Part 3: Managing PCOS (Polycystic Ovarian Syndrome)
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Fertility, Menstrual cycles & Hormones in Relation to Nutrition

a calendar and a calendar app on a phone being used to track the menstrual cycle

Part 3 of a 5 part series to explore PCOS nutrition written by Teagan Evans, University of Alberta Student in the Nutrition and Food Science program at the University of Alberta and reviewed by our Health Stand Nutrition Dietitian Team.  


Polycystic Ovarian Syndrome or “PCOS” is an endocrine condition that affects many women around the world. Having PCOS results in hormone imbalances that cause increased production of male androgen hormones and as a result, cause distinct PCOS symptoms.   


If you missed our first article and second article on PCOS you can check those out here: 


In this third article we explore the role hormones play within our bodies.  Hormones influence many aspects of our health such as our digestive and nervous systems, organ function, and menstrual cycle. The entire menstrual cycle is controlled by female sex hormones and throughout a standard 28-day cycle, hormone levels will fluctuate.  


The role of hormones in the menstrual cycle


There are 4 main female sex hormones that influence your menstrual cycle; estrogen, progesterone, follicle-stimulating hormone, and luteinizing hormone. Each of these hormones rises and falls throughout your cycle and these changes in hormones signal key events such as ovulation and menstruation. 


Ovulation occurs due to increased levels of estrogen that signal the ovary to release an egg. Complementary to the release of an egg, progesterone prepares the uterus for implantation and ensures that the organ lining is able to maintain a healthy pregnancy. Follicle-stimulation hormone and luteinizing hormone increase in concentration up until ovulation, then levels decrease towards the end of the cycle. These two hormones help regulate the cycle in combination with estrogen and progesterone.  


Hormonal changes with PCOS


Polycystic ovarian syndrome (or PCOS) has characteristic hormonal changes that influence the menstrual cycle, fertility, and symptoms experienced by many women. Women who are diagnosed with PCOS have lower levels of female sex hormones and, instead, have higher levels of androgens, a type of male sex hormone.  


Typically, an increase in estrogen production signals the ovary to release an egg (ovulation) that will then travel throughout the rest of the female reproductive system. However, with an increased levels of androgens and not enough estrogen, an egg cannot be fully released and can lead to ovarian cysts which produce the higher levels of androgens.  


diagram of the uterus showing polycystic ovarian syndrome compared to a single ovarian cyst

Hormones & Fertility


Fertility is highly dependent on the various hormones in your body and can be impacted by a variety of external causes. One of the main conditions associated with PCOS is infertility or difficultly being able to conceive.  This is often due to the fact that because of the altered hormone levels and increased concentration of androgens, complete ovulation does not occur. It is estimated that up to 80% of incomplete ovulation infertility is caused by PCOS.   


PCOS has associated conditions and symptoms that can also influence fertility and make conception complicated. Diabetes and insulin resistance, weight concerns, and other metabolic conditions can also influence fertility. As a result of incomplete or absence of ovulation, many women with PCOS are unable to naturally conceive. IVF, hormone supplementation, and pharmaceuticals are often recommended to overcome infertility. These procedures and treatments should always be in consultation with your doctor.  


a same sex female couple hold an infant baby boy outdoors  

Nutrition and diet influence on fertility and healthy menstruation


Diet and nutrition can not only influence your overall health but can have significant impact on your reproductive system and having a healthy menstrual cycle. Women who are not consuming enough daily calories for long periods of time can be at risk of becoming underweight and suffering from irregular or absence of their menstrual cycle.  Ensuring you are consuming enough food to maintain a healthy weight is important to developing a healthy cycle.  


Researchers have found that incorporating foods such as unsaturated fats, fish, vegetables, whole grains, and fruit are significantly beneficial to reducing risk of infertility, both in men and women. Incorporating a balanced diet can positively benefit fertility and reduce long-term health risks, comorbidities, and help create a healthier lifestyle.  


Folate and PCOS   


There have been many studies focused on analyzing specific foods and nutrients and how they can positively impact individual’s fertility. Folate is a type of B vitamin that is essential to the healthy growth and development of babies and ensuring their nervous system is properly formed. Consumption of folate prior and during pregnancy has been associated with increased rates of fertility and higher levels of healthy, successful pregnancies 



Health Canada recommends that all women of child-bearing age ensure they are consuming enough folate every day. Women who are not pregnant should consume 400mg of folate through a daily multivitamin and this amount should increase to 600mg a day when pregnant.  


Caffeine and PCOS


Caffeine has been studied to determine whether or not consumption will influence a women’s ability to become pregnant. The conclusions drawn from numerous studies indicate caffeine’s ability to influence fertility and conception is inconclusive as some indicate that higher levels of caffeine can lead to increased risk of spontaneous abortion.  


Many international health associations such as the European Food Safety Authority and World Health Organization recommend limiting caffeine intake both during pregnancy and if trying to conceive. 


Unsaturated fats and PCOS

a calendar and a calendar app on a cell phone being used to track the menstrual cycle

Selecting heathier fat options can also be highly beneficial to fertility in both men and women.  Unsaturated fats such as omega-3 have been correlated with higher levels of fertility. Unsaturated fats can be found in a variety of foods such as fish, nuts, seeds, vegetable oils, and avocados. Unsaturated fats are not only beneficial for your fertility but provide numerous benefits for your heart and brain health.  


For more related articles about fertility and nutrition, check out these previous articles on our blog:


If you are struggling with infertility or looking for a Dietitian that can help support you to best manage the symptoms of PCOS, reach out to us for help.  Find out more about our nutrition counseling services here: DIETITIAN NUTRITION COUNSELING SERVICES 


Looking for more simple meal planning tips and healthy recipes for a healthier lifestyle? Sign up for our weekly newsletter for a healthy recipe of the week (and nutrition articles and videos with a balanced living philosophy to help encourage healthy habits but still save room for your favorites). Our nutrition newsletter is written by the Online / Calgary Nutritionists on our team who each hold a professional Registered Dietitian license to ensure you are getting credible advice.


View the full PCOS Series:



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