Eat for Your PCOS Type: 4 PCOS Meal Plans for the 4 Types of PCOS

 

Polycystic Ovary Syndrome (PCOS) is a condition characterized by both metabolic and reproductive hormone imbalance, and is one of the most common causes of fertility challenges in women. 

Many women with PCOS experience irregular periods, lack of ovulation, acne, unwanted facial hair growth, mood disorders, and hair loss. PCOS can also have significant metabolic effects, often leading to insulin resistance, weight gain, and difficulty losing weight.

PCOS is diagnosed via the Rotterdam criteria. According to this criteria, you must have two of the following three characteristics: irregular periods, elevated androgens (i.e. testosterone or DHEA), or multiple cysts on the ovaries. We can’t stop at a PCOS diagnosis. 

It’s important to gain a better understanding of the other conditions at play, for example insulin resistance and inflammation. In doing so, we can implement different nutrition strategies to help manage and reverse PCOS symptoms and enhance reproductive health.

 

4 Types of PCOS

Within functional medicine, we classify  PCOS into four types, correlated to the primary underlying drivers of the condition.

The first type, Insulin-Resistant PCOS, is characterized by symptoms related to blood sugar challenges, sugar cravings, and weight gain. The second is Inflammatory PCOS, in which chronic inflammatory symptoms like fatigue, joint pain, skin issues, gut issues, and thyroid conditions like Hashimoto’s thyroiditis, are present. Next, Post-Birth Control PCOS occurs in women who experience PCOS symptoms only after coming off of oral contraceptives. Finally, in the case of Adrenal PCOS, high androgen levels are driven primarily by adrenal androgen production rather than ovarian production, resulting in elevated DHEA levels. 

It is common for there to be overlap between these PCOS types, especially as it relates to challenges with inflammation and insulin resistance. It’s also worth noting that you may have to do some additional investigating to help identify your PCOS type(s), as well as any contributing root causes, such as autoimmune Hashimoto’s thyroiditis. 

Let’s dive into the four PCOS types as well distinct meal plans and tips for each type!

 

1. Insulin-Resistant PCOS

In the case of Insulin-Resistant PCOS, insulin resistance, or blood sugar dysregulation, serves as a primary driver of elevated androgen hormones. This is the most common type of PCOS, and affects around 70% of women with PCOS, even if there are other driving factors at play.

High levels of insulin, a hormone secreted by the pancreas when glucose enters the bloodstream, can trigger excess production of androgens such as testosterone, DHEA, and androstenedione. Elevated androgen levels are a key contributor to impaired ovulation, considering that androgen production competes with progesterone production, an essential fertility hormone. This is one way that elevated androgens in PCOS can cause fertility issues and other reproductive health challenges, common among those with PCOS. Spearmint tea has been shown to have powerful effects of lowering excess androgens.

Nutrition plays a vital role in addressing and correcting insulin resistance, especially as it pertains to driving PCOS symptoms. Foods like apple cider vinegar and other bitters promote the release of stomach acid and digestive juices. Acetic acid (the active compound in vinegar) has been shown to lower the glucose response after a meal, making it a great tool for blood sugar balance. 

Prioritizing protein and spreading protein intake throughout the day effectively helps to regulate blood sugar balance and insulin sensitivity. Consuming protein every 3-5 hours, whether in a meal or snack, also helps maximize muscle protein synthesis, or muscle rebuilding. With muscle being responsible for 70-90% of glucose disposal, ensuring we have adequate muscle mass is critical for blood sugar balance. 

Like many of our other hormones, insulin production is in part driven by circadian rhythms. This makes us more insulin sensitive earlier in the day. That means our body’s ability to utilize and transport glucose is more effective early on and then decreases as the day progresses. Keep this in mind as you time and structure your meals!

PCOS-IR Meal Plan:

• • 15 mins before meals: Apple cider vinegar functional beverage
  • Breakfast: Breakfast skillet with 4 oz ground turkey, 1 diced zucchini, ¼ sweet potato, 1 cup baby kale, 1 egg, ½ cup salsa
  • Lunch: Mexican Burrito Bowls + 4-6 oz of protein
  • Dinner: Greek Chicken Souvlaki Skillet
  • 2 cups spearmint tea

 

 

 

 

 

 

 

2. Inflammatory PCOS

Inflammatory PCOS is driven by, you guessed it, inflammation! Inflammation itself can have a variety of driving factors, making additional testing helpful in many situations. Inflammatory thyroid conditions, such as Hashimoto’s thyroiditis, can be a major driving factor.

In the case of inflammatory PCOS, and especially when the thyroid is involved, it’s essential to incorporate mineral-rich foods and beverages, anti-inflammatory foods, and antioxidant-rich foods. 

Thyroid hormones especially are extremely mineral dependent. Minerals like magnesium, selenium, zinc, and iron are essential for making thyroid hormones. Iodine is another key thyroid mineral, however too much or too little can cause hypothyroidism, so it’s important to ensure iodine levels are balanced.

We can get anti-inflammatory omega-3 fatty acids from salmon, flax seeds, chia seeds, and walnuts. Bone broth, bone-in protein sources, as well as collagen are rich sources of amino acids glycine and glutamine, both of which have anti-inflammatory properties.

Antioxidants help to reduce free radicals in the body and protect against oxidative stress, both of which are drivers of inflammation. Leafy greens, dark berries, citrus fruits, olive oil, and green tea are all potent sources of antioxidants and important to incorporate for those with inflammatory PCOS. 

While not all individuals with inflammatory PCOS have sensitivities to gluten or dairy, these can be helpful foods to avoid to help lower any inflammation that may be coming from these food sources. Other foods that have the potential to fuel inflammation include added sugars, hydrogenated vegetable oils, corn, and soy.  

Another way to support lowering inflammation is by supporting liver function and the liver’s innate detoxification processes. We can do so by incorporating bitter foods that stimulate bile flow, such as citrus fruits, beets, arugula, and dandelion.

PCOS-I Meal Plan:

• • Sodium-focused electrolytes upon waking and mid-afternoon
  • Breakfast: Mediterranean Breakfast Smoothie
  • Lunch: Beet and arugula salad with chicken and pumpkin seeds
  • Dinner: Pineapple Salmon Skewers + Side of Broccoli Slaw
  • Snack: 12 oz bone broth + 4 Brazil nuts + electrolytes

 

3. Post-Birth Control PCOS

Some women may not develop PCOS until after coming off of oral contraceptives. This is what we call post-birth control PCOS, or post-pill PCOS. In this type of PCOS, the primary goal is to restore the brain to ovary connection, or the cascade along the hypothalamic-pituitary-ovarian (HPO) axis. 

A critical factor in re-establishing this connection is managing cortisol, our body’s main stress hormone. We can support our body’s stress response by ensuring we are eating within 1-2 hours of waking, getting sunlight exposure in the morning, and delaying caffeine intake until after breakfast.

Oral contraceptives have been shown to deplete vitamins and minerals, namely B vitamins, vitamin C, vitamin E, magnesium, selenium, and zinc. Recall that these minerals are also all essential for thyroid hormone production! Zinc, along with chromium, is also a key mineral responsible for blood sugar regulation. 

We can work to replenish these vitamins and minerals by incorporating foods such as grass-fed beef, citrus fruits, dark leafy greens, pumpkin, pumpkin seeds, Brazil nuts.

PCOS-BC Meal Plan:

• Sodium-focused electrolytes upon waking and mid-afternoon
• Breakfast: Detoxification Smoothie
• Lunch: Kale and sweet potato frittata 
• Dinner: Bison Enchiladas
• Snack: Greek yogurt with berries and pumpkin seeds + electrolytes

 

4. Adrenal PCOS

The adrenal glands are always at play in PCOS, and are responsible for at least 20-30% of the elevated androgens that are seen. In Adrenal PCOS, DHEA is the main androgen that is elevated. DHEA is primarily produced by the adrenal glands, compared to testosterone, which is made primarily by the ovaries. Similar principles are crucial for adrenal PCOS as in other types, such as blood sugar balance, lowering inflammation, mineral replenishment, and stress management. 

The adrenal glands are responsible for cortisol production, as the final player in the HPA axis, and rely heavily on minerals, namely sodium and potassium, and vitamin C in order to function optimally. It’s important to include these supportive nutrients daily, through whole food sources like citrus fruits, avocado, sweet potato, and a high quality unrefined salt.

Cortisol production and blood sugar balance are intimately connected. Just as we want to avoid moments of hyperglycemia, or elevated blood sugar, we also want to avoid times when our blood sugar drops too low, or hypoglycemia. When our blood sugar is too low, that triggers a stress response and the release of cortisol in order to free up stored glucose from the tissues. This process alone can impact other hormones as well, such as progesterone, estrogen, and thyroid hormone conversion. 

 

PCOS-A Meal Plan:

• Sodium-focused electrolytes upon waking and mid-afternoon
• Breakfast: Mediterranean Breakfast Smoothie + 1 tbsp camu camu powder
• Lunch: Salmon tacos with grain-free tortillas, black beans, cabbage, and salsa
• Dinner: Baked Chicken Stuffed Sweet Potatoes + Side Salad with extra virgin olive oil and lemon juice
• Snack: Coconut yogurt with strawberries and chia seeds + electrolytes

 

 

There are 4 types of PCOS, although you may exhibit symptoms of multiple types. It’s important to identify any underlying drivers of PCOS, be that insulin resistance, autoimmunity, thyroid conditions, inflammation, or elevated cortisol, to name a few. 

By focusing on nutrition and lifestyle strategies to help regulate blood sugar, improve insulin sensitivity, ease inflammation, lower excess androgens, and support the body’s nervous system, we can help manage and reverse PCOS symptoms and enhance our reproductive health.

We can help you identify your PCOS type and determine a personalized nutrition, supplement and lifestyle plan to support healing and PCOS reversal with our 1:1 coaching program.

 

Written by Romana Brennan, MS, RD