Intermittent Fasting and PCOS: Is It Worth It?

By now, I’m willing to bet you’ve heard about intermittent fasting. That’s no coincidence, the entire health community is ablaze with the potential health benefits intermittent fasting can bring about. But is intermittent fasting a smart practice for those with a PCOS diagnosis?

If intermittent fasting is new to you, don’t worry. Read on, we’re going to explore what intermittent fasting is, the proposed benefits, and whether or not someone with PCOS should utilize intermittent fasting as a method to possibly ease their symptoms.

Image of notebook with PCOS polycystic ovarian syndrome on it

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder in premenopausal women, affecting 6-13% of women in the United States alone. PCOS has variable phenotypes, which means each case is highly individualized, so everyone can experience symptoms differently. So much so, that even members of the same family can report wildly different experiences from one another.  

The condition has three main features: multiple cysts on the ovaries, abnormally high levels of androgens (male sex hormones, such as testosterone), and irregular periods. To be diagnosed with PCOS, however, you only need to exhibit two out of the three features.

Other symptoms may include:

  1. Abnormal hair growth (both face and body)
  2. Acne or other skin changes (oily skin, melasma, etc.)
  3. Insomnia or sleep disturbances
  4. Weight gain around the abdominal region
  5. Difficulty conceiving
  6. Mood changes (anxiety, depression, etc.)

While there is no cure for PCOS, diet and lifestyle changes have been proven quite effective in reducing and managing symptoms. To determine the right diet and lifestyle changes for you, it’s vital to understand what specific type of PCOS you’re dealing with. To learn more about the different phenotype criteria and the 4 different types of PCOS, check out this blog post!

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What is Intermittent Fasting? 

Intermittent fasting is an eating pattern where a person alternates between fasting and eating within a 24-hour period. There are many different strategies when it comes to intermittent fasting. Let’s discuss the four most popular methods: 

Time-Restricted Eating

With this method, there are set periods of time for eating, alternating with set periods of time for fasting. The two most popular methods are:

  • 16/8 Method: Fast for 16 hours of the day, then eat only within a specific 8-hour window. For practitioners of this method, a popular eating window is between 10 a.m. and 6 p.m. 
  • 14/10 Method: Fast for 14 hours of the day, then eat within a 10-hour eating window. Many practitioners of this method suggest eating between 9 a.m. and 7 p.m.

Twice A Week 

This method of intermittent fasting involves fasting twice a week, by capping daily calorie intake to 500 on fast days. Generally, this means two meals: one with 200 calories, and one with 300 calories. It is highly recommended to make sure whichever two days are chosen for fasting, two consecutive days are not chosen, and that there is a non-fasting day in-between them.

  • 5/2 Method. This method involves 5 days of eating regularly, alternating with 2 days of fasting (keeping a total intake of 500 calories per day). 

Alternate Day Fasting

This method of intermittent fasting is as it sounds – it involves fasting every other day. On fasting days, caloric intake is limited to 500. On non-fasting days, a regular diet is consumed.

24 Hour Fast

This method of intermittent fasting is performed once or twice a week and is characterized by a full 24 hour fast. Most people tend to take advantage of the hours spent inadvertently fasting while sleeping to help them achieve this more advanced result. Be aware that this method can have extreme side effects including headaches, fatigue, low energy, and irritability.

Why Someone with PCOS May Want to Try Intermittent Fasting

Many studies have suggested positive health benefits associated with intermittent fasting that sound beneficial for someone dealing with PCOS. Those health benefits include:

  1. Weight loss
  2. Improved Insulin Sensitivity
  3. Reduced Inflammation
  4. Lowered risk of Heart Disease
  5. Improved Cognitive Function
Image of woman laying on her bed staring at a donut

Why Someone with PCOS May Have Problems with Intermittent Fasting 

As appealing as those health benefits are, diets such as intermittent fasting, are not the only means of reaping those health benefits. And it’s important to assess your specific case before attempting to incorporate intermittent fasting into your dietary repertoire. There are a few possible issues women with PCOS may face when engaging in intermittent fasting:

Negative Relationship with Food

Intermittent fasting may impact a person’s relationship with food leading to food preoccupation, overeating and binge eating. One five-year prospective study found that fasting for weight control purposes is shown to be a consistent predictor for the future onset of binge eating and bulimia nervosa. We already see that 1 out of 3 women with PCOS struggle with binge eating and this may be in part due to the restrictive diets you are told to follow to improve symptoms.

Hormone Imbalances

Intermittent fasting can alter the level of hormones secreted, as well as the frequency of their secretion. An example of this is insulin sensitivity. While improved insulin sensitivity is championed as a health benefit of intermittent fasting, most studies were not performed solely on women.

In 2015 a study found that intermittent fasting worsened insulin sensitivity in women, while it improved insulin sensitivity in men. The truth is, the overall implications of altered hormone secretions from intermittent fasting are not entirely understood. However, given the hormonal nature of PCOS, fasting may not be a great option for women with PCOS. 

Increased Cortisol

PCOS is marked by high levels of the hormone cortisol, the stress hormone. Unfortunately, intermittent fasting can also increase cortisol levels as strict dieting, especially when coupled with strenuous exercise regimens, can lead to increased oxidative stress. This increased stress, in concert with overactive cortisol production, can exacerbate PCOS symptoms in some patients.  

Hypoglycemia

Hypoglycemia, a deficit of glucose in the blood, can cause dizziness, shakiness, blurred vision, headaches, confusion, and mood swings (just to name a few). Numerous studies involving intermittent fasting have found participants dealing with hypoglycemic effects and this could be dangerous for PCOS patients who are already experiencing some of these symptoms. 

Energy Crashes and Fatigue

Fasting can lead to cravings or result in a person going to sleep either hungry or uncomfortably full, which can lead to disrupted sleep. For someone with PCOS, this presents difficulty due to the integral part that proper sleep plays in balancing hormones, reducing inflammation, regulating metabolism, improving insulin sensitivity, and regulating hunger hormones. Not to mention, we need solid sleep to build up our energy reservoirs for exercising, since exercising can improve insulin resistance, reduce inflammation, and reduce testosterone levels. 

Woman stretching and looking relieved

A Better Solution

Rather than placing the focus solely on intermittent fasting as a weight loss tool, focus on adding sustainable, health-promoting habits to your regimen that will balance your hormones, improve symptoms, and foster a more harmonious relationship with food and your body. Some such examples are:

  • Manage your stress.  Stress comes in many forms and can impact your hypothalamus-pituitary-adrenal axis leading to elevated levels of cortisol. Try to reduce your mental, as well as physical, stress load by setting boundaries as well as brainstorming tools to handle stressful situations.

  • Improve your sleep hygiene. Try to get a minimum of 8 hours of sleep a night. Sleep is a core factor in the regulation of vital hormones, including cortisol and insulin.

  • Focus on addition, not subtraction. Eat foods rich in anti-inflammatory properties, such as green leafy vegetables, berries, tomatoes, nuts, and fatty fish. Incorporate more whole grains into your diet (this has the added benefit of helping you feel fuller, longer).

  • Eat consistently throughout the day. Eating consistently throughout the day involves eating every 3-5 hours. This helps stabilize the body’s blood sugar, which helps to improve insulin sensitivity. It may help to keep balanced snacks on hand to ensure you don’t experience hypoglycemia and the symptoms associated.

  • Spread carbohydrates evenly throughout your day. Eating a consistent amount of carbohydrates throughout the day also helps stabilize the body’s blood sugar. Try to pair carbohydrates with protein and fat to improve insulin sensitivity and avoid blood sugar spikes. 

  • Incorporate harmonious movement. Gentle movement and exercise can improve insulin sensitivity and reduce inflammation. While strenuous exercise can increase the stress load on the body and cause additional issues. So take care not to over-exercise, but to explore ways to move more frequently, while remembering to be gentle with your body.

The Takeaway 

PCOS is a complex condition. With the limited studies available on intermittent fasting and PCOS, and the overlap in issues related to PCOS and intermittent fasting, it is important to understand that this diet may not be the best solution for someone living with PCOS. Instead, I recommend adopting one or all of the many beneficial habits that have been proven to help alleviate the symptoms of PCOS.

If you still have questions about intermittent fasting and PCOS after reading this blog post, and you want help creating a tailored approach unique to you, click this link to apply to work with me 1:1. I hope to be a part of your PCOS journey, so you can ditch dieting and bring out a happier and healthier you!

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