Carbs and PCOS: How Much To Eat & What Types Are Best

By Kym Campbell, BSc. | Updated October 27th, 2023

Key Takeaways

Insulin resistance is one of the underlying causes of all PCOS health problems. A low-carb diet can improve fertility and help with weight control.

Consuming between 50 – 130 grams per day of net carbohydrates is a good amount for most PCOS women. You can achieve this by eating three moderate-sized servings of carbohydrate-rich foods plus one piece of fruit per day.

The best carbs for PCOS are non-starchy vegetables. Starchy vegetables, legumes, and gluten-free grains are also good carbs for PCOS when served in moderation.

For low-carb PCOS recipes and shopping lists join my free 30-Day PCOS Diet Challenge. Or start today with this free 3-Day Meal Plan.

A low carbohydrate diet is good for PCOS because it helps improve insulin sensitivity. But it’s important to choose low-glycemic whole foods to optimize your health outcomes.
So many of the great results women see during my free 30-Day PCOS Diet challenge are thanks to improvements in carbohydrate intake.

In this article, I tell you everything you need to know about carbs and PCOS.

For worked examples of how to put these ideas into practice download this free 3-Day meal plan.

Link Between Carbs and PCOS

Insulin resistance is one of the underlying drivers of polycystic ovary syndrome [1-3]. Insulin resistance contributes to menstrual dysfunction, infertility, and weight gain. Through its impact on androgen levels, insulin resistance promotes acne, hair loss, and unwanted hair. It also impacts mental health.

There are many ways to reverse insulin resistance. The most effective treatment though is to manage your intake of carbohydrate foods.

Unlike fats and protein, carbohydrates in food cause your blood sugar levels to rise. Insulin is then secreted to move this glucose sugar out of the blood and into cells where it can be stored or used. The extent to which blood sugar levels rise determines how much insulin gets secreted. If the carbs you eat have a small impact on blood sugars, then your demand for insulin remains low. By eating this way over time, your cells become more sensitive to insulin. This is how you reverse insulin resistance and the PCOS symptoms it drives.

I’ve done it. And I’ve helped a lot of other women do it too through my free 30-Day PCOS Diet Challenge.

Summary

Insulin resistance is one of the chief causes of all PCOS symptoms. This can be reversed by managing dietary carbohydrate consumption.

Benefits of Going Low-Carb for PCOS

The link between carbs, blood sugar levels, insulin, and PCOS pathology is well established. A diet that’s designed to be low carb for PCOS exploits this link to deliver several health benefits. Low carbohydrate diets are best for improving sex hormone balance and reproductive health [4]. Diets that are low carb for PCOS are also better for insulin resistance and metabolic health [5, 6]. These health benefits may be independent of weight loss [7].

We see this play out in real life among the many past participants from my 30-Day Challenge.

Summary

A low-carb diet can improve hormone balance and fertility. It’s also better for metabolic health and weight management.

How Many PCOS Carbs Per Day?

So, low-carbohydrate diets are good for PCOS. But what’s considered low-carb?

Here’s where most diet authorities get things wrong.

They might support a “lower” carb diet compared to USDA recommendations of 45-65% of calories [8]. But they often fail to go low enough to reverse insulin resistance. This is often out of fear that high-fat diets are dangerous because they contain too much saturated fat. Studies have shown that these concerns are unfounded [7]. Even if the low-carb diet is high in saturated fat, it still lowers cardiovascular disease risks.

Many popular low-carbohydrate diets are not well-defined. This can create unnecessary confusion. To meet the definition of “low-carb”, a diet should contain less than 26% percent of calories from carbohydrate foods [9]. This should not be confused with a ketogenic diet. A ketogenic diet is a “very low-carb diet”. A very low-carbohydrate diet generally contains less than 10% of energy from carbohydrates. See my keto diet for PCOS article to better understand the pros and cons of very low-carb diets.

For people consuming 2,000 calories per pay, a low-carb diet contains between 50 – 130 grams per day of net carbohydrates. Net carbs mean the total carb content, minus the fiber. Fiber doesn’t get counted as a carb because it has minimal caloric value. It just passes straight through you.

Keep in mind too that the weight ranges above refer to the carb content of food, and not the food item itself.

Summary

A low-carb diet contains between 50 – 130 grams per day of net carbohydrates. This is an appropriate amount of PCOS carbs per day to aim for.

Recommended Amount of Carbs for PCOS

There’s no one-size fits all approach to how many carbs you should eat for PCOS. But somewhere between 50 – 150 grams per day seems to be the sweet spot for most people.

The biggest factors for where you sit on this spectrum are your insulin sensitivity and your health goals. If your insulin sensitivity is good and you’re happy with your body weight, then 150 grams per day is a good approximate target. If you’re insulin resistant and you want to lose weight, then 50 grams per day may be more appropriate.

Of course, there are many exceptions to this range. Athletes may want to eat 200 grams of carbs per day or more. Others may find they can eat fewer than 50 grams per day without going into ketosis.

Learn more about macros for PCOS here including my recommendations on protein and fat.

When I create macro-balanced PCOS recipes, I generally aim for around 25 grams of net carbs per meal. If you have three meals a day, and eat a piece of fruit, then this will get you around 100 grams of carbs per day. This is what I recommend for my PCOS meal planner subscribers.

You can find approximately 25 grams of carbs in:

½ cup of cooked rice or quinoa.

¾ – 1 cup of cooked beans or lentils

A medium-sized sweet potato

2 ½ cups of starchy vegetables such as carrots, beetroot, butternut, or acorn squash.

1 cup or 1 medium-sized piece of fruit

Summary

Three moderate-sized servings of carbohydrate-rich foods plus one piece of fruit per day is a good amount for most PCOS patients.

The Best Carbs for PCOS

Lowering your carb intake isn’t the only way to influence how carbs affect blood sugar and insulin levels. Eating foods that have a relatively low glycemic index (GI) also makes a big difference.

These are almost always whole foods that haven’t been heavily processed. They should be high in fiber because that lowers the GI. And, they should be gluten-free. See my gluten and PCOS article to learn why gluten is bad for PCOS.

Non-starchy vegetables are the best carbs for PCOS. That’s because they have a low carb content and a high(ish) fiber content. They’re also a rich source of all the micronutrients that support good health.

Some of the highest-fiber, low-carb vegetables include:

Spinach
Broccoli and cauliflower
Collard greens
Asparagus
Eggplant
Celery
Mushrooms
Radishes
Romaine lettuce

With these kinds of vegetables, you can eat as much as you like with minimal impact on your blood sugar levels.

During my free 30-Day PCOS Diet Challenge, I encourage participants to eat these foods liberally. I also use them in a lot of the recipes in my free 3-Day Meal Plan.

Starchy vegetables, legumes, and gluten-free grains are also excellent PCOS carbs. This includes sweet potatoes, beans, lentils, black rice, and quinoa. These are much higher in carbohydrate content though. In this instance, following the serving size guidelines described above is appropriate.

Summary

Non-starchy vegetables are the best PCOS carbs because they have minimal impact on blood sugar levels. They’re also high in micronutrients and contain fiber. Starchy vegetables, legumes, and gluten-free grains are also good carbs for PCOS when served in moderation.

5 Tips for Optimizing PCOS Carbs

The whole reason carbs are important for PCOS is because of their impact on blood sugar levels. The reason you want to be smart about your carbohydrate intake is to improve insulin sensitivity over time. This is key for beating PCOS.

But there are many other ways to achieve these goals. Here are five practical tips for optimizing insulin sensitivity.

1. Measure blood glucose levels

Since the aim is to have steady blood sugar levels, why not measure them directly? Using blood glucose monitoring devices helps you optimize your carb intake meal by meal. Using a continuous blood glucose monitor for a few weeks is especially helpful. But a finger-prick meter also provides deep insight. See my PCOS macros blog for optimal blood glucose ranges.

2. Eat carbs with protein and fat

Protein and fat have almost no impact on blood sugar levels. What’s more, eating carbs with protein and fat lowers the glycemic index of the carbs. This is a simple hack for eating more good carbs for PCOS without harming blood sugars. This is why I recommend people add nut butter or PCOS yogurt when enjoying PCOS fruit.

3. Increase the resistant starch content of your PCOS carbs

Resistant starch is a type of carbohydrate that functions like soluble fiber. It’s good for your gut and improves blood sugar regulation. Rice, legumes, and starchy vegetables all contain resistant starch. But you can increase these levels by cooking and cooling these foods overnight. This is a great way to enjoy carb-rich foods without negatively impacting blood sugar levels.

4. Take other steps to improve insulin sensitivity

Other diet and lifestyle interventions can further improve insulin sensitivity. For example, not getting enough sleep is a known risk factor for insulin resistance [10-12]. But exercise (of all types) increases insulin sensitivity in women with PCOS [13-15]. This is why sleep and exercise are such important aspects of treating PCOS naturally.

As explained in my article on intermittent fasting for PCOS, the timing of your meals can also affect insulin sensitivity. Research shows good results from restricting when you eat [16-19].

5. Don’t ignore psychological factors

If you’ve tried a low-carb diet before and you saw good results, then that’s a strong sign that it’s good for you. If you found it difficult to maintain, then you need to address why rather than quit the approach.

Being mindful of the psychological impact of dietary changes is often very important. That’s why I include both intuitive eating and emotional wellness modules in my Beat PCOS 10-Week Program. Many participants struggle with disordered eating or trauma from previous diets. These people often find that facing these challenges first is key to their long-term success.

It’s critical to take a long-term approach to a PCOS diet. The changes you make need to be sustainable. Studies show that the longer the duration of a low-carb PCOS diet, the better the results [4, 6].

The Bottom Line

Carbs are important for PCOS because they influence insulin sensitivity. Carbs cause your blood sugar levels to rise promoting the release of insulin. Achieving good insulin regulation is key to managing all aspects of PCOS.

Getting your carb intake right is a matter of consuming the right amounts. You also want to choose high-fiber, low-GI whole foods. These types of carbs result in better blood sugar responses.

There are many ways to further improve insulin sensitivity. Monitoring your blood glucose levels, and preparing your carbs correctly can make a big difference. Exercise, sleep, and intermittent fasting can also be helpful.

To get started on a low-carb for PCOS diet today, download this free 3-Day Meal Plan. For more help join my free 30-Day PCOS Diet Challenge here

FAQ

PCOS and weight lifting – how many carbs should I eat? When exercising intensely, you may want to increase your total caloric intake. It’s not necessary to change your macro levels though.

Should I add more carbs if I’m pregnant or breastfeeding? If you’re eating at the low end of the low-carb range then you may want to increase your carb intake slightly. Be mindful of the impact on blood glucose levels when doing so.

How many carbs should I eat with PCOS and metformin? Taking metformin doesn’t change the recommended carb intake and macros for PCOS. Metformin improves insulin sensitivity. But as explained here, this treatment is generally not recommended for women with PCOS

How much fat, protein, and carbs should I get on low carb to control PCOS? It’s best to get approximately 60% of calories from fat. You should get approximately 20% of your calories from protein, and 20% from carbs. For a person consuming 2,000 calories per day, this means 130 g of fat, 100 g of protein, and 100 g of carbs.

Complex carbs and PCOS. How do these fit into my diet? Complex carbs are the kinds of carbs found in grains, legumes, and vegetables. These are the “good ones”. If you follow the recommendations above, you’ll have this base covered.

PCOS and craving carbs. What should I do? There are two main causes of carb cravings. Quitting sugar abruptly and not having enough carbs. In both cases, the solution is to eat some healthy carbs with fat and/or protein. Don’t cave into processed foods as that will set you back.

PCOS and intermittent fasting – how many carbs to eat? Intermittent fasting shouldn’t change the number of carbs you eat. If you’re following a PCOS diet, then fasting may help enhance your results.

Ready to Take Action?

Join my free 30-Day PCOS Diet Challenge here. This is a unique program where you'll receive weekly meal plans, shopping lists, and helpful video lessons. You'll also be part of a motivated and inspiring community of like-minded women.

Download my free 3-Day PCOS Diet Meal Plan here. This is perfect for getting started if you aren't ready to commit to 30 days.

Join my PCOS Monthly Meal Planning Service here. This service includes hundreds of PCOS recipes within a pre-populated, yet customizable meal plan. It's designed to save you time and help you apply a PCOS diet.

Sign up for my Beat PCOS 10-Week Program. This is a comprehensive program that covers diet, PCOS-centric emotional eating, exercise, stress management, and much more. All within a support group environment. The 10-Week Program includes the same recipes and meal plan as my monthly meal planning service.

Author

Kym Campbell

Combining rigorous science and clinical advice with a pragmatic approach to habit change, Kym is on a mission to show women with PCOS how to take back control of their health and fertility. Read more about Kym and her team here.