Carbohydrates and PCOS: Are Carbs Bad for PCOS?

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder (hormonal disorder) that affects how your body uses carbohydrates and insulin. Understanding the role carbohydrates play in managing PCOS can be helpful. Knowing more about the three macronutrients can help you make lifestyle changes that positively impact PCOS symptoms.

Carbohydrates, the sugars, starches, and fibres found in fruits, grains, vegetables, and milk products, serve as your body’s primary energy source. However, the way your body processes these carbohydrates is significantly influenced by PCOS, which often leads to insulin resistance and can lead to symptoms like rapid weight gain and increased risk of diabetes mellitus.

People with PCOS may find that adjusting their approach to their diet can help manage symptoms and improve insulin sensitivity. Rather than a one-size-fits-all approach, it’s important to consider how different types of carbohydrates and individual dietary patterns impact your body.

Choosing ways to eat that improve your symptoms and feel good to you can be a key strategy in managing PCOS effectively, without the necessity to entirely cut out carbs from your diet.

Key Takeaways

  • PCOS is associated with insulin resistance so many people believe that carbs are bad for PCOS.
  • It is not necessary to have a very low-carb diet or remove carbohydrates entirely to manage PCOS.
  • A considered approach to carbohydrates can contribute to improved PCOS symptom management without fully eliminating them.
  • Carbohydrates are important for satiety and are rich in important nutrients, including dietary fibre.

What are Carbohydrates?

Carbohydrates are essential nutrients that serve as a primary source of energy for your body. Understanding the different types of carbohydrates can help you make informed choices about your diet and help you build meals that are satisfying, both physically and emotionally.

The Role of Carbohydrates in the Body

Carbohydrates are crucial in maintaining your body’s energy levels. After ingestion, carbohydrates break down into glucose, which is transported through the bloodstream. This glucose is utilised by cells to fuel daily activities and maintain bodily functions. Insulin, a hormone the pancreas produces, helps glucose enter the cells.

How Does the Body Use Carbohydrates?

When you consume carbohydrates, your body converts them into glucose. This glucose enters the bloodstream, prompting the pancreas to release insulin. Insulin acts as a key, allowing glucose to be used as energy or stored for later use. While protein and fat can also be used for energy, carbohydrates are the body’s preferred source.

Food Sources of Carbohydrates

Carbohydrates are abundant in a variety of foods.

Complex Carbs

Foods high in complex carbs or starchy carbohydrates like wholegrain bread or wholegrain rice tend to break down into glucose more slowly.

Natural vs Free Sugars

Foods that contain natural sugars include fruit, milk and yoghurt. Some foods have free sugar such as honey or sweets (candy).


Fibre is the part of plant-based foods that cannot be digested when passing through the digestive system. It may also be referred to as ‘roughage’ for this exact reason. Your gut needs fibre to work normally. There are two types of fibre: soluble fibre and insoluble fibre.

Carbohydrates and PCOS

Understanding the relationship between carbohydrates and polycystic ovarian syndrome can help you to manage your condition effectively. Carbohydrates do not need to be excluded entirely to manage PCOS, but it is important to understand carbohydrates’ impact on insulin resistance and sugar cravings.

Insulin Resistance and Carbohydrate Intake

It is estimated that up to 80% of people with PCOS are insulin resistant no matter their body weight. People who meet all three of the PCOS diagnostic criteria (i.e. have irregular periods, hyperandrogenism and polycystic ovaries) are more likely to have insulin resistance.

Your body breaks down carbohydrates into glucose, which is used for energy. However, if you have insulin resistance, your cells don’t respond well to insulin, leading to higher levels of glucose in your blood.

To improve insulin resistance, medication like Metformin or supplements like inositol or berberine may be recommended.

In terms of dietary changes, there is no need to significantly reduce carb intake to improve insulin resistance, but instead, it may be helpful to swap the type of carbs you are consuming from white to their wholegrain alternative. For example, swapping white rice for brown rice, white potatoes for sweet potatoes, or white bread for brown bread. This is because foods high in complex carbs tend to break down into glucose more slowly, preventing an insulin spike.

Sugar Cravings and PCOS

Sugar cravings in PCOS can be a challenge, exacerbated by fluctuations in insulin and glucose levels. When your blood sugar levels drop, you might crave sugary foods to quickly raise them back to normal. However, this can lead to a cycle of spikes and crashes that worsen insulin resistance.

Research, including a meta-analysis, highlights the importance of maintaining a steady blood sugar level through a balanced dietary composition that includes protein and fat along with carbohydrates. Ensure that your meals have a balance of carbohydrates, protein, and fats to help moderate blood sugar levels.

Good news! Eating regularly, including snacking, is recommended for PCOS to prevent blood glucose dips and spikes.

Should You Cut Out Carbohydrates for PCOS?

People with PCOS are often recommended to reduce or cut out carbohydrates entirely. A low carbohydrate diet or a keto diet (very low carb diets) are frequently marketed as beneficial for symptom management but does the evidence support these diets for PCOS?

Well, when you look a little deeper into studies about low-carb diets or keto for PCOS you find the number of people in the studies is often very small, and the drop-out rate is high.

Cutting out carbohydrates or any whole food group from your diet is likely to contribute to disordered eating and, potentially, eating disorders. Plus, cutting out any food group entirely can lead to fatigue and can leave you at risk of nutrient deficiencies, and keto may increase the risk of heart disease because of it’s high fat intake.

What About Low Glycemic Diets for PCOS?

Low GI, or low glycemic index foods, cause a slower rise in blood glucose levels after consumption. This is important because maintaining stable blood sugar may help in managing insulin resistance often associated with PCOS. A low glycemic diet could therefore be a helpful option for PCOS and some studies have shown it can help to reduce symptoms of body hair, improve menstrual cycle frequency and improve energy levels.

However, it is important to mention that any diet can be challenging to adhere to long term and too much emphasis just on GI can be too reductive. For example, red meat has a lower GI than mango but too much red meat can be harmful to health. So it is just one tool we can use within PCOS management.

Key Takeaways: Carbohydrates and PCOS

PCOS management should focus on hormone balance to improve menstrual cycle regularity and reduce symptoms of PCOS like hair loss on the head, excess hair growth, fatigue, acne, oily skin and more.

Lifestyle changes like nutrition changes can be helpful for PCOS management, alongside medication and supplements. However, at The PCOS Collective, we recommend avoiding a low-carbohydrate diet because it may lead to nutrient deficiencies, a low fibre intake and even lead to disordered eating behaviours.

Instead, focus on enjoying carbohydrates with proteins and fats to help with blood glucose management, plus swapping to whole grains to improve satiety and reduce blood sugar spikes.

Frequently Asked Questions

Here are some of your frequently asked questions about carbohydrates and PCOS.

How Many Carbohydrates Should I Eat Each Day?

The quantity of carbohydrates that should be consumed can vary depending on your health, activity levels, age and more. It’s advisable to consult with a healthcare professional to determine a tailored and balanced amount that fits your specific needs.

Can a Ketogenic Diet Exacerbate PCOS Symptoms, and If So, Why?

ketogenic diet, which is very low in carbohydrates and high in fats, may not be suitable for everyone and could result in nutrient deficiencies if not properly balanced.

Should Dairy Products Be Restricted for Those Managing PCOS?

The relationship between dairy intake and PCOS is still under consideration. Some studies suggest that certain dairy products such as low-fat milk may exacerbate PCOS symptoms like acne, but otherwise, there is no evidence to suggest that PCOS is impacted by dairy intake.

Alex Okell ANutr Founder and Editor

Founder and Editor | Registered Associate Nutritionist


Founder of Be The Collective LTD [The PCOS Collective & The Endo Collective] Alex Okell ANutr is a London-based reproductive health nutritionist with experience in research, private practice and digital media. She holds a Master’s degree in Nutrition from King’s College London and has co-authored papers with the University of Cambridge, King’s College London, The Food Foundation and the Food Standards Agency. Alex offers 1:1 PCOS support in our virtual PCOS clinic.

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