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Managing PCOS With Diet: What to Eat and What to Avoid

Contributor Shruthi Mahalingaiah, MD, MS
7 minute read
Woman eating a healthy meal with vegetables

Polycystic ovary syndrome (PCOS) is a hormone disorder that can affect your reproductive system and appearance. People with this condition also are at increased risk of obesity, heart disease, and diabetes.

But a healthy diet, exercise, and restorative sleep can help reduce symptoms and manage the side effects of PCOS, says Shruthi Mahalingaiah, MD, MS, a Mass General Brigham reproductive endocrinologist/gynecologist and director of the Ovulation Health Clinic at the Fertility Center at Mass General Hospital.

“Health optimization in people with PCOS is sensitive to a lot of things — especially the things we eat and drink, our sleep-wake cycle, and physical activity,” she says. “Start with a balanced diet of whole, fresh foods as much as possible and limit ultra-processed foods. And put that diet into context of your circadian rhythms (your sleep-wake cycle). This means eating when you’re having the most activity, because that’s when your body needs the energy and can burn off excess blood sugar.”

This approach will help you control your blood glucose, which affects insulin and androgen levels. Ultimately, that can mean fewer PCOS symptoms and long-term health risks.

Health effects of PCOS

Your body breaks down the food you eat into glucose (sugar). Most of that sugar gets released into your bloodstream (blood sugar). Blood sugar instructs your pancreas to release insulin, which helps your cells use blood sugar for energy. 

Most people with PCOS have insulin resistance, which means the body doesn’t use insulin well. Over time, insulin resistance can lead to elevated blood sugar levels, weight gain, chronic inflammation, and diabetes. Insulin resistance can also lead to excess androgens (male sex hormones).

Insulin resistance and excess androgens can cause symptoms such as:

  • Appearance: Excess hair growth or hair loss, acne, and weight gain
  • Overall sense of well-being: Fatigue, low energy, anxiety, mood disorders like depression, and poor quality of life
  • Reproductive health: Irregular menstrual periods, and infertility

Your doctor may prescribe contraceptive (birth control) medications, fertility-enhancing medications, or diabetes medications to help manage PCOS symptoms. But Dr. Mahalingaiah emphasizes that you can also reduce the effects of PCOS with dietary choices.

Nutrition for PCOS management aims to control blood glucose, which can improve your body’s use of insulin and decrease androgen levels. 

It helps to plan your meals at times when they can actually fuel your activity.

Shruthi Mahalingaiah, MD, MS

Obstetrician and Gynecologist

Mass General Brigham

PCOS diet plan

Nutrition for PCOS is similar to nutrition for people with diabetes. The two most important factors are the types of foods you eat and the times of day you eat, Dr. Mahalingaiah says.

First, think about your food choices. Many people fall into a pattern where they eat starchy carbohydrates or sugars for a quick energy boost (or because they taste good). The sugar in those foods enters your bloodstream very quickly. Then your pancreas produces insulin to help your body process the glucose. People with PCOS who have insulin resistance are not able to process blood glucose effectively. As a result, the pancreas makes more and more insulin. 

It’s important to manage this process so you don’t develop obesity and diabetes. Try to pair carbs and sugars with protein and fiber. This can slow the release of glucose into your bloodstream, which lessens the amount of insulin your body releases. A balanced diet can also help level out energy levels, reduce the symptoms of PCOS, and improve long-term health.

You should also think about when you need energy during the day, Dr. Mahalingaiah says. For example, many people tend to eat their heaviest meal at night, right before they go to sleep. Your blood glucose will rise, but it won’t get used to fuel activity.

The best diet for PCOS includes small healthy meals throughout the day. Dr. Mahalingaiah recommends eating your largest meals just before your more active times of day. For many people, this is right before you walk out the door to work or school. “It helps to plan your meals at times when they can actually fuel your activity,” she explains.

Finally, Dr. Mahalingaiah cautions against fad diets, intermittent fasting, and binge eating. She also usually doesn’t recommend weight-loss drugs or bariatric surgery as a first-line treatment. They may not help establish good habits and can ultimately lead to rebound weight gain.

Good foods for PCOS management

Dr. Mahalingaiah recommends whole, natural foods that fuel your body over longer periods of time and avoid spikes of glucose and energy.

Incorporate foods that contain more protein and fiber, which slow the release of glucose into the bloodstream:

  • Green, leafy vegetables such as spinach, kale, and lettuce
  • Foods rich in fiber, such as berries, whole grains, beans, and apples
  • Fresh foods that have not been processed and are as close to whole as possible
  • Lean proteins, such as beans, legumes, nuts, and fish
  • Non-starchy vegetables such as peppers, broccoli, cauliflower, mushrooms, snow peas, and celery
  • Whole grains, such as whole grain breads and pastas, brown rice, and barley

Foods to avoid with PCOS

Try to limit foods that tend to spike blood glucose, such as packaged, processed foods like chips. If you can’t read or recognize the ingredients on a food label, that food is highly processed.

Other foods to avoid include:

  • Foods with refined flour, such as white bread, pizza crust, and pasta
  • Fried foods
  • Red meat and processed lunch meats
  • Saturated fats such as butter and margarine
  • Sugary snacks, such as candies, cookies, and cakes
  • White rice

Dr. Mahalingaiah recommends working with your primary care provider (PCP), your OB/GYN, or a nutritionist. They can help you make small, sustainable changes to establish a PCOS meal plan. Over time, those changes will help you control blood glucose, insulin, and androgens — reducing PCOS symptoms and the risk of chronic conditions.

Shruthi Mahalingaiah, MD, MS


Obstetrician and Gynecologist