7 Mistakes You Might Be Making When Managing PCOS

Guest post from Nutritionist and Hormone Expert Sarah Gale

PCOS (polycystic ovary syndrome) is a condition that affects 1 in 10 women worldwide, yet is often misunderstood, misdiagnosed, and dismissed.

If you have PCOS, you have probably been told to “just lose weight”, “cut carbs” or “take the pill” - yet managing this complex condition is not that simple. It's about far more than weight. It is a condition deeply tied to hormonal imbalances, insulin resistance, and inflammation, meaning quick fix advice often falls short and can sometimes make symptoms worse.

Many women find themselves stuck in cycles of restrictive dieting, exhausting workouts, and frustration, wondering why they still feel fatigued, bloated, and out of sync with their bodies.

But here’s the good news, supporting PCOS doesn’t have to feel like a constant battle. Small, strategic shifts can make a huge difference in your energy, mood, metabolism and cycle regularity. Let’s break down the most common mistakes that could be standing in the way of progress and what to do instead.

 

 

1.  Skipping Breakfast

If your mornings start with nothing but coffee or a rushed bite of toast, you might be setting yourself up for an energy crash later in the day. Skipping breakfast disrupts blood sugar balance, which is a major issue for women with PCOS (around 70% of PCOS cases are linked to insulin resistance). When blood sugar isn’t stable, you are more likely to crave sugar, feel fatigued, and experience hormonal imbalances that make PCOS symptoms worse.

The best way to keep blood sugar stable is to eat a protein rich breakfast within an hour of waking up. Try scrambled eggs with avocado, Greek yoghurt with nuts and berries, or a protein smoothie with fibre rich ingredients. Adding healthy fats and fibre helps prevent cravings and energy dips later in the day.

 

2.  Pushing Yourself Through High Intensity Workouts

Exercise is important for PCOS, but too much high intensity exercise can actually make symptoms worse. Many women are told to “just work out more” to lose weight, but intense cardio and HIIT workouts can spike cortisol (your stress hormone), which leads to increased inflammation, worsened insulin resistance, and fatigue. Since women with PCOS often have higher baseline cortisol levels, excessive workouts can do more harm than good, making it harder to regulate weight and energy levels.

Instead of pushing through exhausting workouts, focus on strength training, Pilates, walking, and yoga, all of which support metabolism, improve insulin sensitivity, and reduce inflammation without overwhelming the body.

 

3. Focusing Only on Weight Loss Instead of Hormone Balance

It is no secret that many women with PCOS are told that weight loss is the answer to everything, but this approach ignores the fact that PCOS is a hormonal and metabolic disorder, not just a weight issue. The pressure to lose weight often leads to chronic dieting, excessive exercise, and a cycle of restriction and bingeing, which is especially concerning since PCOS women are 3–4 times more likely to develop disordered eating.

Instead of obsessing over the scale, focus on balancing hormones first. When insulin, cortisol, and inflammation levels are better regulated, your metabolism naturally works more efficiently, and weight loss (if needed) happens in a more sustainable way. Start by stabilising blood sugar, reducing stress, and focusing on nourishing, whole foods rather than restriction.

 

 

4.  Cutting Out All Carbs Instead of Choosing the Right Ones

Carbs have a bad reputation in the PCOS world, but eliminating them completely can actually make symptoms worse. While reducing refined carbs is important for insulin balance, cutting out all carbohydrates can increase stress on the body, disrupt thyroid function, and worsen energy crashes. Instead of going zero carb, focus on choosing the right types. Slow digesting, fibre rich carbs like quinoa, sweet potatoes, oats, and legumes support hormone balance without causing blood sugar spikes. Pairing carbs with protein and healthy fats helps keep insulin levels stable and reduces cravings throughout the day.

 

5.  Cutting Out Your Favourite Foods and Over Restricting

In an effort to “eat clean,” many women with PCOS eliminate entire food groups, avoid social situations, and create rigid food rules, but over restriction often leads to intense cravings, binge eating, and increased stress around food. Studies show that women with PCOS are at a much higher risk of developing disordered eating patterns, and the mental and emotional toll of extreme restriction can actually make symptoms worse by increasing cortisol and inflammation.

A sustainable approach means allowing flexibility in your diet. You don’t need to eliminate your favourite foods - balance is key. If you love pasta or chocolate, find ways to enjoy them in moderation while still focusing on nutrient dense meals. PCOS management should be realistic and enjoyable, not feel like punishment.

 

 

6.  Skipping Out on Sleep Hygiene

PCOS makes women more sensitive to circadian rhythm imbalances, meaning poor sleep habits can significantly disrupt hormone balance, metabolism, and appetite regulation. Research shows that women with PCOS have a higher prevalence of sleep disorders, including insomnia and sleep apnoea, which can make symptoms like weight gain, fatigue, and cravings even worse. Since melatonin, cortisol, and insulin are closely linked, sleep deprivation can worsen insulin resistance, increase inflammation, and throw off hunger hormones, making it harder to manage PCOS symptoms.

To support better sleep, stick to a regular bedtime, reduce blue light exposure in the evening, and aim for at least 7–9 hours of quality sleep. Using blackout curtains, avoiding caffeine in the afternoon, and getting morning sunlight can help regulate your circadian rhythm and improve overall hormone balance.

 

7.  Trying to Do Too Much & Ignoring Stress

Stress is a major driver of PCOS symptoms, but many women push through exhaustion, take on too much, and ignore the impact of chronic stress on their health. Whether it is overworking, skipping self care, or feeling pressure to “fix” your PCOS overnight, trying to do it all can raise cortisol, disrupt ovulation, and worsen insulin resistance. Women with PCOS often have higher baseline cortisol levels, making them more sensitive to stress than those without PCOS. This means that learning to slow down, set boundaries, and prioritise self-care is just as important as diet and exercise. Instead of constantly pushing yourself to do more, try scheduling small moments of rest each day, whether that is a 10-minute walk, a quiet tea break, or simply saying no to unnecessary commitments. Managing stress isn’t a luxury, it is a necessity for hormone balance.

 

 

 

Meet Sarah...

If you feel lost, overwhelmed, and frustrated with your symptoms, you don’t have to navigate PCOS alone.

I’m Sarah, a Registered Nutritionist who has PCOS myself, and I’ve helped many women with PCOS reduce symptoms, regulate their cycles, and feel more in control of their bodies. Through nutrition, lifestyle shifts, and hormone support, I help you create a plan that works with your body, not against it.

If you’re ready to take back control of your health, get in touch today to find out how we can work together. Your PCOS doesn’t define you, you just need the right support.

 

Find out more about Sarah and the services she offers over at Sarah Gale Nutrition.