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Nutrition – Proper nutrition is crucial to naturally manage PCOS, especially for women who are already in a healthy weight range. A diet that is heavy in carbohydrates, even whole grains and lots of fruit, may still not be the best for people with PCOS.

• Carbs can cause your blood sugar to rise and then crash, which exacerbates the metabolic condition associated with PCOS.
• Eating plenty of lean protein, healthy dietary fats, fresh vegetables, and high-fiber fruit like apples, pears, and berries can help you maintain a healthy weight and manage your PCOS symptoms.

Getting the right macronutrients (protein, fats, and carbs) and micronutrients (vitamins and minerals) from your food is essential to make sure your body is nourished. Eating plenty of lean protein, healthy dietary fats, fresh vegetables, and high-fiber fruit like apples, pears, and berries can help you maintain a healthy weight and manage your PCOS symptoms.

• PCOS is also linked to heart disease, so eating a low-sodium diet, or one designed for hypertension patients, such as the DASH diet, can help reduce your chances of high blood pressure or even stroke.
• Eating refined sugar, simple carbs, and low-quality, fatty meats, can make the symptoms of PCOS worse.

The peaks and crashes of high blood sugar worsen with a diet heavy in simple-carbs, plus your body won’t get the vital nutrients you need to improve your health.

Can you have PCOS and be lean?

Although a majority of cases with PCOS are obese/overweight, a small but significant proportion of patients present with normal body mass index (BMI; ≤25 kg/M 2 ) that makes diagnostic work up and therapeutic approach more difficult. These cases are termed as lean PCOS.

What vitamins help lean PCOS?

PCOS supplements are an increasingly common method by which to deal with PCOS symptoms (which often include hair loss, weight gain, acne, insulin resistance, and irregular periods, to name a few). But this solution can soon seem overwhelming when you’re looking at the hundreds of options at the drugstore, with zero idea of which PCOS supplements are going to really move the needle on your health.

1. So where should you begin? Exactly which PCOS supplements are scientifically-supported to help manage this hormonal imbalance? And finally, which ones are going to be most effective for you and your body ? These are the questions we’ll be answering in this article.
2. Let’s dive in.
3. What is PCOS? Before we explain which PCOS supplements are going to help mitigate symptoms and manage PCOS pain, we should first explain a little about PCOS and how it works.

PCOS (otherwise known as polycystic ovarian syndrome or polycystic ovary syndrome) is a relatively common hormonal imbalance that affects 6-12% of women in the United States who are of reproductive age. In a nutshell, women with PCOS usually have higher levels of androgens (a male sex hormone), and the knock-on effects of this imbalance leads to ovarian cysts, irregular periods (thanks to halted or inconsistent ovulation), acne, thinning hair on the scalp, excess hair on other areas of the body, insulin resistance, and weight gain.

• Women with PCOS often go on to develop even more serious health problems, especially if they are overweight, including diabetes, heart disease, high blood pressure, sleep apnea, and even stroke.
• Now, the above symptoms and implications of PCOS are common results of this hormonal imbalance, but it’s not a definite sentence.

Just because you are diagnosed with PCOS doesn’t mean you’re going to suffer from every problem that we just mentioned – because there are ways you can naturally treat PCOS using a carefully curated set of supplements (decided alongside input from a physician), alongside an intentional diet and lifestyle,7 Great PCOS Supplements (And Why) Before we dive into which supplements are best to help aid PCOS, we need to understand that finding quality and safe supplements that are a good fit for your body is of the utmost importance.

• This means opting for supplements that are National Sanitation Foundation (NSF) certified, as well as United States Pharmacopeial Convention (USP) certified.
• This is because, currently, the US Food and Drug Administration does not test or approve dietary supplements before they’re marketed.
• As such, by opting for supplements backed by the above-mentioned organizations, you can ensure the products you’re purchasing pass the objective measures and strict criteria the NSF and USP demands of products that bear their marks of approval.1.

Inositol Inositols like myo- and d-chiro inositol B-vitamins (which should be combined in a 40:1 ratio), are a type of of carbocyclic sugar naturally found in foods like fruits, beans, nuts, animal foods, and grains, and they offer antioxidant properties.

Interestingly, inositol used to be considered a vitamin, but it has since been declassified since most people make enough of it internally. The catch here? Those with PCOS do not, so they may need to supplement. As we mentioned earlier, PCOS is a metabolic condition, which is often aggravated by inflammation, insulin resistance, and/or increased androgen levels.

So how does inositol work in controlling insulin levels? Myo and d-chiro inositol work in a complex set of reactions that help run your metabolism, as well as key reproductive pathways, and ultimately assist in the regulation of insulin levels. The end story here? Research suggests that inositols help lower high insulin levels and improve blood sugar levels in women with PCOS.

In addition, a meta-analysis of studies evaluating the effects of MI and DCI inositols on women with PCOS concluded that: 1) MI inositol is helpful in lowering testosterone levels overall, and 2) it takes 6 months and longer to see the positive effects of inositols on androgen profiles and acne. So pick up your inositol supplements soon to start seeing results! When to take this supplement?: 2 hours outside of meal times (minimum) Interested in trying inositol? Allara offers a high quality, PCOS inositol supplement that you can shop here.2.

Vitamin D It’s not just women with PCOS that have low levels of vitamin D – research indicates that around 42% of Americans are deficient in this essential vitamin. That being said, research indicates that supplementation of vitamin D in women with PCOS improves menstrual regularity (after 3 months of supplementation), while it also has been shown to improve fertility and pregnancy rates during assisted reproduction therapy.

1. If these results aren’t enough, vitamin D supplementation has also been shown to improve mood and reduce likelihood of depression in women both with and without PCOS! When to take this supplement?: With food (particularly high-fat foods like avocados, nuts, and salmon!).3.
2. B Complex B vitamins such as B12 and folate are among the most helpful in treating PCOS naturally.

Specifically, they’re thought to help fight insulin resistance in those with PCOS. And that’s not all they do – these water soluble nutrients come with a list of benefits as long as your arm! For instance, B6 is a high-powered supplement that is purported to support mood regulation (it helps in the production of serotonin and dopamine, essential for feelings of happiness and contentment), while B12 is also thought to aid in mood regulation (since this vitamin plays a key role in synthesizing and metabolizing serotonin).

B12 supplementation may be particularly important for women with PCOS to help offset the effects of Metformin, which may reduce levels of B12 in the body. When to take this supplement?: 2 hours outside of meal times (minimum) 4. Fish Oils/Omega 3 Next, we have fish oil supplements, which are heavy in Omega 3s.

(Here, it’s important to keep in mind that fish-based omega 3’s are preferable to plant-based sources, thanks to increased bioavailability of the former!) Omega 3s are so powerful thanks to their anti-inflammatory properties, especially when it comes to treating inflammatory and autoimmune conditions.

Placebo-controlled trials of fish oils through supplementation demonstrate that Omega 3s offer “significant benefit” over placebo, and often result in decreased disease activity and a lowered use of anti-inflammatory drugs. So we know Omega 3 is good for you in general, but what does it do for managing your PCOS symptoms? Well, in a recent meta-analysis of Omega 3s’ impact on women with PCOS in particular, results indicate that these fatty acids are particularly helpful for fighting insulin resistance and treating high levels of total cholesterol (TC) in the blood.

So if nothing else, these omega 3-rich tablets are a good fortifier to pick up and consume alongside natural omega 3 sources, such as fish (particularly salmon, mackerel, and herring), nuts (walnuts, flaxseeds, and chia seeds), and plant oils (like canola oil, flaxseed oil, and walnut oil)! When to take this supplement?: when you’re eating your food! 5.

Berberine Berberine is an alkaloid extracted from herbs, and it can be taken in liquid or capsule form. When it comes to naturally treating PCOS, it’s particularly noteworthy for its role in improving insulin resistance through better insulin signal transduction. For instance, in one small study of 89 women with PCOS, compared to metformin or a placebo, berberine supplementation proved to be just as effective as metformin at lowering insulin and glucose levels, while also reducing levels of LDL (otherwise known as bad cholesterol), and increasing levels of HDL (otherwise known as good cholesterol).

But berberine doesn’t stop there. It’s also known to reduce the secretion of the hormone leptin, which works to stimulate appetite. As such, losing weight may become a lot easier through berberine supplementation, as cravings are reduced, and the enzyme lipoprotein lipase, (responsible for fat storage) is inhibited at the same time.

Finally, apart from the positive effects on improving the metabolic implications of PCOS, berberine may also improve fertility in women suffering from this condition. In one pilot study, ovulation improved by 25% after 4 months supplementing with berberine, while another study indicated that women with PCOS taking berberine had higher pregnancy rates (compared to metformin or placebo) and fewer side effects when taking berberine 3 months prior to their fertility treatment.

When to take this supplement?: Take just before meals.6. Magnesium Did you know that whether you’re considered a healthy weight, overweight, or obese on a BMI scale, that if you have PCOS, there’s a high chance you have insulin resistance? According to recent research, 70-95% of obese individuals diangosed with PCOS have insulin resistance, while 30-75% of lean individuals with PCOS are found to also have insulin resistance.

So why is this symptom in particular such a big deal? And how does it impact your PCOS? Well, insulin resistance leads to Type 2 Diabetes (which comes with a plethora of other health implications affecting the circulatory, nervous, and immune systems), while recent data indicates that insulin resistance is not only a symptom of PCOS, but that it also may be a driver of the hormonal imbalance.

Enter Magnesium. Magnesium is a cofactor of many enzymes involved in glucose metabolism, and in those with Type 2 Diabetes, there appears to be a much lower intracellular magnesium concentration, In other words, there’s deficient levels of magnesium in insulin-resistant patients, and it’s suspected that low levels of magnesium are spurring insulin resistance and heart disease.

So consider topping up on magnesium through magnesium rich foods – like spinach, cashews, almonds, pumpkin seeds, and whole grains – as well as magnesium supplements. In general, you can expect that nuts, seeds, beans, and legumes are generally high in magnesium, so feel free to expand beyond the range of this list.

Just keep in mind that not all supplements are created equally – some forms of magnesium are better processed by our bodies than others. Opt for magnesium citrate or magnesium glycinate, and avoid magnesium oxide (which is insoluble in water and thus has low absorption rates in the human body).

1. Finally, if you choose to increase your magnesium intake through the aforementioned foods, then we recommend not supplementing, to reduce chances of hypermagnesemia (a term used to describe too-high levels of magnesium in the blood).
2. When to take this supplement?: Anytime! 7.
3. Zinc Zinc is a critical micro element that is responsible for the regulation of cell growth, hormone release, reproduction, and immunological response.

It appears that women with PCOS may have lower levels of zinc than women without it, and because of this, women with PCOS may see impaired hormonal, lipid, and glucose metabolism, in addition to “increased concentrations of oxidative stress biomarkers” – yikes.

• So low levels of zinc means you’re at risk for insulin resistance, oxidative stress, and impaired hormonal metabolization.
• So how can zinc help you naturally manage your PCOS symptoms? And does it actually work? Well, in a review of 36 randomized, controlled studies of the effect of zinc supplementation on reproductive symptom disorders (such as PCOS), it was concluded that zinc has a positive effect on insulin resistance and lipid balance.

This means that it helps fight against insulin resistance. As an added bonus, when dosed before and during each menstrual cycle, it may also reduce the intensity of pain associated with menstruation – which means if you suffer from PCOS pain, then you may want to pick up some zinc as part of your regular drugstore shop.

Finally, other studies have shown that zinc may help fight acne, reduce inflammation, and prevent hair loss, as well as protect against chronic conditions like heart disease and diabetes. Just keep in mind that like magnesium, the form you consume your zinc supplement in matters. For the best absorption rates, opt for zinc picolinate, zinc acetate, and zinc glycerate, and avoid zinc sulfate since it has a low absorption rate.

When to take this supplement? 2 hours outside of meal times (minimum)

Can diet help with lean PCOS?

Many people with PCOS find that they’re able to manage their symptoms by making changes to their diet. This often includes consuming more high-fiber foods and lean protein, and limiting refined carbohydrates and sugary foods. People with PCOS are often found to have higher than normal insulin levels.

Insulin is a hormone that’s produced in the pancreas, It helps the cells in the body turn sugar ( glucose ) into energy. If you don’t produce enough insulin, your blood sugar levels can rise. This can also happen if you have insulin resistance, meaning you aren’t able to use the insulin you do produce effectively.

If you have insulin resistance, your body may try to pump out high levels of insulin in an effort to keep your blood sugar levels normal. Too-high levels of insulin can cause your ovaries to produce more androgens, like testosterone, Insulin resistance may also be caused by having a higher body mass index,

What is the root cause of lean PCOS?

Is it possible to be lean and still have PCOS? – The short answer is yes, PCOS can occur in anyone with ovaries. It’s a condition caused by a hormonal imbalance, and an improperly functioning pituitary gland can happen to anyone, regardless of weight.

1. However, excess adipose tissue can exacerbate hormonal imbalances.
2. Young women and teenagers may have irregular cycles, and people with a BMI in the normal range who choose hormonal birth control, such as the pill, patch, or vaginal ring, may not even realize that they have PCOS until they try to conceive.

Hormonal birth control is one of the most frequently recommended ways to help reduce the symptoms of PCOS (after weight loss). Lean women who take birth control can have undiagnosed PCOS for years, which can make treatment more complicated.

How rare is lean PCOS?

Lean PCOS is polycystic ovary syndrome in people of normal weight. Up to 30% of women with the condition fall into this group. But since they are in the minority and excess weight is considered a classic symptom, those with lean PCOS may not be diagnosed right away.

Those who are lean with PCOS can face challenges, including fertility issues and a higher risk of undiagnosed diabetes and heart disease. Their increased levels of androgens (male hormones) can also lead to symptoms like acne, unwanted hair growth, and hair loss, This article explains the unique challenges lean individuals with PCOS face.

It also underscores how lifestyle and diet habits can help any person with PCOS improve their overall health. Skaman 306 / Getty Images

Is inositol good for lean PCOS?

2. Inositol May Reduce Testosterone Levels – In lean women with PCOS, D-chiro-inositol decreased free testosterone by 73% with no change in the placebo group. Six of the 10 women in the D-chiro-inositol group ovulated in comparison with 2 of 10 women in the placebo group.9 Results from a double-blind study on the use of Myo-Inositol also showed promising results.

Can lean PCOS drink milk?

PCOS or polycystic ovarian syndrome is a medical condition, which affects the menstruating women and results in the formation of multiple cysts in the ovaries. PCOS is mainly caused by hormonal imbalance due to the excess production of male hormones like androgen or testosterone.

Around 60-70% of women are suffering from PCOS across the world, although the exact cause is unknown. However, there are several factors that influence i genetics or unhealthy lifestyle can be blamed. Diet plays a vital role in controlling and improving PCOS. A healthy, well-balanced diet that consists of proper nutrients can show positive results in managing PCOS weight and improving insulin production and resistance.

Also, acne, irregular periods, hair thinning, hair loss, excess production of testosterone, excess hair growth and mood swings can be controlled and improved by just making a few lifestyle changes. You need to understand the link between hormonal imbalance and unhealthy food habits. Foods to avoid in PCOS: Foods to avoid in PCOS: Sugar When you have PCOS you also have a higher risk of getting diabetes, As insulin and glycemic levels are already high in your body, eating complex carbs or sugar will make your situation worse. Also, excess sugar will add on to your PCOS weight. Therefore, avoid artificial sweeteners, packaged juices, sugary sweets, and candies. Red meat Red meat Red meat such as mutton, beef, pork, etc contains saturated fat and cholesterol which increases the risk of cardiovascular diseases. It leads to weight gain and contributes to already existing hormonal imbalance. Processed junk Processed foods contain high amounts of salt and preservatives which aren’t healthy.

• Also, these foods are filled with unhealthy species, trans fats and artificial sweeteners that contribute to the growth of bad cholesterol and affects the blood pressure of the body.
• Junk, fried foods increase the glycemic index and also triggers diabetes.
• These are the major factors behind obesity.
• Dairy foods Dairy foods are not strictly prohibited for women with PCOS, you can consume milk and products to enjoy their nutritive values but in a limit.

Excess consumption of dairy which is a carbohydrate can lead to an increase in blood glucose level and also stimulate insulin growth factors. Therefore, maintain a balanced diet with the required diary content. Fried Food Fried foods like fritters and Indian deep fried foods should be avoided.

• They are rich in saturated or hydrogenated fats These unhealthy fats can increase estrogen production, which can make your PCOS symptoms worse.
• Gluten foods If you have PCOS then you should definitely limit your gluten consumption and if possible switch to a gluten-free diet,
• Avoiding gluten foods such as wheat-based bread, pasta or cereals which are very commonly consumed on an everyday basis can help in reducing the inflammation in women with PCOS.

These are high in glycemic index, that can spike your blood glucose level and also contribute to weight gain. Therefore, it is advised to limit your white bread, white rice and pasta consumption you improve your insulin production and resistance.

What is the best exercise for lean PCOS?

CARDIO – Good for reducing insulin resistance, boosting fertility, stabilising mood Moderate exercise like brisk walking, jogging, cycling or swimming are all great activities that can help with PCOS. This type of exercise increases your bodies sensitivity to insulin, which reduces your risk of cardiovascular disease and type 2 diabetes.

1. Doing 30 minutes or more a day can also help with weight management, symptoms of depression and anxiety, as well as improving frequency of menstrual cycles and ovulation.
2. And if you’re about to start IVF, regular light exercise can boost your reproductive success.
3. Not sure how to start running, easy download the free Nike Run Club app that provides your with guided runs to help you begin your running journey! STRENGTH TRAINING Good for reducing insulin resistance, increasing metabolic rate, improving body composition (more muscle and less fat tissue) Bodyweight exercises like squats, push-ups, or tricep dips improve the function of insulin in your body, but can also boost your metabolism by building more muscle mass.

Don’t worry though; you won’t bulk up unless you’re taking steroids! More muscle simply means burning more calories while exercising, but also throughout the day even at rest. Combining resistance moves with cardio exercise is the best way to ensure you’re building a lean body, achieving a healthy BMI, and reducing your risk of chronic diseases like type 2 diabetes.

1. HIGH INTENSITY INTERVAL TRAINING Good for increasing cardiovascular fitness and decreasing waist circumference Intervals involve swapping between short bouts of high intensity work and lower intensity recovery.
2. It’s a time efficient way of boosting your cardiovascular fitness, with extra benefits for PCOS.

Going hard on the spin bike burns bucket-loads of calories, and reduces abdominal fat more effectively then say, a brisk walk. This can help you achieve a 5 – 10% weight loss, which studies show can decrease PCOS symptoms by reducing excess testosterone and improving insulin resistance.

• CORE STRENGTH Good for general well-being and injury prevention, preparing your body for pregnancy Being above your ideal weight can cause lower back pain and poor posture, so including core training in your program is essential.
• These muscles support the spine and learning how to switch them on ensures you don’t injure yourself during exercise.

Also if you’re trying to conceive, start training your pelvic floor muscles! These muscles are also part of your core and help prevent incontinence, boost sexual health, and improve pelvic stability to help support a healthy pregnancy. The most effective exercise is the one you keep up with, so choose something you enjoy! Seeking help from an Accredited Exercise Physiologist is a great way to guarantee you’re exercising right for your condition.

What herbs for lean PCOS?

PCOS Herbs & Nutritional Supplements – Supplements That Are Beneficial for PCOS are complementary to the dietary and lifestyle changes you will be making with the goal to support the body in re-learning balance by promoting healthy hormonal balance, a healthy uterine lining, regular ovulation, improved estrogen metabolism and ultimately a healthy pregnancy if that is your wish.

vitamins and minerals like calcium and vitamin Dherbs that promote hormonal balance and support regular ovulation like Vitex (Vitex agnus-castus) and Maca (Lepidium meyenii), Licorice root (Glycyrrhiza glabra) and White Peony (Paeonia lactiflora) nutritional supplements like DIM, essential fatty acids like Evening Primrose Oil and Cod Liver Oil, Saw Palmetto (Serenoa repens), and D-chiro inositol and Myo-Inositol

Click here to learn about other herbs helpful for women with PCOS Your health begins with you! Your condition does not define who you are as a woman! If you chose health, you will achieve health! References

PCOS and Diabetes, Heart Disease, Stroke (March 14, 2018). Centers for Disease Control. Retrieved from https://www.cdc.gov/diabetes/library/spotlights/pcos.html Cohen, S. (2007, September 1). Thin With PCOS: “How can I have PCOS if I’m not overweight?”. In PCOSA Today Newsletter. Retrieved from: https://pcos.com/thin-with-pcos-how-can-i-have-pcos-if-im-not-overweight/ Corbould, A. (2008). Effects of androgens on insulin action in women: Is androgen excess a component of female metabolic syndrome? Diabetes/Metabolism Research and Reviews, 24(7), 520-532. doi:10.1002/dmrr.872 Retrieved from: https://onlinelibrary.wiley.com/doi/abs/10.1002/dmrr.872 Polycystic Ovary Syndrome (PCOS). (n.d.). Retrieved from: https://www.healthwise.net/ahni/Content/StdDocument.aspx?DOCHWID=tw9103 Kirchengast, S., & Huber, J. (2001). Body composition characteristics and body fat distribution in lean women with polycystic ovary syndrome. Human Reproduction, 16(6), 1255-1260. doi:10.1093/humrep/16.6.1255 Retrieved from: https://academic.oup.com/humrep/article/16/6/1255/619529 Milsom, S. (n.d.). Polycystic Ovary Syndrome. Retrieved from: https://www.fertilityassociates.co.nz/news-and-blog/pcos-symptoms-and-self-help/ Nestler, J.E., & Jakubowicz, D.J. (1997). Lean Women With Polycystic Ovary Syndrome Respond to Insulin Reduction With Decreases in Ovarian P450c17 alpha Activity and Serum Androgens. The Journal of Clinical Endocrinology & Metabolism, 82(12), 4075-4079. doi:doi.org/10.1210/jcem.82.12.4431 Retrieved from: https://academic.oup.com/jcem/article/82/12/4075/2865999 Slater, B. (n.d.). Skinny with PCOS. Retrieved from: https://www.ovarian-cysts-pcos.com/skinny-with-pcos.html The Lean PCOS Diet – PCOS Diet Tips. (2012, November 2). Retrieved from: http://www.pcosdietsupport.com/diet-tips/lean-pcos-diet/ Kogure GS, Miranda-Furtado CL, Silva RC, Melo AS, Ferriani RA, De Sá MF, Dos Reis RM. (2016 Apr). Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome. Med Sci Sports Exerc,48(4):589-98. doi: 10.1249/MSS.0000000000000822. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26587847

Does lean PCOS cause poor egg quality?

Whether PCOS negatively affects egg quality is a complex question, in part due to the diversity within a PCOS diagnosis – Whether PCOS adversely affects egg quality in IVF has remained a highly controversial issue, with many authors claiming yes and similar numbers of investigators claiming no.

The reason for this discrepancy is, likely, the same problem that has prevented the field of infertility from making significant progress in understanding PCOS over many decades: What is currently defined as PCOS is really a basket of very different conditions, with different causes, etiologies and pathophysiologies,

Throwing them all together in the “PCOS” moniker does not make any sense; yet, this is exactly what has been happening in the PCOS literature for decades, even though different PCOS phenotypes have been described and characterized. Though a large recent conference once again tried to bring some order to the subject, disagreement still rules.

• For some years, CHR investigators have, however, been following a different track, and have made some interesting discoveries.
• All the world agrees that the two most frequent phenotypes of PCOS are the so-called ” classical ” and ” lean ” phenotypes.
• Though each represent roughly 40% of PCOS, it is only the “classical” phenotype, characterized by hyper-androgenism, anovulation, irregular menses, truncal obesity, hirsutism, acne and metabolic syndrome later in life, that even the most experienced investigators see in front of their eyes when thinking about PCOS.

These “classical” PCOS phenotype has attracted most of the attention for many reasons, and to some degree rightly so, because they represent a life-long phenotype with serious medical consequences, not only for fertility at young ages but for general health later in life.

Because “classical” phenotypes had a typical appearance, menstrual problems and often other medical issues, they were traditionally considered the “more difficult” PCOS cases to treat in infertility practices. They were also more noticeable in contrast to “lean” PCOS phenotypes, usually young and lean women, mostly with regular menses and no obvious later sequalae in life.

That is, until CHR investigators one day realized that practically all of CHR’s PCOS patients had the “lean” phenotypes. This unexpected finding initiated a brand-new research effort at CHR: Trying to understand this surprising discovery, CHR’s investigators concluded that only a self-selection process of patients could explain why no “classical” and only “lean” PCOS phenotypes sought fertility care at CHR.

As an IVF center of last resort, CHR almost exclusively serves patients who previously had, often multiple, failed IVF cycles elsewhere. The only possible explanation for not finding “classical” PCOS patients at CHR was, therefore, that they conceived before reaching CHR. In contrast, the “lean” PCOS patients sought CHR in quite surprising numbers, by extension suggesting that they had been unable to conceive at other IVF centers before seeking tertiary-level fertility care at CHR.

The pearl-like appearance of follicles is one of the few PCOS characteristics common to both classical and lean PCOS phenotypes. This observation, of course, contradicted the fertility field’s decades-long understanding that “classical” PCOS patients were the more “severe” cases.

The new observations at CHR now, suddenly, appeared to suggest exactly the opposite, namely that “lean” PCOS women, at least when it came to conception at more advanced ages, were more challenging infertility patients than “classical” PCOS women, Further investigations, published in two manuscripts in the medical endocrinology literature, then described the ontogeny of this “lean” PCOS phenotype in considerable detail, confirming that “classical” and “lean” phenotypes, likely, represent very different disease entities, having little in common besides a PCOS-like ovarian phenotype on ultrasound and hyper-androgenism (high testosterone) at younger ages.

While the ovarian phenotype remained a common feature into older ages, women with “lean” phenotype between mid-20s and -30s lost their hyperandrogenism, becoming instead hypo-androgenic, Zona renticularis in the adrenal gland produces about half the androgens in a woman’s body. It would exceed the framework of this section to go into too much further details regarding the “lean” hypo-androgenic PCOS-like phenotype; the interested reader is referred to a more detailed discussion in a recent issue of the VOICE,

As it turned out, the above-noted difference in status of hyper-androgenism both PCOS phenotypes shared at younger ages, but between mid 20s and -30 started to differ when “lean” PCOS women, suddenly, lost the adrenal component of their androgen production, and testosterone levels, therefore, plummeted, was identified as the principal reason why these “lean” PCOS women had not been able to conceive before seeking more advanced care at CHR.

As is now widely accepted, ovaries must have good testosterone levels in their ovarian micro-environment in order to produce good quality eggs, Therefore, these, usually older, women only started conceiving once CHR’s practice of androgen supplementation via DHEA of women with low testosterone levels improved their egg and embryo quality.

1. The answer to the question whether PCOS affects egg quality is, therefore, a complex one but can be answered as follows: At younger ages (approximately till age 35), PCOS, whether of “classical” or “lean” phenotype, does _not _affect egg quality.
2. In “classical” PCOS patients, there also appears to be no effect at older ages.

However, in older “lean” PCOS women, who by this time usually have become hypo-androgenic, egg quality is, indeed, negatively affected, unless androgen levels are appropriately pre-supplemented, starting at least 6-8 weeks prior to IVF cycle start. One final comment: CHR investigators also presented evidence that loss of adrenal androgen production in lean PCOS patients, likely, is the consequence of an autoimmune attack on the zona reticularis of the adrenals.

What lifestyle is lean PCOS?

24 Lean PCOS Diet and Lifestyle Recommendations – Whether or not you have insulin resistance, it’s important that follow as many of my tips as possible. Because it’s not all about insulin resistance! High levels of androgens, inflammation, and altered gut microbiome are also major components of PCOS. DIET

1. Eat a balanced diet that is nutrient rich. While you don’t have to restrict calories, it’s still important that you consume a variety of nutrient rich foods. Certain nutrients can help heal PCOS. Read my previous post on top 18 Foods for PCOS.
2. Limit sugary drinks/foods and high glycemic carbs including white bread, pasta, rice and other highly processed foods. These foods have a negative impact in 3 major areas of PCOS: insulin resistance, inflammation and gut health.
3. Follow an anti-inflammatory diet. Include anti-inflammatory foods including fatty fish, green leafy vegetables, fruits, whole grains, tea, and spices including turmeric, ginger, garlic, basil, cayenne pepper, rosemary, sage, nutmeg, oregano, and thyme. They have been shown to have anti-inflammatory properties.
4. Eat a diet that is good for the gut. Studies are suggesting women with PCOS may have an altered gut microbiome. Optimizing your gut flora is important for a well-functioning immune system, helps ward off chronic inflammation and may help with insulin resistance. Fermented foods such as kefir, many yogurts, natto, kimchee, miso, tempeh, pickles, sauerkraut, olives, and other fermented vegetables, will help ‘reseed’ your gut with beneficial bacteria. Read my blog post on Top 8 Tips for a Healthy Gut as well as my blog post on Prebiotics and PCOS
5. Pay attention to food sensitivities. Individual food sensitivities may trigger an immune-based reaction which can lead to inflammation. Common allergens like casein and gluten (proteins found in dairy and wheat) are quick to spark the inflammatory cascade. If you think you might have a food sensitivity, try going on an elimination diet for two weeks to see how you feel. Many women with PCOS choose to avoid soy, gluten and dairy. There is no evidence-based research that all women with PCOS need to avoid these foods, yet some women feel better omitting them. So try the elimination diet. Studies have shown the dairy can worsen acne in PCOS, so pay attention to how it affects you.
6. Add in flaxseeds. Flaxseeds contain the omega-3 fatty acid ALA, lignans, fiber, some protein and vitamins and minerals. They have numerous health benefits including improving heart health, lowering cholesterol and decreasing risk of stroke. They are rich in both soluble and insoluble fiber. These fibers aid in gut health, may help lower blood sugar in people with type 2 diabetes as well as slow the rise and fall of blood sugar and insulin. Flaxseeds also contain lignans which may help prevent certain types of cancer. Lastly, one small study showed consuming 4 T. of flaxseeds a day for 4 months lowered all 3 scores of androgen markers decreased significantly
7. Drink tea. -Spearmint tea. Preliminary findings are encouraging that spearmint has the potential for use as a helpful and natural treatment for hirsutism in PCOS. Research has suggested that spearmint tea lowers androgen levels in women with hirsutism. Further research is needed to determine how effective it might be in treating hirsutism. But in the meantime, it’s worth a try! Aim for at least 2 cups of tea a day. – Green tea is rich in antioxidants
8. Plan healthy snacks for in between meals if you experience hypoglycemia. My favorite snack ideas include almond butter on an apple, natural peanut butter on your favorite high fiber cracker, a handful of nuts, guacamole and veggies, plain Greek yogurt (or a non-dairy yogurt) with sunflower seeds and a few berries. Or you are on the run, try a healthy energy bar. See my previous blog post on the Best Energy Bars for PCOS.
9. Meal timing: The time of the day you eat affects how your body metabolizes food. This is due to to your body’s circadian rhythm. The body functions on a 12 hr sleep/wake cycle. Eating more calories earlier in the day during the “wake cycle” can improve insulin resistance, testosterone levels and ovulation in PCOS. I know this can be difficult as many of like to socialize around dinner time versus breakfast! But just make sure you are eating a fair amount of your calories earlier in the day and taper down a bit as the day goes by. This study is a bit radical as most of us don’t eat 980 calories for breakfast but you get the point. Study: -60 lean PCOS women were randomized into two groups (both 1800 cal) for 90 days:Big breakfast: (980 kcal breakfast, 640 kcal lunch and 190 kcal dinner) -Big dinner:(190 kcal breakfast, 640 kcal lunch and 980 kcal dinner) Results: Big breakfast group experienced a 56% decrease in insulin resistance, 50% decrease in testosterone and 50% increase in ovulation
10. Enjoy the foods you eat, Eating is one of life’s pleasures. Feeling deprived will only set you up for an eating disorder. The goal will be to have a healthy relationship with food.
11. Don’t take your calories too low! This can stress the body and may elevate adrenal androgens, Reference EXERCISE, LIFESTYLE, MIND-BODY
12. Weight train. Both cardio and weight training have health benefits, but it is especially important that you weight train if you have lean PCOS. Weight training builds/preserves muscle. And muscle is one of the major ways to get glucose out to the blood and into the cells. So it helps you make less insulin! Check out my 4 blogs posts on exercise for PCOS, including What are the Best Exercises for PCOS? Some of my favorite PCOS Exercise guru’s to follow are @ GinnybeFit, The PCOS Personal Trainer BeFabbeYou PCOSoracle @Lindsayrenemartin and @BatesLovesWeights
13. More exercise is not better! The exact I feel that weight training 2-3 times a week and cardio 2 -3 times a week is a good plan for most lean women with PCOS. Overexercising can decrease fertility, increase chances of HA and set you up for exercise bulimia.
14. Stress management including yoga and mediation. And I love this book by Dr. Gretchen Kubacky – The PCOS Mood Cure, This is especially important you have elevated adrenal androgens. See above.
15. Adequate sleep. Sleep deprivation can affect almost every part of your body ranging from your brain, muscles, immune system and even skin. And if that’s not enough, inadequate sleep can increase risk of heart disease, diabetes and obesity as well as cause inflammation and worsen insulin resistance. This is the last thing a woman with PCOS wants. Read my blog post on 14 Reasons Why You Need Sleep with PCOS
16. Try acupuncture. As per Dr. McCullough, acupuncture benefits the opiod system, and HPO axis dysfunction. Try low frequency electrostimulation 2-3 times a week before ovulation. I’ve had many lean women with PCOS swear acupuncture helped them with fertility SUPPLEMENTS
17. Myoinositol and D-Chiro-Inositol, These supplements are relatives of the B complex vitamins. Studies have demonstrated they decrease insulin, triglycerides, testosterone and blood pressure. In addition, they may regulate periods, restore hormone balance, and improve egg quality and ovulation. The brand I recommend is Ovasitol as it contains the most effective ratio (40:1) of the 2 ingredients – 1 packet twice a day. But keep in mind this supplements works best in women with insulin resistance. If you are not insulin resistant, it may have no benefit. More studies are needed!
18. Keep vitamin D levels within a normal range.80% of women with PCOS have low vitamin D levels. Low vitamin D is associated with insulin resistance in PCOS. It also improves fertility, decreases androgens and inflammation. Read this great blog post by PCOS Nutrition on Vit D and PCOS.
19. Omega 3 fish oil. Research has shown that omega-3 fish oils offer many benefits to women with PCOS, including reducing testosterone levels, helping regulate menstrual cycles and improving mood. You can get the omega-3 fatty acids by eating fatty fish more than twice a week. However, if you don’t eat fish that often, you will benefit from taking a fish oil supplement. Studies suggest that supplementing with 1,500 mg of omega-3 fatty acids daily may improve insulin resistance and supplements of 2,000 mg of omega-3 fatty acids improve menstrual regularity. Reference OTHER
20. Be on guard for weight gain, It’s harder to stay lean with PCOS. Lean women with PCOS have lower caloric intakes than other lean women without PCOS– it’s more difficult to stay lean! But be careful not to take your calories too low as this can slow your metabolism.
21. Being too lean can have negative consequences on fertility and overall health (i.e. bone health). Too little body fat can affect ovulation and cause menstrual cycles to stop.
22. Keep track of your HbA1c and cholesterol levels, especially as you age. While the risk of diabetes and heart disease is increased with body weight, you may still have an increased risk due to having PCOS.
23. Beware of endocrine disrupters, especially BPA. Endocrine disruptors can wreak havoc on the endocrine system – especially when the endocrine system is already disrupted as it is in PCOS. Studies are suggesting there may be a connection between endocrine disruptors and PCOS – especially BPA. Bisphenol A or BPA is an estrogen-mimic industrial compound that is widely produced in food and beverage packaging. Multiple studies report a strong relationship between BPA and the production of testosterone. Women with PCOS tend to accumulate more of them as compared to women without PCOS. This study showed lean women with PCOS, BPA values were significantly higher compared with lean controls and the same difference was observed in the obese subgroups. Read more about Endocrine Disruptors and PCOS,
24. Seek additional support if needed. -Meet with a registered dietitian who specializes in PCOS if you need additional nutrition guidance. -If you feel you have an unhealthy relationship with food, meet with therapist who specializes in eating issues or body image issues.

Is it hard to gain weight with lean PCOS?

Published: 23 Oct 2021, 11:00 am IST

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Can you be skinny and have PCOS? The answer to this question is yes! Of course, you can be underweight, and yet have the condition.This type of polycystic ovary syndrome (PCOS) is known as lean PCOS. For the unversed, polycystic ovary syndrome is a common hormonal disorder that causes multiple cysts in your ovaries.

1. This condition affects women who are in their childbearing years, anywhere between 15-45 years of age.
2. More often than not, PCOS is associated with overweight women,
3. However, the cases of lean PCOS are continuously increasing.
4. Why is that so? Dr Sneha Sathe, Fertility Consultant, Nova IVF Fertility, Mumbai, explains, “Most women with PCOS have difficulty managing their weight.

There is a tendency to gain weight easily and weight loss is difficult. Some women with PCOS maintain a normal weight (lean PCOS); but they still face fertility challenges, increased androgens, and an increased risk of diabetes and cardiovascular disease.” You just can’t afford to ignore PCOS.

Can you have lean PCOS without insulin resistance?

What about the 25% who are not insulin resistant? Research suggests that many lean PCOS women have normal fasting insulin, but are more likely to have hyperinsulinemia after eating. In the earliest stages with very lean PCOS – even post meal insulin may be normal – in these cases there is insulin hypersensitivity.

What is the success rate of lean PCOS IVF?

Ovulation inducing agents – Lifestyle modification is recommended as first-line therapy among obese women with PCOS to optimize their outcomes. Among lean and obese women with PCOS, ovulation induction can be achieved with aromatase inhibitors, selective estrogen receptor modulators, insulin sensitizing agents, gonadotropins, and ovarian drilling with varying rates of ovulation, live birth, and multiple gestations.

Assisted reproductive technologies are reserved for women who do not conceive despite the restoration of ovulation or couples with additional factors contributing to their infertility. This review will outline treatment strategies for achieving a healthy pregnancy among lean and obese women with PCOS and infertility.

Obese women with PCOS are more likely to be anovulatory than thin women with PCOS. In addition, overweight women with PCOS are less likely to respond to the pharmacological induction of ovulation. Popova et al, found that lean women with PCOS treated with metformin had menstrual function (55%) and ovulation (45%) restored more often than obese women with PCOS (only one patient (7%) responded to the treatment), P = 0.018.

A significant decrease in testosterone level (from 3.1 ± 1.0 to 2.7 ± 0.8 nmol/l; P = 0.049), fasting glucose (from 5.2 ± 0.4 to 4.9 ± 0.4 mmol/l, P = 0.013), and HOMA (from 1.6 ± 0.7 to 1.2 ± 0.7, P = 0.045) during metformin treatment was shown only in lean women with PCOS. There was no change in BMI and waist circumference in both groups.

They concluded that treatment with metformin 1700 mg daily was more effective in lean than in obese women with PCOS. Its efficacy was independent of the initial surrogate markers of resistance to insulin. Krohn et al, found that in lean patients with PCOS undergoing combined ovulation induction–intra-uterine insemination (IUI), the unadjusted clinical pregnancy rate was 52%; clinical pregnancy rate was comparatively lower in overweight (22%), obese (27%), and morbidly obese (21%) women for all cycles.

Adjusting for age and the duration of infertility, the odds of clinical pregnancy after combined ovulation induction–IUI was significantly diminished in overweight (odd ratio, OR = 0.27, confidence interval, CI = 0.12–0.63), obese (OR = 0.41, CI = 0.20–0.83), and morbidly obese women (OR = 0.33, CI = 0.14–0.78) as compared to the lean women with PCOS.

A similar but nonsignificant trend was identified in women undergoing oral ovulation induction–IUI.

Can lean PCOS cause diabetes?

What is PCOS? – PCOS is one of the most common causes of female infertility, affecting 6% to 12% (as many as 5 million) of US women of reproductive age. But it’s a lot more than that. This lifelong health condition continues far beyond the child-bearing years.

Women with PCOS are often insulin resistant ; their bodies can make insulin but can’t use it effectively, increasing their risk for type 2 diabetes. They also have higher levels of androgens (male hormones that females also have), which can stop eggs from being released (ovulation) and cause irregular periods, acne, thinning scalp hair, and excess hair growth on the face and body.

Women with PCOS can develop serious health problems, especially if they are overweight:

• Diabetes —more than half of women with PCOS develop type 2 diabetes by age 40
• Gestational diabetes (diabetes when pregnant)—which puts the pregnancy and baby at risk and can lead to type 2 diabetes later in life for both mother and child
• Heart disease —women with PCOS are at higher risk, and risk increases with age
• High blood pressure —which can damage the heart, brain, and kidneys
• High LDL (“bad”) cholesterol and low HDL (“good”) cholesterol—increasing the risk for heart disease
• Sleep apnea —a disorder that causes breathing to stop during sleep and raises the risk for heart disease and type 2 diabetes
• Stroke —plaque (cholesterol and white blood cells) clogging blood vessels can lead to blood clots that in turn can cause a stroke

PCOS is also linked to depression and anxiety, though the connection is not fully understood.

Can you be skinny and have insulin resistance?

Even Really Healthy People Are Prone to Diabetes: Here’s What You Should Know We often assume that just because a person is skinny, they’re in perfect health. However, even healthy people can develop insulin resistance, a condition that leads to high blood sugar or diabetes. Type 2 diabetes may be more common in people who are overweight or obese, but Dr.

Syed Farhat Zaidi and Dr. Imran Baig at Integrative Primary Care in Houston and Katy, Texas, understand it can strike those who seem perfectly healthy. And, in those cases, it can have even more serious complications, including doubling your chances of dying from diabetes complications, like heart disease.

To reduce your chances of developing diabetes, we can help you identify your personal risks, even if you’re a really healthy person.

Is PCOS lean or obese?

Lean PCOS = BMI 2, obese PCOS = BMI ≥ 25 kg/m 2, HOMA-IR = homeostasis model assessment-insulin resistance, HDL-c = high-density lipoprotein cholesterol, LH = luteinizing hormone, FSH = follicle-stimulating hormone, PCOS = polycystic ovarian syndrome.

Does PCOS affect body shape?

Most women at some point have to contend with weight gain. But for women with polycystic ovary syndrome ( PCOS ), losing weight can become a constant struggle. PCOS is the most common hormonal disorder in women of childbearing age and can lead to issues with fertility,

1. Women who have PCOS have higher levels of male hormones and are also less sensitive to insulin or are ” insulin -resistant.” Many are overweight or obese,
2. As a result, these women can be at a higher risk of diabetes, heart disease, sleep apnea, and uterine cancer.
3. If you have PCOS, certain lifestyle changes can help you shed pounds and reduce the disease’s severity.

PCOS makes it more difficult for the body to use the hormone insulin, which normally helps convert sugars and starches from foods into energy. This condition – called insulin resistance – can cause insulin and sugar – glucose – to build up in the bloodstream.

High insulin levels increase the production of male hormones called androgens. High androgen levels lead to symptoms such as body hair growth, acne, irregular periods – and weight gain. Because the weight gain is triggered by male hormones, it is typically in the abdomen, That is where men tend to carry weight.

So, instead of having a pear shape, women with PCOS have more of an apple shape. Abdominal fat is the most dangerous kind of fat. That’s because it is associated with an increased risk of heart disease and other health conditions. No matter what the cause, weight gain can be detrimental to your health.

Type 2 diabetes High cholesterolHigh blood pressure Sleep apnea InfertilityEndometrial cancer

Many of these conditions can lead to heart disease, Experts think weight gain also helps trigger PCOS symptoms, such as menstrual abnormalities and acne, Losing weight not only cuts your risk for many diseases, it can also make you feel better. When you have PCOS, shedding just 10% of your body weight can bring your periods back to normal.

It can also help relieve some of the symptoms of polycystic ovary syndrome. Weight loss can improve insulin sensitivity. That will reduce your risk of diabetes, heart disease, and other PCOS complications. To lose weight, start with a visit to your doctor. The doctor will weigh you and check your waist size and body mass index.

Body mass index is also called BMI, and it is the ratio of your height to your weight. Your doctor may also prescribe medication. Several medications are approved for PCOS, including birth control pills, anti-androgen medications and Metformin (Glucophage).

Eat a high-fiber, low-sugar diet. Load up on fruits, vegetables, and whole grains. Avoid processed and fatty foods to keep your blood sugar levels in check. If you’re having trouble eating healthy on your own, talk to your doctor or a dietitian.Eat four to six small meals throughout the day, rather than three large meals. This will help control your blood sugar levels.Exercise for at least 30 minutes a day on most, if not all, days of the week.Work with your doctor to track your cholesterol and blood pressure levels.If you smoke, get involved in a program that can help you quit.

Is it hard to gain weight with lean PCOS?

Published: 23 Oct 2021, 11:00 am IST

139

Can you be skinny and have PCOS? The answer to this question is yes! Of course, you can be underweight, and yet have the condition.This type of polycystic ovary syndrome (PCOS) is known as lean PCOS. For the unversed, polycystic ovary syndrome is a common hormonal disorder that causes multiple cysts in your ovaries.

1. This condition affects women who are in their childbearing years, anywhere between 15-45 years of age.
2. More often than not, PCOS is associated with overweight women,
3. However, the cases of lean PCOS are continuously increasing.
4. Why is that so? Dr Sneha Sathe, Fertility Consultant, Nova IVF Fertility, Mumbai, explains, “Most women with PCOS have difficulty managing their weight.

There is a tendency to gain weight easily and weight loss is difficult. Some women with PCOS maintain a normal weight (lean PCOS); but they still face fertility challenges, increased androgens, and an increased risk of diabetes and cardiovascular disease.” You just can’t afford to ignore PCOS.