Is it possible to be lean and still have PCOS?
The short answer is yes, PCOS can occur in anyone with ovaries. It's a condition caused by a hormonal imbalance, and an improperly functioning pituitary gland can happen to anyone, regardless of weight. However, excess adipose tissue can exacerbate hormonal imbalances.
Young women and teenagers may have irregular cycles, and people with a BMI in the normal range who choose hormonal birth control, such as the pill, patch, or vaginal ring, may not even realize that they have PCOS until they try to conceive. Hormonal birth control is one of the most frequently recommended ways to help reduce the symptoms of PCOS (after weight loss). Lean women who take birth control can have undiagnosed PCOS for years, which can make treatment more complicated.
What is considered “lean”?
Lean in this case refers to a healthy BMI or body mass index. This is a measurement of your weight in proportion to your height. A healthy BMI spans from 18 to 24.9 — which for most women is a range of about 30-40 pounds.
"Lean" PCOS women have a harder time burning calories as efficiently as other women their size who do not have the condition. This means that most lean PCOS women must pay very careful attention to their diet and their caloric intake.
Insulin resistance in lean women with PCOS
Insulin resistance means you have a more difficult time managing your blood sugar and may also be at risk for pre-diabetes and Type 2 diabetes. Insulin is a hormone that helps your cells get the nutrients needed from your bloodstream, but it’s also a hormone that signals fat storage. With insulin resistance, your body needs to create an overabundance of insulin to “get the job done.”
Insulin resistance means you have a more difficult time managing your blood sugar and may also be at risk for pre-diabetes and Type 2 diabetes.
Insulin works hardest to store fat in your abdomen, which is particularly dangerous as abdominal fat is linked to other health conditions, such as heart disease. Excess abdominal fat also contributes to insulin resistance — creating a vicious cycle of weight challenges. In addition, increased insulin resistance is also linked to an increased appetite, which makes it hard to limit the amount of calories consumed.
Ways to treat lean PCOS
Women with lean PCOS may need to change their eating habits to balance their blood sugar and maintain a healthy weight. Your doctor or a licensed dietician can help you develop the right meal plan to help you maintain your weight and feel satisfied.
You may also find other lifestyle changes can help you manage your symptoms and boost your overall health without needing prescription medication. As with any change to your routine, consult your doctor before beginning.
Exercises
There are a few different options for exercise, depending on what you prefer to do. Cardio — typically jogging, brisk walking, cycling, or swimming — can help elevate your mood with naturally produced endorphins. If you get 4–5 30-minute cardio sessions per week, you may also find it improves mild depression and that you have more energy. This is especially important for people with PCOS, as fatigue and a feeling of “the blues” often accompany the condition.
Cardio also helps increase fertility by improving the blood flow to your reproductive organs. In addition, it increases insulin sensitivity, which can reverse insulin resistance and pre-diabetes.
Strength training, including bodyweight fitness routines and lifting weights, can also help manage your PCOS symptoms. A heavy lifting program, such as a 5x5 training program, can help you build more muscle tissue. Muscle cells burn more energy than other types of cells — the more muscle mass you have, the more calories you’ll burn at rest. This may make it easier to maintain a healthy BMI.
Strength training can also improve your overall body composition by reducing the amount of adipose tissue in your body. Remember that fat is a living organ and releases hormones of its own — the less excess fat you have, the easier it is to manage PCOS hormonal imbalances.
Nutrition
Proper nutrition is crucial to naturally manage PCOS, especially for women who are already in a healthy weight range. A diet that is heavy in carbohydrates, even whole grains and lots of fruit, may still not be the best for people with PCOS. Carbs can cause your blood sugar to rise and then crash, which exacerbates the metabolic condition associated with PCOS.
Eating plenty of lean protein, healthy dietary fats, fresh vegetables, and high-fiber fruit like apples, pears, and berries can help you maintain a healthy weight and manage your PCOS symptoms. Getting the right macronutrients (protein, fats, and carbs) and micronutrients (vitamins and minerals) from your food is essential to make sure your body is nourished.
Eating plenty of lean protein, healthy dietary fats, fresh vegetables, and high-fiber fruit like apples, pears, and berries can help you maintain a healthy weight and manage your PCOS symptoms.
PCOS is also linked to heart disease, so eating a low-sodium diet, or one designed for hypertension patients, such as the DASH diet, can help reduce your chances of high blood pressure or even stroke.
Eating refined sugar, simple carbs, and low-quality, fatty meats, can make the symptoms of PCOS worse. The peaks and crashes of high blood sugar worsen with a diet heavy in simple-carbs, plus your body won’t get the vital nutrients you need to improve your health.
Stress management
PCOS is a hormonal condition that doesn’t just affect the male and female hormones that regulate reproduction. When you are overly stressed, your body produces cortisol, another hormone.
Meditation, gentle yoga, or hobbies that are soothing, such as knitting, gardening, or even coloring in an adult coloring book, can help naturally decrease stress.
Cortisol encourages the accumulation of fat in your abdomen around your organs. This is problematic in a few ways. First, fat produces hormones, too — too much fat increases the severity of your PCOS. Second, too much abdominal or visceral fat can crowd your organs and reduce the efficiency of your heart, lungs, and digestive system.
Meditation, gentle yoga, or hobbies that are soothing, such as knitting, gardening, or even coloring in an adult coloring book, can help naturally decrease stress.
Supplements
There are a few supplements that you can take for PCOS. Zinc is a mineral with natural antioxidant and anti-inflammatory properties that help reduce inflammation in your body, as well as reducing stress around your heart. Another supplement that many women take is inositol, a substance similar to glucose that has a positive effect on your fertility. Not all supplements are created equal, however. Before you begin taking anything for PCOS, speak with your doctor about what you’re interested in and follow their recommendations about which supplements to take at what dosage levels.
The takeaway
Careful management of your PCOS, even when you’re within a healthy BMI range, can reduce symptoms and side effects. With a carefully planned diet and exercise regimen, you may find the severity of your PCOS reduced and your fertility improved.