Polycystic Ovary Syndrome (PCOS) is now the most common endocrine disorder in reproductive-age women, occurring in up to 15%. The abnormally steep rise in Western women diagnosed with such a harsh condition is not surprising. We live in a world where endocrine disruptors are everywhere – in your food, water, clothing, and even air! However, there is no need to fret; new management strategies for PCOS have been discovered and are currently being extensively researched.

Often coinciding with irregular cycles, acne, unwanted hair growth, and fertility troubles, PCOS is an unforgiving condition that occurs due to elevated androgens (male-dominant hormones) and numerous premature follicle developments on the ovaries. But what causes it? Unfortunately, we do not exactly know which genetic coding causes some women to produce extra androgens. Still, we do know that it results in complex interactions with a certain hormone called insulin.

Insulin, the hormone that governs blood glucose levels, is produced within the pancreas and helps absorb sugar from the bloodstream to use as energy or to store for later. In women with PCOS, their elevated levels of androgens, alongside female sex hormones, can interfere with the signalling pathways of insulin, causing cells to become less sensitive to it. As a result, even though sufficient levels may be present, insulin cannot trigger the uptake of glucose into the cells. This not only leaves the glucose floating around in the bloodstream but also forces the pancreas to produce more insulin.

All of this causes an increased likelihood of developing insulin resistance, where the body is unable to maintain adequate blood glucose levels, despite elevated insulin production. What’s worse is that heightened insulin makes the symptoms of PCOS far worse by stimulating the production of more androgens. This, in turn, causes more cysts to develop, damaging the regularity of a woman’s cycle and harming reproductive health. In the end, some women are left in a damning chain of discomfort, weight fluctuation, emotional instability, and metabolic damage, progressively worsening as they age.

So, what can be done? What can a woman living with PCOS do to overcome her heightened insulin, abnormal androgen levels, and declining fertility? Well, according to the most recent research on the topic, PCOS can be treated as a metabolic disease. As with preventative strategies for mental and physical disorders alike, your metabolic health plays a huge role in its proliferation.

It may surprise some that I refer to PCOS as a metabolic disorder, but when drastic lifestyle changes can have a huge impact on patients, I believe it is correct to define this syndrome within an environmental context.

According to the most recent research, the most effective treatment for Polycystic Ovary Syndrome is a ketogenic diet. It might sound odd at first, but let me explain. A ketogenic diet, one that is extremely low in carbohydrates, has been found to significantly improve reproductive hormone levels, androgens, cyst proliferation, and weight loss. Not only this, but the women involved in these studies saw vast improvements in their fertility and the predictability of their cycles. They also experienced improvements in their mental health across the board.

This is likely to occur because insulin is primarily reduced to remove glucose from the blood. Carbohydrates themselves digest into glucose (blood sugar), acting as a form of instant energy within the body. So, when someone has difficulty with removing glucose due to unresponsive cells, alongside elevated insulin production, they are left with abnormally high blood glucose levels. As a result, their body treats the excessive glucose levels as excess energy, storing it inside fat tissue for later use.

When we digest carbohydrates – which could include bread, pasta, fruits, and vegetables – they are broken down into glucose, fructose, and galactose. Once broken down, these molecules travel throughout the body where they are used to produce ATP (the body’s main energy currency).

This means the women in these studies did not have access to this rapid, instant energy that could cause miscommunication within the body due to their metabolic complications. A ketogenic diet instead forces the body to produce a molecule called a ketone, which the body uses as an alternative energy source when glucose is unavailable. The interesting part about this? Ketones completely bypass the miscommunication issues caused by insulin resistance, the most common metabolic complication surrounding PCOS.

Instead of having to process carbohydrates into energy, which requires insulin to send the message for consumption, ketones are converted from dietary fats and do not need any insulin to enter cells. They require no other substance to be consumed during cellular respiration; they can do it completely on their own.

This suggests that the reason these women fared better on a ketogenic diet than on a regular, higher-carbohydrate diet (SAD – Standard American Diet) is that their bodies almost ‘forgot’ they had insulin resistance issues.

The only discrepancy left is how to conduct a proper ketogenic diet. There are differing opinions on how to do this, especially with the misinformation surrounding fibre (which is a carb) and the dangers of meat. All I will mention in this article is that the only true way to conduct a “healthy” ketogenic diet (completely an opinion of my own) is through something called the carnivore diet.

The food eaten on a carnivore diet are the only ones that contain almost zero sugar molecules. There are carbohydrates within virtually all non-animal products – fruit, vegetables, fibrous foods, grains, and wheat-based snacks are some prime examples. As a result, I would highly recommend that someone with PCOS conduct their own proper, extensive research, look into the pros and cons of this diet, and never follow a vegan one, as it contains only the foods you should ignore.