Polycystic Ovarian Syndrome – Evidence-Based Nutritional Support

By Georgia Marrion (MNut, BHSci, Adv. Dip Health Sci (Nat).

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder impacting reproductive aged women of all races and ethnicities, with prevalence rates of diagnosed cases reported to be 15-20%.1-5 Australian prevalence rates are comparable, with several studies estimating it to range from 7.3-16%.6 However, a significant proportion of the female population are reported to have undiagnosed PCOS.2 This is attributed to different PCOS diagnostic criteria (see Table 1) and PCOS’s variable and complex clinical presentation (phenotype, type and severity of symptoms) across the female lifespan, often resulting in lengthy delays in accurate diagnosis (See Table 2).6-9 This is particularly significant given the considerable physiological consequences of the clinical, metabolic and hormonal imbalances and pathologies of PCOS and its associated comorbidities.

Although not completely elucidated, current evidence strongly suggests that the complex clinical presentation of PCOS is caused by synergistic intercommunication between an extensive aggregation of genetic, metabolic, endocrine, environmental (prenatal and postnatal) and lifestyle factors across the female lifecycle.9,11-14  Consequently, along with an accurate diagnosis, a key therapeutic goal in the clinical management of PCOS is treating the specific pathophysiological imbalances causing the clinical presentation in each individual. This requires implementation of effective dietary, lifestyle, environmental and nutritional support strategies.

Recommended dietary and lifestyle strategies shown to beneficial for ameliorating inflammation, oxidative stress, insulin resistance, PCOM, menstrual irregularities, hyperandrogenism, body fat % and lipid parameters in women with PCOS include reducing overall energy intake and consumption of high glycaemic-index carbohydrates and sugars; and increasing mono- and polyunsaturated fatty acids and fibre and regular physical exercise.13-18

The most effective nutritional support for the clinical management of PCOS requires nutrients that target the appropriate pathophysiological, clinical, metabolic and hormonal imbalances. (Table 3)

The significant burden of PCOS on the health and quality of life of affected women necessitates thorough, accurate and timely diagnosis and effective and comprehensive clinical treatment of evidence-based strategies.

*References available on request