Making Peace With PCOS

by Emily Kennedy, MSc, RHN, Billings Ovulation Instructor (in Practicum) and health coach 

In the BOMA-USA pamphlet entitled “Unraveling the mystery of PCOS”, Dr. Mary Martin speaks to natural ways of treating this increasingly common condition. As Billings user may already be more natural-minded than the average woman, this is a great question to know how to address with ready-to-go tips.  

Besides drugs such as metformin, bromocriptine or dexamethasone, Dr. Martin has some good advice for managing PCOS naturally. This advice can be organized into two categories:  

1. Improving insulin sensitivity 
2. Eliminating foods that trigger an inflammatory immune response 

First, improving insulin sensitivity. Here are some proven therapeutic lifestyle changes: 

Exercise – works by activating the Glut 4 alternate pathway for glucose entry into the cell. Three 10-minute session per day (ie a brisk walk after every meal) only 5 days per week will give you the CDC recommended 150 minutes per week. Doesn’t that sound doable? 

Calorie shifting (or caloric cycling) – works by improving fasting insulin concentrations as well as subcutaneous and visceral fat. There are many variations of the calorie shifting approach, all involve eating a regular amount of food for a set number of days, then significantly reducing caloric intake for another set time frame. Some variations also include specific intervals between meals. (Using a food tracker like the MyFitnessPal app helps a lot with this technique.)  
 
Limit sugars and starches – works by reducing the carbohydrate/glucose load in your bloodstream, thereby reducing the insulin spike. Sugars include refined sugars from processed “treat” items as well as natural sugars found in fruit, dairy, grains and starchy vegetables like potatoes and corn. Ask your client to start by picking one sugary/starchy item they can do without. 

Emphasize fat, fiber and protein – works by slowing the digestion of food, resulting in a slower rise in insulin. Choose unprocessed plant-based fats like nuts, seeds, avocado, and coconut more often than animal-based fats like cheese, butter or bacon. Many of the whole foods listed as plant-based fats are also sources of fiber and protein. Bonus! 

In some cases, PCOS has an autoimmune component in addition to endocrine and reproductive effects. A physician can determine the presence or absence of antibodies that indicate autoimmunity.  

What’s going on with your client’s digestion? Protein components (ie gluten, casein) from foods containing wheat and dairy are some only partially digested, creating macromolecules the immune system does not recognize and therefore attacks. This is the food-digestion-autoimmunity connection.   

An Elimination Challenge is the best way to determine if improving autoimmune PCOS is as simple as cutting out gluten, dairy or another possible food offender. Per Precision Nutrition’s infographic guide, here’s a synopsis of an Elimination Challenge: 

1. Decide which food you like to test (ie wheat/gluten, dairy/casein/lactose). 
2.  Get into the habit of checking food labels for “May contain trace..” or “Contains...” 
3. Avoid all foods that contain the food you are testing for 3 weeks. (Keeping a food record is very handy for tracing back any symptoms to possible ingestion of the test food) 
4. After 3 weeks, re-assess signs and symptoms. Have things improved? 
5. Slowly re-introduce the test food, once per day, every 3-5 days. Note if symptoms reappear.

 
(N.B. When eliminating gluten, be mindful of the tips to improve insulin sensitivity and stay away from highly refined carbohydrates like gluten free cookies, pretzels, crackers, etc.)   

According to the U.S. Department of Health and Human Services, PCOS affects 1 in 10 women of childbearing age worldwide. Lifestyle changes are hard work but have the potential to cut medication costs and restore reproductive and endocrine function naturally. If your client is motivated, consider referring them to an experienced health coach who can help them stay on track with their wellness goals.  

As Billings Ovulation Method® teachers we cannot be seen to advise in areas where we do not have the expertise or training. However, this article may be a good resource for you to give to women you are helping who have PCOS, so they can decide if they would like to follow up and get help with their diet and lifestyle changes.

References: 
1. “Unraveling the mystery of PCOS (Polycystic Ovarian Syndrome): Q&A with Mary Martin, MD, FACOG. BOMA-USA pamplet available at www.boma-usa.org  
2.Davoodi, Sayed Hossein et al. “Calorie shifting diet versus calorie restriction diet: a comparative clinical trial study” International journal of preventive medicine vol. 5,4 (2014): 447-56.  
3. Mobeen, Hifsa et al. “Polycystic Ovary Syndrome May Be an Autoimmune Disorder” Scientifica vol. 2016 (2016): 4071735.