Polycystic Ovarian Syndrome (PCOS) is a hormonal condition in which small fluid-filled sacs (cysts) develop on the ovaries. Normally, during the first half of the menstrual cycle , several follicles develop in the ovaries, one of which ruptures, triggering ovulation. However, with PCOS, multiple follicles remain unmatured and ruptured, often resulting in a failure to ovulate. This leads to irregular or absent menstruation, which can negatively impact fertility. Women who menstruate fewer than eight times a year or have difficulty conceiving may have PCOS. Approximately 5-10% of Dutch women suffer from this condition.

Hormonal imbalance in PCOS: estrogen

PCOS is often accompanied by an excess of estrogen, resulting in an imbalance between estrogen and progesterone. This is also called estrogen dominance . Traditionally, birth control pills are often prescribed to suppress the symptoms, but this doesn't address the underlying cause. Fortunately, there's a lot you can do to support your hormone balance.

Important steps include adjusting your diet and weight , and avoiding hormone-disrupting substances like xenoestrogens. These are found in plastic plasticizers, such as water bottles. Opt for a glass or stainless steel bottle instead. Unfortunately, you can also find them in some tea bags. There's much more you can do, though, and my next article will cover that.

Also avoid phytoestrogens , such as those found in soy. Stress reduction, regular exercise, and eating plenty of brassicas (such as kale and broccoli, which contain diindolylmethane (DIM), a natural estrogen balancer) can help support your estrogen balance. DIM helps your body break down excess estrogen more effectively.

Additionally, it's wise to reduce your coffee consumption because the enzyme cytochrome P450 (CYP1A2), which is necessary for breaking down certain substances in coffee (such as polyphenols), is also involved in the breakdown of estrogen. This also applies to decaffeinated coffee. Since many people enjoy coffee, cutting back can be difficult, but alternatives like bamboo coffee are a good option without these effects on the enzyme.

Testosterone and PCOS

Some women with PCOS also have elevated testosterone levels. Testosterone, which is also produced in women by the ovaries and adrenal glands, can lead to symptoms such as excessive hair growth and acne. Lowering your testosterone levels can be achieved by avoiding soy products, non-organic meat, trans fats (common in processed foods like chips, cookies, ready-made meals, and fast food), and alcohol .

Insulin resistance and PCOS

Insulin resistance is another common problem with PCOS. Elevated insulin levels reduce the sensitivity of insulin receptors, leading to blood sugar spikes and increased fat storage. This can ultimately be a precursor to type 2 diabetes. Although insulin resistance is often associated with being overweight, poor diet isn't always the cause. Stress also plays a significant role, as the adrenal glands and stress hormones influence sex hormones, contributing to hormonal imbalances.

Endocrine disrupting substances

In addition, hormone-disrupting substances (such as toxins) can burden the liver, which is responsible for breaking down excess hormones. Examples of toxins include BPA (in plastic), phthalates (in personal care products), pesticides (in non-organic foods), and lead (in polluted air or old paint). When the liver becomes overloaded, the body can have difficulty regulating its own hormone balance. Certain medications, such as the contraceptive pill, can also play a role in this.

Nutritional advice for PCOS

With PCOS, nutrition is a powerful tool. So focus on:

• Whole grains : Oats, quinoa, and brown rice help keep blood sugar levels stable.
• Healthy fats : Avocados, nuts, seeds, and olive oil promote healthy hormone production.
• High-fiber vegetables : broccoli, kale, spinach, and Brussels sprouts help support estrogen balance.
• Protein-rich foods : Chicken, fish, eggs, and vegetable proteins like lentils and beans help keep blood sugar levels stable and build muscle mass.
• Low-carb meals : Reducing refined carbohydrates, such as white bread and sugar found in sweets and cookies, helps manage insulin resistance. Natural sugars from fruit, dairy, and grains are certainly beneficial, but don't overdo it. Two servings of fruit a day is often sufficient, preferably more acidic fruits.
• Herbs and spices : Cinnamon and turmeric can help keep blood sugar levels stable and reduce inflammation.

What else can you do?

Very obvious but oh so important: drinking enough water, sleeping well, and reducing stress are good ways to support your hormone balance.