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How should 'lean' PCOS'ers eat and exercise?

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Updated about 7 hours ago
Created October 23, 2013 at 1:27 AM

So here's some background info: I was diagnosed with PCOS at the age of 14, after seeing an endocrinologist because of my facial hair and acne. I was found to have tons of ovarian cysts too. Tried birth control but that was too expensive and didn't do anything. Tried spironolactone, but that made me short of breath, weak, and made my hair fall out in huge clumps. So I decided to start Paleo last year to tackle my issues from a holistic viewpoint. Since then, all my acne is gone, as are my cysts, but I have have high testosterone and disgusting facial hair that is coarse and prone to forming painful, bumpy ingrown hairs, which looks like hormonal acne :(. The hairs really affect my self-esteem, and since I'm in medical school and interacting with tons of people, I'm often afraid that patients can see my bumps and hairs. I'm 5'4" and when I first went Paleo, I was 137 22% body fat. I lifted heavy 5x a week, followed by 30 mins of cardio after each session and sprinted once a week. In 3 months, I lost 5% bodyfat and 7 pounds. I was looking great, and after instituting one higher-carb day to combat my low energy problems and eating 60% fat, 25% protein, and 15% carb the other 6 days, also feeling great. But during this time, my facial hair issues were HORRIBLE. So bad that I started electrolysis. And my testosterone levels shot up. I bought and read Stephanie from Paleo for Women's PCOS: Unlocked and also corresponded with her. We determined that I have stress induced PCOS, since I weigh less now than I did when I hit puberty and have compounded stress from the med student lifestyle with insufficient sleep. So, per her recommendations, I've tried incorporating more carbs, increasing my intake to 20% which is about 115 g of carbs, and have reduced my exercise to lifting heavy 2x a week, 1x a week HIIT, and 1x a week sprinting. I've been trying to sleep more, getting 8-10 hours per night, but I am still waking up extremely tired and groggy so I know my hormones are still wacky. I've also regained all the weight I lost when I first went Paleo, now back to 138, 18-19% body fat. Even though I am a size 4 in dresses, 6 in pants, and small in shirts, the number on the scale kills me! My facial hair is much better (which might also be due to the electrolysis and supplements), but my long winded question is: in an effort to both reduce my testosterone and lose weight, how should I be eating and exercising? I should also mention that I don't think I am insulin resistant as my non-fasting glucose is usually in the mid 80s.

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