Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder among women of reproductive age. It is estimated that between 7 to 10 percent of American women of childbearing age are affected by PCOS. The exact cause of PCOS is unknown, but researchers have found a link between PCOS and insulin resistance. In this blog post, we will explore what PCOS is, how it is related to insulin resistance, and what you can do to manage your symptoms.
What is Polycystic Ovary Syndrome?
Polycystic Ovary Syndrome is an endocrine condition in which a woman’s hormones are not balanced properly. In a healthy woman, her ovaries and adrenal glands (located on top of each kidney) produce a small amount of male sex hormones (androgens). A small amount of androgens are required for ovarian follicular development and the proper functioning of the reproductive system. However, in women with PCOS, the body produces too many androgens.
Excess androgen production can cause women with PCOS to have irregular periods or no periods at all. They may also experience other symptoms such as acne, excessive hair growth, and weight gain. The additional hormones can impact the ovarian follicles (which produce estrogen and progesterone during ovulation). This may cause the ovaries to develop small cysts, hence the name "polycystic."
Women with PCOS are frequently insulin resistant. Insulin resistance means that the body can produce insulin, but the insulin does not work effectively. As a result, glucose is not able to be pulled into the cell and used as fuel. When insulin resistance is not treated, it can progress to weight gain, pre-diabetes, and eventually type 2 diabetes.
In order for an endocrinologist to diagnose PCOS two of the following criterion must be met: irregular ovulation, increased androgen (sex hormone) levels, or multiple cysts on the ovaries.
How is PCOS Related to Insulin Resistance?
Insulin resistance is a metabolic feature that commonly occurs with PCOS. Approximately 35 to 80% of women with PCOS have insulin resistance. It should be noted that in PCOS, insulin resistance occurs independently from body mass index or fat distribution. This means that both lean and overweight women with PCOS may experience chronically elevated and ineffective insulin levels.
Insulin is a hormone that helps your body regulate blood sugar levels. When your body becomes resistant to insulin, it can't use it effectively, which can lead to high blood sugar levels and metabolic conditions like pre-diabetes and type 2 diabetes.
When your body becomes resistant to insulin, your pancreas produces more insulin to compensate. This can lead to high levels of insulin in the blood, which can stimulate the ovaries to produce more androgens. These high levels of androgens can disrupt the menstrual cycle and lead to other symptoms associated with PCOS.
In addition, insulin resistance can cause weight gain and make it harder for your body to lose weight. This can exacerbate PCOS symptoms, as excess weight can cause the body to produce even more androgens.
Managing PCOS and Insulin Resistance
If you have been diagnosed with PCOS, working with your healthcare provider to manage your symptoms is important. Here are some strategies that may help:
Stabilize Blood Sugar
A healthy diet can help to regulate blood sugar levels and improve insulin sensitivity. Reducing sugar intake and increasing our consumption of soluble fiber help to keep our blood sugar stable and not make our insulin work as hard. Focus on eating a variety of whole, nutrient-dense foods, including fruits, vegetables, lean proteins, and healthy fats. Limit your intake of processed and sugary foods, which can contribute to inflammation and other metabolic problems.
Regular exercise can help to improve insulin sensitivity and reduce inflammation. Aim to get at least 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity exercise each week. Moderate intensity involves increasing your heart rate to a point where you are able to talk, but not sing, the words to your favorite song. Jogging, cycling, swimming, interval workouts, or a strength-training circuit are all great options.
Chronic stress can contribute to insulin resistance and other metabolic conditions. Stress causes the release of hormones like cortisol and adrenaline. While these stress hormones effectively provide the energy for us to produce a ‘fight or flight’ response, they also increase insulin resistance. Find healthy ways to manage stress, such as meditation, yoga, or deep breathing exercises.
Talk to your Physician
Depending upon the severity of PCOS and whether or not you are trying to conceive, your healthcare provider may suggest medication. Metformin may be prescribed to help regulate blood sugar. Birth control may be suggested to regulate menstrual cycles or reduce the amount of monthly blood loss for women with a heavy flow. Spironolactone may be recommended to reduce facial hirsutism (excess hair growth in a male-like pattern). Talk to your healthcare provider about whether medication is right for you.
Take Away Message
PCOS is a common hormonal condition that frequently impacts women of reproductive age. Symptoms of PCOS include irregular periods (or no periods at all), increased androgen levels, or multiple cysts on the ovaries. These can result in acne, excessive hair growth, weight gain, or insulin resistance.
Managing insulin resistance can be an important part of managing PCOS symptoms. By following a healthy diet, exercising regularly, managing stress, and consulting your healthcare provider, you can improve your insulin sensitivity and reduce your risk of complications associated with PCOS.
Author: Dr. Colleen Gulick