If you're suffering from polycystic ovary syndrome (PCOS) and struggling to reach weight and fitness goals, you're likely not alone: The syndrome affects up to 20 percent of women of reproductive age, and may be the most common hormone disorder in the world.

PCOS is caused by an imbalance of reproductive hormones, which wreaks havoc on ovary function and causes myriad symptoms, like irregular menstrual cycles, hirsutism (male pattern hair growth), weight gain, and infertility issues.

No one knows the exact cause of PCOS, but genetics likely plays a role, as do high levels of androgens (sometimes called “male hormones”) and insulin—which often leads to insulin resistance, weight gain, diabetes, and cardiovascular disease in women with the syndrome.

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“If you have PCOS, eating a healthy diet and exercising is crucial” for avoiding medical problems, says G. Wright Bates, MD, director of the UAB Division of Reproductive Endocrinology and Infertility in Birmingham, Alabama. “Your risk for cardiovascular disease, weight gain, and diabetes is already higher, so you need to be extra vigilant to lower your risk.”

Reaching your athletic goals may take more work due to PCOS symptoms, Bates concedes, but he notes that cycling and other exercise can also help you avoid weight gain and limit the development of glucose intolerance or diabetes. (Learn how to become your fittest and fastest cycling self in The Bicycling Big Book of Cycling for Women!)

“Women with PCOS also can still be athletically competitive. You can achieve the same level of fitness and endurance as women without the syndrome,” says Bates. “Research shows that women with PCOS have an altered training response in the way they process oxygen and how their muscles function, but they can get there.”

Here are some tips for managing your fitness and weight while living with PCOS.

Consider oral contraceptives.
Women with PCOS often have unpredictable menstrual bleeding. Hormonal birth control—such as the pill, patch, shot, vaginal ring, and hormone intrauterine device (IUD)—can help regulate menstrual cycles and may also improve acne and reduce extra body and facial hair. Birth control pill usage, specifically when the placebo pills are taken, may be adjusted to limit menstrual bleeding to every few months or to plan the timing of your period, says Bates.

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Limit simple sugars.
Many women with PCOS often experience glucose intolerance or develop pre-diabetes, says Bates. Although this metabolic dysfunction is less commonly seen in active women, due to their regular exercise, limiting refined sugars is still important for them.

Fortunately, there are plenty of lower-carbohydrate ride food options available today. Hydration products to look out for include Nuun Performance, which is formulated with about 25-percent less sugar (60 calories a bottle) than most low-carb sports drinks; you can also make your own sports drinks. There are also plenty of low-added sugar snacks on the market, and savory snacks can be great alternatives.

To make sure you avoid added sugar, read the ingredients to make sure there are no words ending in “ose” in the first few ingredients. In general, even healthy women should aim for no more than 25 grams of added sugar daily.

Eat a healthy balance of fat, protein, and carbohydrates.
When choosing carbs, opt for whole grains, fruits, and starchy vegetables that are high in fiber.

Eat antioxidant and anti-inflammatory foods.
There’s some evidence that women with PCOS have higher levels of oxidative stress and inflammation than women without the syndrome. Some studies suggest that may lead to cell damage and more painful recovery, though the science is not conclusive.

A diet rich in monounsaturated fats from olive oil, fatty fish, nuts, and avocados can help minimize inflammation. Also, colorful fruits and vegetables are rich in natural antioxidants.

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selene yeager
“The Fit Chick”
Selene Yeager is a top-selling professional health and fitness writer who lives what she writes as a NASM certified personal trainer, USA Cycling certified coach, Pn1 certified nutrition coach, pro licensed off road racer, and All-American Ironman triathlete.