In case nobody's told you...

Hey there Reader,

You DO have choices when it comes to managing PCOS.

I'm speaking at 2 conferences next month, so I'm DEEP in the current research and guidelines at the moment, and it's making me mad all over again.

Did you know that the updated International Expert Guidelines say "Shared decision making between the patient and the healthcare professional is required" when it comes to deciding whether you want to take medications for your PCOS or not? Sure doesn't feel that way, and that's not what I hear from my clients is happening.

And that's not all... even though the guidelines clearly state "Lifestyle intervention (exercise alone or multicomponent diet combined with exercise and behavioural strategies) should be recommended for all women with PCOS, for improving metabolic health including central adiposity and lipid profile" and "Healthcare professionals should be aware that lifestyle management is a core focus in PCOS management"...

they include little digs like "Inositol (in any form) could be considered in women with PCOS based on individual preferences and values, noting limited harm, potential for improvement in metabolic measures, yet with limited clinical benefits including in ovulation, hirsutism or weight."

Um, there are nearly 100 studies including actual head-to-head studies showing similar efficacy to metformin but without the side effects so okayyyyy.

Not to mention statements like:

Healthcare professionals and women should consider that there is no evidence to support any one type of diet composition over another for anthropometric, metabolic, hormonal, reproductive or psychological outcomes.

Healthcare professionals and women could consider that there is a lack of evidence supporting any one type and intensity of exercise being better than another for anthropometric, metabolic, hormonal, reproductive or psychological outcomes.

(If you want to read the guidelines yourself, you can find them here.)

Okay, so all that being said... so now what? What actual action steps are you supposed to take from recommendations like this?

Well, that's where I come in.

Evidence-based practice is NOT just relying on randomized clinical trials (thank goodness, because the evidence in PCOS is limited since less than 0.01% of research funds are dedicated to this condition that affects anywhere from 5-15% of those AFAB).

Evidence-based practice means reviewing and interpreting the best available clinical evidence, combining that with clinical expertise, judgment, and experience, and working with the patients' unique needs and goals to develop a customized plan.

(Hmmm... sound familiar?)

I've read literally every study on various nutrition strategies for PCOS. I've incorporated some of these strategies with patients to determine what's actually effective AND sustainable. And I've built my PCOS programs based on those findings.

Because what good is a diet if you can only stick to it for 3 weeks at a time?

What good is a diet if you're miserable and restricted and it's worsening your relationship with food and your body?

What good is a diet if it's not actually addressing ANY of the underlying root causes but just masking your symptoms and they all come raging back the second you stop?

There's a BETTER way!

Want to learn:

Need more help? Get on the waitlist for group coaching or apply here to work with me.

Don't let your doctors bully you into thinking there's only one way to treat PCOS!

All my best,


The Hormone Dietitian

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IMPORTANT NOTE -> This information is provided for educational purposes and should not be construed as medical advice. Please consult with your healthcare practitioners before undertaking any changes in your diet or adding supplements.

Melissa Groves Azzaro, RDN, LD, The Hormone Dietitian®

Award-winning integrative and functional dietitian specializing in women's health and hormones, including PCOS, fertility, and hormone imbalances. I help busy women identify and address the root causes of their hormone imbalances so they can live a balanced life! Author of A Balanced Approach to PCOS, host of the podcast Hormonally Yours with the Hormone Dietitian, and creator of The PCOS Root Cause Roadmap (tm) and The Period Problems Root Cause Roadmap. Check out the resources I offer below and sign up for my newsletter!

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