Newly Diagnosed with PCOS? 14 Tips to Get You Started
If you’ve just been diagnosed with PCOS, you’re probably feeling overwhelmed on what to do next. And turning to Dr. Google or social media makes it worse as much of what you read is conflicting. It’s natural to want to do everything you can NOW can to manage POCS. Unfortunately, this often leads to acting on inaccurate info and trying to make too many changes at once. And this creates more overwhelm and stress which worsens symptoms of PCOS. I’ve been contacted by so many women on social media asking me for advice. So I put together some tips on how to reduce overwhelm if you’ve been newly diagnosed with PCOS. Keep in mind, these are only generalizations and I’m not giving medical (or medication) advice. And don’t feel that you have to do all of these at once. Pick 1-2 of them and start to make small changes at a time.
PCOS in a nutshell
PCOS is a genetic, reproductive and metabolic condition that can affect up to 15% of women. It’s the most common hormone abnormality in females, yet 50% of women remain undiagnosed. It can affect girls through menopausal women. While medications may be used with some women, keep in mind that lifestyle should be the first line treatment for PCOS.
It’s believed that the majority of women with PCOS have insulin resistance and low-grade inflammation. Some studies also suggest there may be an altered gut microbiome. Women with PCOS often have more carb cravings and experience difficulty losing weight. There is also an increased risk of type 2 diabetes and heart disease for some women with PCOS. Many of my tips below take these factors into account. These tips are more for “newbies” but may also be a good reminder for women who have had PCOS for a while.
One more thing – there is no ONE PCOS. Although many women do have similar symptoms, it doesn’t mean YOU will get all the symptoms. And also, symptoms may vary through different phases of your life.
13 Tips to stop the overwhelm if you are newly diagnosed with PCOS
- Take a deep breath and slow down. Don’t feel that you have to learn everything overnight. That urgency will only create more stress. You want to take your time and weed through the “good” and “bad” advice. The good news is that diet and lifestyle play an important role in decreasing symptoms and health risks. And by lifestyle, I mean healthy diet, movement, stress management, emotional health and maybe supplements.
- Start to educate yourself. Do your research and look for reputable sources. Don’t jump into taking any medications or supplements until you’ve done your homework. The most important point I can stress here is that there is no one size fits all approach to treating PCOS. This includes the areas of diet, exercise, supplements and medications.
- Don’t believe everything you read on social media. Much of what you read is not evidence based. Examples:
-Just because a type of diet (i.e. keto, gluten/dairy free or plant-based) worked for someone else, it does not mean it’s right for you or that you will even benefit from it.
-Beware of quizzes that give rigid advice for your “type” of PCOS. Or that you need to do specific kind of exercise for your “type” of PCOS.
-Beware of sites and groups that use scare tactics “you need to avoid this food if you have PCOS”. Maybe at some point, you will decide you do best avoiding “this food”, but just because you have PCOS, it doesn’t mean you have to follow rigid guidelines that are not individually tailored.
- Get a qualified health care team together that specializes in PCOS. I know this is easier said than done! Ask your physician, friends or other women with PCOS for referrals. Looking for lists in the back of a good book or websites online (that offer evidence-based info) are other ways to find a doctor. Do your research before going to your appointment and gather a list of questions. Be sure to take careful notes during your appointment as well. Here are some health care professionals you may want on your team:
-Internist, MD or ND
-Medical endocrinologist. Look for someone who specializes in PCOS. Check out their website and ask other women with PCOS in support groups.
-Reproductive endocrinologist if having difficulty getting pregnant
The rest of your team depends upon your goals and symptoms:
-Dermatologist (skin and hair issues)
-Therapist. There are higher rates of depression, anxiety, other mood disorders as well as eating disorders in women with PCOS. So a therapist can be an important part of your team.
-Registered dietitian who specializes in PCOS (not all RD’s specialize in PCOS)
-Health coach if you feel coaching would help support you in making positive changes
- Keep track of your labs + blood pressure
Since PCOS is metabolic condition, it’s important to keep track of these labs. There are numerous labs you could keep track of … but here are some ones to start with:
Cholesterol (total, LDL, HDL, triglycerides. And even better if you can get a more detailed lipid panel like Boston Heart Labs)
Fasting blood glucose
HbA1c (12 week average of blood glucose)
It would also be helpful to get a 2 hr glucose tolerance test
- Exercise. Physical activity is a key component in managing PCOS naturally. Not only does it decrease insulin resistance and inflammation, but it aids in weight loss, decreases risk of heart disease and diabetes, helps with mood and improves the gut microbiome! These are all important issues in PCOS. But you might be wondering where to start. The conflicting info on the internet can drive you nuts! PCOS health coach and exercise expert Letisha Bates (facebook Live Free Health Coaching and @bateslovesweights on IG) gives this helpful advice. Start where you are at. Ask yourself these questions:
What is feasible right now?
What workouts do I enjoy?
How often can I workout?
How much time do I have for working out?
What workouts do I feel confident doing?
Do I want to workout at home or at a gym/studio/class?Once you can answer these questions then you should have an idea of where to start. It’s easy to get overwhelmed when you’re being told do this, don’t do that, no go back and do this. When I started my journey to health and fitness I started by walking at the park. That’s it. Don’t be fooled, at that time in my life walking for an hour was hard for me and was about all I could manage.The biggest take home point is to start where you are at. Maybe that will be to walk for 15 minutes instead of 5! And keep in mind that more is not better. Over-training can be stressful to the body and may show up as weight gain, weight loss resistance, achy or swollen joints, puffiness, or sleep disturbance.The ideal program would be balanced and include resistance training as well other form (s) of activity including Yoga, HIIT (High Intensity Interval Training)), LISS (low intensity steady state cardio), kick boxing, dancing, swimming, cycling, hiking, or running. It’s really important to find what you enjoy and what works best for you.”I did a series of blog posts on exercise and PCOS including:
PCOS and Exercise: Tips to Get You Started
What are the Best Types of Exercise for PCOS?
Is HITT Good for PCOS?
- Find a good support system. Finding a support system is important when you have PCOS. It can help you feel empowered and like you are no longer alone. It can also be a way to share info and tips. This can come from family, friends, PCOS advocates, other women with PCOS, health professionals in person or online or PCOS or online PCOS support groups. A word of warning here: choose support groups that bring you up … not tear you down. Unfortunately, not all “support” groups do this. Here’s an example from one of my followers on IG:⠀”The worst thing I did was join PCOS “support” forums that were full of false information, desperate pleas, women and young girls writing about how their symptoms make them suicidal, and people assuring me that “it’s only gonna get worse” for me. That was my first impression of PCOS and I’m still trying to unlearn everything. It’s been over a year since then and my health has only gotten light years better, not worse. I felt so hopeless at first and the internet absolutely did not help. But I definitely still have anxiety in the back of my mind because of how terrifying the “intro” to my diagnosis was. I don’t wish it on anybody.”⠀
As per Letisha Bates,“following my diagnosis I didn’t really talk about it with my husband or my friends. To be honest, I didn’t dive into anything after being diagnosed. I sort of took it as an “ah hah” moment for my weight and menstrual issues and resumed life as before. Then when I mentioned having PCOS I also dealt with some criticism and claims that I “don’t look like someone with PCOS” so this further discouraged me from mentioning my diagnosis. This was until I met my tribe on social media. I began following and interacting with over women or PCOS advocates and that changed my life. It gave me the strength to stand up for myself and my diagnosis. This is also when I started becoming more empowered about my body, and how to live a life with PCOS. I began discussing this diagnosis with my husband so he had an idea of what I was going through. Thanks to finding my support system I no longer feel alone with a diagnosis that can certainly isolate you. Just know that we are out here and we do have your back.”So it’s key that you find the right kind of support that makes you feel GOOD, empowered and hopeful after talking with them. If they bring you down, stay away or #unfollow!
- Find a way to manage stress. Stress is toxic to PCOS. Some studies even suggest stress plays a role in the pathogenesis of PCOS. It worsens symptom of PCOS including hair loss, reproductive dysfunction, sleep problems, depression, anxiety. It also increases risk of many diseases associated with PCOS. Studies done in women with PCOS, have also shown that stress can lead to weight gain and increase in visceral abdominal fat.Now there’s nothing wrong with the short- term stress process in the body. We need this for survival. The problem is when it becomes long term. This long-term activation of the stress-response system causes an overexposure to cortisol and other stress hormones that can disrupt almost all your body’s processes. This causes chronic inflammation which can lead to and/or worsen diseases including heart disease, type 2 diabetes, rheumatoid arthritis, IBD (inflammatory bowel disease), neurodegenerative diseases.Here’s some advice from Letisha .”If you were just diagnosed with PCOS, then it’s likely that you’re stressing over your diagnosis. Many women with PCOS have a dysregulation of cortisol, a stress hormone. In addition, being overweight (a common characteristic of PCOS) also contributes to increased cortisol. So you may be getting a double whammy of stress. Then add this to other lifestyle factors like inadequate sleep, too little or too much exercise which also contribute to stress. Working on your mindset and your relationship with yourself and your body is also a great way to tackle stress. Acts of self care and self love are extremely beneficial. My favorite ways to bust stress are establishing a sleep routine, practicing yoga and meditation.”It’s so important to find ways to decrease stress including:
- Getting regular physical activity
- Do yoga or tai chi
- Practicing relaxation techniques, such as deep breathing, meditation
- Keeping a sense of humor
- Spending time with family and friends who are lift you up vs drag you down
- Setting aside time for hobbies, such as reading a book or listening to music
- Saying no more often
- Unfollow people on social media who bring you down
- Get adequate sleep
- Avoid too much caffeine
- Write out to do lists
- Avoid people (in person and on social media) who irritate you
- Keep a journal including what you eat, the time you eat, how you feel, any physical or emotional feelings, sleep, stress, degree of fullness/hunger. Pay attention to what makes your body feel good or bad. This will be really important to help you find what works best for your body in terms of the foods you eat and the meal timings. For example, do you feel better if you have eggs and avocado for breakfast or a Greek yogurt with chia seeds and berries. Do certain types of meal make you feel tired? What time of the day do you get more carb cravings? Does a poor nights sleep make you have more cravings the next day? This journal can also help you determine whether or not you have sensitivities to certain foods like dairy and gluten.
- Work on getting adequate sleep. Many women with PCOS spend a great deal of energy focusing on their diet and exercise regimen, but tend to neglect one of the most important aspects of health when it comes to PCOS – 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. It’s common to have more hunger and carb cravings after a poor nights sleep.Women with PCOS tend to have more sleep problems than those without PCOS. There is a greater prevalence of obstructive sleep apnea (OSA) in PCOS patients, possibly due to the mechanisms associated with the obesity caused by PCOS-induced metabolic abnormalities.As per Dr. Walter Futterweit, overweight women with PCOS with elevated androgens are 4 times more likely to have OSA than healthy women. Second, regardless of OSA, studies have shown that the sleep disorders in patients with PCOS might be related to raised nighttime urinary melatonin levels, which are associated with lower sleep quality. Other preliminary hypotheses for sleep disorder among PCOS patients include the impact of insulin resistance and hyperandrogenemia.So do your best to make sleep a priority! Aim for at least 7 hours a night, although ideally you’d be getting even more. Read my blog post on why sleep is important for PCOS
- Eat a healthy diet. Nutrition plays a major role in managing PCOS. A healthy diet can decrease insulin resistance, inflammation, help balance hormones, improve the gut microbiome. It can improve mood, cut carb cravings and aid in weight management. However, this is also the area where you’ll find the most conflicting info!.Keto, plant-based, intermittent fasting, no gluten, dairy or soy are just some of the things you’ll read on social media.There are general principles that most women with PCOS will want to follow, but I want to stress – there is no one size fits all diet approach to PCOS. Women have different metabolisms, genes, gut microbiomes, degrees of insulin resistance and inflammation, lifestyles, food preferences.
So how can there be ONE perfect diet? You’ll need to find what works best for YOU!*make sure you sign up for my FREE download – 30 Nutrition Tips for PCOS. It will give you a lot more details on nutrition.
Here are some general tips:
1. Cut out sugary drinks and processed snack foods
2. Choose whole grains over white highly processed carbs
3. Make your plate “balanced” by making about ½ your plate veggies, ¼ protein and ¼ healthy carbs.
Protein (i.e. fish, poultry, eggs, meat, nuts/seeds, non-GMO unprocessed soy like tofu, legumes, nut butters, Greek yogurt, cheese) at each meal.
Fats: the healthiest fats include extra-virgin olive oil, avocado, nuts/seeds and nut butters, olives. Other choices include grass fed butter and extra-virgin coconut oil.
Healthy carbs: whole grains (either with gluten or without – your preference), fruit, legumes
4. Increase your intake of non-starchy veggies
5. Increase intake of fiber rich foods
- Pay attention to food sensitivities. You’ve probably heard that you need to avoid gluten, dairy and soy if you have PCOS. There is no evidence to back up the claims that ALL women with PCOS need to avoid these foods. But that being said, some women do have sensitive to these foods and feel better avoiding them. If you are curious, you could do a 3 week trial of omitting one food group at a time to see if you feel better. If you have acne, I would recommend a trial of eliminating dairy to see if your skin improves. If you want to include soy in your diet, look for nonGMO unprocessed soy versus soy found in processed foods like energy bars and cereal. And if you consume dairy, avoid skim and fat free. Full fat or 2% plain Greek yogurt and cheese in moderation are your best bets.
- Meal timing
Here are few quick tips:
Don’t go too long without eating
Eat more of your carbs earlier in the day if possible
Try to have at least 12 hrs without food. So maybe breakfast at 8 am and then stop eating by 8 pm. If this is easy, aim for eating within a 10 hour window and stop eating by 6 pm. This “rest” has numerous health benefits for the body!
- Consider some supplements. Here’s an area where you’ll need a lot more individualization as there is no one size fits all supplement for PCOS. This is also an are where you’ll need to be careful as supplements aren’t regulated by the FDA and some can actually be harmful or have interactions with your meds. The few that I recommend for most women with PCOS include:
– Vit D if your levels are less than 30
– Vit B12 if your levels are low. Make sure you always get your Vit B12 levels checked if you’re taking Metformin (as that med can deplete B12)
– inositol. My fav brand is Ovasitol. Read more about it here.
– Omega 3 supplement containing EPA and DHA (1-2 gm a day)
Those are the basic supplements.
So you have my 14 tips to get you started. But the take home point here is not to feel like you have to do everything at once. Maybe start with the journal and make a few changes in your diet each week. Slowly start to increase your exercise. And then move on with the other tips.
Need personalized guidance? I’d love to work with you. I’ve been specializing in PCOS for almost 20 years and have helped hundreds of women improve their symptoms and meet their goals with my coaching. I’ll help you separate fact from fiction and come up with a plan for YOU! You’ll learn a lot about PCOS, get practical tips, meal plan ideas (and no – you don’t have to cook if you don’t want to), supplement and exercise recommendations. As a registered dietitian and a health and wellness coach, you’ll get support in all areas. Contact me at email@example.com for more info!
I especially love problem-solving, whether it’s helping women defeat issues plaguing them for years, helping a busy executive find practical ways to get heart healthy, or providing tips to help you reverse diabetes. That’s why I’m on a constant quest to expand my knowledge by staying on top of the latest research.