Beyond the Cysts – Understanding PCOS and the Power of Functional Nutrition
- Sep 17, 2025
- 6 min read
Katarina Lijovic is a Functional Nutrition and Holistic Wellness expert who successfully applies her knowledge and skills to help individuals and communities to optimize their health and quality of life.
Polycystic Ovary Syndrome (PCOS) is a complex hormonal, metabolic, and reproductive condition affecting millions of women worldwide. As we observe PCOS Awareness Month in September, it’s more important than ever to shine a light on what PCOS is, how many are affected, the symptoms, and critically, what role diet, nutrition, and lifestyle play in managing it.
What is PCOS & how common is it?
PCOS (Polycystic Ovary Syndrome) is a hormonal and metabolic disorder usually manifesting in women of reproductive age. It’s a syndrome, a collection of symptoms with multiple drivers that can look different in every woman. It involves a combination of features, including irregular or absent menstrual periods (due to oligo or anovulation), elevated androgens (male-type hormones), and polycystic-appearing ovaries on ultrasound. But PCOS is not just about “cysts”, it’s a systemic condition that affects hormones, metabolism, and quality of life. You can be diagnosed with PCOS if you have two of these criteria, even if cysts are not present on your ovaries. That’s one of the biggest misconceptions about PCOS, and many women believe that having cysts on the ovaries is the defining feature.
PCOS affects an estimated 1 in 10 women of reproductive age worldwide. Depending on the criteria, prevalence ranges from 5% to 15% of women. In 2021, it was estimated that almost 70 million women globally were living with PCOS. However, roughly 70% of cases go undiagnosed, leaving millions struggling without answers. This makes PCOS not only the most common hormonal condition in women of childbearing age but also one of the leading causes of infertility.
Common symptoms & associated health risks
PCOS manifests differently in each woman, but common symptoms include:
Irregular, unpredictable, heavy, or absent menstrual cycles.
Infertility or difficulty conceiving (because ovulation can be irregular or missing).
Excess androgen symptoms: Acne, oily skin, excessive hair growth (hirsutism), male-pattern hair thinning on the scalp.
Weight gain or difficulty losing weight: Particularly fat accumulation around the abdomen.
Metabolic issues: insulin resistance, which can lead to elevated insulin levels and an increased risk of type 2 diabetes.
Other possible issues: fatigue, anxiety, mood swings, elevated cholesterol or dyslipidemia, mood disturbances (anxiety, depression), increased risk of cardiovascular disease, possibly disturbed sleep.
Beyond the clinical signs, the everyday struggles are often overlooked, such as planning life around unpredictable or painful periods, the frustration of doing “everything right” yet still struggling with weight or acne, emotional distress from unwanted hair growth or hair loss, the toll on mental health from repeated infertility struggles, and feeling unheard or dismissed by medical professionals. Sounds familiar? For many, PCOS becomes not just a medical condition but a daily burden that affects confidence, relationships, and quality of life.
What’s causing PCOS?
The root cause approach is at the heart of Functional Nutrition. The main root causes include insulin resistance and blood sugar dysregulation, hormonal imbalances (elevated androgens such as testosterone and low progesterone drive many hallmark symptoms such as acne, excess hair growth, irregular cycles, anxiety, sleep issues, heavy bleeding, etc.), chronic low-grade inflammation, gut health and microbiome imbalance, adrenal dysfunction, environmental and epigenetic factors.
Why nutrition & lifestyle matter: The functional view
From a functional medicine perspective, PCOS is a web of interconnected imbalances, not just cysts on the ovaries or reproductive health issues. Supporting blood sugar, reducing inflammation, healing the gut, lowering toxic load, and balancing stress hormones together can calm the storm of PCOS and help women regain balance. Many symptoms and risks can be substantially improved and sometimes reversed through targeted diet, nutrition, and lifestyle changes. As a functional nutritionist, I work with clients to support their hormonal balance, metabolic health, regulate their stress, and reduce inflammation. Here’s how these approaches help in PCOS:
1. Improving insulin sensitivity & balancing blood sugar
Insulin resistance is central in many cases of PCOS. In fact, up to 70% of women with PCOS are insulin resistant. High insulin levels can increase androgen production, disrupt ovulation, and exacerbate weight gain. Dietary strategies that lower glycemic load, such as choosing whole grains, pairing carbohydrates with protein & fiber, and avoiding refined sugars, can reduce spikes in blood sugar and insulin.
2. Reducing inflammation & oxidative stress
Chronic, low-grade inflammation is often elevated in PCOS and worsens metabolic and hormonal imbalance. I highly recommend a Mediterranean-style diet (seafood, olive oil, vegetables, legumes, nuts, seeds, herbs/spices, minimal processed foods), which is one of the most evidence-backed dietary patterns for reducing inflammation.
3. Support for healthy weight and body composition
Even modest weight loss (5-10% of body weight) in overweight or obese women can improve menstrual regularity, ovulation, insulin sensitivity, and reduce androgen levels. Functional nutrition can help with individualized plans so that weight loss is sustainable.
4. Optimizing macro- and micronutrients to support healthy hormone production
Adequate protein: Helps with satiety, lean mass preservation.
Healthy fats: Omega-3s (from fish, flax, or walnuts) may help reduce inflammation and support hormone production.
Fiber: Helps slow glucose absorption and supports gut microbiota, which may influence hormone metabolism.
Micronutrients: Vitamin D, magnesium, zinc, B vitamins, etc., all play roles in insulin metabolism, androgen conversion, energy, and mood.
Timing and quality of meals: Avoid long periods of undereating that trigger stress hormones, distribute protein and complex carbs throughout the day.
5. Lifestyle factors
Physical activity: Regular aerobic and resistance exercise improves insulin sensitivity, helps with weight, mood, and menstrual regularity.
Sleep: Poor sleep exacerbates hormonal dysregulation, insulin resistance, and inflammation. Ensuring good sleep hygiene is vital.
Stress management: High stress, elevated cortisol and other stress hormones, which can worsen insulin resistance and androgen excess. Practices like mindfulness, yoga, breathing, and psychological support can have a real impact.
Practical tips: What to eat & what to avoid
What to prioritize:
Whole, unprocessed foods
Whole grains (brown rice, oats, quinoa, buckwheat)
Non-starchy veggies and plenty of colorful plant foods
Lean protein sources (meat, fish, legumes, eggs)
Healthy fats (olive oil, nuts, seeds, fatty fish)
Adequate hydration (min 2L of water/day)
What to limit/avoid:
Refined sugars, sugary drinks
Refined, highly processed carbs, white bread, sugary cereals
Fried foods, excess saturated fats, trans fats
Processed meat
Overeating late at night, irregular/skipped meals
Alcohol in excess, too much caffeine
The functional nutrition approach: Putting it all together
As a functional nutritionist, I often work with clients in a multi-step, personalized protocol. Here’s a rough outline:
Assessment: Detailed history, labs (hormones, insulin, lipids, micronutrients), nutrition, and lifestyle assessment.
Diet reset: Remove or reduce high glycemic load foods, processed and inflammatory elements, increase fiber, phytonutrients, healthy fats, and diversify microbiome.
Lifestyle optimization Involves Establishing regular physical activity, improving sleep and circadian rhythm, employing stress reduction techniques, and adjusting meal timing.
Supportive tools: When indicated, use of targeted nutritional supplementation to monitor response.
Monitoring & adjusting: Track symptoms (menstrual cycles, acne, weight/composition, mood), lab markers, adjust as needed over time.
Why awareness matters
With the right knowledge, dietary tools, and lifestyle changes, many of the burdens of PCOS can be reduced. As a functional nutritionist, I believe in empowering every woman to understand her body, adapt her nutrition and habits, and reclaim her health. Women are often undiagnosed or misdiagnosed. Early recognition and intervention can greatly improve quality of life, and that is why the whole month of September is dedicated to raise the awareness about PCOS. Many long-term risks (metabolic disease, cardiovascular disease, and infertility) can be mitigated with early lifestyle and dietary intervention. Raising awareness helps reduce stigma, improves access to care, and increases support for more research into PCOS heterogeneity (why some women have more severe metabolic involvement, others more reproductive symptoms, etc.). If you suspect you might have signs of PCOS (irregular periods, acne, excess hair growth, unexplained weight gain), talk with a healthcare professional who understands hormonal and metabolic health. Dietary changes, even small ones, paired with lifestyle adjustments (sleep, exercise, stress), often make a big difference. Functional approaches tailored to the individual offer the best chance for lasting improvement and well-being.
Read more from Katarina Lijovic
Katarina Lijovic, Functional Nutrition Counselor/Nutritionist
Katarina Lijovic is a Nutritionist and Functional Nutrition Counselor who focuses on addressing the root causes of nutritional imbalances and health concerns, rather than merely managing symptoms. By using a holistic, personalized approach, Katarina works to optimize an individual’s health through tailored nutrition plans, lifestyle modifications, and evidence-based practices. Her mission is to guide individuals toward long-term, sustainable solutions. With her focus on prevention and balance, Katarina empowers individuals to make informed choices that support their overall health and well-being.
