Dra. Marina Augusto Estêvão

Nutritionist

Nutrition in polycystic ovary syndrome

HPA Magazine 21 // 2024

Polycystic Ovary Syndrome (PCOS) is a hormonal dysfunction that causes alterations in the ovaries; instead of producing a single follicle to release an egg, the ovaries produce multiple follicles that do not release eggs, leading to the formation of multiple cysts.
PCOS is one of the causes of female infertility and is often only detected when a woman is trying to conceive.

There are metabolic dysfunctions associated with this syndrome such as insulin resistance and hyperinsulinemia that may progress to Type II Diabetes Mellitus or Gestational Diabetes. 
Additionally, obstetric complications, increased risk of cardiovascular events, and ovarian cancer may also occur.
Today, we know that some lifestyle changes such as healthier eating habits, regular physical exercise, good sleep, and regular sleep patterns can help alleviate this syndrome and prevent some of its complications.
An imbalanced diet causes alterations in intestinal bacteria – intestinal dysbiosis – which increase intestinal permeability and consequently inflammation. 
Since the immune system interacts with insulin receptors, there will be an increase in androgen production by the ovaries and consequently alterations in normal follicular development. Studies have shown that supplementation with certain probiotics and vitamin D improves intestinal flora, reduces inflammation, body fat, and insulin sensitivity.
It is also known that certain types of diets can improve insulin resistance, such as the Mediterranean diet which prioritizes anti-inflammatory foods rich in polyphenols, such as olive oil, nuts, grains, and some berries, with interesting levels of resveratrol. Low-carb and hypocaloric diets that prioritize low-glycemic index foods, such as certain vegetables and fruits, have also shown favorable results in improving insulin resistance.
 

Maintaining good sleep habits allows the body to respond physiologically to environmental stimuli, resulting in the production of melatonin.
 In patients with PCOS, there is a decrease in melatonin in the follicular fluid.
This hormone has several benefits in PCOS, particularly in hormonal regulation and improvement of the menstrual cycle. 
There are some foods/nutrients that may improve melatonin production, such as vitamin D (morning sunlight), folic acid (found in green leafy vegetables like kale, spinach, beans, fish, peanuts), omega-3 (flaxseeds, chia seeds, fatty fish), and certain probiotics (such as kefir).
In addition to diet, there are also environmental factors, such as toxins, that play an important role in PCOS and its predisposition. 
For example, plastics with Bisphenol A (BPA), found in some plastic bottles (water, for example) and other containers used for food storage. 
These toxins are endocrine disruptors that affect health, and excessive direct contact during pregnancy may cause genetic alterations in the fetus's DNA that will affect future generations. 
A good strategy may be to use glass bottles and containers free of BPAs.
Therefore, a healthy diet rich in anti-inflammatory foods, good sleep habits, and regular physical exercise are essential to reduce potential complications, control symptoms, and promote good health for women with PCOS, whether they intend to conceive or not.