Importance of dietary control for PCOS (Polycystic ovarian syndrome) By Mike Dougherty on October 24, 2023

Diet is an important aspect of fertility.  Our dietary intake of nutrients provides the building blocks for healthy growth and development of oocytes (eggs) and subsequently the embryo and fetus.  While this is incredibly important for all patients, it is especially important for patients with PCOS. 

Women with PCOS are prone to complications from insulin resistance.  For this reason, 3 meals a day with portion control (using 8-10 inch dinner plates, not the standard American 11-12 inch dinner plate).  Three meals a day is associated with improved egg quality.  This is especially true in women with PCOS because of their frequent complications with insulin resistance.  If a patient with PCOS were to eat 1 meal a day, they would have huge spikes in their insulin after eating.  That very high level of insulin will cross react with a receptor on the ovary called Insulin-like growth factor receptor.  As the name suggests, at high concentrations of insulin, the insulin can bind to this receptor.  When this receptor is activated, it will cause an increase in male hormone production from the ovary.  This increase in male hormone production result in poorer egg quality, increased androgenic side effects (facial hair growth, acne , etc...) as well as an increase in central adipose deposition (increase in belly fat specifically more than in the extremities).  It is also ideal to decrease preservatives as much as possible and eat fresh foods as much as possible.  In today’s society that is incredibly challenging but doing what you can is beneficial.

Women who have PCOS will have weight loss and decreased androgenic effects from eating 3 meals a day as opposed to 1-2 meals a day.  Even if you cannot eat 3 meals, it is important to eat SOMETHING at least 3x a day to avoid your brain being exposed to extended periods of starvation.  After 3-6 months of this patients often note improved quality of life.  For patients who have PCOS and are obese, weight loss is also beneficial.  This pattern of eating helps with weight loss.  Patients who are trying to lose weight should set a goal of 5-10% reduction of their body weight over 3-6 months. 

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Dr. Louis R. Manara

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