The link between PCOS and the Low FODMAP diet

When I enrolled in the intensive Polycystic Ovarian Syndrome (PCOS) training course, specifically the Online PCOS Training Course for Registered Dietitian Nutritionists, I quickly realized the importance of understanding the Low FODMAP diet. This dietary approach is commonly used to manage symptoms of Irritable Bowel Syndrome (IBS), which seemed unrelated to PCOS at first. However, I discovered that many of my PCOS clients struggled with high-fiber foods that were emphasized in our sessions. As a result, they experienced gastrointestinal discomfort and felt demoralized. Not a good combo. Both PCOS and its treatment can be frustrating on their own, with no need for extra curveballs.

To address this issue, I completed the Monash University’s FODMAP Diet for IBS course, which equipped me with the necessary knowledge to simultaneously manage both conditions. I now have immediate strategies that can have a positive or neutral impact on gut symptoms. When discussing dietary changes, it’s important to consider fiber intake. However, simply increasing fiber without considering IBS tolerance can worsen symptoms. There are high fiber foods that are low FODMAP to begin with, such as quinoa, citrus, just ripe bananas, and potatoes which are all usually well tolerated. By identifying individual intolerances, I can provide more targeted recommendations for fiber intake.

While PCOS treatment encompasses various aspects such as an anti-inflammatory eating pattern, physical activity, and targeted supplements, including fiber in the diet is crucial. High-fiber foods help regulate blood glucose and insulin levels, which are key pillars in PCOS management. Elevated insulin levels can disrupt hormonal balance, leading to symptoms like hirsutism, cystic acne, hair loss, increased central adiposity, and even hypoglycemic episodes or uncontrollable cravings.  Not a comfortable way to live.

Fiber also helps decrease cholesterol levels and improve liver health. Both of which are often compromised in individuals with PCOS. Increasing fiber containing foods to meet daily goals is the natural next step and this is where combined expertise comes in handy. The good part is that FODMAPs are carbohydrates. Balancing meals with protein and fat sources is pretty easy after that, which also helps to keep blood glucose and insulin levels in check. Although there are some considerations to keep in mind, there is generally much more freedom consuming those macronutrients.

The good news is that I can guide you through every step of the process. Once bloating and other bothersome GI symptoms are under control, clients often experience enhanced comfort in their own bodies and improvements in their physical appearance. Once we can diversify intake based on identified intolerances, fiber intake can increase in a more sustainable (read: less monotonous) way. There will be setbacks, especially due to the nature of IBS, the gut-brain axis and ever-changing stress levels, but there is always a way back to relative comfort and an eating plan that supports both IBS and PCOS. And tolerances can change over time, perhaps once there is more comfort and ease in handling health issues. We can certainly try!