For many women with Polycystic Ovary Syndrome (PCOS), nutrition is one of the most powerful tools in managing symptoms like irregular periods, fatigue, acne and weight gain.
PCOS affects how your body uses the hormone insulin, which means if you have this condition, your diet can directly impact your hormones, metabolism, and long-term health.
If you have been told to “just eat healthier,” but do not know where to start—or you cannot currently see a dietitian—this guide can help you build a realistic PCOS-friendly nutrition plan from home.
Why Diet Matters in PCOS
PCOS is the most common hormonal disorder among women of reproductive age. It affects not only the reproductive system but also many aspects of metabolic health.
One of the key underlying issues of PCOS is insulin resistance, which occurs when the body produces insulin but does not respond to it efficiently. When this happens, the pancreas compensates by producing even more insulin.
Chronically high insulin levels can promote fat storage, especially around the abdomen, and increase androgen (testosterone) production, which can worsen symptoms like irregular periods, acne, and hair growth. High insulin and androgens also make it difficult for those with PCOS to lose weight.
What is the Best Diet for PCOS?
There is no single, best PCOS diet, but certain eating patterns show strong evidence for improving PCOS symptoms, such as focusing on minimally processed foods that are consumed in their most natural state.
The Mediterranean Diet is one that is rich in foods with anti-inflammatory properties can help improve insulin sensitivity and lower cholesterol in women with PCOS. It includes a wide variety of whole foods, making it sustainable and relatively easy to adopt. The Mediterranean Diet focuses on:
- Plenty of leafy, green vegetables (spinach, kale, collard greens) and
- Fruits that are lower in sugar (berries and citrus)
- Beans, legumes and whole grains, which are high in fiber and plant protein
- Healthy fats like olive oil, avocado and nuts
- Lean proteins like fish (especially those high in omega-3’s) and chicken
- Nuts (walnuts) and seeds (sunflower)
- Whole grains such as quinoa, brown rice, barley, whole wheat pasta
- Make water your primary drink as it aids digestion, hydrates, and helps us feel satisfied. Add natural flavoring to your water, such as lemon or cucumber slices, or try naturally sugar free flavored seltzer.
What Is the Best Breakfast for PCOS?
A balanced breakfast is key to blood sugar balance, steady energy, and appetite control. Avoid skipping breakfast, since it can worsen insulin resistance later in the day.
Aim for a combination of protein + fiber + healthy fats to start your day. Then, for the remainder of your day, try including these same three components in your other meals, too.
Examples of Balanced Meals that are PCOS-Friendly
- Greek yogurt bowl: Plain yogurt topped with chia seeds, nuts or seeds, berries, and cinnamon
- Scrambled eggs with veggies: Eggs with spinach, peppers, avocado and served with whole-grain toast
- Overnight oats: Made with unsweetened oats, almond milk, flaxseeds, and cinnamon (skip flavored packets, which are high in sugar and additives)
- Protein smoothie: Blend protein powder, frozen berries, spinach and unsweetened milk or kefir
How Much and How Often Should You Eat?
Eating smaller, balanced meals throughout the day can help control hunger and insulin spikes. Aim to eat every 3-4 hours to maintain steady blood sugar levels and limit overeating urges later in the day. Ideally, evening meals should be lighter and lower in refined carbohydrates (focus on protein and healthy fats instead) to prevent nighttime insulin spikes.
Regarding healthy portion sizes, here is a general guide:
- Protein containing lean meat/fish (palm-sized serving)
- Fiber-rich whole grains (fist-sized serving)
- Healthy fats (thumb-sized serving)
- Raw leafy greens and non-starchy vegetables (at least a fist-sized serving)
- Lower sugar fruits (handful)
Smart Snacking Tips for PCOS
Snacks can help you avoid overeating when consumed in between meals. The following examples that pair protein and fiber will help provide lasting energy:
- Apple slices with all-natural nut butter
- Carrots or celery with hummus
- Hard-boiled egg with a handful of almonds
- Unsweetened Greek yogurt or cottage cheese with chia seeds, fruit and cinnamon
Other Lifestyle Tips That Support a PCOS Diet
In addition to eating a meals and snacks that are anti-inflammatory and whole food based, you will have the best success managing PCOS when you focus on being active, getting adequate sleep and promoting a healthy lifestyle. This includes:
- Moving daily: Focus on improving your cardio by walking, jogging, cycling outside regularly. Incorporate more movement into your day by taking the stairs, dancing, mowing the lawn. Participate in resistance training at least 2 times per week to improve muscle strength and promote insulin sensitivity.
- Getting 7-8 hours of sleep: Poor sleep increases cravings and hormone imbalances.
- Managing stress: High cortisol, being tired, or feeling overwhelmed or anxious can worsen insulin resistance and cravings. Sometimes we eat when we are bored, anxious, lonely or because it has become a habit, which is why recognizing our emotions is so important.
What Foods Should You Avoid With PCOS?
Certain foods can worsen insulin resistance and promote inflammation. Foods that are rich in sugar or heavier in starches enter into the bloodstream quickly. The pancreas responds by producing insulin to help the body process the glucose. Insulin resistance which may be seen in individuals with PCOS makes it difficult to process blood glucose effectively, contributing to increased risk of developing diabetes and obesity.
Whether you have PCOS or not, but especially if you do, it’s best to limit or avoid:
- Sugary foods and drinks: Soda, sports drinks, ice cream, dessert, sweetened coffee, desserts, pastries, sugary cereals, yogurts and candy
- Refined grains: White bread, rolls, wraps, white rice, pasta, dessert and baked goods
- Fried foods: French fries, fried chicken and fried fish
- Processed snacks: Cakes, cookies, chips and granola bars
- Saturated and Trans Fats: Butter, lard, stick margarine or Crisco
- Processed Meats: Hot dogs, salami, sausage and fast food
FAQs About PCOS and Nutrition
Can I eat carbohydrates with PCOS?
Yes, but choose complex carbs like lentils, quinoa and oats, and pair them with protein or fat to prevent blood sugar spikes.
Should I follow a low-carb or keto diet if I have PCOS?
Low-carbohydrate or keto diets can help some people with PCOS by improving insulin sensitivity and reducing blood sugar spikes, but they are not necessary or a sustainable option for everyone. A moderate, balanced approach that limits refined carbs and emphasizes fiber-rich vegetables, lean proteins and healthy fats is usually more effective long-term.
Why is it hard to lose weight with PCOS?
Insulin resistance makes it easier to store fat and harder to use glucose for energy. A balanced, anti-inflammatory diet and regular movement help counteract this.
Can supplements help with PCOS?
Some women with PCOS can benefit from inositol, vitamin D, omega-3s or magnesium, but you should talk to your doctor before starting any supplements (especially if you take other medications).
Is intermittent fasting good for PCOS?
Intermittent fasting was designed to potentially reduce body weight and improve metabolic health beyond simple calorie restriction. While it may have the potential to help some women regulate insulin, it may also potentially trigger fatigue or overeating later in the day.
When to See a Doctor or Registered Dietitian Nutritionist
You do not need to manage PCOS alone. Professional support can make a significant difference, including tailoring your diet and treatment plan to your needs.
If you struggle with persistent fatigue, irregular periods, acne or difficulty losing weight despite lifestyle changes, your endocrinologist or gynecologist can order labs to check blood sugar, insulin and hormone levels.
At Stony Brook Medicine’s PCOS Center, our team of endocrinologists, gynecologists and nutrition specialists helps patients create sustainable, personalized plans to balance hormones and support long-term health. Our experts teach practical ways to improve your relationship with food, manage emotional eating and adopt small, lasting habits that fit your life.
To learn more or schedule an appointment, visit Stony Brook Medicine’s PCOS Center.
