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Taking down the PCOS ninja

September 11, 2009


As promised yesterday, I’m going to talk a bit about how I’ve dealt with my PCOS post-diagnosis; this is probably going to be my only post today because my medicine’s been fucking with my sleep schedule and I’m turrrred, so for those of you here for non-PCOS reasons – sorry.  For those of you new to the PCOS thing, check this post out first.  What I did won’t work for everyone, bc of PCOS’s highly variable nature, but it’ll give you an idea of treatment options – both conventional and holistic medicines, lifestyle changes, etc., and what’ll happen after your diagnosis.  And all in an easy to read bulletpoint format!

I shouldn’t have to write this, but just in case, remember that I am only a PCOS patient and have absolutely no training in medicine or nutrition whatsoever, so ask a real doctor before you take any of my advice.

Available conventional medicines:

  • birth control pills, to regularize your periods and some hormones
  • glucophage/metformin, FDA approved as a diabetes medication only though it’s been proven effective in PCOS patients (however, some health insurance companies won’t cover it).  It helps stabilize insulin spikes, I think (I’ll check and get back to you), which helps with the weight loss problems and sugar cravings.

About glucophage/metformin (what it did for me, at least):

  • Pro: I went from eating 400 calories a day to probably a bit over 2000 calories a day immediately after beginning to take the metformin and lost 5 pounds, which sounds small but was huge for me.  I just didn’t have to watch what I was eating at all.
  • Con: it hurts.  A lot.  Metformin messes up your GI system for a while at first.  Really painful cramps and certain other side effects that require one to be close to a bathroom for a while after meals…

Mitigating metformin GI pain:

  • My endocrinologist didn’t tell me this, , but you should always work up to a full dose of metformin.  Your body will tell you – loudly – if you’re going too fast.  It takes a few days for some people and weeks or months for others.
  • Avoid dairy, or it and the metformin will stage a pitched battle in your stomach and intestines.  For me, dairy residue was enough to do it, even though I hadn’t eaten any dairy for hours or days.
  • Take the metformin in one larger dose at night or in the morning.
  • Sometimes, the GI problems will continue past the first few weeks, which can make it difficult or impossible to continue taking the metformin.  I was one of those people; the one time I didn’t get horrible cramps was when I was on a diet very much like the paleolithic diet, which is all whole foods and mostly produce, lentils, and lean meats.  I couldn’t sustain it, but maybe you can.

Prescription weight-loss pills:

  • I am currently on a round of phentermine, which is a prescription-strength weight loss pill.  If your BMI is over 27 (regulations depend on the state), you may qualify for it.
  • It won’t be a permanent fix if you don’t also change your eating and exercising habits, of course, because you can only stay on it for 3 months, but it can be enormously helpful in getting you a kick-start.
  • I’ve been losing 2-3 pounds a week on it (as long as I don’t eat carbs – those carbs destroy everything).
  • I’ve experienced side effects ranging from sleeplessness to nausea to feeling a bit high.  Especially the first few days, you probably shouldn’t plan to do anything mentally taxing or important.

Once you get this medicine from your endocrinologist, go to a nutritionist and personal trainer.  If you think you can do it without professional help, go for it, but I failed until I went to the pros.  My nutritionist focuses on holistic medicine, and even though I’m a pretty scientific person, I’m now pretty sold on holistic medicine.  She helped me when no one else could.  My local community hospital has a gym with personal trainers who will set up a workout program for you after a fitness test and then let you to yourself, which keeps expenses down.

What to eat:

  • Low – very low – carb.  I know this was a thing that got popular, was destroyed by critics, and then faded from view, but it really works for people with insulin resistance.  The basic idea is that you want to stop your insulin from spiking, which will cause you to store fat.
  • I’ll make a longer and better list later, but basically what you want to cross off your list permanently is: gluten, sugar, grains (of any kind – whole grains may possibly be added back later, once you’re maintaining), potatoes, corn, peas, beans, dried fruit, watermelon, oranges, bananas, pears, plums, and apricots.  The fresh produce at the end of that list can be eaten occasionally – just don’t make a habit of it.
  • Fake sugar (Splenda) is okay – it’s not good for you, but it’s not been definitively been proven to be bad for you either, when eaten in reasonable amounts, and sometimes the sweet can really help you past a weak moment.
  • Almon flour (almonds put through a food processor, or bought) can almost always replace real flour.
  • It’s not a big deal if you cheat occasionally – just know that the scale will bump up, sometimes as much as several pounds, because of water retention the day after, and it can throw you off your fat-burning cycle for days, so make sure it really is just occasionally.
  • Eating Stella Style uses an excess number of exclamation points! But it is an incredible cookbook for low-carb living! Everything is delicious!  Link will take you straight to google books! The first 80 pages or so are online for free!
  • Try to keep between 30-60 carbs a day (remember, veggies have carbs in them, too.)
  • Veggie carbs are good carbs, and sometimes even combat the effects of bad carbs, so don’t cut back on them so you can indulge on a Twinkie later.  Not all carbs are created equal.
  • No processed foods.  Ever.
  • Look at the beginning of Stella Style, commit the names of the bad chemicals to memory, and check the ingredients list of everything you buy.  Try to avoid anything that gets too chemical-sounding.
  • I don’t follow any named diet, but doctors have suggested checking out the Zone, South Beach, the Maker’s diet, and the Paleolithic diet.  As with any diet, they can be a bit faddy and have a lot of misinformation about them available, so it’s probably better to know the underlying reasons so your bullshit detector will go off if you encounter any of it.


  • It is very, very important for PCOS women to get regular physical activity.  Ideally, you should be doing a mix of vigorous cardio and weight training, but just walking the dog or upping the activity in general is also very good, and it’s certainly better than nothing.
  • Aim for about an hour of physical activity, 6 days a week.
  • Again, exercise is VERY IMPORTANT for women with PCOS, even more so than for those regulars.

Okay, I think that’s about it for now.  Hopefully that’s helpful!  Please write more suggestions in the comments!ho

6 Comments leave one →
  1. October 1, 2009 9:48 pm

    Thank you .
    Really , i appreciate that .

  2. Bec permalink
    December 15, 2009 11:32 pm

    Thanks this was really helpful and straight to the point. Great Advice

  3. July 26, 2010 1:42 pm

    There is so much controversy around PCOS as it is all still in early stages that hearing from someone that has been there and done it, is great. Thank you for sharing and please keep this updated regularly so that we keep learning. PCO can be beaten thru diet and exercise and actually, its not hard its just the way we are meant to be in life…

  4. Dee permalink
    June 3, 2013 8:34 am

    Thanks for the info! The low card thing will be a killer!


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