been found to have positive effects on insulin resistance in PCOS. Although more research needs to be conducted to confirm this association, results so far have been promising for improved fertility, assistance with weight loss and lowered risk for metabolic complications.

Berberine may not interact well with other medications, so it is important to consult with a physician for proper dosing and regular monitoring.

Bottom Line: Living With PCOS

While the causes of PCOS are still not fully understood, we do have effective strategies that can alleviate the symptoms of this metabolic disorder, and maybe even reverse them. Lifestyle and nutrition modifications can and should be a part of any protocol for clients living with PCOS.

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(Image: Shutterstock)

About Ellie Erlich, MS, RD
Ellie Erlich is a registered dietitian and holds a Master of Science in clinical nutrition from New York University. She works privately with clients to accomplish a wide range of wellness goals from weight loss to chronic conditions and autoimmune disorders.

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