Best Milk for PCOS (Weight Loss, Acne, Fertility + More)

What is the best milk for PCOS? As a registered dietitian who specializes in PCOS, this is a question I get asked frequently. 

In this blog post, I’m going to dive into the pros and cons of dairy milk, non-dairy milk alternatives, and how they affect PCOS symptoms. By the end of the article, you’ll be able to determine what the best milk choice for you and your PCOS symptoms is going to be.  

Is Milk Bad for PCOS? 

I wish the answer for this was a straightforward yes or no. Unfortunately, when it comes to PCOS and dairy, the answer is more gray. 

Why? We have very limited research on dairy in those with PCOS specifically. There’s lots of research on dairy for the general population but results have been largely conflicting. That means that we need to take the research that was done in women without PCOS and try to interpret it and apply it to PCOS…which is obviously not ideal. 

Don’t worry though, I’m going to walk you through what the research says. Let’s first talk about the benefits of milk or dairy. Then we’ll dive into some of the potential cons so you can make an informed decision on what’s best for you. 

Dairy Milk Pros: 

• Important Nutrients. Milk is a good source of high-quality protein, calcium, choline, phosphorus, vitamin B12, vitamin D, and zinc.

• Lower Diabetes Risk. Overall, consuming milk and dairy products appears to lower insulin resistance and the risk of developing prediabetes or type 2 diabetes. 

• Insulin Sensitivity. Milk increases IGF-1 (insulin-like growth factor) concentrations which increases the absorption of glucose (aka your blood sugar) into muscle and fat tissues. This improves insulin sensitivity (1, 2). 

• Improved Fertility. Adding just one serving of whole milk daily may decrease ovulatory infertility by over 50% (3). 

• Anti-Inflammatory. For most people, dairy milk has no negative effect on inflammation and it actually may have anti-inflammatory effects (4, 5). 

Dairy Milk Cons: 

• Acute Insulin Response. Milk can raise insulin levels temporarily but overall it’s still typically associated with lower insulin resistance and diabetes risk.

• Infertility. Low-fat dairy may increase the risk of anovulatory infertility.

• Acne. All dairy products, and especially skim milk, can worsen acne for some people (6, 7).

• Inflammation. If you’re allergic to milk or have an intolerance, consuming milk or dairy products will result in inflammation. One study did find that a higher amount of women with PCOS had lactose intolerance compared to the general population – so lactose-containing dairy may be inflammatory for more people with PCOS (8). 

What About Other Dairy Products? 

A recent systematic review found that fermented dairy products such as kefir and yogurt consistently show positive health benefits. Some of these benefits include a reduced risk of breast cancer, colorectal cancer and type 2 diabetes, improved weight maintenance, and improved cardiovascular, bone, and gut health.

Fermented dairy products contain live cultures called probiotics that can improve the gut microbiome leading to improved health. If you don’t need to be dairy-free, I highly recommend incorporating these types of dairy products if you’re able to.

Do I Have To Be Dairy-Free If I Have PCOS?

If you’re feeling even more confused now than you were when you started, trust me, you’re not alone. The research for those of us with PCOS is lacking and underwhelming…and the research in the general population isn’t exactly straightforward either. 

Here’s my take on dairy and who should avoid it when it comes to PCOS. 

Who Should Definitely Avoid Milk & Dairy Products: 

• Those with a milk allergy or intolerance.

Who Should Maybe Avoid Milk & Dairy Products:

• Those with significant or severe acne or hidradenitis suppurativa that hasn’t responded to modest dietary changes may benefit from a dairy-free or low-dairy diet trial.

• Those with lactose intolerance. Many people with lactose intolerance can tolerate fermented dairy products since they have a very low amount of lactose.

If you don’t meet any of the above criteria, then you may be able to include dairy in your diet without any negative consequences for your PCOS symptoms. 

In general, I recommend trying to incorporate fermented dairy products such as Greek yogurt, kefir, or cottage cheese more routinely. These foods are great sources of probiotics, quality protein, calcium, vitamin D, and other micronutrients associated with improved health. 

Non-Dairy Milk Alternatives For PCOS

If you need to (or you’re choosing to) use non-dairy milks, let’s run through which ones are the best options for PCOS.

Almond Milk

Unsweetened almond milk is a great option for PCOS. It’s the best milk alternative for PCOS weight loss since it’s low calorie and low carb. I love adding almond milk to smoothies, oatmeal, or overnight oats.

Almond Milk Pros:

• Low calorie and low carbohydrate.
• Usually fortified with calcium and vitamin D.

Almond Milk Cons: 

• Not a good source of protein. 
• May contain added sugars or sweeteners. Opt for unsweetened versions of almond milk to avoid this.

Oat Milk

Oat milk is a great milk substitute for those with PCOS. It’s a particularly good option for those with a nut allergy. 

Oat Milk Pros:

• May provide a small amount of fiber from oats, particularly a beneficial prebiotic fiber called beta glucans for improved gut health.
• Usually fortified with calcium and vitamin D.

Oat Milk Cons: 

• Usually higher in carbs compared to other non-dairy milks. May contain added sugars or sweeteners. Opt for unsweetened oat milk to avoid this.
• Not a good source of protein.

Soy Milk

Soy milk is the O.G. when it comes to non-dairy milk. Nutritionally, it’s one of the most comparable to cow’s milk. 

Soy Milk Pros:

• Has the same amount of protein per serving that cow’s milk does.
• Usually fortified with calcium and vitamin D.
• For PCOS, soy products may reduce insulin resistance, BMI, triglycerides, inflammation, and testosterone (9, 10). 

Soy Milk Cons: 

• May contain added sugars or sweeteners. Opt for unsweetened versions to avoid this.

Rice Milk

Although not as popular as some of the other non-dairy milk options, rice milk may be a good option for some people.

Rice Milk Pros:

• Great option for those with nut or soy allergies. 
• Tends to be digested well so it may be a good option for those with digestive issues.
• Usually fortified with calcium and vitamin D.

Rice Milk Cons: 

• Usually higher in carbs compared to other non-dairy milks. May contain added sugars or sweeteners. Opt for unsweetened versions.
• Not a good source of protein.

Coconut milk

Coconut oil had its moment, so it’s only fitting for coconut milk to be a milk alternative you’re wondering about. I’ve found that coconut milk drinks tend to vary greatly among brands in regards to nutrition.

Coconut Milk Pros:

• Typically low in carbs.
• Contains medium-chain triglycerides (MCTs), which may provide a quick source of energy.

Coconut Milk Cons:

• Very low in protein compared to other milk options.
• Can be high in calories and saturated fat, which may not be ideal for everyone depending on your health goals.
• Not always fortified with calcium or vitamin D.

Pea Milk

Pea milk is one of the new kids on the block when it comes to non-dairy milks. It’s usually a combination of mostly water and pea protein.

Pea Milk Pros: 

• Usually fortified with nutrients like calcium, vitamin D, and others.
• Has the same amount of protein per serving that cow’s milk does.
• Pea protein performs similarly to whey protein for building muscle mass.

Pea Milk Cons: 

• May contain added sugars or sweeteners. Opt for unsweetened versions.

Dairy vs Non-Dairy Milk: Nutrition Comparison

Milk (8oz)	Calories	Protein	Carbs	Fat	Calcium	Vitamin D
Whole Milk	149 cal	8g	12g	8g	276 mg	124 IU
Almond Milk	40 cal	1g	3g	3g	482 mg	107 IU
Oat Milk	40-90 cal	0-3g	6-14g	1-5g	350 mg	160 IU
Coconut Milk	40-50 cal	0g	1-2g	4-5g	varies	varies
Soy Milk	80 cal	8g	4g	4g	300 mg	120 IU
Rice Milk	70 cal	0g	11g	2g	283 mg	101 IU
Pea Milk	80 cal	8g	0g	4g	440 mg	200 IU

The Bottom Line

Dairy-free diets may not be necessary for everyone with PCOS. 

Milk and dairy may be helpful in reducing insulin resistance, type 2 diabetes risk, and inflammation. Full-fat dairy products may improve fertility and live birth rates. A definite downside though is that dairy intake, especially skim milk, is associated with worsened acne. 

High-fat dairy may have more benefits than low fat dairy products. Fermented dairy products appear to have even more health benefits than traditional milk.

If you choose to opt for dairy-free milks or milk products in your diet, there isn’t one single best option. There are many options that are good for PCOS depending on your goals. Some examples are almond milk, pea milk, soy milk, or oat milk. 

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Disclaimer: This is for informational purposes only. It is not intended to substitute for or replace medical advice for the management of polycystic ovary syndrome (PCOS). Always discuss your individualized needs with your registered dietitian or healthcare provider.