All you need to know about PCOS: Symptoms, Causes & Treatment

Acne, weight gain, irregular periods and fertility struggles. Those are just some of the symptoms of polycystic ovary syndrome (PCOS), a hormonal problem that affects up to 20 percent of women worldwide.

The prevalence of PCOS in India is higher than in other countries and unfortunately, PCOS cases in young Indian women are on the rise. Studies say that 1 in 5 Indian women of reproductive age suffers from PCOS.

In this article we will explore the symptoms, the causes, the details of the PCOS diet, and the lifestyle that women who have been affected by PCOS should follow. This should be considered alongside the PCOS treatment advised by your Doctor.

PCOS number of cases: global average graph

PCOS causes

PCOS causes are varied and it arises from a combination of factors.

Genetics

Studies show that PCOS runs in families¹. Multiple genes contribute to an increased risk of PCOS. Carrying a specific gene variant doesn’t guarantee you’ll exhibit symptoms but it is a factor which could, when combined with other factors noted below, result in PCOS².

If your mother has higher levels of testosterone during her pregnancy with you, your risk of developing PCOS goes up³.

Lifestyle habits and insulin resistance

A sedentary lifestyle, poor nutrition, and obesity contribute to insulin resistance and excess inflammation. This makes PCOS more likely, as well as worsens PCOS symptoms.

Up to 70 percent of women with PCOS have insulin resistance, meaning that their cells can’t use insulin properly.

Obesity is a major cause of insulin resistance.

Getting adequate movement, good nutrition, and managing weight won’t cure you if you have PCOS, but they can improve symptoms, quality of life, and future health outcomes⁴.

Environmental factors

Several environmental pollutants have been linked to PCOS, too⁵. These include organochlorine pesticides, perfluorinated compounds, phthalates, and bisphenol A (BPA). Major hormone disruptors, these chemicals are found in air, water, soil, and food, as well as in household cleaning supplies, food containers, and beauty products.

Many women have PCOS but don’t know it. In one study, up to 70 percent of women with PCOS hadn’t been diagnosed⁶.

Polycystic Ovary Syndrome (PCOS) Symptoms

PCOS is a “syndrome” or a group of symptoms that affects the ovaries and ovulation. Its three main features are:

• cysts in the ovaries
• high levels of male hormones
• irregular or skipped periods

The PCOS hormonal landscape of a woman. Source: Precision Nutrition

The most common PCOS symptoms are:

• Irregular periods. Some women with PCOS get fewer than eight periods a year or none at all.
• Heavy bleeding. The uterine lining builds up for a longer period of time, so the periods you do get can be heavier than normal.
• Hair growth. More than 70 percent of women with this condition grow hair on their face and body — including on their back, belly, and chest.
• Acne. Male hormones can make the skin oilier than usual. This can cause breakouts on areas like the face, chest, and upper back.
• Weight gain. Up to 80 percent of women with PCOS are overweight or obese.
• Male pattern baldness. Hair on the scalp gets thinner and may fall out.
• Darkening of the skin. Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.
• Headaches. Hormone changes can trigger headaches in some women.

Doctors would typically diagnose PCOS when someone exhibits at least two of the following three symptoms:

• Irregular periods:They may be shorter than 21 days, longer than 35 days, or completely absent.
• “Cysts” in the ovaries: Confirmed by an ultrasound.
• High androgen levels, like testosterone: This is confirmed by a blood test or visible signs like facial hair, acne, or male pattern baldness.

PCOS treatment

While it is common for doctors to prescribe medication to treat PCOS, several international guidelines as well as the national guidelines by the Ministry of Health and Family Welfare, India, note that the first-line of treatment for PCOS is weight management through proper diet and exercise.

The guidelines note that certain lifestyle changes, such as diet and exercise, are considered first-line treatment for adolescent girls and women with PCOS.

These modifications have been effective in restoring ovulatory cycles and achieving pregnancy in obese women with PCOS. Weight loss in obese women with PCOS also improves hormone levels.

Lifestyle changes for PCOS: diet, exercise, sleep and stress management

On the Internet, you’ll find PCOS diet plans that contain long lists of foods to avoid, or ‘must have’ foods or high-intensity exercise programmes.

We are not going to do that here. Based on the science and our experience of working with thousands of clients, we know one thing for sure: it’s not possible to consistently stick to an extreme diet and fitness plan. It just does not work long term.

The good news is that most people see big improvements with just three small and sustainable lifestyle changes.

1. The PCOS diet: Aim for a lower-carb diet

Research shows that lower carb diets can be helpful⁷. Diets with a lower diary content can also help. See this article we’ve written on a low-carb Indian diet.

When you think of lower-carb, focus on what you should eat and not on what not to eat. This will help you focus on what you need to do and take action.

Here are the key things to focus on when looking to lower your carb intake.

• More proteins: paneer, greek yogurt, soya bean, tofu, lean meat including poultry and fish.
• Non-starchy vegetables: the more colors the better. Like spinach, broccoli, cabbage, green beans, ladies’ finger, cucumber, capsicum, tomatoes, mushrooms.
• Low-sugar fruits: apples, oranges, guava.
• Healthy fats: nuts and seeds, ghee and oils (olive and coconut)

When the above foods take up most of the space on your plate, you will find that you automatically fill your plate with smaller amounts of grains and starchy vegetables (like potato).

2. Exercise for PCOS: Do something you enjoy

In women with PCOS, exercise can provide many benefits:

• Improve insulin sensitivity
• Improve ovulation and menstrual regularity ⁸
• Decrease risk of cardiovascular disease
• Improve mental health ⁹

Here is the goal you should aim for.

Aim to get at least 45 mins of movement each day.

This does not need to be a workout. Even a brisk walk can make a big difference. Find exercise options that you like doing – playing a sport, dancing, cycling. Whatever you look forward to doing. This will ensure that you are regular with it and don’t need to rely on motivation or willpower to keep you going.

3. Sleep & stress relief for PCOS

Getting enough sleep is not a ‘nice to have’. It’s a ‘must do’ to allow your body to operate at its best. This includes hormonal health too.

Aim to get 7 hrs of sleep on a consistent basis.

Having a good sleep routine helps a lot to prepare your body and mind for sleep.

Take a look at this infographic where we outline a power-down ritual that you can use to wind down for the day and get high-quality sleep.

If stress is a problem for you, include some stress-relieving activities into your daily schedule. Meditation, walking outdoors, time with family and friends, and engaging in your favorite hobbies are great stress-busters.

PCOS weight loss diet plan for women

It can be harder losing weight with PCOS. That is one reason you should focus on the lifestyle habits we mentioned in the previous section. Your diet, movement and sleep have a bigger influence on your health and PCOS symptoms than just your weight. In many cases, fat loss will happen anyway as a natural side effect of better overall health. But if it doesn’t, you’ll still be eating, moving, feeling, and living better.

We have outlined below a PCOS weight loss diet plan that you can try in order to better balance your diet, lose excess weight and improve your PCOS symptoms.

Please use this as a guide only. The portions are based on a woman in the weight range of 60-70 kgs.

We would recommend that you work with a Daily9 coach to customize it further for your needs.

7 days pure vegetarian diet plan for PCOS

Day 1

Breakfast:

• 1 fist paneer bhurji with ½ cup tomato, onion, capsicum
• 1 slice toast
• 1 orange
• 1 cup tea/coffee

Lunch:

• ½ cup rice
• ¾ cup methi dal (½ cup lentils)
• ½ cup cauliflower
• ½ cup yoghurt

Snack:

• ½ scoop Whey fruit smoothie with ½ cup milk,
• 1 banana

Dinner:

• 1 cup veg stir fry
• ¾ cup dal (½ cup lentils)
• ½ cup jeera rice
• ½ cup green salad

Day 2

Breakfast:

• 1 cup tea/coffee
• Whey fruit smoothie (1 scoop whey, 1 banana, ½ cup milk, ½ cup oats)

Lunch:

• ½ cup rasam rice
• ½ cup cabbage poriyal/ stir fry
• 1 cup pumpkin and lentil stew (with ½ cup pumpkin, ½ cup dal)

Snack:

• ½ fist sauteed spiced paneer
• 1 pear
• 1 black tea/coffee

Dinner:

• Veg+soy bean curry (½ cup each)
• 1 radish paratha
• 1 cup mix veg raita (with ¾ cup veg)

Day 3

Breakfast:

• 2 adais (lentil dosa)
• 1 cup aviyal (vegetable and coconut stew)
• 1 cup tea/coffee

Lunch:

• ½ cup pulao
• 1 cup Green salad
• 1 fist tava Paneer

Snack:

• 1 Banana
• 1 black tea/coffee

Dinner:

• ½ cup ridgegourd or other vegetable chutney
• ½ cup spiced soy bean
• 2 dosas
• 1 cup yoghurt

Vegetarian diet for PCOS

Day 4

Breakfast:

• 1 cup tea/coffee
• 1 fist paneer bhurji with ½ cup tomato, onion, mushroom
• 1 slice toast

Lunch:

• ½ cup rice
• ½ cup beans/carrot sambar (¼ cup veg+¼ cup dal)
• ½ cup bhindi sabzi
• ½ cup yoghurt

Snack:

• 1 scoop Whey+apple smoothie

Dinner:

• 1 cup veg stew/kurma
• ½ cup rice
• ¼ cup Grated carrot salad with ¼ cup chickpeas

Day 5

Breakfast:

• 1 cup tea/coffee
• ½ cup Overnight oats with 100 gms Greek yoghurt +1 grated apple

Lunch:

• ½ cup Jeera pulao
• ¾ cup rajma in tomato/onion gravy (½ cup rajma+¼ cup gravy)
• ½ cup Ivy gourd (kundru) sabzi

Snacks:

• Broccoli and paneer tikki (with ½ cup broccoli + ½ fist paneer+¼ cup oats)
• 1 green tea

Dinner:

• Palak tofu (1 cup palak, 1 fist tofu, without cream)
• 1 roti
• Mixed veg raita with ¼ cup veg

Day 6

Breakfast:

• 1 cup tea/coffee
• 2 besan ka cheela with ½ cup tomato onion chutney

Lunch:

• Stuffed bell pepper (½ cup rice, ½ cup veg, ½ fist paneer)
• ½ cup salad (lettuce, cucumber, cherry tomato)

Snacks:

• ½ scoop Whey protein shake
• 1 cup papaya

Dinner: Eating out

• ½ fist Tofu satay
• 1 cup Veg curry
• 1 cup jasmine rice

Day 7

Breakfast:

• 1 cup tea/coffee
• ½ cup spiced soy bean, ½ cup mushroom and spinach
• 1 cup melon

Lunch:

• 1½ cup pulao (½ cup veg/ ½ cup rice)
• 1½ cup black dal (1 cup lentils)

Snacks:

• 1 glass coconut water
• ½ cup cucumber, tomato and bell peppers

Dinner:

Eating out

• 3 slices Paneer and Veg Pizza (½ fist paneer+½ fist cheese+¼ cup veg)
• ¾ cup Caesar salad

Foods to avoid for PCOS

When your goal is to improve your PCOS, you need to be laser-focused on what will help with that goal and what will not.

As we noted at the start of the article, insulin resistance is one of the causes for PCOS. One big factor behind insulin resistance is a high consumption of certain types of foods in the diet.

Foods like this usually fall in 3 categories:

1. Sugary foods. A simple way to think of this is anything sweet that is not a fruit.
2. Oily foods. Anything fried or with excessive oil that you can feel on your fingers.
3. Junk foods. Most things that come in a packet and have a long shelf life.

High calorie foods to avoid for PCOS

Here are some examples of such foods:

• biscuits
• chikki
• popcorn
• Chips
• candy
• all forms of alcohol
• chaat
• samosa & puff
• Large amounts of nuts roasted in oils, with added salt, preservatives etc

It is impossible to have a full list but hopefully you have understood the logic – foods that offer little nutrition but contain a lot of calories.

Conclusion

Women who have been affected by PCOS can certainly improve their situation and lead a healthy and normal life by following the diet, exercise and sleep strategies noted in this article. While losing weight with PCOS can be harder, it is possible.

This is echoed in the national guidelines which state the following.

Eating well, staying active, and maintaining a healthy weight (or losing even a small amount of weight if you’re overweight) can improve PCOS symptoms.

The Daily9 weight loss programme

We’ve worked with hundreds of women and understand the unique challenges they face when trying to lose weight or find a weight loss diet plan. You can see some of our success stories here, including the story of Chitra who lost 25 cms in spite of her thyroid and PCOS issues. The Daily9 system is proven to work as an effective weight loss diet plan. Women coaches at Daily9 have developed practical ideas and strategies that work in real life and improve the weight loss that women achieve with Daily9. This helps with weight loss and also many health conditions that Indian women face like digestive issues, diabetes, PCOS, thyroid, fatty liver and joint problems from excess weight.

While there are many calorie counters out there, we believe that a focus on quality & nutrition (and not just calories) is critical for any weight loss diet plan. Instead of tracking calories, we believe in tracking healthy habits at Daily9.

Most importantly, the Daily9 system is practical and suits an Indian family environment. This will set you up for success with weight loss and also weight maintenance in the long run.

If you’re looking for a scientific and practical approach to weight loss, take a look at the Daily9 coaching programme. It’s the only programme that helps with weight loss and weight maintenance.

About the Author

Coach Shivani

Shivani is a Precision Nutrition-Certified Nutrition Coach with experience of coaching thousands of women. As a mom of two, Shivani knows what it takes for women to achieve weight loss & a healthy lifestyle through diet, exercise & sleep habits. She dislikes one-size-fits-all type advice.