5 Simple Food Swaps to Beat Sugar Cravings with PCOS

Many women with PCOS describe feeling stuck in a cycle of cravings, fatigue, and energy dips. I often hear clients say things like:

• “I feel like I’m constantly craving sugar.”
• “If I eat breakfast, I’m hungry again by mid-morning.”
• “I crash in the afternoon and reach for something sweet.”

These are signs that your blood sugar might be fluctuating more than it should be. When blood sugar rises quickly after eating, the pancreas releases insulin to move glucose into your cells for energy. Over time, repeated spikes can make the body less responsive to insulin’s signal — a key feature of PCOS known as insulin resistance.

Balancing blood sugar helps reduce cravings, stabilise energy, and support hormone regulation. And the good news is, it doesn’t mean cutting out all carbohydrates! We just need to make a few simple swaps that help your body use energy more efficiently.

Swap 1: White carbs → colourful veggies and legumes

Refined carbohydrates such as white bread, pasta, or rice are digested quickly, leading to sharp rises in blood sugar and insulin. Replacing some of these with non-starchy vegetables and fibre-rich legumes can help keep blood sugar steady and provide more vitamins, minerals, and antioxidants.

Try switching to:

• Cauliflower rice instead of basmati rice, or at least mixing it half and half
• Lentils, chickpeas, or beans as a base for curries, soups, and salads – or as a base for pan-fried fish or chicken
• Vegetable noodles (like courgetti or carrot ribbons) instead of refined pasta

Vegetables and legumes add fibre, colour, and texture to meals while supporting healthy digestion and a more balanced insulin response. For ideas, see our Courgetti – Three Ways recipe.

Swap 2: Sugary snacks → protein-based snacks

That mid-afternoon biscuit or cereal bar may give a quick lift, but it often leads to a crash soon after. Protein slows digestion and releases glucose gradually, helping you stay satisfied for longer.

Try replacing sugary snacks with:

• A handful of mixed nuts and a few berries
• Apple slices with nut butter
• Greek yoghurt with flaxseed and cinnamon
• Oatcakes with hummus or boiled eggs

A little protein between meals helps stabilise mood and energy while reducing the urge to reach for something sweet.

Swap 3: Fruit juice → fruit paired with protein

Fruit juice, even when labelled “100% pure”, contains concentrated sugars without the fibre that helps slow absorption. This can cause a quick rise and fall in blood sugar.

Whole fruit is a better option, especially when paired with protein or healthy fats to keep energy steady. For example:

• Berries with a few almonds or pumpkin seeds
• A small apple with nut butter
• Sliced pear with Greek yoghurt

Pairing fruit with protein supports satiety and smoother energy through the morning or afternoon.

Swap 4: Sugary breakfasts → savoury, protein-rich breakfasts

Starting the day with a sugary cereal or pastry may feel comforting, but it often leads to mid-morning energy dips. A savoury, protein-rich breakfast balances blood sugar and supports hormone health throughout the day.

Try options like:

• Scrambled eggs or tofu with spinach and tomatoes on rye or sourdough toast
• Smoked salmon with avocado on oatcakes
• A veggie omelette cooked in olive oil
• Savoury overnight oats made with milk, chia seeds, ground flaxseed, and grated courgette

These breakfasts combine protein, healthy fats, and fibre to help you stay full, focused, and energised.

Swap 5: Processed ready meals → simple home-prepped meals

Ready meals are convenient but often contain refined oils, added sugars, and low-quality fats that can make blood sugar harder to manage.

Cooking simple meals at home doesn’t need to be complicated. Start small:

• Batch-cook soups, curries, or stir-fries at the weekend
• Use olive oil, herbs, and spices instead of sugary sauces
• Combine lean proteins like chicken, fish, tofu, or lentils with plenty of colourful vegetables

Even one or two home-cooked meals each week can help improve energy, digestion, and overall wellbeing.

Small changes, big impact

Balancing blood sugar isn’t about restriction or perfection, it’s about consistency. Small, everyday swaps can support steadier energy, reduce cravings, and make it easier to manage PCOS symptoms in the long term.

Try one or two of these swaps this week and notice how your body responds. Over time, these small steps can make a real difference to your energy, mood, and hormonal balance.

For more on managing symptoms, visit my blog on PCOS Symptoms.

If you’re ready to balance your blood sugar and feel more energised, book a free discovery call to explore how a personalised nutrition plan can support your PCOS journey.

This article is for educational purposes only and does not replace medical advice or diagnosis.

PCOS and Insulin Resistance: What You Need to Know

What is insulin resistance?

Insulin is a hormone made by your pancreas that helps move glucose (sugar) from your blood into your body’s cells, where it can be used for energy. When, over time and with increased levels, cells in the muscles, liver, and fat tissue become less responsive to insulin’s signal, your pancreas compensates by releasing more. This is called insulin resistance.

Over time, if insulin levels stay high (known as hyperinsulinaemia), the system becomes strained. This increases the risk of higher blood sugar levels and, in the long term, type 2 diabetes.

The latest international PCOS guidelines highlight that insulin resistance is a common feature of PCOS and recommend assessing blood glucose control with an oral glucose tolerance test (OGTT), rather than measuring insulin directly.

Why insulin resistance happens in women with PCOS

Insulin resistance can affect anyone, but it’s especially common in PCOS due to a mix of genetic, hormonal, and metabolic factors, not simply weight or diet.

Key factors include:

1. Cellular insulin signalling changes
Women with PCOS can have differences in how their cells respond to insulin, even at a healthy weight. The muscles and fat tissue don’t take up glucose efficiently, so the pancreas produces more insulin to compensate.

2. Androgen excess
High androgen levels, one of the defining features of PCOS, can reduce how well the body responds to insulin. Meanwhile, high insulin can also drive-up androgen levels, creating a vicious cycle that reinforces both problems.

3. Visceral fat and inflammation
Fat stored around the abdomen produces inflammatory molecules that interfere with insulin’s action. Even small reductions in waist size can make a measurable difference to insulin sensitivity.

4. Genetic predisposition
Insulin resistance and type 2 diabetes often run in families. Genetic factors linked to PCOS can affect how the body regulates insulin and glucose metabolism.

5. Cellular energy and oxidative stress
Emerging research suggests that reduced mitochondrial efficiency (how cells produce energy) and oxidative stress can also impair insulin function in women with PCOS.

These overlapping mechanisms explain why insulin resistance can occur in both lean and overweight women with PCOS, and why it requires a personalised, whole-body approach.

Why hyperinsulinaemia makes PCOS symptoms worse

Persistently high insulin levels can influence other hormone systems and worsen many PCOS symptoms.

Androgen excess
High insulin stimulates the ovaries to produce more testosterone and lowers sex hormone-binding globulin (SHBG), increasing the amount of active testosterone in circulation. This contributes to acne, oily skin, and excess hair growth.

Ovulation disruption
Elevated insulin and androgens can disrupt the hormonal feedback loop needed for ovulation, leading to irregular or absent periods and difficulty conceiving.

Weight management challenges
Insulin promotes fat storage, especially around the abdomen. This creates a cycle where higher insulin makes weight loss more difficult, and higher fat levels worsen insulin resistance.

Cravings and appetite changes
Fluctuating blood sugar and insulin can disrupt hunger hormones such as leptin and ghrelin, leading to intense sugar cravings and a feeling of never feeling full.

Mood and energy
Blood sugar swings can affect energy and concentration. Many women report fatigue, brain fog, or irritability that improve once blood sugar becomes more stable.

Signs and symptoms of insulin resistance

Insulin resistance develops gradually, so it’s easy to miss. While there is no single symptom, these patterns are common among women with PCOS:

• Strong sugar or carbohydrate cravings
• Feeling tired, shaky, or irritable between meals
• Difficulty losing weight despite a balanced diet
• Weight gain mainly around the middle
• Feeling hungry again soon after eating
• Fatigue after carbohydrate-rich meals
• Darkened, velvety skin patches on the neck or underarms (acanthosis nigricans)
• Acne, oily skin, or unwanted hair growth
• Irregular or missing periods
• Blood tests showing raised triglycerides, low HDL cholesterol, or elevated glucose or HbA1c

Recognising these early signs allows you to take proactive steps through nutrition and lifestyle before complications develop.

Practical next steps if you’re concerned

If several of these symptoms sound familiar, here are steps to support metabolic and hormonal balance – but always seek guidance from your GP or a registered nutrition professional before making major changes.

Request appropriate testing
Ask your GP whether an Oral Glucose Tolerance Test (OGTT) is suitable for you. It’s the most sensitive way to assess glucose handling in PCOS.

Review your wider metabolic picture
Blood pressure, cholesterol, liver function, and waist measurement all contribute to understanding overall metabolic health.

Focus on balanced eating
There is no single “best” diet for PCOS, despite what influencers might try and tell you! It depends on the individual. However, it is best to focus on:

• Protein at every meal to support satiety
• Fibre-rich vegetables to slow glucose release
• Whole-food carbohydrates, such as veggies and legumes, in moderate portions
• Healthy fats to support hormones

Over-restricting carbohydrates can cause fatigue and cravings, so aim for balance rather than extremes.

Move regularly
Regular movement improves insulin sensitivity. A combination of brisk walking, cycling, or swimming along with weight or strength training offers broad benefits. Consistency matters more than intensity.

Prioritise sleep and stress management
Poor sleep and chronic stress raise cortisol, which can worsen insulin resistance. Good sleep hygiene and simple stress-reduction techniques can make a noticeable difference.

Insulin resistance and diabetes risk
Research shows that women with PCOS are at a higher risk of developing impaired glucose tolerance and type 2 diabetes, even at a healthy weight. This happens because insulin resistance often develops earlier and progresses more quickly in PCOS. Studies show that women with PCOS have a four- to eight-fold increased risk of type 2 diabetes compared with women without PCOS.

Over time, if insulin levels stay high, the pancreas may struggle to keep up with demand, leading to rising blood glucose. Early identification and consistent lifestyle changes can significantly reduce this risk.

Regular blood sugar checks and ongoing metabolic monitoring are therefore key parts of long-term PCOS care. The goal isn’t restriction - it’s understanding and prevention.

For a refresher on the fundamentals, see What is PCOS?

If you’d like to understand your blood sugar and hormone balance better, book a consultation to create a tailored, evidence-based nutrition and lifestyle plan designed to support PCOS and insulin sensitivity.

This article is for educational purposes only and does not replace medical advice or diagnosis.

Are you saying I’m cranky?
Tackling Mood and PCOS

For many women with PCOS, irregular or absent periods are more than just a medical symptom. They can bring uncertainty, frustration, and even a sense of disconnection from your body. Some women I’ve worked with have described feeling “broken” or anxious about not knowing when their period will arrive, while others feel dismissed when their concerns are minimised by healthcare providers.

These emotional experiences are valid. Understanding the impact of irregular cycles is an important step in caring for both your physical and mental health.

Why irregular cycles affect emotions

Menstrual cycles are guided by a rhythm of hormonal changes that influence not only reproduction but also mood, energy, and mental wellbeing. In PCOS, irregular or absent ovulation means these hormones often do not follow their usual patterns. Instead of a predictable rise and fall of oestrogen and progesterone, women may experience fluctuating oestrogen with little or no progesterone to balance it.

This disruption can lead to:

• Anxiety and stress: hormonal fluctuations, particularly low progesterone, may reduce the calming influence of GABA in the brain, contributing to heightened anxiety.
• Low mood and irritability: unopposed oestrogen and variable androgens can influence neurotransmitters such as serotonin and dopamine, making mood changes more likely.
• Uncertainty about fertility: the absence of ovulation or irregular bleeding can raise questions about reproductive health, adding another emotional burden.

Rather than being “all in your head,” these experiences are rooted in the biology of PCOS, which helps explain why mood changes are so common.

Research has shown that women with PCOS are significantly more likely to experience mood difficulties. One large UK survey reported that around 50% of women with PCOS met criteria for anxiety and nearly 14% experienced depression using standard screening tools. Other international studies have found that more than half of women with PCOS report depressive symptoms, with around a quarter experiencing anxiety symptoms. These rates are substantially higher than in women without PCOS, highlighting the very real emotional burden of the condition.

How hormonal changes influence mood

Alongside the unpredictability of cycles, hormonal imbalances themselves can affect emotional wellbeing.

• Unopposed oestrogen: In regular cycles, ovulation triggers the release of progesterone, which balances oestrogen. In anovulatory cycles (common in PCOS), progesterone may be low or absent, leaving oestrogen relatively “unopposed.” High oestrogen without progesterone’s calming balance has been linked to mood swings, irritability, and heightened emotional sensitivity.
• Low progesterone and GABA: Progesterone plays a key role in producing allopregnanolone, a neurosteroid that enhances the calming neurotransmitter GABA in the brain. Without sufficient progesterone (as in anovulatory cycles), this pathway is weakened, which can contribute to anxiety, low resilience to stress, and difficulty with sleep.
• Androgens and mood: Higher levels of testosterone and other androgens, often present in PCOS, have been associated with changes in mood regulation and may contribute to irritability in some women.
• Insulin resistance and blood sugar swings: Fluctuating glucose and insulin levels can also affect energy and mood stability, adding another layer of emotional disruption.

These hormonal dynamics help explain why women with PCOS may experience more frequent or intense mood changes, beyond the emotional impact of irregular cycles alone.

PMS and PCOS

Premenstrual syndrome (PMS) describes the physical and emotional symptoms that occur in the days before a period. These may include mood swings, irritability, bloating, and breast tenderness. In PCOS, PMS can sometimes feel more severe.

Because cycles are often longer and ovulation less frequent, progesterone levels can remain low while oestrogen fluctuates. This imbalance contributes to symptoms such as heightened irritability, anxiety, and sleep disturbance. The unpredictability of cycles can also mean PMS arrives unexpectedly, adding to distress.

While PMS is very common, if symptoms are severe or interfere with daily life, it is important to discuss them with a healthcare professional.

When PMS becomes PMDD

For some women, premenstrual symptoms go beyond PMS and develop into premenstrual dysphoric disorder (PMDD), a recognised mood disorder. PMDD causes severe emotional symptoms such as intense mood swings, depression, irritability, or anxiety in the luteal phase of the cycle (the two weeks before menstruation).

Although research into PMDD in PCOS is still developing, the hormonal irregularities of PCOS may increase vulnerability in some women. If you suspect PMDD, it is important to speak to your GP. Diagnosis usually involves symptom charting across several cycles, and treatment options can include medical, psychological, and lifestyle approaches.

You do not need to suffer in silence. Support is available, and seeking help is an important step towards improving quality of life.

The impact of feeling dismissed

A common theme for many women with PCOS is feeling unheard when they raise concerns. Being told “it’s just irregular periods” or “come back when you’re trying for a baby” can feel incredibly invalidating. Over time, this can add to feelings of isolation and frustration.

Recognising that these concerns are legitimate – and that your emotional wellbeing matters as much as your physical symptoms – is an important part of managing PCOS.

Supportive ways to cope with cycle unpredictability

While irregular cycles cannot always be fully controlled, there are ways to feel more grounded and supported:

• Cycle journaling: Even when cycles are long or unpredictable, noting symptoms such as mood, skin changes, or energy can help you find your own patterns.
• Self-care planning: Keeping essentials on hand (period products, heat packs, calming teas) can reduce stress about being caught off guard.
• Emotional support: Talking to others with PCOS, or to a practitioner who understands, can reduce feelings of isolation.
• Mind-body approaches: Techniques such as mindfulness, yoga, or breathing exercises can help calm the nervous system, especially when GABA is lower due to lack of progesterone.

These strategies cannot change the underlying hormonal patterns alone, but they can restore a sense of control and self-compassion.

When to seek professional input

If irregular cycles, PMS, or possible PMDD are causing distress or interfering with daily life, it may help to seek support. A GP can investigate medical options, while a nutrition practitioner can help you explore evidence-based ways to support hormone balance.

It is important to remember that you deserve support not just for your physical health, but also for the emotional impact of living with PCOS. If you’d like to chat further, why not book a free call?

Autumn Nourish Bowl with Pumpkin, Quinoa, and Seeds

When autumn arrives, many of us look for food that feels comforting but still nourishing. This recipe combines roasted pumpkin with quinoa, greens, and seeds - and adds either salmon or tofu - to create a colourful bowl with around 30g protein per portion. The ingredients have been chosen to support healthy ovulation, hormone balance, and steady energy for women with PCOS.

Why this recipe supports ovulation in PCOS

Ovulation can be disrupted in PCOS due to hormonal imbalances, insulin resistance, and inflammation. While food is absolutely not a cure, balanced meals can provide the nutrients needed for healthier cycles.

This nourish bowl offers:

• 30g protein per portion to support hormone production, blood sugar balance, and ovulation.
• Zinc and magnesium from pumpkin seeds, quinoa, and greens, vital for ovarian function.
• Fibre to support gut health and stable blood sugar.
• Antioxidants from colourful vegetables to help reduce oxidative stress.

Key ingredients and their benefits for ovulation

• Pumpkin or butternut squash: Beta-carotene and fibre for ovary health and immune support.
• Quinoa: A complete plant protein with magnesium and iron for energy and hormone regulation.
• Pumpkin seeds: A top source of zinc, important for egg development.
• Spinach or kale: Folate, vitamin C, and magnesium for cycle health.
• Tahini dressing: Sesame seeds provide healthy fats, zinc, and calcium.
• Protein option – Salmon or Tofu: Both deliver high-quality protein to bring the bowl to ~30g per serving. Salmon also provides omega-3s for inflammation balance, while tofu provides a plant-based, phytoestrogen-rich alternative.

Serves 2

Ingredients:

• 200g peeled pumpkin or butternut squash, cubed
• 1 tbsp olive oil
• 100g quinoa (uncooked, rinsed)
• 2 large handfuls spinach or kale
• 2 tbsp pumpkin seeds
• 1 small avocado, sliced
• Pinch of sea salt and black pepper

Protein option (choose one):

• 2 × 120g salmon fillets (cooked weight), OR
• 300g firm tofu, pressed and cubed

For the tahini dressing:

• 1 tbsp tahini
• Juice of ½ lemon
• 2–3 tbsp warm water to loosen
• Seasoning

Method:

1. Preheat the oven to 200°C (180°C fan). Toss the pumpkin cubes with olive oil, salt, and pepper, and roast for 25–30 minutes until golden.
2. While the pumpkin roasts, cook the quinoa according to packet instructions (usually simmered in double the volume of water for 15 minutes). Drain any excess water and fluff with a fork.
3. Lightly steam or sauté the spinach or kale until just wilted.
4. Toast the pumpkin seeds in a dry frying pan for 2–3 minutes until lightly golden.
5. For salmon: season and bake in the oven alongside the pumpkin for 15–20 minutes until cooked through.
   For tofu: toss cubes with a little olive oil, salt, and pepper, then roast or pan-fry for 10–15 minutes until golden.
6. Whisk together the tahini, lemon juice, and enough water to make a smooth, pourable dressing.
7. Assemble the bowls: divide quinoa, pumpkin, greens, avocado, and chosen protein between two bowls. Top with pumpkin seeds and drizzle over the dressing.

How to adapt this bowl for your needs

• Swap quinoa for buckwheat or brown rice.
• Try sunflower seeds, walnuts, or hemp seeds instead of pumpkin seeds.
• Roast extra vegetables such as beetroot, carrots, or sprouts for more antioxidants.

By building your bowl with a base of protein, fibre, healthy fats, and colourful vegetables, you’ll nourish your body and support healthy ovulation.

Want more practical recipe ideas to support healthy ovulation with PCOS? Book a consultation today for personalised nutrition guidance.

How to Track Your Cycle with PCOS: A Practical Guide

Many women with PCOS I work with describe feeling lost when it comes to their cycles. “My app says I should be ovulating today, but I haven’t had a period in months.” Others share with me the frustration they have of never seeing a positive ovulation test, despite trying month after month. Unfortunately these experiences are not unusual. Tracking cycles in PCOS is complex, and often the tools designed for “average” cycles just don’t work.

In this blog, we will look at why tracking feels confusing in PCOS, what you can track more reliably, and how wearable and digital fertility trackers fit into the picture.

Why cycle tracking feels confusing with PCOS

Most fertility awareness methods and apps are designed around the assumption of a 28-day cycle, with ovulation on day 14. For women with PCOS, cycles are often longer, shorter, or unpredictable, and ovulation may happen later, less frequently, or not at all. This makes standard predictions inaccurate.

There are also unique challenges:

• Elevated luteinising hormone (LH): Ovulation predictor kits (OPKs) measure LH, which normally surges before ovulation. In PCOS, LH can already be high at baseline, leading to false positives.
• Anovulatory cycles: Some women experience monthly bleeding but without ovulation, making cycles appear “regular” when ovulation isn’t occurring.
• Unreliable signals: Changes in cervical mucus or basal body temperature may still occur, but they can be harder to interpret in PCOS. See below for further details.

This combination of irregular cycles, altered hormone levels, and inconsistent signals makes tracking with PCOS uniquely challenging — but not impossible.

How to track cervical mucus

Cervical mucus is one of the most useful signs of fertility. Rising oestrogen around ovulation makes mucus clearer, wetter, and more slippery. After ovulation, progesterone thickens mucus again. In PCOS, these patterns can be less predictable, but paying attention over time can still reveal valuable information.

• Check daily: Once a day, observe mucus either by wiping with toilet paper, collecting a small sample with clean fingers, or noting changes in your underwear.
• Look for changes: Record whether mucus is dry, sticky, creamy, watery, or stretchy. The “egg-white” type (clear and stretchy) is typically associated with higher fertility.
• Notice sensation: Pay attention to whether you feel dry, damp, or slippery.

Because hormone fluctuations in PCOS can produce mucus without actual ovulation, this method is not perfect, but it can still offer insight into your unique patterns.

How to track basal body temperature (BBT)

Basal body temperature can help confirm that ovulation has happened. Progesterone released after ovulation raises resting body temperature slightly.

• How to measure: Use a sensitive thermometer and take your temperature every morning immediately after waking, before getting out of bed or drinking anything. Try to do this at the same time each day.
• What to expect: If ovulation occurs, you may see a small but sustained temperature rise that lasts until your next period.
• Limitations: Poor sleep, illness, alcohol, or stress can all affect readings. In PCOS, the rise may be less clear or inconsistent.

BBT confirms ovulation after the fact but cannot predict it. It works best alongside other methods rather than on its own.

Journal your cycle

Keep a record of your cycle so you can find out what is happening for you. Consistency matters more than the format you choose. Options include:

• Paper journals or charts: A fertility notebook or calendar lets you write down daily observations of mucus, temperature, and symptoms.
• Digital logs: Some apps allow you to record data without relying on their predictions. This can be helpful if you prefer to store everything in one place.
• Spreadsheets: Customisable, and especially useful if you like visualising data over time.

The aim is to notice your patterns, not to fit your cycle into a textbook model.

Can new technologies help?

Wearable devices and fertility trackers are becoming increasingly popular. Many women use them already for sleep, fitness, or general wellbeing, but can they can also help with cycle tracking in PCOS?

Here is an overview of some of the options currently available. This is for information only (we are not affiliated with or endorsing any company, and this should not be taken as a product recommendation):

• Oura Ring: Measures temperature, heart rate variability, and sleep. Useful for spotting overall trends but designed for women with regular cycles. Predictions may be less reliable in PCOS.
• Tempdrop: A wearable thermometer worn on the arm overnight. It can make BBT tracking easier for women who struggle with consistent wake-up times. However, like all BBT devices, it confirms ovulation after it happens rather than predicting it.
• Ava Bracelet: Worn overnight, measuring multiple signals such as temperature, pulse rate, and breathing. Data may be less accurate in very irregular cycles.
• OvuSense: A vaginal sensor that measures core body temperature continuously. It claims to work better in irregular cycles but some women say it can feel invasive and is more expensive.
• kegg: A device that measures electrolyte changes in cervical mucus. Potentially useful, but relies on good mucus production, which may not always be the case in PCOS.
• Mira Fertility Tracker: Mira is a home urine test system that measures hormones including LH, oestrogen, and progesterone metabolites, giving numerical values rather than simple positives/negatives. This can be more useful for PCOS because it tracks multiple hormones, though interpretation may still be tricky with irregular cycles and consistently elevated LH.
• Natural Cycles: This app uses basal body temperature data (and in some cases Oura Ring integration) to predict fertile days. Again, its accuracy depends on regular cycles and consistent ovulation. In PCOS, where ovulation is unpredictable, the app may label long stretches of “red” (fertile) days, which can be frustrating and limiting.

Emerging devices are also starting to measure saliva hormones or combine multiple parameters. While promising, most have not been thoroughly validated in women with PCOS.

The bottom line: Technology can be a helpful tool, but in PCOS it is best seen as an additional source of information rather than a standalone solution. Combining data from wearables with your own observations and professional support often provides the clearest picture.

When to seek professional support

If your tracking leaves you feeling more confused than informed, it may be time to seek support. In PCOS, ovulation is not always straightforward, and trying to decode apps or devices alone can feel overwhelming.

While cycle tracking can provide useful insights, it is not a diagnostic tool. If you have very infrequent periods (fewer than four per year), prolonged cycles (longer than 35–40 days), or symptoms that interfere significantly with your quality of life, medical assessment is important.  Your GP or specialist can rule out other causes, offer medical investigations, and discuss options for managing PCOS. Nutrition and lifestyle support can work alongside medical care, but they are not a substitute for it.

Working with a qualified practitioner can help you interpret your data and understand what it means in the bigger picture of your health. If you are trying to conceive, fertility specialists can also advise on medical options when needed. Don’t hesitate to book a call with us if you’d like to talk further.

For more detail on how nutrition and lifestyle support ovulation in PCOS, see our article: Understanding Ovulation and Fertility Challenges in PCOS.

Please note, we do not endorse or sell any products mentioned. Devices should be chosen with professional guidance.

Why is my ovulation all over the place?

Ovulation and Fertility Challenges in PCOS Explained

Often when I speak to women in the clinic for the first time, they come with feelings of having been dismissed. Many are told to “just lose weight” or are left with little explanation as to why their cycles are so unpredictable. And when it comes to fertility, the confusion and worry can be overwhelming. This blog takes a look at how PCOS affects ovulation and fertility, looking at the signs you may not be ovulating, and also evidence-based ways to support your body naturally. Whether you are looking to have a baby or not, regularly ovulating is super important for you health. Read on to find out why.

What is ovulation and why does it matter in PCOS?

Ovulation is the point in the menstrual cycle when an ovary releases a mature egg. In a typical cycle, this happens once a month, around the middle of the cycle. In PCOS, hormonal imbalances mean ovulation can often be irregular or absent entirely.

Ovulation matters not just for conception but for overall health. And this is key. Regular ovulation supports progesterone production, balances oestrogen, and plays a role in bone, heart, and uterine health. When ovulation is disrupted, many of these systems can be affected too.

How PCOS affects ovulation

PCOS is characterised by higher levels of insulin and androgens (male hormones like testosterone). Elevated insulin drives the ovaries to produce more androgens, which then interfere with normal follicle development. Instead of one follicle maturing and releasing an egg, several small follicles remain underdeveloped, which can lead to missed or irregular ovulation.

This is why cycles may be long, unpredictable, or sometimes appear regular but without ovulation actually taking place (anovulatory cycles).

Signs you may not be ovulating regularly

Are you wondering if this might be you? Clues that ovulation may be inconsistent include:

• Cycles that are longer than 35 days
• Periods that come unpredictably or are missed altogether
• Negative results on ovulation predictor kits (although these can often be unreliable in PCOS due to elevated LH)
• Lack of noticeable changes in cervical mucus or basal body temperature

Some women also bleed monthly without ovulation — highlighting just how confusing PCOS cycles can be without deeper investigation.

Fertility treatments vs lifestyle approaches

Medical options such as ovulation induction or assisted reproductive technology can be effective and are appropriate for many women with PCOS. Alongside these, nutrition and lifestyle changes are strongly recommended in the current guidelines as first-line therapy to support fertility. These are not quick fixes, but consistent approaches that create a better environment for ovulation to happen. And again – even if you’re not looking to have a baby right now (or ever!) regular ovulation should be considered a vital sign – it’s important for your health.

Balancing blood sugar

Insulin resistance is common in PCOS and disrupts ovulation by raising androgen levels. Stabilising blood sugar helps to reduce these effects. Research shows that balanced meals combining protein, healthy fats, and fibre-rich carbohydrates improve insulin sensitivity and ovulation frequency.

Some small changes you can include are:

• Always pairing carbohydrates with protein (e.g. apple with nut butter)
• Choosing pulses over refined carbs (e.g. swapping rice for lentils)
• Avoiding sugary drinks and choosing water or herbal teas instead
• Eating three good meals per day, and trying to avoid snackign

Key nutrients for ovulation

Certain nutrients have shown particular benefit in PCOS and fertility research:

• Myo-inositol: may improve insulin sensitivity and has been shown in trials to restore more regular ovulation.
• Vitamin D: often lower in women with PCOS; adequate levels are associated with better cycle regulation and fertility outcomes.
• Omega-3 fatty acids: support lower inflammation and may reduce androgen levels.
• Magnesium and zinc: both play important roles in insulin action, ovarian function, and egg development.

Food sources matter — oily fish, nuts, seeds, legumes, and green leafy vegetables all contribute these nutrients in a natural form.

Stress and fertility in PCOS

High stress levels can disrupt the delicate hormonal signalling needed for ovulation. Cortisol interferes with the hypothalamic–pituitary–ovarian axis and can also worsen insulin resistance and inflammation.

Mind–body approaches such as yoga, mindfulness, gentle walking, or breathwork have been shown to lower stress in women with PCOS and are linked with improved cycle regularity. Building daily practices to calm the nervous system is just as important as food and supplements.

Movement and exercise

Exercise improves insulin sensitivity, lowers androgens, and supports ovulation. Both aerobic activity (such as brisk walking or cycling) and resistance training (such as weights or bodyweight exercises) are effective.

Research shows that even modest increases in activity improve metabolic and reproductive outcomes in PCOS. Consistency matters more than intensity, and over-exercising can sometimes have the opposite effect. Aiming for regular, enjoyable movement is the best approach.

Sleep and circadian health

Poor sleep is increasingly recognised as a hidden driver of hormonal imbalance. And women with PCOS have been seen to have higher rates of sleep disturbance. Annoyingly, insufficient sleep worsens insulin resistance, inflammation, and stress hormones – so it’s a vicious cycle. 

Prioritising good sleep hygiene: a consistent bedtime, minimising screens in the evening, and creating a dark, cool sleep environment, can support more regular ovulation. Screening for sleep apnoea is also important where symptoms suggest it. Check with your GP or healthcare provider.

Gut health and inflammation

The gut microbiome is closely linked with both immune and hormonal health. Research shows women with PCOS often have less microbial diversity, which may contribute to inflammation and insulin resistance.

Supporting the gut through fibre diversity (vegetables, nuts, seeds, pulses), prebiotic foods (onion, garlic, asparagus), and fermented foods where tolerated may help reduce systemic inflammation and support ovulation.

Reducing endocrine disruptor exposure

Environmental chemicals such as BPA and phthalates can mimic or interfere with hormone signalling. Research suggests they may worsen symptoms in PCOS.

Practical steps include avoiding microwaving food in plastic, choosing glass or stainless-steel water bottles, and reducing use of fragranced personal care products where possible. These small changes may help reduce the overall hormonal burden.

Alcohol, smoking and ovulation

Both alcohol and smoking are linked with reduced fertility outcomes. Excess alcohol can disrupt cycles and ovulation, while smoking contributes to oxidative stress and poorer egg quality. Minimising or avoiding these is an important but often overlooked step for reproductive health in PCOS.

Anti-inflammatory dietary patterns

Low-grade inflammation is a recognised driver of PCOS symptoms. Diets rich in antioxidants and omega-3 fats, and lower in ultra-processed foods, support a more balanced inflammatory state.

The Mediterranean diet, with its emphasis on vegetables, legumes, fish, olive oil, and nuts, has been shown to reduce inflammation and improve metabolic and reproductive outcomes.

When to seek support

If you’ve been trying to conceive for over a year (or six months if you’re over 35), fertility investigations are recommended. But you don’t have to wait until then. If your cycles feel confusing, or if you’ve felt dismissed by healthcare professionals, getting evidence-based support sooner can make the process less overwhelming and give you practical steps forward.

Whether you’re hoping to conceive now or in the future, there are clear, evidence-backed ways to create better conditions for ovulation. And you don’t have to figure it out alone.  Why not get in touch and book a free call? We’d love to talk further with you.