Healthy eating, regular movement and good sleep are part of care for PCOS (polycystic ovary syndrome, a hormone condition that can affect periods, skin, hair and fertility). The 2023 international PCOS guideline recommends healthy habits for everyone with PCOS. It does not name one diet as the best. It also says these habits help even when your weight does not change.
femio gives health information for learning and planning. It is not medical advice, and it does not replace your clinician.
What the guideline says about lifestyle
The 2023 guideline calls lifestyle a core part of PCOS care. A lifestyle plan can be exercise alone. It can also mix healthy eating, exercise and support with daily habits.
One aim is better metabolic health. Here, that means things like blood sugar and blood fat levels. Another aim is general health and quality of life.
The guideline is clear on one point. There are benefits to a healthy lifestyle even without weight loss. So a change on the scale is not the only sign that something is working.
The guideline also says your goals should be set with you, not for you. You and your clinician agree on them together.
No single diet is proven best
The guideline found no evidence that one type of diet works better than another for PCOS. Any eating pattern that follows general healthy-eating advice can help your health.
That means you do not need a special "PCOS diet". The food you already eat at home can fit, as long as it follows that general advice. The guideline says changes should suit your food likes and your daily life. It also notes that money, culture and family life can make change harder. These are real limits, not personal failings.
The World Health Organization (WHO) also says healthy eating and physical activity matter for all women with PCOS.
Be careful with strong diet claims online. The guideline asks clinicians to warn about wrong health information and to point to trusted sources.
Movement that fits your life
The guideline found no proof that one type or intensity of exercise is best. Any activity that matches general activity advice has health benefits. Doing some activity is better than doing none.
For adults, general advice is 150 to 300 minutes of moderate activity each week. Another option is 75 to 150 minutes of harder activity. Adults are also advised to do muscle-strengthening work on two days that are not back to back. For teens, the advice is at least 60 minutes of activity a day.
Activity is not only sport. The guideline counts walking or cycling to get somewhere, active work and housework. Sitting less also helps.
Support with habits can include setting a small goal, keeping notes and solving problems as they come up. Start at a pace you can keep. Ask your clinician what is safe for you if you have other health conditions.
Sleep and snoring
Sleep matters too. People with PCOS have higher rates of obstructive sleep apnoea. The NHS describes sleep apnoea as breathing that stops and starts while you sleep.
The guideline asks clinicians to check for signs of it. The main sign is snoring, together with waking up unrefreshed, feeling sleepy in the day, or tiredness. A clinician may use a short questionnaire or refer you. Only a formal sleep study can confirm sleep apnoea.
Weight, without blame
Many people with PCOS face weight stigma. Stigma means unfair judgement or blame because of body size. The guideline says many women with PCOS experience weight stigma in healthcare and in other settings. It asks clinicians to be aware of their own weight bias.
WHO notes that symptoms such as weight and unwanted hair face social stigma in many places.
The guideline asks clinicians to offer two options. One is weight-focused care, which aims for weight loss. The other is weight-inclusive care, which does not make weight loss the goal. Your goals decide which approach fits you. The guideline gives one simple example of respectful care: asking your permission before weighing you.
This page sets no weight, calorie or kilogram target. Any weight goal should be a shared decision with your clinician, and only if you want one.
Planning a pregnancy
If you hope to get pregnant, the guideline says healthy habits are worth looking at before pregnancy. This includes activity, sleep and mental health. See PCOS and fertility for more on this.
Questions to ask your clinician
- Which healthy habits would help my goals most, such as periods, fertility or blood sugar?
- Would a dietitian or an exercise plan suit me?
- Should I have a sleep check if I snore and feel tired during the day?
- Which signs of progress, besides weight, can we track together?
- Can we talk about weight only when I say yes?
When to see a doctor
Book a visit if you snore and also wake up unrefreshed or feel tired during the day. The NHS also advises seeing a GP if your breathing stops and starts in your sleep, or you are always tired in the day.
Book a visit if worries about eating, exercise or body image affect your daily life. The guideline says eating disorders should be considered in PCOS whatever a person's weight. If an eating problem is suspected, a qualified professional should assess it in full.
Bring your notes on habits, sleep and questions. Ask what each suggestion aims to change, and when you will review it together.
What femio does and does not do. femio helps you note cycles, habits and questions, so a visit is clearer. femio does not diagnose PCOS, set food, exercise or weight goals, or choose a treatment. femio is not a substitute for your clinician.