Navigating Ramadan with PCOS: A Guide for Balanced Fasting

PCOS (Polycystic Ovary Syndrome) affects millions of women worldwide, and as Ramadan approaches, it's essential to consider how fasting may impact those managing this condition.

If you're observing Ramadan and managing PCOS, you might be wondering how fasting could affect your symptoms. Fasting can disrupt hormonal balance and exacerbate symptoms like irregular menstrual cycles and insulin resistance. However, with careful planning and support, you will be able to find balance between your spiritual practices and health, enabling you to fully participate in this sacred time.

What changes may you experience/notice during fasting for Ramadan?

Changes in Blood Sugar Levels: Fasting can lead to fluctuations in blood sugar levels. For women with PCOS, particularly those who experience insulin resistance, managing these fluctuations becomes crucial. Hypoglycaemia (low blood sugar) may occur during the day whilst fasting, while hyperglycaemia (high blood sugar) and therefore hyperinsulinemia can occur after breaking the fast if large quantities of high-glycaemic-index/sugary foods are consumed.

Weight Fluctuations: Some women might experience weight loss due to reduced food intake and changes in eating patterns, while others may gain weight if they consume highly processed, sugary, or fatty foods at Suhoor (pre-dawn meal) or Iftar (meal to break the fast). Your weight may fluctuate daily depending on the time of day and the type of foods you’ve consumed.

Changes to the menstrual cycle: Fasting can influence your menstrual cycle. Some women might notice changes in the length or flow of their cycle or experience missed periods. These changes can occur due to the stress fasting places on the body and the potential for weight changes, both of which can affect hormone levels.

Gastrointestinal Changes: Changes in eating times and patterns can lead to gastrointestinal discomfort, including bloating, constipation, or indigestion. These symptoms can be particularly challenging for women with PCOS, who may already be more prone to digestive issues.

Fatigue and Energy Levels: Alterations in sleep patterns and the physical challenge of fasting can lead to increased fatigue. This can be exacerbated in women with PCOS, who may already struggle with fatigue as a symptom of the condition.

Mood Fluctuations: Fasting can affect mood and mental health, leading to feelings of irritability, anxiety, or depression. Hormonal imbalances associated with PCOS can make women more susceptible to these mood fluctuations.

Being aware of the changes you may experience can help you feel better prepared, know what to expect and therefore how to manage better during Ramadan.

Here are some strategies to help you manage your PCOS during Ramadan:

• Drink plenty of water during Iftar and Suhoor to prevent dehydration and choose foods that are good for hydration such as cucumber, melon, strawberries, soups.
  

• Engage in light exercise, such as 20 minutes of walking, Yoga, or Pilates to maintain physical health without overexerting yourself. You may feel better exercising straight after Suhoor as this is when you’re likely to have more energy.
  

• Try to maintain a regular sleep schedule as much as possible to reduce stress and manage fatigue. Avoid scrolling on your phone too close to bed time and take opportunities during the day to rest if time allows.
  

• Avoid too many foods that are high in sugar and/or fat. Prioritise eating nutrient dense foods in an attempt to meet your daily nutrient requirements. That's not to say you can't have the sweet foods - there are so many delicious traditional sweets to have as part of your celebration. Aim to eat the nutrient dense foods first, followed by the sweets you choose, this ensures that you don't fill up on sweets and encourages a slower glucose release.
  

• Choose complex carbohydrates like whole grains (oats, brown rice) to sustain energy levels throughout the day and get adequate amounts of fibre to help with digestion and promote stable blood sugar levels.
  

• Include lean proteins (eggs, Greek yogurt, tofu, fish, chicken) to promote satiety and muscle repair.
  

• Don't forget healthy fats (avocado, nuts, seeds) to keep you feeling full and satisfied until Iftar.
  

• Continue to take your supplements, especially inositol to help optimise insulin sensitivity.
  

• If taking metformin it is safe to continue taking it whilst fasting. If you are taking it three times a day you may benefit from skipping your mid day dose and prioritising your morning and evening dose.

Remember, listening to your body's hunger and fullness cues is key during Suhoor and Iftar. Focus on nourishing your body with wholesome, nutrient-dense foods to support your overall health and well-being during Ramadan. If it any point you feel unwell or worry about your general health whilst fasting you should contact a health care professional.