Do I have to eat Dairy Free if I have PCOS?

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Do I have to eat dairy free if I have PCOS? This is one of the most common questions I get asked as a PCOS dietitian.

Are you totally confused about dairy and wondering if it’s good or bad for PCOS? Do an internet search for dairy and you will be sure to come up with conflicting view points in women with PCOS.

In this study, published in Nutrients, I and fellow colleagues surveyed over 1,000 women with PCOS living in the United States. Approximately 30% of the women reported following a dairy free diet for their PCOS. More than half of participants in this study used the internet and social media as their primary source of nutrition information.

In this article, I review the most recent research on dairy for women with PCOS and answer questions such as “Do I have to eat dairy free if I have PCOS?” “Is a dairy free diet good for PCOS?” And “How much dairy is ok for PCOS?”

Is it Necessary for People with PCOS to Go Dairy Free?

Studies investigating a link between PCOS and dairy are extremely limited. There are only 2 in fact and none of them are randomized controlled studies or involve a good number of women. Here’s what the available studies show:

In a cross-sectional design study involving 400 Iranian women with PCOS, researchers found a higher consumption of low- and free-fat milk among women with PCOS who self-reported their intake.

A small study (24 women) found that a low starch/low dairy diet resulted in weight loss, improved insulin sensitivity and reduced testosterone in women with PCOS. This diet was very low in calories, eliminated all starches, and included 1 ounce of cheese daily. Based on the small size and duration of this study, it’s not enough evidence to recommend a dairy free diet for PCOS.

A randomized controlled trial did show that the DASH eating pattern resulted in the improvement of insulin resistance, serum hs-CRP levels, and abdominal fat accumulation in overweight women with PCOS. The DASH diet is designed to be rich in fruits, vegetables, whole grains, and low-fat dairy products and low in saturated fats, cholesterol, refined grains, and sweets.

These few studies show that women with PCOS can eat moderate amounts of dairy and still see improvements in metabolic and reproductive aspects when accompanied by other nutrition modifications like a low GL diet.

What’s the Link Between Dairy and Acne in PCOS?

Got acne? You may want cut back on milk. This, according to new research published in the Journal of the Academy of Nutrition and Dietetics, showing a positive link between dairy consumption and acne.

In their review of 27 studies, researchers concluded that frequent dairy intake as well as a high glycemic load diet (GL) contributes to acne. As the figure below shows, there are several ways dairy influences acne development:

1. Dairy ingestion can lead to increased insulin levels leading to increased cellular growth and acne.
2. Dairy products are carbohydrates which stimulate insulin growth factor 1 (IGF-1), resulting in high insulin levels. “Both skim and whole milk (but not cheese products) have a 3 to 6 fold higher glycemic-load compared with other carb foods”. High insulin levels lead to increased androgens creating more sebum production.
3. Milk contains growth-stimulating hormones, including IGF-1 and dihydrotestosterone (DHT), which increases androgens resulting in higher sebum production and acne.

 dairy free if pcos

Individuals who suffer from a type of acne known as hidradenitis suppurativa (HS), which causes painful and large boils under the skin, have been shown to have symptoms improve with a dairy free and low glycemic-load diet.

What’s interesting is that this review showed fat-free and low-fat milk had the most impact on acne development whereas full fat milk didn’t have as strong effect. Nor did cheese, which is considered low GI.Compared with low-fat dairy products, whole milk and fat-rich dairy products have a higher estrogen concentrations and lower levels of androgens. Estrogen can decrease levels of IGF-I. Skim and whole milk (but not cheese products), have a three- to six-fold higher GL response.. Cheese has been reported to be less insulinemic than other dairy products. In one study, the risk of acne increased when 3 or more servings of milk were consumed (6).

dairy free if pcos

Can Dairy Cause Pre-diabetes?

Studies have looked at the relationship between dairy and prediabetes risk in non-PCOS people. In this large study, a higher intake of high-fat yogurt was associated with lower prediabetes risk and lower insulin resistance . In addition, an intake of high-fat milk was associated with lower prediabetes risk. This is in comparison to the associations that were found for low-fat dairy, low-fat milk and total cheese with a higher prediabetes risk.

Does Dairy Cause Inflammation in PCOS?

The link between dairy and inflammation in PCOS is unclear. While there is insufficient evidence to recommend specific dairy foods as “anti-inflammatory,” the substantial body of clinical research discussed in this review indicates that dairy foods do not increase concentrations of biomarkers of chronic systemic inflammation.

What’s the Link Between Fertility and Dairy?

Dairy consumption has been a subject of interest in this regard, with conflicting evidence regarding its impact on fertility in women with PCOS. A prospective cohort study published in the American Journal of Clinical Nutrition reported that high intake of low-fat dairy was associated with an increased risk of ovulatory infertility, whereas high intake of high-fat dairy showed no such association. Conversely, another study published in Human Reproduction found no significant correlation between dairy consumption and fertility outcomes in women with PCOS.

Dairy intake, specifically full-fat dairy products, has been shown to have a positive impact on fertility.  In their prospective cohort study, Chavarro et al. found that a high intake (2 servings or more) of low-fat dairy products may lead to an increase in the women’s risk of ovulation-related infertility, whereas incorporating high-fat dairy foods may decrease the risk for infertility.

What Type of Dairy Is Ok If I have PCOS?

So, getting back to the original question: Do I have to eat dairy free if I have PCOS? The answer: You may not need to.

Nowhere in the International Evidence-Based Guidelines does it say that people with PCOS should avoid dairy or eat a dairy free diet for PCOS.

Fat-free and low fat dairy types seem to negatively impact women with PCOS the most. These types of dairy have been linked with poor ovulation and increased inflammation, acne, and insulin resistance.

How Much Dairy Is OK for PCOS?

Because of the direct influence on androgens and insulin, it may advisable for women with PCOS (who have acne or not) to limit their dairy intake to 2 or fewer servings each day and go for the full-fat versions.

One serving of dairy is:

1 cup milk or yogurt, or
1.5 ounces hard cheese

If your acne is a source of concern for you, you may want to try and cut back dairy or eliminate it for a few weeks to see if it improves.

Non-Dairy Calcium Sources

American women need 1,000 mg of calcium daily. There are ways to get calcium other than from dairy. Milk alternatives such as almond, hemp, rice and coconut milk can easily be used in place of cow’s milk (but usually lack the protein content of cow’s milk). Many vegetables (kale, broccoli, bok choy, for example) provide a good source of calcium as does fish (5 ounces of salmon contain more calcium than a glass of milk), seeds (chia, sesame and flax) and quinoa.

Dairy Free if pcos

Bottom Line

The International Evidence Based Guidelines do not say that people with PCOS need to avoid dairy. Much more research, especially randomized controlled trials, need to be done on the role of dairy in women with PCOS.

If you do have acne or want to see if dairy has an effect on you, you may first want to start with cutting back on dairy or eliminating dairy entirely and slowly reintroduce it in small amounts after 2 weeks to see if it has any effect. Some women with PCOS (and those without it too) can’t tolerate any dairy or they will break out in acne. Others can tolerate it just fine. Be sure to get your calcium and vitamin D from other sources if you do cut back on dairy.

Have you cut back on dairy and seen an improvement in acne or other PCOS symptoms? Let us know!

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Comments (24)
  • Chantelle

    November 30, 2014 at 7:58 pm

    I have sucessfully introduced a low gi diet as well as eliminating dairy. It was only a matter of days before I noticed a transformation to my skin. I have been eating this way for two months now and I am virtually spotless. I have suffered with acne relentlessly between the ages of 13 – 34. It has been horrific. I have mild hirsutism and don’t consider that part of pcos significant, however I have noticed a slower rate of growth. My daily diet also includes – a massive mug of spearmint tea (made from dried spearmint leaves) – sesame seeds daily (either in tahini, halva or raw form) – greens (kale, spinach, watercress) -a vit d3 supplement – a zinc supplement – nuts and seeds (particularly sunflower and pumkin) I do not drink alcohol or caffine. I drink a couple of tablespoons of apple cider vinegar on occasions when I may be about to eat something higher carb. So that is my experience of what you need to do to stop acne caused by insulin resistance / pcos. No doubt some people will think its not worth it, but after a while the foods you eat just becomes a habit and you don’t even miss the white bread or the glass of wine.

  • Marie

    January 18, 2015 at 7:58 pm

    Eliminating dairy has entirely cleared up my acne in conjunction with other dietary changes and supplements. There is a clear link between dairy and acne in my personal case of pcos.

  • Sonja

    August 23, 2015 at 7:58 pm

    The reduction of dairy products and also gluten products helped with my acne breakouts almost immediately. I was able to notice a difference with in a week to two of the dairy reduction. I occasionally have cheese but I am consistently regretful of the decision. I am careful to say reduction of dairy because I have refused to omit organic butter from my diet. My hair is still thinning but not at the same rate. The hirsutism has increased but I believe it is due to my Biotin intake increase.

  • YB

    March 29, 2016 at 9:06 am

    Hi Prof. Grossi:

    “What’s interesting is that this review showed fat-free and low-fat milk had the most impact on acne development whereas full fat milk didn’t have as strong effect. Nor did cheese.”

    FYI, when whole milk is processed/centrifuged to reduce milk the effect is an increase in the male hormone, androgen. So whole milk actually has less androgen than low fat milk which explains this effect.

  • Joy

    April 7, 2016 at 3:06 pm

    Going dairy free made an almost immediate difference in my skin. I still have oily skin, but now I have very few breakouts, only around the time of my period. And very few at that!

  • K

    April 28, 2016 at 11:07 pm

    Before being diagnosed with PCOS, I tried an elimination diet, cutting out dairy, gluten, soy, and a few other things for 2-3 weeks. I had mild acne since my teen years, and at the time, was in my early 20s, but after this diet, my skin cleared up. I added back the foods that I eliminated one at a time to see if I had any adverse reactions. A day or two after I added back dairy, I noticed some acne. I tried eliminating it again, then added it back, and the same thing happened. I actually tried this a total of FIVE times to make sure it was the dairy because I didn’t want to give up an entire food group if I didn’t have to. One of these times, I had about 3 servings of dairy in one day, which I think included Greek yogurt, cottage cheese, and whey protein powder. Within 1-2 days, I had the worst breakout of my life with most of my forehead covered in little pimples.

    About 3 years later, I continue to avoid pretty much all dairy. I still get 1-2 occasional pimples on my chin, but also have periods where my skin is clear. I seem to get an extra pimple or two if I accidentally have a small serving of dairy, but this rarely happens. I don’t seem to notice much of an effect if I have butter, possibly because it is mostly fat.

  • Soni

    February 15, 2017 at 11:27 am

    My acne goes away completely after quitting sugar and dairy.In less than three days results start showing.


    May 12, 2017 at 4:33 am


    I have PCOS from last few months. I have already excluded dairy products from my diet but as it is too hot nowadays I sometimes feel like having curd/yogurt. Can I have the same of about on bowl on a daily basis?

  • Angela Grassi

    May 12, 2017 at 8:31 am

    Every woman with PCOS is different. Many women can tolerate small amounts of dairy, say a serving or two, with no problem. As long as you tolerate dairy and haven’t noticed an impact on your symptoms such as acne, enjoy your yogurt 🙂

  • Jeannie

    May 31, 2017 at 11:12 pm

    Excellent article with science based information. Thank you.

  • Aimee

    September 23, 2017 at 8:30 pm

    My acne goes CRAZY along my chin line and my face gets swollen when I have too much dairy. When I cut it out completely, my face stays clear and no swelling. I’ve found lactose free and vegan cheeses that I can have and don’t have any issues with, but I love cheese so it’s difficult to cut out all the time.

  • Fiona

    November 4, 2017 at 6:47 pm

    I often consume milk as my post-workout drink. Since I have PCOS I work out, do strength training, etc and milk is my go-to beverage to build muscle and I don’t have any pimples considering my often intake of dairy. I really feel okay and good about drinking milk. Perhaps it’s case to case basis?

  • Angela Grassi

    November 13, 2017 at 9:35 am

    Fiona, Yes, there is still so much we don’t know about the role of dairy for PCOS women. What we do know is that fat free milk is high in glycemic index and in some people, has the potential to increase acne. If you tolerate milk fine, please enjoy it! It is a great recovery drink for athletes.

  • Kelly Ransdell

    November 14, 2017 at 6:18 pm

    Hi! Does Whey protein have an effect on IGF-1 levels? Or is it something else in dairy?

    Also, I was told by my endocrinologist that I do NOT have the “insulin-related” PCOS—does this mean my diet does not affect my symptoms? Thanks!

  • Angela Grassi

    November 15, 2017 at 9:17 am

    Kelly, Yes, whey protein does seem to affect IGF-1 levels but we do see a difference between fat free and full fat milk. The latter doesn’t have quite as high GI.

    If your docotor says you don’t have insulin resistance, it can still mean that your insulin levels are high, but not high enough to cause resistance.

  • Erin

    February 6, 2018 at 2:48 pm

    I was diagnosed with pcos in 1999. I haven’t had acne on my face since my teen years but I’ve had severe hidradenitis suppurativa all of my adult life. Sadly it was misdiagnosed as furunculosis so I felt very alone with “my curse” and was not able to find anything to help.

    I started cutting back on dairy (still use butter and many of my smoothies get 1/2 cup of yogurt), began taking myo inositol, and switched to sourdough bread. I figured I’d start slowly. Well to my utter amazement my HS started healing the first week! Seeing the improvement, I was more strict with my changes the second week and my skin smoothed out in a way I haven’t known since puberty. Even though I started my period in the third week I had none of the typical flare ups. I’m just flabbergasted and wish I would have known this was possible. After 23 years of suffering, could it really be this simple?!?

    A few other things I noticed:

    – I broke out with facial acne the 2nd week but it went away pretty quickly. I’m assuming some sort of detoxing…?

    – My hirsutism has improved.

    – I’ve lost about 7lbs

    I’m really tempted to start calling my previous providers and tell them about this so they can pass on the idea. No one should have to suffer needlessly.

  • Angela Grassi

    February 8, 2018 at 9:39 am

    Wow! That’s great! Yes, all it takes is some diet changes to see a difference. The power of nutrition!

  • Nadine Bartholomew

    March 21, 2018 at 2:49 pm

    I woman living with pcos also am looking for health tips

  • Angela Grassi

    March 27, 2018 at 3:45 pm

    Hi Nadine,
    Definitely spend some time on our website which is full of nutrition info for PCOS. Also, check out these books to help you

  • Kristyn

    December 17, 2018 at 6:44 pm

    I drink Lactaid milk which is lactose free. But I’m wondering if its better to buy the fat free or the whole milk? Reading the above info I’m not sure if the same applies if the milk is lactose free. Any help? I’ve been buying fat free for years but just bought whole milk for the first time in forever, hoping it makes a difference. I just want to make sure.

  • Angela Grassi

    December 20, 2018 at 5:55 pm

    I would recommend the higher fat milk because it can be more satisfying. Other milks to try are cashew milk and oat milk.

  • Priya Sharma

    April 29, 2021 at 7:57 am

    hi there! this article is really very informative and helpful for those who are suffering from PCOS. thanks for sharing this article with us. I got alot to know from it. I sharing this article with my female friends so that they can also get benefitted from this.

  • Laffy

    August 2, 2021 at 3:13 am

    I’m very jealous of those who can tolerate cheese/ a bit of dairy.
    My skin is generally clear these days but every now and again I struggle with craving cheese…low and behold the after effect of cystic acne. Then once my skin is bad I feel like I might as well enjoy cheese for a few days and then inevitably regret looking like a pizza and the painful bumps. Any tips on how to deal with this craving?

    I also get ‘folliculitis’ on my arms chest and legs when I consume a lot of dairy. GP wanted to put me on a 3 to 6 month course of antibiotics but once I cut out dairy and it went away and no nasty antibiotics!

  • Elizabeth

    June 20, 2022 at 3:41 pm

    I’ve been diagnosed with PCOS for 9 years and have always had irregular periods. 2 months ago I went dairy free in hopes that it would help me get a cycle on my own. It worked! I had a cycle after 11 months with no cycles. I thought “there’s no way!”. So I went on vacation and indulged in a ton of dairy. I waited for a period to come and it never did. 2.5 weeks ago I decided to go dairy free again and today I started a cycle after 55 days from the last one. I am shocked and wish I knew this so much sooner or that it was recommended by a doctor as something to try before being put on medication to have normal cycles. There needs to be more research on this! I’m hoping this will continue to help my PCOS symptoms!

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