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Is Coffee Bad For PCOS? 8 Pros & Cons According To Science

Kym Campbell

By Kym Campbell, BSc. | Updated March 18th, 2024

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Is coffee bad for PCOS?

No. It could, in fact, be good for you. Provided the following:

  1. You’re not overly sensitive to stress
  2. You have good gut health
  3. You take your coffee black and unsweetened
  4. You get plenty of good-quality sleep

In my experience, few women in the PCOS community meet these requirements. That’s why I recommend avoiding all caffeinated beverages during my free 30-Day PCOS Diet Challenge. 30 days of abstinence is enough to discover how coffee affects your health and happiness.

But if you want to know where the science is currently at with PCOS and coffee, then keep on reading.

1. Pro: Coffee Reduces Type 2 Diabetes Risks

Overweight women with PCOS have an elevated risk of developing type 2 diabetes [1]. This is because insulin resistance is one of the underlying factors driving a PCOS diagnosis [2, 3]. When left untreated, insulin resistance evolves into diabetes.

Coffee may be good for PCOS because it improves insulin sensitivity. But there are two opposing forces at play here.

Caffeine alone reduces insulin sensitivity and raises blood glucose levels [4]. That’s bad for PCOS. But the other biologically active compounds in coffee have the opposite effect.

These bioactive compounds may more than compensate for the negative effects of caffeine. A 2020 randomized control trial found that four cups of caffeinated coffee per day had no impact on insulin sensitivity [5]. But they did notice a small reduction in fat mass.

That’s why long-term consumption of coffee (and tea too) is associated with better health outcomes. Meta-analysis shows that coffee consumption reduces the risk of type 2 diabetes in a dose-dependent manner [6, 7].

2. Pro: Reduces Heart Disease And Cancer Risks

In 2017, researchers conducted an umbrella review of the evidence on coffee and health outcomes. They found that the largest intakes of three to four cups a day produced the greatest benefit [8]:

  • All-cause mortality risk was reduced by 17%.
  • Cardiovascular mortality risk was reduced by 19%
  • Cardiovascular disease risk was reduced by 15%.
  • High versus low consumption was associated with an 18% lower risk of cancer.

Similar studies have supported these findings [9, 10].

3. Pro: May Improve Sex Hormones

Studies show that caffeinated coffee consumption is linked to higher levels of sex hormone binding globulin (SHBG) [11, 12]. This research is valuable because SHBG is an important biomarker for predicting the risk of type 2 diabetes.

But SHBG is also important for PCOS. SHBG can bind to any of the 17 sex hormones including testosterone and estrogen. It’s an integral part of your endocrine system that controls the bioavailability of your sex hormones.

Elevated testosterone levels are an underlying driver of PCOS [2]. Too much free testosterone is why many women with PCOS suffer from acne, unwanted hair, or hair loss. Raising SHBG levels can reduce testosterone and that means fewer PCOS symptoms. Because of this relationship, people have speculated that coffee may improve PCOS-related hormone regulation.

It’s worth noting here that other studies have shown mixed results when it comes to coffee and sex hormone levels. For example, this study by the NIH found that coffee affected estrogen levels differently, depending on race. The take-home here is that mechanistic data like this should be taken with a grain of salt.

4. Pro: Coffee Enhances Our Mental And Physical Performance

No surprises here. Both caffeinated and decaffeinated coffee improve alertness [13]. Coffee and caffeine intake are also associated with better cognitive functioning in older populations [14, 15]. It’s worth noting here though that the caffeine in coffee may enhance processing speed, but it does not improve attention [16].

Caffeine consumption is well understood to improve physical performance [17, 18]. Most studies on athletes tend to use caffeine supplements or energy drinks. But caffeinated coffee appears to have comparable results [19]. Since it’s the caffeine doing the heavy lifting here, decaf doesn’t seem to help.

5. Con: Caffeinated Coffee Activates Our Stress Response

The hypothalamic-pituitary axis (HPA) is the communication system that manages our stress response. It also regulates our mood, digestion, immune system, metabolism, and energy levels. All pretty important stuff for women with a systemic, chronic health issue like polycystic ovary syndrome.

Dysregulation of the HPA provides a pathway through which stress can impact our health.

Caffeinated coffee activates this stress response. That’s partly why we love it. It helps wake us up. But it’s also the biggest reason why coffee might be bad for women with PCOS.

Studies have shown that women with PCOS experience greater HPA axis reactivity than non-PCOS women [20]. This suggests that caffeinated beverages may make our symptoms worse.

Also incorrectly known as adrenal fatigue, here are some of the common symptoms of HPA axis dysfunction:

  • Persistent unexplained fatigue
  • Waking unrefreshed after a good night’s sleep
  • Brain fog
  • Impaired memory
  • Muscle aches and joint pains
  • Tiring easily after minor exertion
  • Decreased capacity to handle stress
  • Mild depression
  • Irritability
  • Low libido
  • Frequent infections

If you frequently experience any combination of these symptoms, then caffeinated coffee may do you more harm than good.

6. Con: It Can Be Bad For Gut Health

As I’ve written about before, focusing on your gut health is central to managing PCOS. Coffee can make this difficult for many individuals. Coffee promotes gastro-oesophageal reflux and has other adverse effects on the gut [21].

Common sense is key here. If your gut feels fine after a cup of coffee, then it’s probably not doing you any harm. But if you get acid reflux or a loose bowel movement, then your body may be trying to tell you something.

7. Con: Caffeinated Coffee Disrupts Sleep

Again, this one’s pretty common sense. Getting good quality sleep is one of the foundational PCOS natural treatments. Anything you can do to improve your sleep helps address the underlying mechanisms of PCOS. Sleep is associated with insulin resistance [22-24]. Sleep disturbance and duration are also linked to systemic inflammation [25].

Studies show that it takes longer to fall asleep after consuming caffeine. It also reduces total sleep time and sleep efficiency [26].

It takes about 5 hours on average for the concentration of caffeine in the blood to halve. But this may range between 1.5 and 9.5 hours [27]. With this in mind, any caffeinated drinks, including coffee, are best only consumed in the morning.

8. Con: Sugar And/Or Dairy Are Bad For PCOS

During my free 30-Day PCOS Diet Challenge, I show how dietary changes impact PCOS symptoms.

Eliminating dairy and reducing sugar intake as much as possible makes a big contribution to most of the success stories I see. That’s why both of these ingredients are on my list of seven foods to avoid with PCOS. Dairy and sugar are pro-inflammatory. Sugar also spikes your blood glucose levels.

The take-home here is simple. If you sweeten your coffee, or you like it with creamer, then the downsides of your beverage go well beyond the coffee itself.

The Bottom Line

If you’ve already gotten your PCOS under control, then on balance, coffee may be good for PCOS. When you start adding dairy and sugar to it though, the negative effects grow.

If, like most women with PCOS, you have an overactive stress response, then caffeinated coffee may do more harm than good. This is especially true if you have poor gut health or you don’t get enough good-quality sleep.

If you’re asking “is coffee bad for PCOS”, then there are good reasons on both sides of this debate. If you want to know if coffee is bad for YOU though, there’s an easy way to find out. Try quitting for a month or so and see how you feel. If you want to do so with other like-minded women, then sign-up now for my free 30-Day PCOS Diet Challenge.

FAQ

What’s the best coffee for PCOS? Many coffees contain pesticides, mold, and other toxins. These contaminants can further exacerbate PCOS-related health issues. When shopping for coffee, I recommend looking for USDA organic products. I also only buy products that use third-party labs to test for quality and purity. Natural forceTM is one such example of this.

What is a good PCOS coffee alternative? There are many great PCOS-friendly coffee alternatives. Within my PCOS monthly meal planning service, I have product recommendations for Crio Bru and MUD/WTR. Hone also makes a great PCOS drink using matcha and cordyceps mushrooms.

Can you recommend a PCOS coffee creamer? Sure can. I like Laird Superfood Unsweetened Creamer and Nutpods.

What’s the caffeine content of decaf vs regular coffee? According to the American Pregnancy Association, an 8 oz (240 mL) brewed coffee contains approximately 95 – 165 mg of caffeine. A similar, decaf coffee, by comparison, contains just 2 – 5 mg of caffeine.

Do I need to be concerned about coffee and blood pressure? No. Studies show that moderate and habitual consumption of coffee doesn’t affect blood pressure in most people. This includes people with arterial hypertension [28].

Is coffee okay during pregnancy? No. There is strong evidence suggesting that coffee consumption is not suitable during pregnancy. Risks increase for low birth weight, preterm birth, and pregnancy loss [8].

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.

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References

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