Can’t imagine starting your day without a cup of coffee? Me neither! Some days, a Cup o’ Joe is the only thing keeping me from crawling back into bed, wishing my whole life was a long weekend. Yet, if you are a woman with PCOS, you might be wondering if coffee should be a part of your PCOS diet.
We’re not surprised you’re confused! Truth is – there are conflicting points of view when it comes to coffee and PCOS. Some PCOS experts insist that you must eliminate coffee from your PCOS diet completely, while others recommend it in moderation. So what is the truth? Should you, or should you not, drink coffee with PCOS? Let’s understand by looking at how coffee affects some key causes and symptoms of PCOS.
The evidence on whether or not coffee should not be a part of a healthy diet is sketchy. A lot of the confusion centers around insulin sensitivity, and how caffeine may affect it. To be honest, the scientific data on this is contradictory and can be confusing.
Research from Nestlé Research Center, Switzerland found that when lifestyle confounders are taken into account, individuals consuming ≥6 cups coffee per day have at least 50% less risk of developing Type 2 Diabetes than those consuming ≤2 cups per day. However, scientists agreed that it is perhaps premature to recommend increased coffee or caffeine intake to prevent the development of Type 2 Diabetes or insulin resistance.
Another Canadian study had similar findings. In a cross-sectional study, caffeinated coffee was positively related to insulin sensitivity. And decaffeinated coffee was favourably related to measures of beta cell (which produces insulin) function. Researchers concluded that these results provide insight as to how coffee could impact the risk of type 2 diabetes mellitus.
However, a study from University Medical Center, Nijmegen, Netherlands found contradictory results. When caffeine or placebo was given to 12 healthy volunteers in a randomized, double-blind, crossover design, it was found that caffeine did indeed decrease insulin sensitivity in healthy humans. It’s possible that this was the result of elevated plasma epinephrine levels due to coffee intake.
Though all this scientific data is contradicting, we have some answers for you. This is what happens when you drink a cup of coffee:
Now, this means that coffee imparts some insulin balancing benefits to regular and habitual coffee drinkers. What’s interesting to note is that both caffeinated and decaffeinated coffee drinkers may enjoy a reduced risk of Diabetes Type 2, suggesting that it’s not essentially ‘caffeine’ but some other compound in coffee that’s the secret behind these benefits.
A lot of women with PCOS trying to get pregnant worry about the effects of caffeine on fertility. Truth is, the potential effects of coffee consumption on fertility are not clearly established but appear to be quite limited. Some research indicates that high levels of caffeine intake may delay conception among fertile women. Considering that PCOS already makes it harder for you to get pregnant, it may not be wise to add to your fertility woes with your coffee addiction.
There is also strong evidence that coffee can increase your risk for miscarriage. The study of 1,063 pregnant women found that women who consumed 200 mg or more of caffeine per day doubled their miscarriage risk. What’s worrisome is that PCOS already puts you at increased risk of miscarriage in your first trimester. Now if you are trying to get pregnant, or are already pregnant, it may be best to eliminate coffee from your PCOS pregnancy diet for this reason alone.
PCOS is characterized by hormonal imbalance, and coffee may be able to help in this regard….to some extent, anyways. Caffeinated coffee has been positively associated with SHBG or Sex Hormone Binding Globulin – a protein produced in the liver. SHBG binds with excess androgens (testosterone and dihydrotestosterone) as well as estrogen so that they become inactive and harmless.
Now women with PCOS sometimes have low SHBG levels, which is what causes an increase in active testosterone and estrogen in the blood. A cup of coffee can boost SHBG levels so that these circulating testosterone and estrogen become ineffective, improving your PCOS symptoms.
Don’t celebrate just yet, coz now we have some bad news for you. Caffeine can strongly affect the activity of the hypothalamic-pituitary-adrenal (HPA) axis.
There’s a growing body of evidence that shows PCOS patients have a hyper-responsive HPA or Hypothalamus-Pituitary-Adrenal axis. The hypothalamus and pituitary gland located in the brain control the adrenal glands which produces male hormones (androgens) like DHEA as well as cortisol. Disturbances in the HPA axis leads to excess androgen production, stress, increased abdominal fat, impaired glucose sensitivity and insulin resistance.
The adrenal glands secrete two key hormones: epinephrine and cortisol. Research has shown that caffeine increases cortisol and epinephrine at rest, stressing out the adrenal glands. In fact, levels of cortisol after caffeine consumption are similar to those experienced during an acute stress response. Caffeine raises blood pressure and also increases levels of free epinephrine excreted by up to 32%. This increase in blood pressure and heart rate has been associated with higher levels of self-reported stress during the activities of the day. It’s believed that even if you stick to drinking coffee only in the morning up till early afternoon, these effects are undiminished through the evening until bedtime. Studies have also shed light on the fact that caffeine may elevate cortisol by stimulating the central nervous system in men but may interact with peripheral metabolic mechanisms in women.
Simply put – coffee can worsen adrenal fatigue. This happens when your adrenal glands are weakened over time, causing chronic lethargy, hormonal disruption, anxiousness and irritability.
Well, as you can see, there’s no straight answer to that question. Whether the pros outweigh the cons of coffee is a personal decision, one that should be made keeping in mind your individual PCOS symptoms.
In my opinion, it may be a good idea to review your relationship with coffee. Caffeine in coffee is a highly addictive substance. If you’re drinking more than 3 cups of coffee per day, and can’t seem to think straight without them, I would consider taming that coffee addiction. Personally, I like to limit myself to one cup a day on most days. And when I’m extra-stressed out, I omit coffee completely from my routine. I haven’t committed to giving up coffee completely, though.
Here are my 5 tips for ensuring your coffee addiction is not detrimental for your PCOS:
Coffee is a polarizing topic in the PCOS community; hence it’s difficult to find any concrete answers to your conundrum. However, we recommend that you limit your coffee intake with PCOS. It’s best to err on the side of caution with this one.
Caffeine and Insulin Sensitivity – http://online.liebertpub.com/doi/abs/10.1089/met.2005.3.19
Caffeine Can Decrease Insulin Sensitivity in Humans – http://care.diabetesjournals.org/content/25/2/364.short
Associations between the intake of caffeinated and decaffeinated coffee and measures of insulin sensitivity and beta cell function – https://link.springer.com/article/10.1007/s00125-010-1957-8
Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women – http://www.sciencedirect.com/science/article/pii/S0091305706000645
Caffeine Affects Cardiovascular and Neuroendocrine Activation at Work and Home – http://journals.lww.com/psychosomaticmedicine/Abstract/2002/07000/Caffeine_Affects_Cardiovascular_and_Neuroendocrine.9.aspx
Caffeine Intake and Delayed Conception: A European Multicenter Study on Infertility and Subfecundity – https://academic.oup.com/aje/article/145/4/324/69064/Caffeine-Intake-and-Delayed-Conception-A-European
Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study – http://www.ajog.org/article/S0002-9378(07)02025-X/fulltext
Coffee and Caffeine Consumption in Relation to Sex Hormone–Binding Globulin and Risk of Type 2 Diabetes in Postmenopausal Women – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3012180/