female_health

Polycystic Ovary Syndrome (PCOS)

PCOS affects 8-13% of reproductive-age women. 5-10% weight loss in overweight PCOS women restores ovulation in 50-60%. Mediterranean + resistance training is first-line.

Nutrition

Pattern

Mediterranean OR low-glycaemic

Foods to emphasise

Non-starchy vegetables
Legumes
Whole grains
Fatty fish
Nuts/seeds (30 g/day)
EVOO
Berries

Foods to limit

Sugar-sweetened beverages
Refined carbohydrates
Ultra-processed foods
Trans fats
Excess saturated fat

Exercise

Aerobic

Moderate 30 min × 5 d/wk drops insulin resistance + restores cycles.

Strength

3 d/wk — most insulin-sensitising modality; minimum 8-week trial before judging.

Flexibility

Daily 10 min.

Weekly target

150 minutes

Supplements

Myo-inositol + D-chiro-inositol (40:1)

2 g myo + 50 mg DCI × 2/day

RCT

Restores ovulation in 60-70%; safe.

Vitamin D3

1000-2000 IU/day

RCT

Low D common in PCOS.

Omega-3

1-2 g/day

RCT

Improves lipid + androgen profile.

N-acetyl-cysteine

600 mg × 2/day

observational

Antioxidant; may improve ovulation.

Monitor + cadence

What to track

Cycle length + ovulation tracking
HOMA-IR or fasting insulin annually
Lipid panel annually
HbA1c annually
BP annually
Endometrial protection (if cycles > 90 days)

Red flags — seek care

Cycles > 90 days for > 6 months → endometrial protection needed (progestin)
Sudden hirsutism + virilisation → androgen-secreting tumour workup
Suicidal ideation (PCOS depression prevalence 4×)

Sources

2023 International PCOS Guideline (Monash)
ACOG Practice Bulletin 194 (2018)

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