Protein as a Metabolic Anchor in Polycystic Ovary Syndrome: A Case Report and Practical Nutrition Framework

Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder characterized by reproductive, metabolic, dermatologic, and psychological manifestations.Lifestyle modification remains the cornerstone of management.Limited studies have evaluated higher-protein dietary patterns in women with PCOS; however, PCOS-specific evidence remains insufficient to establish validated condition-specific protein intake targets.This drives clinicians to offer nonspecific recommendations such as to increase protein or reduce carbohydrate intake without measurable targets.This case report examines current PCOS guidelines and available related evidence regarding higher protein dietary patterns and proposes an evidence-informed clinical framework for translating current protein recommendations and applying them to PCOS.Dietary adherence was self-reported, and concurrent weight loss, dietary changes, and continued spironolactone therapy preclude causal attribution of the observed outcomes to protein intake alone.For adult females with no contraindications, the framework proposes protein intake according to body weight in kg, PCOS presence, and physical activity.Approximate targets of 1.2-1.6 g/kg/day may be appropriate for PCOS patients with insulin resistance, appetite dysregulation, or weight management goals.For PCOS patients with resistance training, fat loss goals, or lean mass preservation goals, 1.6-2.0g/kg/day is proposed.Calculated daily protein goals are then distributed across meals throughout the day.Available PCOS-specific evidence suggests that higher-protein dietary patterns may improve fasting insulin and insulin resistance, while broader nutrition and weight-management literature supports potential benefits for satiety, dietary adherence, and body composition.However, evidence is limited due to underinvestment leading to small sample sizes, heterogeneous interventions, short follow-up periods and lack of calculated protein recommendations.This underinvestment has practical clinical consequences: when disease-specific nutrition trials and implementation studies are limited, clinicians are left to extrapolate from general nutrition, metabolic, and exercise literature rather than relying on PCOS-specific dose-response data.PCOSspecific trials are needed to establish optimal intake thresholds, long-term safety, and the clinical phenotypes most likely to benefit.This review provides a practical framework for translating emerging evidence into clinical practice while highlighting the need for further high-quality research to define optimal protein targets in PCOS.