Following a PCOS diagnosis, individuals can integrate various medical, supplemental, and nutritional modalities into their lives. After comprehensive testing is done to identify specific areas of concern and to formulate a specialized treatment plan, it is essential to consider additional elements that enhance the quality of life and alleviate symptoms. In this article, we share the recommended lifestyle interventions to help manage PCOS.
SLEEP
We know the vast benefits of sleep for everyone, but getting adequate quality sleep may be even more important for those with PCOS. There is much more research that needs to be done to better understand how impaired sleep impacts those with PCOS as well as the development of PCOS. A few basics we encourage you to focus on when looking to improve sleep hygiene
- Going to bed and waking up around the same time each day helps to support a normalized circadian rhythm. Keep in mind that we all have a chronotype which may dictate our ideal bedtime and wake up window.
- Sleep in a room that isn’t too hot or too cold (aiming for 66-67 degrees Celsius is optimal). One of the benefits of sleeping in a cooler room is that we can increase our brown fat volume which in turn can improve insulin sensitivity. 1
- Consider taking a hot shower prior to bedtime.
- Aim for 7-9 hours of sleep each night. Keep in mind that there may be some individuals who may be outliers in their sleep needs, but this is generally considered to be the recommendation.
- Turn off electronics 30-60 minutes before going to sleep.
- If, despite sleep hygiene strategies, you struggle with insomnia, we recommend you speak to your licensed healthcare provider. There are strategies that can be employed, including Cognitive Behavioral Therapy for Insomnia (CBT-I), stress management and supplemental support, and (usually only short term) pharmacotherapy, if needed.
In one study of women with PCOS, researchers found that those with PCOS in comparison to a control group had higher rates of sleep disorders. 2 Multiple studies looking at women with PCOS found that they also have a greater risk of developing obstructive sleep apnea. 3 4 Additionally, sleep disturbances are much more common in those with PCOS and in general they had a harder time falling asleep and staying asleep. 5 Those with PCOS should be mindful of sleep habits and also seek out a specialist if they suspect their sleep is impaired or that they may have sleep apnea. It is not yet clear if poor sleep plays a role in the development of PCOS or if having PCOS leads to worse sleep. It is clear that good sleep reduces metabolic stress, inflammation, and improves overall wellbeing, therefore it is important to ensure you are taking steps to prioritize quality sleep. 6 7
Our hormones are also impacted by sleep, specifically melatonin, cortisol, leptin and ghrelin. 8 Research has found that that individuals who get less sleep have lower levels of leptin and higher levels of ghrelin. 9 Leptin is the hormone that tells our body we are satiated and full in turn helping our body regulate hunger cues. Ghrelin is often referred to as the “hunger hormone” and signals us to eat but also plays an important role in glucose and energy homeostasis. 10 When our sleep is impaired, the downstream effect is that our hormones can also become more imbalanced.
STRESS REDUCTION MODALITIES
Making time for stress reduction is critical for mental and physical wellbeing. Whether it is a yoga practice, walk, phone call with a friend, or listening to a guided meditation, making time to quiet the mind and calm the body has a wealth of benefits for our long-term health. The American Psychological Association points out the various ways stress can impact the body from musculoskeletal tension, to impaired hormone production and impaired GI function. 11
PCOS is characterized by metabolic stress and those with PCOS in general have increased rates of psychological stress including anxiety, depression, and negative body image. 12 13 Additionally, increased levels of stress can lead to increased cortisol and if the stress becomes chronic then this can cause cortisol to stay elevated and lead to more systemic inflammation as well as reduce serotonin levels. 14
Everyone has different ways of managing or reducing stress, however some techniques and apps we recommend include:
- Spending intentional time with family, friends, and pets
- Spending time in nature
- Spending time AWAY from technology
- Getting sufficient sleep
- Prioritizing movement
- Having a yoga practice
- Bodywork practices (stretching, massage, chiropractic care, acupuncture, facials)
- Breathwork
- Meditation
Recommended Apps:
ACUPUNCTURE
One modality that can be beneficial for individuals with PCOS to explore is acupuncture. There is research showing that acupuncture can help to support a more regular menstrual cycle and lower levels of LH (luteinizing hormone) and testosterone in women with PCOS. 15 Some additional benefits of receiving acupuncture may include supporting more normalized lipid levels as well as improvement in insulin resistance and hormone levels. 16 While this modality may not be for everyone and surely will have varying benefits dependent on the type of treatment the acupuncturist carries out, duration of sessions, and other modalities used in conjunction with acupuncture (herbs, cupping, moxibustion, etc.) it may be worth trying if you have PCOS and are finding other modalities unsuccessful at bringing relief. If you are looking for an acupuncturist to work with it is recommended to go here or here to find a licensed provider.
MOVEMENT
All forms of movement and exercise that have been studied have shown to have positive impacts on metabolic health. The most beneficial movement to do is the movement you will enjoy doing and will be able to do consistently. Therefore, knowing that you will reap some benefit from any type of movement, think about what types of movement you enjoy and will stick with. For those with PCOS, around 120 minutes of vigorous exercise has been found to improve clinical outcomes related to body composition, insulin resistance, and respiratory and cardiovascular function. 17 In a meta-analysis looking at exercise interventions in women with PCOS, the most consistent areas where individuals saw improvement were in cardiorespiratory health, BMI, weight circumferences, and fasting insulin. 18 Some types of movement that were found to be beneficial for those with PCOS include: resistance training and aerobic interval training. 19 Vigorous activities such as brisk walking, HIIT, jogging, and weightlifting can improve insulin resistance. 20 21 Remember to have variety in your movement and find something you enjoy and can stick with. Additionally, it may be beneficial to talk with your medical provider or a fitness professional about exercise that may help your specific PCOS symptoms.
Upon exploring, you’ll find a range of lifestyle adjustments that can aid in alleviating PCOS symptoms. Integrating these lifestyle modifications with nutrition changes, supplements, and when necessary, medical interventions can significantly enhance the overall well-being of individuals with PCOS. For further information on PCOS and getting a diagnosis, you can explore our blog here. If you’re interested in delving into nutritional changes for PCOS, visit our blog here, and for a comprehensive look at the evidence-informed supplements for PCOS, you can read our blog here.