Polycystic Ovary Syndrome (PCOS): What’s the Best Diet to Help Ease Symptoms?

Polycystic ovary syndrome (PCOS) affects about 1 in 10 women of child-bearing age in the U.S., according to the Office on Women’s Health (OWH). The endocrine disorder is often characterized by hormonal imbalance and metabolic problems — despite its name suggesting that multiple cysts develop on the ovaries.  

“The name is a bit of a misnomer, since women with PCOS actually don't have cysts on their ovaries but tiny, underdeveloped follicles all competing to ovulate — and no one [follicle] is winning,” Cory Ruth, MS, RDN says.  

For context, follicles usually contain egg cells, which are released during the ovulation stage of the menstrual cycle. But in women with PCOS, many of these follicles won’t mature and will instead rest on the ovaries. On an ultrasound scan, the ovaries can appear polycystic (or containing multiple cysts) due to the increased volume of resting follicles.   

What causes PCOS?

While the exact cause of PCOS isn’t known, experts suspect that genetics play a role. More specifically, high levels of androgens can prevent the ovaries from ovulating (or releasing an egg) during the menstrual cycle. 

Having high levels of insulin, the hormone that’s responsible for converting food into energy, is also believed to play a role in the development of PCOS. High levels of insulin can turn into insulin resistance. When this happens, the pancreas goes into overdrive, trying to pump out enough insulin to lower blood sugar levels. Without adequate levels of insulin, the cells in the body can’t properly absorb blood sugar for energy. 

“The cells are not getting the energy they need, and you may suffer from fatigue, sugar cravings, and brain fog,” Nicole Holness MS, RD, CDN, IBCLC, and director of Holness Nutrition says.

How is your diet linked to PCOS symptoms?

Certain foods could worsen PCOS symptoms. 

Holness says that eating excessive amounts of foods that are rich in refined carbohydrates (think: sugary, processed foods) “makes the pancreas work harder to produce more insulin, making insulin resistance even worse.” 

 Foods with high glycemic indexes — like baked goods, breads, and pastas — can cause spikes in blood sugar levels. That’s why Holness recommends opting for complex carbohydrate options that have lower glycemic indexes, such as legumes, nuts, and whole wheat tortillas. 

“This way, your body will not need to produce as much insulin as quickly due to the carbs breaking down more slowly,” she says.

What is the best diet for PCOS?

As is the case with most health conditions, there isn’t one single diet that will fix PCOS symptoms. Instead, both experts suggest monitoring your sugar intake by choosing low-glycemic foods and focusing on eating a balanced diet.

“Focusing on protein, fat, and fiber while decreasing carb and sugar intake is the best way to go about eating for your PCOS,” Ruth says. “There is no one food you should eliminate completely, nor is there one food you need to include. Like most things in life, eating for your PCOS is about balance.”

Holness added that increasing your intake of antioxidant-rich foods, such as fruits and vegetables, can help decrease inflammation in the body — which may lower your risk of more serious health complications associated with PCOS later in life.

Including more whole, unprocessed foods in your diet and removing ultra-processed ones — such as fried foods and sugary pastries — may help alleviate symptoms. 

A healthy diet can also lead to weight loss, which can improve insulin resistance. “The good news is even just a modest weight loss of 5% to 10% of body weight can significantly improve insulin resistance,” Holness says. She also says that, for some people, this can also help normalize menstrual cycles. 

“Aside from diet, there are many other important things to consider when treating PCOS, like a solid exercise routine, reducing stress levels, healthy digestion, getting good sleep, and reducing exposure to hormone-disrupting chemicals,” Ruth says.

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Written by:

Cheyenne Buckingham, BS

Cheyenne Buckingham is a journalist and editor who specializes in nutrition, women's health, fitness, food injustice, and the relationship between chronic disease and diet. She has 6 years of experience covering food, health, wellness, and fitness.

Edited by:

Kelsey Abkin

Kelsey Abkin has been working as a journalist since 2016. She has held many titles throughout her career, including editor, content strategist, digital strategist, and writer.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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