Polycystic Ovary Syndrome (PCOS) affects millions of women worldwide and is a complex condition that goes beyond irregular periods and fertility challenges. PCOS involves insulin resistance, inflammation, hormonal imbalances, and even issues with autophagy—the body’s natural process for cleaning out damaged cells and regenerating new ones. Because of this, diet and lifestyle changes that target these root causes can be game-changers in managing PCOS.

As someone who has both studied and lived with PCOS, I’ve learned that taking a holistic approach to the condition can make a huge difference. In this post, I’ll share five key support ideas, including how understanding autophagy and utilizing ketosis with carb cycling can help you manage PCOS more effectively.

1. Support Autophagy with Fasting and Ketosis

One of the lesser-known but critical aspects of PCOS is how it disrupts autophagy, your body’s cellular cleaning process. When autophagy is impaired, it can worsen inflammation, hormone imbalances, and insulin resistance—all major factors in PCOS. One way to kickstart autophagy is through ketosis, which is achieved by following a low-carb, high-fat diet.

Ketosis mimics the effects of fasting by pushing the body to burn fat for fuel, which can reduce inflammation and improve insulin sensitivity—two core issues in PCOS.

Intermittent fasting (IF) can stimulate autophagy by allowing your body more time to repair and regenerate cells. I’ve found that a simple 16:8 fasting schedule—where you fast for 16 hours and eat during an 8-hour window—can be a great way to ease into this practice. Not only does this boost autophagy, but it also helps regulate insulin levels.
The ketogenic diet emphasizes high-fat, moderate-protein, and low-carb intake, which can push your body into a state of ketosis. This diet may reduce the frequency of insulin spikes and improve hormonal balance, helping manage PCOS symptoms like weight gain and irregular periods.

Together, fasting and ketosis can be powerful tools in activating autophagy and giving your body the internal reset it needs to manage PCOS more effectively.

2. Use Carb Cycling to Balance Hormones

While ketosis is great for managing insulin resistance and inflammation, long-term strict keto can sometimes be challenging, especially for women with hormonal imbalances. Enter carb cycling—a method where you alternate between low-carb and higher-carb days to support both metabolic flexibility and hormone regulation.

Carb cycling is beneficial for women with PCOS because it helps:

Support thyroid function: Long-term keto can sometimes suppress thyroid hormones, leading to fatigue and sluggish metabolism. A higher-carb day can give your thyroid the boost it needs to keep hormone production balanced.
Prevent metabolic slowdown: Constantly being in ketosis can reduce leptin levels (the hormone responsible for hunger and metabolism). Carb cycling helps maintain healthier leptin levels and prevents metabolic adaptation.
Boost energy: PCOS often leads to low energy, and adding carbs strategically around workout days can help you maintain energy levels and build muscle.

For example, you might follow a ketogenic diet for five days, then incorporate two days of higher carb intake, focusing on healthier carbs like sweet potatoes, quinoa, or fruit. This flexibility allows you to manage insulin resistance without the hormonal imbalances that sometimes come from strict low-carb diets.

3. Incorporate Strength Training for Insulin Sensitivity

Exercise is critical for managing PCOS, especially when it comes to improving insulin sensitivity. Strength training, in particular, has been shown to help the body use insulin more efficiently by building muscle mass, which can reduce insulin resistance—a key driver of PCOS.

Weight training helps build lean muscle, which burns more glucose and helps regulate blood sugar levels.
Resistance exercises like squats, deadlifts, and lunges improve metabolic health and encourage better insulin regulation. Over time, this helps mitigate the hormonal imbalances that are often linked to PCOS.

When you pair strength training with intermittent fasting or ketosis, it amplifies the benefits for both insulin sensitivity and autophagy, helping your body regulate itself more effectively.

4. Prioritize Gut Health with Anti-Inflammatory Foods

PCOS is often linked with chronic inflammation, which can exacerbate symptoms like acne, fatigue, and weight gain. Poor gut health can contribute to inflammation, so it's essential to include foods that nourish your gut and reduce inflammation.

Eat fermented foods like sauerkraut, kimchi, and yogurt, which provide beneficial probiotics to support gut health.
Incorporate anti-inflammatory foods like fatty fish (salmon, sardines), leafy greens, and berries. These foods contain omega-3 fatty acids and antioxidants, which help reduce the chronic inflammation associated with PCOS.
Limit inflammatory triggers like processed foods, refined sugar, and trans fats. These can worsen insulin resistance and inflammation, which only makes PCOS symptoms harder to manage.

A diet rich in fiber, healthy fats, and anti-inflammatory foods can also support your body’s autophagy process, helping your cells function optimally and reducing the underlying inflammation that drives many PCOS symptoms.

5. Reduce Stress to Support Hormonal Balance

Stress is one of the biggest but often overlooked factors that can worsen PCOS. When you're constantly stressed, your body produces more cortisol, which can lead to increased insulin resistance, weight gain, and hormonal imbalances.

Chronic stress also interferes with autophagy and cellular repair processes, making it harder for your body to recover and heal. Reducing stress through simple daily practices can help balance your hormones and improve PCOS symptoms.

Practice mindfulness or meditation for at least 10 minutes each day. Even short sessions can lower cortisol levels and help regulate your menstrual cycle.
Breathing exercises can calm the nervous system and reduce stress-induced hormonal imbalances.
Prioritize sleep. Poor sleep can spike cortisol and insulin, both of which are already problematic in PCOS. Aim for 7–8 hours of restful sleep each night to support hormonal balance and improve your body’s ability to activate autophagy.

By managing stress, you're giving your body the chance to function more optimally and regulate hormones naturally.

Final Thoughts

Managing PCOS requires a multi-faceted approach that addresses not just symptoms but the root causes—insulin resistance, inflammation, and impaired autophagy. Strategies like intermittent fasting, ketosis with carb cycling, strength training, gut health, and stress reduction all work together to support your body’s natural healing processes.

If you’re looking for holistic ways to manage PCOS, start by exploring how these strategies fit into your lifestyle. Small, sustainable changes can have a significant impact on your health and help you take control of PCOS in a way that works for your body.

If you are interested in learning more, then pitch my KetobyCarli virtual class.