PCOS affects approximately one in ten Australian women — and it's one of the conditions I'm most passionate about supporting in my clinic. Unfortunately, the internet is full of conflicting, fear-based advice. Here's what the evidence actually says.
First — what's actually going on with PCOS?
Polycystic ovarian syndrome is a complex hormonal condition. Most women with PCOS have some degree of insulin resistance, elevated androgens (male hormones), and disrupted ovulation. Because insulin resistance is so central to PCOS, much of what helps metabolically also helps hormonally.
1. Focus on low GI carbohydrates — not no carbohydrates
I see so many women told to cut carbs entirely for PCOS. The evidence doesn't support this. What does help is choosing lower glycaemic index (GI) carbohydrates — wholegrains, legumes, sweet potato, oats — which cause a slower, gentler rise in blood glucose and insulin. Eliminating carbs entirely is unsustainable and can negatively impact mood, energy and gut health.
2. Prioritise protein at every meal
Protein slows digestion, reduces insulin spikes and keeps you fuller for longer. I encourage my clients with PCOS to include a good quality protein source at every meal — eggs, fish, chicken, legumes, Greek yogurt or tofu. This alone can make a significant difference to blood glucose regulation and appetite control.
3. Don't fear healthy fats
Omega-3 fatty acids found in oily fish, walnuts and flaxseeds have anti-inflammatory properties and can help with insulin sensitivity. Monounsaturated fats from olive oil, avocado and nuts are also beneficial. Fat does not cause weight gain — the overall dietary pattern matters far more.
4. Support your gut health
Emerging research suggests the gut microbiome plays a role in PCOS. Including plenty of fibre from vegetables, fruit, wholegrains and legumes, along with fermented foods like yogurt and kefir, can support a healthy gut environment. Aim for at least 25-30g of fibre daily.
5. Be wary of restrictive "PCOS diets"
Keto, intermittent fasting, dairy-free, gluten-free — I've seen clients try them all, often with no clinical reason to do so. Some of these approaches may suit certain individuals, but they're not evidence-based as a blanket recommendation for PCOS. What matters most is a balanced, anti-inflammatory pattern of eating that you can actually sustain long-term.
A note on weight and PCOS
Not all women with PCOS carry excess weight, and weight loss is not the only path to symptom improvement. I work with clients of all body sizes using a Health at Every Size approach — because everyone deserves evidence-based care, regardless of their weight.
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