PCOS Diet: Eating to Manage Polycystic Ovary Syndrome

If you've been diagnosed with polycystic ovary syndrome (PCOS) , your doctor may start you on a variety of medical treatments - but lifestyle changes can be a major part of PCOS management. One important area where you can make healthy changes is your diet. Though there's no "official" PCOS diet, evidence shows that certain patterns of eating may ease PCOS symptoms.

Here's a look at how diet can make a difference for women with this condition.

PCOS Diet Basics

Wondering what to eat for PCOS? According to Melissa Groves Azzaro, RDN, of The Hormone Dietitian in Keene, New Hampshire, several key dietary principles can be helpful when you're building a PCOS-friendly eating plan. "First, insulin resistance is a common driver of PCOS symptoms, so following a blood-sugar-balancing diet may help," she says.

"Increasing protein and fiber and eating a moderate amount of carbohydrates with an emphasis on whole grains, legumes, fruits, and vegetables is a good place to start." Meanwhile, a focus on anti-inflammatory foods (which also include whole grains, legumes, fruits, and veggies, fatty fish, and some herbs and spices) is another good approach. "[This] helps lower the inflammation levels common in PCOS," Groves Azzaro says. And if you support your gut and hormone health with both soluble and insoluble fiber, probiotics, and prebiotics , it can help your body effectively get rid of excess hormones, she says.

Several mainstream diets may have a positive effect on PCOS. Here's what we know so far.

A Low-Carb or Ketogenic Diet

Low-carb and ketogenic diets are popular among women with PCOS, especially those looking to lose weight or improve insulin resistance, says Alyssa Pacheco, RD, the Boston-based creator of PCOS Nutritionist Alyssa . "Limiting carbs can decrease blood sugar levels and ultimately reduce insulin resistance . It can also promote weight loss, which may improve symptoms as well," she says.

There's another potential benefit to a low-carb eating plan: "Lower carb intake has been shown to improve fertility and ovulation rates among those with PCOS," Pacheco says. A study published in 2023 revealed that women with PCOS who followed a ketogenic diet for 45 days or more experienced improvements in reproductive hormones.

On the other hand, Pacheco points out that a keto diet has some significant drawbacks for PCOS. With its extreme carbohydrate restriction, it can be difficult to stick with. "Dieting and weight cycling can lead to worse metabolic health and a higher body weight in the long run," she says. Plus, going low-carb often means cutting fiber - not a good thing for those with this condition. "Women with PCOS are already at a disadvantage when it comes to gut health," Pacheco says. "Research has found that women with PCOS tend to have a less diverse gut microbiome . Limiting dietary fiber may negatively impact the gut microbiome long term."

Mediterranean Diet

This diet is based on the eating patterns of people living around the Mediterranean Sea and abounds in whole foods, especially vegetables, fruits, fish, seafood, legumes, nuts, whole grains, and olive oil. "These foods naturally contain antioxidants and anti-inflammatory properties that can help to lower chronic inflammation, which is common for women with PCOS," says Pacheco. "The foods consumed on a Mediterranean diet also tend to be high fiber, which is an important nutrient for improving gut health and stabilizing blood sugar levels." She adds that the anti-inflammatory nature of a Mediterranean diet could also reduce insulin resistance.

Research backs these principles. One study found that a Mediterranean diet could play a therapeutic role in reducing inflammation and normalizing hormone levels in women with PCOS.

DASH Diet

Like the Mediterranean diet, the DASH diet (which stands for Dietary Approaches to Stop Hypertension) focuses on increasing fruits and vegetables, whole grains, and lean proteins while decreasing processed foods. Some research has found that this eating plan could benefit PCOS. In an older study, for example, 48 women with PCOS were assigned to either a DASH diet or a calorie-restricted control diet. Those who adhered to DASH's principles had significantly reduced levels of serum insulin, triglycerides, and LDL cholesterol.

For Americans, a DASH diet may have an advantage over a Mediterranean diet because it typically involves foods that are more familiar to people used to eating a Western diet. "This can be easier to adhere to for some than a dietary pattern that is very different from what they're currently eating," says Groves Azzaro. "And since PCOS is a lifelong condition, any diet changes that you plan on making, you need to be able to stick with for a lifetime."

Best Foods for PCOS

In general, the best foods for PCOS are minimally processed choices. They include:

• Lean proteins like skinless chicken, lean beef, tofu, tempeh, and eggs
• Fatty fish, including salmon, tuna, herring, and mackerel
• Nuts and seeds, such as walnuts, almonds, chia seeds, and pumpkin seeds
• Whole grains, such as whole-wheat breads and pasta, barley, brown rice, quinoa, and oats
• Beans and legumes, including black beans, chickpeas, kidney beans, white beans, and lentils
• Leafy green vegetables, such as kale, collard greens, spinach, and mustard greens
• Cruciferous vegetables like broccoli, Brussels sprouts, and cauliflower
• Root vegetables like sweet potatoes, beets, and carrots
• Fruits, including apples, bananas, berries, cherries, kiwi, papaya, pears, pomegranate
• Healthy fats, such as olive oil, ground flaxseed, and avocados
• Anti-inflammatory herbs and spices like garlic, turmeric, and ginger
• Water, tea, or other low-sugar beverages

Foods to Avoid if You Have PCOS

"There aren't any foods that are automatically off-limits for women with PCOS," says Pacheco. "However, there are some foods which, when consumed frequently or in large quantities, may worsen PCOS symptoms." These may include:

• Refined grains like white breads, pastas, crackers, or rice
• Ultra-processed foods like packaged snacks, flavored chips, or protein bars
• Processed meats, including deli meat, sausage, or salami
• Foods with added sugars, such as candy, cakes, cookies, brownies, and ice cream
• Sugar-sweetened beverages like soda, sweet teas, lemonade, and juice with added sugar

The Role of Gluten in PCOS

You may have heard chatter on social media about the relationship between PCOS and gluten. While some women report feeling better when eliminating gluten from their diets, evidence is lacking to support a direct connection between PCOS and gluten sensitivity. "There have been no studies either establishing a link between PCOS and gluten sensitivity or on benefits of a gluten-free diet for PCOS," says Groves Azzaro.

If you already have celiac disease, however, you may have a higher risk of developing PCOS. Research found that women with celiac disease had three times the risk of developing PCOS than the general population.

That said, every person's experience is different. If you feel your symptoms are improved by scaling back on (or outright nixing) gluten from your diet, you may want to seek out gluten-free recipes for PCOS.

PCOS and Weight Loss

Weight gain is a symptom of PCOS, not a cause, says Groves Azzaro. But excess weight can worsen symptoms by increasing insulin resistance and overall inflammation.

Unfortunately, traditional approaches to weight loss may not always be successful for women with this condition. Weight loss becomes especially challenging in the face of issues like insulin resistance, inflammation, elevated androgen levels, cortisol dysregulation, and thyroid problems, Groves Azzaro says. She suggests working with your healthcare team to identify and address which of these root causes are to blame for weight loss difficulties.

You can always work with your provider(s) to develop a diet plan for PCOS weight loss, too. "In general, we want to focus on a balanced meal plan that is in a slight deficit for steady weight loss, exercising in alignment with the guidelines (150–300 minutes of cardio per week plus two to three full-body weights workouts a week), managing stress, and getting seven to nine hours of sleep a night," says Groves Azzaro.

Still, Pacheco notes that, even if these efforts move the number on the scale, it's not a guarantee of fewer PCOS symptoms. "This is especially true when you consider that up to 30 percent of women with PCOS have a normal BMI," she says. ( One study , for example, found that 24.5 percent of PCOS patients were categorized as "lean.")

How to Make Sure You're Eating a Balanced Diet With PCOS

A balanced diet ensures you get adequate nutrition with PCOS. In addition to nutrients like fiber, protein, and healthy fats, you may want to focus on a few "extras," whether from food or supplements. "There are some supplements that are foundational for most people with PCOS, including myo-inositol and vitamin D to improve insulin sensitivity, and omega-3-rich fish oil to lower inflammation and testosterone levels," says Groves Azzaro.

Other potential best supplements for PCOS, she says, include magnesium glycinate for sleep, magnesium citrate for constipation, ashwagandha for stress, and turmeric, resveratrol, or quercetin for inflammation. "Work with a practitioner like a dietitian to help determine which supplements may be helpful as well as safe and effective in your situation," she suggests. "And always check with your healthcare practitioner before starting a new supplement."

The Takeaway

Finding your best diet for PCOS may take some time and experimentation. Consider beginning with whole, anti-inflammatory foods like lean proteins, whole grains, fruits, vegetables, nuts, and seeds. These may start you on the path toward fewer symptoms - or even weight loss as an extra benefit.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

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2. Angoorani P et al. The effects of probiotics, prebiotics, and synbiotics on polycystic ovarian syndrome: An overview of systematic reviews. Frontiers in Medicine . 2023.
3. Khalid K et al. Effects of Ketogenic Diet on Reproductive Hormones in Women With Polycystic Ovary Syndrome. Journal of the Endocrine Society . August 2023.
4. Sun Y et al. Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications. Frontiers in Cellular and Infection Microbiology . February 2023.
5. Barrea L et al. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women With Polycystic Ovary Syndrome (PCOS). Nutrients . October 2019.
6. Asemi Z et al. Effects of DASH diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: A randomized clinical trial. Nutrition . November–December 2014.
7. Rama N et al. Women's Health Disorders in a Celiac Disease Population - a Nationwide Cohort Analysis. American Journal of Gastroenterology . October 2023.
8. Mohapatra I et al. BMI and Polycystic Ovary Syndrome: Demographic Trends in Weight and Health. Cureus . March 2024.

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Lynn Grieger is a registered dietitian-nutritionist, certified diabetes care and education specialist, certified personal trainer, and certified health and wellness coach. She completed requirements to become a registered dietitian at Valparaiso University in 1987 and completed a dietetic internship at Ingalls Memorial Hospital in Harvey, Illinois, in 1988.

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