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Can Diet and Exercise Actually Improve PCOS Symptoms?

Figuring out how to manage polycystic ovary syndrome (PCOS) can feel like a maddening game of throwing darts while blindfolded. And maybe while using your non-dominant hand, too. PCOS is a hormonal disorder that can prompt a wide range of symptoms including irregular periods, excess facial hair, scalp hair loss, and acne, all of which may make it feel like your body isn’t, well, yours anymore.

If you have this condition, you may have heard that diet and exercise can help. But people tend to say that for a lot of health issues, even when it couldn’t be further from the truth. So, is this medical fact or fiction? Here, SELF explores the connection between PCOS, diet, and exercise.

What causes PCOS

Let’s walk through the science of PCOS a bit. Stay with us here, because it will help you understand any possible diet and exercise links.

One commonly accepted theory suggests that PCOS happens because the brain’s hypothalamus sends incorrect signals to the pituitary gland (a pea-sized organ that produces hormones), resulting in ovarian dysfunction that causes PCOS symptoms, Leanne Redman, Ph.D., director of the Reproductive Endocrinology and Women’s Health Research Program at Pennington Biomedical Research Center in Baton Rouge, Louisiana, tells SELF.

Typically, your ovaries are tasked with producing hormones such as estrogen, progesterone, and androgens (hormones that have historically been viewed as “male,” like testosterone). Ovarian dysfunction can throw these hormones out of whack, leading to PCOS symptoms. For instance, your ovaries might churn out excess androgens that rear their head through PCOS symptoms like acne, excess facial hair, scalp hair loss, and problems conceiving due to irregular or totally absent ovulation.

Experts aren’t sure of exactly how these excess androgens can affect ovulation. It could be that the buildup of these hormones inside ovarian follicles (small sacs that each hold an egg) keeps the follicles from maturing and

eventually releasing eggs to be fertilized, John Nestler, M.D., a professor at Virginia Commonwealth University in Richmond, tells SELF.

Another prevalent theory holds that insulin resistance is at the root of PCOS. The relationship here is incredibly complex, but here’s the gist: If you’re insulin resistant, your cells don’t react properly to the insulin hormone your pancreas makes so you can absorb glucose (i.e., sugar from food), the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) explains. In that instance, your pancreas pumps out extra insulin. But if that’s still not enough to help your cells properly absorb glucose, high blood sugar levels lead to prediabetes, which then raises your risk of type 2 diabetes.

Where does PCOS come in? Insulin resistance can cause your ovaries to make too many androgens, according to the Mayo Clinic. Insulin resistance may also affect how the pituitary gland regulates your levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), both of which prepare those ovarian follicles for maturation. But data on this is conflicting, according to 2012 research on insulin resistance and PCOS in Endocrine Reviews.

So, how are diet and exercise supposed to help with these PCOS symptoms? If you're insulin resistant, then becoming more sensitive to insulin can lower the androgen levels that give rise to PCOS symptoms. “You can improve the insulin sensitivity and improve the syndrome,” Dr. Nestler says. The way you eat and exercise might help you do it.

The relationship between diet, insulin resistance, and PCOS

Maybe you’ve heard people say that trying this diet or swearing off those foods helped their PCOS symptoms. Don’t believe the claims that any particular food or food group worsens, causes, or cures PCOS, Lisa Moran, Ph.D., a dietitian and head of the Healthy Lifestyle Research Program at the Monash Centre for Health Research and Implementation in Melbourne, Australia, tells SELF.