Intermittent fasting is being explored by scientists and doctors as a treatment for PCOS with promising results. In this week’s newsletter, we interviewed Dr. Jamie Seeman on how she uses fasting in her clinical practice.
Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine disorders, impacting up to 10% of women in their reproductive years. Recently, researchers have begun investigating the potential for intermittent fasting to help treat and manage PCOS. The researchers hypothesize that metabolic features underlying the disease could be alleviated with a targeted fasting protocol. So far, the results are promising!
In April of this year, researchers from Shengjing Hospital of China Medical University published their results studying the popular 16:8 time-restricted feeding (TRF) protocol in PCOS patients with chronic anovulation, meaning they did not have a cycle.
The women in this study followed a set TRF schedule for five weeks, eating from 8am to 4pm, thus fasting from 4pm to 8am daily. They recorded their caloric intake before and during the intervention to ensure that caloric intake was consistent within the TRF intervention; caloric intake wasn’t to fluctuate more than 10% from baseline during the study. During the fasting window, participants could consume water and zero calorie beverages, but nothing else.
The results showed that five weeks of daily TRF significantly improved body composition, insulin resistance, and inflammation. 11 of the 15 women experienced significant improvements in their menstrual cycle as well. This is a major finding! At the beginning of the study, all women were anovulatory. After five weeks of TRF, over half of the patients had restored their normal menstrual cycle.
We interviewed Dr. Jamie Seeman, a board-certified OBGYN and fellow in integrative medicine who has extensive experience using both carbohydrate restriction and intermittent fasting in her PCOS patients to find out just what might be happening to trigger these dramatic results.
She shared with us that “Not all women with PCOS have peripheral insulin resistance, some do indeed, but the central clinical feature is insulin resistance at the level of the ovary. High insulin can impair ovulation and drive excess androgen production (testosterone) from the ovaries. If a patient has peripheral insulin resistance, causing hyperglycemia and worsening hyperinsulinemia, it drives the disease even harder.”
The rationale behind using TRF to treat PCOS is to periodically lower blood glucose and insulin levels, and essentially lower the features that Dr. Seeman says can drive the disease further.
“The timing of when we eat and what we eat matters when it comes to PCOS. The first line therapy for patients with PCOS is nutritional intervention. By using dietary carbohydrate reduction and/or TRF we are able to drive down the production of insulin. The reduction in insulin helps normalize androgen levels, repair the LH/FSH ratio and restore ovulation in many patients. These benefits can be seen independent of weight loss, although studies show patients will tend to lose weight, especially visceral fat, and have positive changes in their lipid profiles as well.”
In the present study, almost all the participants experienced no challenges adhering to TRF and all women even said they wanted to continue using TRF.
“If patients are not willing to try a low carbohydrate diet, TRF is a great place to start! It costs no money and anyone can do it. It also allows the patient to choose their eating window that fits their schedule.” says Dr. Seeman.
I asked Dr. Seeman what other lifestyle modifications she recommends to her patients, and she explained the importance of weight lifting and taking advantage of our most metabolically active organ: muscle!
“Most patients with PCOS gain muscle quicker than their counterparts due to the extra androgens and insulin, so resistance training can be helpful as well. Muscle is a great metabolic organ! Since PCOS patients have higher rates of cardiovascular disease and type-2 diabetes long term, focusing on a muscle centric lifestyle can be helpful in reducing those risks.”
Altogether, intermittent fasting can be a powerful lifestyle intervention to help women suffering from PCOS, and we want to thank Dr. Seeman for providing us with her clinical insight. Given the high prevalence of PCOS worldwide, we hope more researchers will dig into the potential of TRF and fasting to help.
To learn more, check out this video to hear what our Chief Medical Officer, Dr. Peter Attia, has to say about fasting for PCOS.
See you next week,
Science Writer at Zero