Is Intermittent Fasting a Ray of Hope for PCOS? Evidence-Based Answers

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women during their reproductive years. Responsible for various issues such as infertility or subfertility, insulin resistance, obesity, hormonal disorder, and hyperinsulinemia, PCOS exerts enormous mental and physical stress on those with this condition.

Amongst the recommended treatments are diabetic and birth control drugs with specified risk factors. This makes one wonder whether there is a holistic approach to treating PCOS. In this guide, we will determine whether intermittent fasting can help PCOS patients.

What is PCOS?

PCOS, or polycystic ovary syndrome, is a hormonal imbalance disorder affecting women. Even though women can experience it anytime during their childbearing years, it mainly manifests during the early years of reproductive age, i.e., between 15 and 44 years. Around 2.2 to 26.7% of women in this age bracket suffer from PCOS. [1]

The syndrome mainly affects women’s ovaries, which are one of the many reproductive organs in women. These are responsible for the following: 

• Production of hormones like progesterone and estrogen
• Control of the male hormones, androgens, in women
• Making, releasing, and storing eggs start the reproduction process as a man’s sperm fertilizes them. [2]

In PCOS, many tiny and fluid-filled sacs usually grow inside the ovaries. These sacs are known as follicles or cysts. Each cyst contains an immature egg that never goes into the ovulation stage, releasing the egg from the ovaries and entering into the fallopian tube.

As ovulation doesn’t occur, the hormone level like estrogen, progesterone, FSH, and LH lowers while the male hormone androgen increases. 

High production of male hormones further causes delays in the menstrual cycle in the affected women and is also responsible for more facial hair. It can cause adverse pregnancy outcomes, type 2 diabetes mellitus, metabolic syndrome, and carcinoma. Nearly 40-80% of women suffering from PCOS are also obese. Obesity in PCOS-suffering women is the most central type responsible for diabetes. 

Emerging studies prove that many women suffering from PCOS also have a high chance of developing breast, ovarian, and endometrial cancer. 

Women with PCOS might have a tough time conceiving. PCOS refers to small cysts in the ovaries that may make a woman’s menstrual cycle irregular. When menstrual cycles are irregular, eggs are not released at the normal frequency. 

In PCOS, FSH or follicle-stimulating hormone might also not release in adequate quantity. FSH plays a key role in the female reproductive system as it supports the development and maturation of ovarian follicles or eggs. 

When the FSH level is low, instead of releasing mature eggs, the ovaries store these. Hence, such women might have difficulty conceiving. However, this is not the case with every woman with PCOS.  

Those with infertility issues can have a child with the help of treatment and lifestyle changes. However, it has been observed that nearly 30-50% of women with PCOS may experience a miscarriage during the early stages of pregnancy. [3]

The above-mentioned are the most common symptoms of PCOS that occur at varying intensities in women with PCOS. It is also not necessary that every woman experiences all these symptoms. Some women will experience extreme weight gain, while others might have high insulin resistance. In a nutshell, PCOS is tricky and affects women in multiple ways. 

Suggested Treatments for PCOS

As PCOS causes many reproductive, metabolic, and cosmetic complexes in women, as mentioned above, ignoring it for a long time is not recommended. Early intervention is the right approach to treating PCOS.  

PCOS can be managed with proper guidance and treatment recommendations. Here is a list of common treatments for PCOS:

• Birth control pills are often suggested to manage the symptoms of PCOS as they can help regulate hormones and ovulation while protecting against endometrial cancer. [4]
• Insulin-sensitizing agents are also recommended for women with PCOS as they help clear acne, control weight, slightly reduce PCOS-induced infertility, and regulate the menstrual cycle. [5]
• Metformin is a drug used to treat type 2 diabetes and is often used as a treatment for PCOS. As PCOS affects the insulin level, Metformin can control the insulin level and promote ovulation in women. [6]
• To treat PCOS-related infertility in women, clomiphene is also used very commonly. The American College of Obstetricians and Gynecologists (ACOG) recommends this drug for PCOS treatment as it encourages egg maturity and ovulation. However, it’s observed that women using this drug are more likely to have twins.
• Letrozole effectively promotes the production of FSH or follicle-stimulating hormone, which is important for ovulation. In many studies, it’s observed that letrozole is more effective than clomiphene in increasing the live birth rate.
• Ovarian drilling or surgery is the last option to treat PCOS. In this treatment, doctors make tiny holes in the ovaries to extract the cysts so that ovulation is restored. [7]

Can Intermittent Fasting Help Treat PCOS?

With all the above-stated treatments, making certain lifestyle changes like controlling weight, having a low-calorie diet, and staying active is highly recommended. These lifestyle changes, combined with recommended medications tend to deliver positive outcomes early. [8]

Intermittent fasting is a great way to control body weight. In this fasting method, people restrict calorie consumption to a specific time so that the body uses stored fat as an energy source.

People only eat during a particular window and fast for the rest of the day. The most commonly followed IF schedule involves fasting for 14-16 hours and eating in an 8-10 hour window.

Intermittent fasting has been observed for centuries and is well known for its excellent benefits. From reducing weight to improving brain health, 12-hour intermittent fasting offers lucrative benefits if you follow it correctly.

When it comes to PCOS, intermittent fasting has a great role to play. It can help you manage PCOS symptoms in many ways. Let’s understand this in detail.

Intermittent Fasting is Great for Weight Management

The main goal of intermittent fasting is to push your body into ketosis, where the body burns fat instead of carbohydrates. When the body burns fat, it also burns glycogen or blood sugar. 

Losing weight helps with PCOS management in many ways. For instance, weight loss can fix infertility by restoring ovulation and insulin level imbalance.

Fasting-induced weight loss is also effective in reducing metabolic syndrome and diabetes mellitus. During a fast, insulin levels decline, and insulin resistance improves. This further trims down the risk of metabolic syndrome. Overall, with reduced weight comes a better metabolic profile that helps control PCOS symptoms. [9]

Decreases Androgen Production

Androgen is a male hormone found in women in less quantity. However, women with PCOS have a high androgen percentage, which further causes menstrual cycle imbalance and causes cosmetological concerns in women, like more facial hair and acne.

Anti-androgen drugs are recommended to treat these concerns, as they can lower the androgen level and control hair growth in women. However, these medications are not to be consumed by women trying to conceive because they are known to cause birth defects. This is why they must always consume oral contraceptives while taking these drugs. Also, the FDA doesn’t recommend using these drugs with insulin-sensitizing medications. [10] Hence, using anti-androgen drugs for long periods is not at all recommended.

However, fasting can help lower androgen levels in men and women. A study on the effectiveness of intermittent fasting on the reproductive hormones of humans revealed that this fasting practice could decrease the level of androgen in both genders. This is why it’s recommended as a viable and natural way to treat hyperandrogenism in females with the polycystic ovarian syndrome. As androgens decline, the menstrual cycle and fertility are restored. [11]

Fixes Insulin Resistance

High insulin resistance remains a major concern for women with PCOS. Hyperinsulinemia (high insulin levels) leads to hyperandrogenism and anovulation. Insulin resistance is also responsible for android obesity in 50-60% of women with PCOS. Hence, managing high insulin is very important when we talk about treating PCOS.

Intermittent fasting has a proven record of improving insulin resistance in humans. As one fasts, the body consumes its fat reservoir. When this happens, glycogen replication occurs, and insulin is controlled. Also, fasting controls mid-day snacking. Whenever we consume calories, our insulin level goes up. By avoiding eating for long hours, you keep your insulin levels under control.

Research has proven that a six-week calorie restriction controls glucose and EGP levels, further improving glucose metabolism. [12]

Better Ovarian Functions

Women with PCOS have disturbed ovaries due to the high production of androgens and low IGFBP-1 serum levels. They both are essential to encourage the proper functioning of the ovaries. Hence, it’s vital to keep them under control. [13]

Intermittent fasting effectively controls IGFBP-1 and IGF-1 levels that promote better ovarian functioning. [14] And with improved ovarian function comes a regular menstrual cycle, controlled hormones, and enhanced fertility.

Seeing what’s mentioned above, one can understand that intermittent fasting can help women with PCOS deal with this issue by reducing its symptoms and improving the efficacy of ongoing treatment. Along with treating PCOS naturally, intermittent fasting has other benefits, including reducing cancer risk and improving brain function and longevity.

Frequently Asked Questions

How much calorie deficit is required to lose weight in women with PCOS? 

Obesity is observed in many women with PCOS; weight management remains a key goal of PCOS treatment. While every woman has a different weight loss goal, it’s observed that a 30% energy deficit is required at minimum to manage the symptoms of PCOS. 

Can women with PCOS conceive? 

Women with PCOS can conceive, but some might have difficulty with it. Those with challenges can become mothers with proper treatment, lifestyle changes, and dietary recommendations. 

What effect does intermittent fasting have on women with PCOS? 

When followed correctly, intermittent fasting helps control androgen production, balance insulin resistance, manage weight, and encourage a woman’s ovaries to function normally. 

Conclusion

PCOS is a common disorder that women experience during their reproductive years. The broad symptoms impact women’s ovary functioning, reproductive system, and hormones. 

With high androgen levels come multiple cosmetic concerns, which trigger a chain reaction in the body as one problem leads to another. Hence, its early and effective treatment is a must. While many medication-based treatments are available, they are all recommended to be combined with lifestyle changes like weight reduction. 

Weight management is the key to success in PCOS management. As intermittent fasting encourages a low-calorie diet and fasting for long hours, it’s one of the most holistic approaches to treating PCOS. 

Intermittent fasting can help women manage weight, control androgen production, reduce insulin resistance, and even improve the ovaries’ health. IF can change lives for the better. However, make sure you’re doing it correctly. Get yourself familiar with the nitty-gritty of intermittent fasting to achieve desired results.

References 

1. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria – PubMed. (2010, February 1).
2. Gibson, E., & Mahdy, H. (2022, July 25). Anatomy, Abdomen and Pelvis, Ovary – StatPearls – NCBI Bookshelf. Anatomy, Abdomen and Pelvis, Ovary – StatPearls – NCBI Bookshelf.
3. Tehrani, F. R., & Behboudi-Gandevani, S. (2015, February 4). Polycystic Ovary Syndrome.
4. Polycystic Ovary Syndrome (PCOS). (n.d.). Polycystic Ovary Syndrome (PCOS) | ACOG. https://www.acog.org/en/womens-health/faqs/polycystic-ovary-syndrome-pcos
5. Polycystic ovary syndrome – PubMed. (2014, March 1). PubMed.
6. Naderpoor, N., Shorakae, S., Courten, B. D., Misso, M. L., Moran, L. J., & Teede, H. J. (2015, October 1). Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis. OUP Academic.
7. Treatments for Infertility Resulting from PCOS. (2017, January 31).
8. Polycystic Ovary Syndrome (PCOS). (n.d.). Polycystic Ovary Syndrome (PCOS) | ACOG.
9. Ionescu, C. A., Popescu, I., Banacu, M., & M. (2018, February 14). Lifestyle Changes and Weight Loss: Effects in PCOS. Lifestyle Changes and Weight Loss: Effects in PCOS | IntechOpen.
10. Martin, K. A., Anderson, R. R., Chang, R. J., Ehrmann, D. A., Lobo, R. A., Murad, M. H., Pugeat, M. M., & Rosenfield, R. L. (2018, April 1). Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society* Clinical Practice Guideline. OUP Academic.
11. Effect of Intermittent Fasting on Reproductive Hormone Levels in Females and Males: A Review of Human Trials – PubMed. (2022, June 3).
12. Sathananthan, M., Shah, M., Edens, K. L., Grothe, K. B., Piccinini, F., Farrugia, L. P., Micheletto, F., Man, C. D., Cobelli, C., Rizza, R. A., Camilleri, M., & Vella, A. (2015, September 1). Six and 12 Weeks of Caloric Restriction Increases β Cell Function and Lowers Fasting and Postprandial Glucose Concentrations in People with Type 2 Diabetes. OUP Academic.
13. Fasting as possible complementary approach for polycystic ovary syndrome: Hope or hype? – PubMed. (2017, August 1). PubMed.
14. The influence of fasting and energy restricting diets on IGF-1 levels in humans: A systematic review and meta-analysis – PubMed. (2019, August 1). PubMed.

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