PCOS and Nutrition: How Diet and Lifestyle Support Hormone Balance and Fertility

This one’s for the girls! About 5-6 million of them, to be exact. According to the Endocrine Society, polycystic ovarian syndrome (PCOS) affects about 7-10% of women of childbearing age in the United States.

Understanding PCOS and Its Nutritional Implications

PCOS is a hormonal disorder and the most common contributor to female infertility. Symptoms include excess levels of the male hormone androgen, cysts on the ovaries, and irregular menstrual cycles. Unfortunately, the exact causes of PCOS are unknown.

PCOS occurs frequently in women who are overweight or obese. This relationship between PCOS and body fat is complex; it is unclear which precedes the other. Insulin resistance is also linked to PCOS, leading to further weight gain and potential development of Type 2 diabetes mellitus.

Key Nutritional Strategies for Managing PCOS

While there is no cure for PCOS, diet and exercise are a significant part of the treatment of its symptoms and may improve the condition altogether. Managing a healthy body weight, stress reduction, and eating a balanced diet are part of the treatment plan. A whole foods-based diet, with an emphasis on the following nutrients, is generally recommended:

High fiber foods provide your body with necessary carbohydrates without causing an immediate blood sugar spike. This offers up better overall glucose control while supporting gut health. On a PCOS plate, try adding many non-starchy vegetables, legumes, nuts, and seeds.

Lean protein foods like chicken, turkey, fish, eggs, and plant proteins provide satiety that can aid weight management, while also supporting muscle mass. Protein is also an essential building block for many hormones and helps with their function. This includes the hormones insulin and cortisol, aka the stress hormone, believed to play a role in PCOS.

Healthy fats such as omega-3-rich fish, nuts, seeds, avocados, and olives are also involved in hormone production, specifically the reproductive hormones, including estrogen, progesterone, and testosterone. Without adequate fat intake, the body may struggle to produce these hormones. These healthy fats also help reduce inflammation, support brain function, and regulate mood, which may make managing PCOS easier.

Foods to Limit or Avoid: Managing PCOS Symptoms through Diet

While I prefer to focus on what foods to add in, it is good to keep in mind the foods to eat in moderation or avoid altogether. Foods that are going to spike your blood sugar will be at the top of the list. These include refined starches like white breads and pastas, and foods with high amounts of added sugars and little to no fiber. This extends to beverages, too. Avoid sugary beverages as these add additional calories that make weight management difficult and typically spike glucose levels quickly. 

Limit saturated and trans fats. These are high in calories but are not anti-inflammatory. Lastly, be mindful of dairy products. For some women, but not all, dairy may be pro-inflammatory. More research is needed on the link between dairy and PCOS, but it is hypothesized that it may have some negative effects on women’s hormone health.

Supplements and PCOS: Evidence-Based Considerations

In conjunction with dietary intervention, supplement use may be advised in the treatment of PCOS. However, supplement use should always be personalized under the supervision of a healthcare provider. Inositol is one supplement often recommended due to its potential role in supporting insulin sensitivity and reproductive metabolic outcomes. Omega-3 is another possible supplement. While best obtained through the diet, if there is difficulty getting adequate omega-3 in food form, supplements can be considered. 

Vitamin D, on the other hand, can be tricky to get through the diet, especially if you are avoiding dairy products, where vitamin D is often fortified. Many women with PCOS are vitamin D-deficient. While this could be coincidental, there may be a link. Either way, addressing this deficiency is a good idea.

With women making up about 50% of the population, women’s health cannot be ignored. Neither can the fact that nutrition, fertility, and overall well-being are so intricately linked. While we have a lot more to learn about PCOS, these identified associations give us a great place to start in taking control of our health. 

1. _{Endocrine Society. “Polycystic Ovary Syndrome, Endocrine Society.” Endocrine.org, Endocrine Society, 6 August 2025, https://www.endocrine.org/patient-engagement/endocrine-library/pcos}

2. _{Mohan, A., Haider, R., Fakhor, H., Hina, F., Kumar, V., Jawed, A., Majumder, K., Ayaz, A., Lal, P. M., Tejwaney, U., Ram, N., & Kazeem, S. (2023). Vitamin D and polycystic ovary syndrome (PCOS): a review. Annals of medicine and surgery (2012), 85(7), 3506–3511. https://doi.org/10.1097/MS9.0000000000000879} 

3. _{Unfer, V., Facchinetti, F., Orrù, B., Giordani, B., & Nestler, J. (2017). Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine connections, 6(8), 647–658. https://doi.org/10.1530/EC-17-0243}