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PCOS & Low Carb Fertility Diet - Fertility Food Plan

PCOS and a Low Carb Fertility Diet 

By Rebecca Hyett - Fertility Chef. Published April 2018

Polycystic ovary syndrome, or PCOS, is an endocrine disorder that commonly affects women of reproductive age. This disorder affects approximately five million women in the United States, and despite its prevalence, physicians still don't know for sure what causes it.

What we do know, however, are the symptoms. Women with PCOS frequently have high levels of androgens, which can cause excess facial and body hair, acne, and even male-pattern baldness. They also tend to have multiple small cysts in the ovaries, which lead to issues with ovulation.

This means that getting pregnant with PCOS is often extremely challenging. Women with this condition frequently have irregular periods, and it is often easy to gain weight, as polycystic ovary syndrome tends to cause insulin resistance.

While this syndrome is often challenging to treat, it is not hopeless. Currently, a significant body of medical research points to a low carb diet as being helpful for patients. A reduced-carbohydrate PCOS diet has been shown to improve levels of testosterone and insulin, support weight loss and reduce body hair, and even help women conceive.

tuna salad low carb fertility diet

7 Great Reasons Why a Low-Carb Diet Works for PCOS

With the seemingly endless parade of diet-advice gurus on the internet, it may seem overwhelming to try and find a way to lose weight. However, a significant amount of scientific evidence suggests that the best diet for polycystic ovary syndrome is a low-carb one. Here are seven reasons why a low-carb diet works:

1. It Tends to Improve Insulin Resistance 

Most women with polycystic ovary syndrome suffer from insulin resistance. This means that they tend to be less sensitive to levels of insulin in the body. Insulin is a hormone that signals to cells in the body that they need to accept glucose from the blood.

In women with PCOS, insulin resistance also tends to result in testosterone levels becoming high. It disrupts the ratio of FSH to LH (follicle stimulating hormone to luteinizing hormone), and this ratio is likely very important for ovulation Thus, the insulin resistance experienced by many women with PCOS doesn't just tend to cause weight gain--it also may result in a plethora of other problems.

Several studies have indicated that a low carb diet for PCOS has positive effects on women with the syndrome. Most notably, a North Carolina study of the effects of the ketogenic diet (a strict low-carb, high-fat diet) on women with polycystic ovary syndrome found that, after 24 weeks, the following symptoms improved:

  • obesity
  • testosterone levels
  • FSH/LSH ratio
  • insulin levels

2. For Those Who Want To Conceive, Conception Becomes More Likely

As noted above, the ratio of LSH to FSH is thought to be very connected to a woman's ability to conceive. And several studies support the hypothesis that getting pregnant with PCOS becomes much easier when patients start eating a diet that is low in carbohydrates (and that is preferably higher in fat).

In fact, fertility specialist Dr. Michael Fox, of the Jacksonville Center for Reproductive Medicine, notes that pregnancy rates at his clinic went up to between 90 and 95 percent when patients adopted this diet.

Experts in the United Kingdom have found that the impact of a low-carb diet on fertility is even higher than we may have originally thought. A very low-carb diet might increase fertility by five times. And while fertility experts advise limiting carbohydrates, they suggest that white bread, pasta, and breakfast cereals are key foods to avoid with PCOS.

salad low carb fertility diet food

3. It Supports Weight Loss

Women with PCOS are at an increased risk for type II diabetes, and this makes it especially important to lose weight for those who are overweight or obese.

While virtually all physicians working with women who have PCOS agree that weight loss is often helpful in improving symptoms, some dispute remains over the best PCOS meal plan to adopt in order to improve symptoms.

However, most of the current research indicates that a low carb diet for PCOS is more effective than just restricting calories. As the popularity of diets like the Atkins diet have shown, low carb eating tends to support weight loss even in those who do not have PCOS.

4. It Helps Reduce Levels of Androgens

Just as a low-carbohydrate diet often supports significant weight loss in those who do not have PCOS as well as in those who do, additional research suggests that a low carb diet (and specifically, a diet with a low glycemic load) may improve acne, even in adults who don't have PCOS.

"Glycemic load" means the amount of simple carbohydrates that can be quickly turned to sugar in the body, so even cutting out or reducing simple sugars and continuing to eat high-fiber complex carbohydrates in moderation may result in some improvement of acne.

But since acne tends to be one of the more distressing symptoms of PCOS (especially because issues with acne often extend well into adulthood), this aspect of the PCOS meal plan is an important one to remember, even for those who are not trying to conceive.

5. Some Evidence Suggests Anxiety and Depression May Be Reduced

As a whole, PCOS is a condition that needs more research to be understood, but the intersection of PCOS and mental health is especially poorly understood. But some research has begun to suggest that low-carb eating is more than just a PCOS fertility diet; it also may help to alleviate symptoms of depression and anxiety in women who suffer from PCOS.

Doctors don't know for sure why a low-carb diet may lessen symptoms of depression in women with PCOS, but some studies indicate that high levels of free testosterone may contribute to depression in women with the condition. Additionally, many of the symptoms of PCOS, by themselves, may contribute to depression and anxiety.

6. It May Make It Easier to Eat Fewer Calories

Generally speaking, consuming a PCOS fertility diet or other diet low in carbohydrates means that you will be consuming a diet with a low glycemic index. This means that the diet is much less likely to cause blood sugar spikes. And when you keep your blood sugar stable, you avoid crashes that make it tempting to eat excessive amounts of sugar or other simple carbohydrates.

Because low-carb, low-GI diets tend to be made mostly of vegetables, high-protein foods, and high-fat foods, you are also more likely to stay fuller for longer, making it easier to eat less overall.

If you recall a time when you started eating chips, cookie, or other high-carbohydrate snacks and then had trouble stopping, you've experienced why a high-GI diet may make it harder to lose weight. Foods with a high glycemic index spike your blood sugar, and they make it significantly harder to stop eating.

With a diet designed for PCOS, you will be much better equipped to handle cravings, and your mood and general health are likely to improve as well.

egg dukkah breakfast low carb fertility

7. It May Help Regulate Periods

All aspects of PCOS are connected. As you adapt to a low-carb diet, your sensitivity to insulin is likely to improve. Then, in turn, your hormonal balances are likely to improve.

While you probably have heard that this is excellent news for those trying to conceive, it also tends to be helpful for those who are just trying to regulate their periods. 

As testosterone levels decrease and the ratio of LH to FSH becomes more typical, chances are good that regular menstrual periods will return.

PCOS Diet and Dairy

While a significant portion of available research has suggested that a low-carbohydrate diet is the best one for PCOS, it is less clear on whether or not dairy is one of the foods to avoid with PCOS.

Why Might Dairy Not Be Ideal?

You probably recall that, as discussed above, women with PCOS tend to be resistant to insulin in the body. This often causes higher levels of insulin. Dairy contains insulin growth factor 1, often called IGF-1. This is a molecule that acts very similarly to insulin in the body.

Generally, women who have PCOS also have less of a binding protein that attaches to IGF-1 and makes it non-reactive. You may wonder why women with this condition may want to avoid IGF-1.

Since the high amount of insulin in the body causes the ovaries to overproduce testosterone, and IGF-1 acts much like insulin in the body, the IGF-1 in dairy products may worsen PCOS symptoms by increasing the amount of testosterone in the body.

The extent of the effect that dairy has on your PCOS may also depend, in part, on how you treat your PCOS. Because metformin helps to normalize the ratio of IGF-1 and its binding protein in the body, women on metformin may see less of an adverse effect from consuming dairy than women who do not take metformin.

What Has the Research Shown?

Of course, the above explanation describes the mechanism by which dairy consumption can, theoretically, worsen symptoms. But does dairy consumption always make PCOS worse?

The research into PCOS and dairy consumption is still very limited. But in one study, women who consumed a diet low in starches and dairy (but still consumed some dairy products) saw improvement in their PCOS symptoms.

Another study done on women suffering from fertility issues (but not necessarily from PCOS) differentiated between low-fat and high-fat dairy products. This study found that women who consumed low-fat dairy products tended to be more at risk for fertility issues related to being unable to ovulate.

While this certainly sounds similar to PCOS (since the cysts in the ovaries often make the release of an egg difficult or impossible), the study did not determine the definite cause of these women's infertility.

However, in this same study, women who consumed high-fat dairy products did not share the fertility risk. Again, because the study did not definitively determine whether PCOS was the cause of the test subjects' fertility issues, it is impossible to know with certainty whether consuming high-fat dairy lessens infertility risk for women with PCOS.

However, the IGF-1 connections suggests that, if you have PCOS and want to control your symptoms or try to conceive, reducing or eliminating dairy may be worth trying for a period of time. Anecdotally, some women have sworn by cutting out dairy as a means to reduce PCOS symptoms, while others eat dairy regularly and don't seem to notice any ill effects.

salmon fertility food fertility diet low carb diet

PCOS Diet and Soy

As with dairy, the relationship between soy and PCOS is contested in the PCOS and nutrition community, and there unfortunately is not yet enough research to conclusively determine whether removing soy from the diet is beneficial or not.

After all, since soy is a phytoestrogen, or a food that acts somewhat similarly to estrogen in the body, some women may be wary of adding it to their diet.

Is Soy Safe for Women With PCOS? 

Much of the current research suggests that the answer here is yes--available studies indicate that soy consumption reduces cholesterol, insulin levels, and oxidative stress on the body. Additionally, available research also suggests that consuming a moderate amount of soy may also lower testosterone.

However, while much of the available research suggests that soy may actually be helpful, soy may also worsen thyroid issues, which are common in women with PCOS. Moreover, while the action of soy on the endocrine system is not nearly as strong as the action of pure estrogen would be, it nonetheless may pose a problem for some.

Many women with PCOS are estrogen-dominant, meaning they have more estrogen than progesterone. With estrogen dominance, women may suffer from painful periods, fat gain, uterine fibroids, and many other health problems. And especially for those who are very sensitive to hormonal changes, or for those who consume a significant amount of soy, estrogen dominance may worsen.

Does Soy Affect Fertility in Women With PCOS Who Want to Conceive?

While there is some conflict over whether soy is helpful or harmful for women with PCOS, research into women being treated for infertility (though not necessarily for PCOS) indicates that pregnancy rates and rates of live births were higher for women who took phytoestrogens, and especially for those who consumed soy.

Folic Acid and PCOS

Folic acid is a necessary nutrient for everyone, but it is especially vital for pregnant women and those trying to conceive. But there is a crucially important concern when it comes to folic acid and PCOS: most women with this syndrome have a gene called MTHFR that makes them up to 80% less efficient at converting folic acid (a synthetic form of folate) into bioavailable folate.

But why is folate important? It's needed for virtually every metabolic process, including the synthesis of DNA. And because plenty of metabolic processes happen in pregnancy, folate is particularly important for women who are pregnant or trying to be.

Women with PCOS, since they tend to need more metabolic support, will likely benefit from a diet high in folate. Here are 15 foods high in folate:

  1. Collard greens
  2. Romaine lettuce
  3. Papaya
  4. Lentils
  5. Pinto beans
  6. Avocado
  7. Brussels sprouts
  8. Okra
  9. Flax seeds
  10. Beets
  11. Cauliflower
  12. Celery
  13. Squash
  14. Carrots
  15. Corn
fertility diet low carb diet recipe eggplant

So, What is the Best Diet for PCOS?

Clearly, while there is still a good bit of research that needs to be done, a low-carb diet is the most evidence-based and best diet for PCOS.

A low-carb diet helps women with PCOS lose weight if necessary, improve insulin sensitivity, and improve hormonal imbalances. In fact, as noted earlier, a low-carb diet has the potential to drastically improve all symptoms of the syndrome.

Some women may opt to cut out dairy and soy, but since this is a personal choice, doing your own research and consulting with a doctor if you need more information is a good idea.

However, consuming a high-folate diet is strongly suggested for most women with PCOS. Through diet adjustment and perseverance, you likely will be well on your way to improved health and overall well-being.

How Can We Help?

We have many delicious recipes that are of course all low carb and cater to PCOS diets and individual dietary preferences.

If you want to keep things really simple you can sign up to our meal plan and have access to weekly meal plans and shopping lists that cater to your specific requirements. You will find meal plans that are:

  • Diary free
  • High in natural folate
  • Vegetarian
  • No red meat



Through my own journey I learned that a low carb high protein diet helps restore hormonal balance and reproductive health. Now I empower and challenge women who are finding it hard to have a baby to look past the ovulation predictor kits and expensive and aggressive medical procedures and instead start looking at nutrition and what they eat as a source of healing.

Through my own journey I learned that a low carb high protein diet helps restore hormonal balance and reproductive health. Now I empower and challenge women who are finding it hard to have a baby to look past the ovulation predictor kits and expensive and aggressive medical procedures and instead start looking at nutrition and what they eat as a source of healing.



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