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PCOS and Insulin Resistance: What’s the Link?

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Polycystic ovary syndrome (PCOS). While it might sound like a condition exclusive to the ovaries and the menstrual cycle, it’s actually a full-body endocrine and metabolic disorder, and insulin resistance is a hallmark of PCOS.

Yep, as many as 30 to 40% of women with PCOS also have insulin resistance. That translates as women with PCOS are at an increased risk of prediabetes and type 2 diabetes. But… just how are these two conditions interlinked!? *insert confused Jackie Chan meme here*

Let’s find out!

What is PCOS?

Affecting nearly 1 in 10 women, PCOS is an endocrine condition caused by an imbalance of reproductive hormones. In women with PCOS, the ovaries produce excess levels of androgens, such as testosterone, which can affect ovulation, making it difficult for the body to release eggs for fertilization. As a result, the most recognizable symptom of PCOS is absent or irregular periods.

The high levels of androgens can also cause other PCOS symptoms, such as:

  • Excessive facial and body hair growth
  • Male pattern hair loss
  • Acne breakouts

Although the causes of PCOS are not fully understood yet, there are certain factors that can increase your chances of developing PCOS. These risk factors are as follows:

  • A family history of PCOS
  • Eating junk and following an unhealthy diet
  • Leading a sedentary lifestyle (or, in better words, rotting away on your office chair)

What Is Insulin Resistance?

Insulin is an hormone produced by the pancreases that helps bring glucose (sugar) from the blood into the cells. The cells then use the glucose for energy to power your body’s functions.

Now, how does insulin resistance happen? Insulin resistance happens when your body can’t use the insulin it produces as efficiently or as quickly as it should. As a result, your blood sugar level rises, and you end up with low energy. Do you know how your body responds to this situation? By producing more insulin (hyperinsulinemia) because “WHY ARE THE GLUCOSE NOT CONVERTED TO ENERGY YET!? MAYBE I’M NOT PRODUCING ENOUGH INSULIN!”

With constant high blood sugar levels, you end up with diabetes.

What’s the connection between PCOS and insulin resistance?

As of now, even though we know there’s a connection between the two conditions, the cause of the relationship isn’t completely clear.

Even though PCOS is recognized as a risk factor for diabetes, it’s believed that insulin resistance may play a role in causing PCOS in the first place as well as worsening its symptoms. Research suggests that insulin resistance linked to obesity alter the functioning of the hypothalamus and the pituitary gland in the brain. This alteration leads to an increased level of androgens, playing a role in the development of PCOS.

Increased levels of androgen hormones pose a risk to fertility and ovary function, with or without PCOS. Furthermore, insulin resistance too can increase the risk of miscarriage, with or without PCOS, due to inadequate nutrition or support for the developing embryo.

Symptoms of Insulin Resistance PCOS

Symptoms of insulin resistance is same in women who have PCOS and those who don’t. However, it’s important for you to be aware of these symptoms for early intervention and effective management. The insulin resistance PCOS symptoms include:

  • Dark pigmentation or thickening of skin in the folds of the skin around the neck, armpits, and groin.
  • Craving and increased hunger, which can contribute to overeating.
  • Weight gain and difficulty losing weight.

Treating Insulin Resistance PCOS

Although PCOS cannot be cured, it can be effectively managed, and treating insulin resistance can help improve PCOS symptoms and prevent diabetes. Here’s how insulin resistance and PCOS can be effectively managed and treated:

  • Eating a healthy diet: Aim for a balanced diet rich in whole grains, lean proteins, fruits, and vegetables. Avoid eating excessive amounts of carbohydrates and unhealthy fat, sugar, and red meats.
  • Weight management: If you are overweight, even a modest weight loss of 10 to 15% can significantly improve insulin resistance. A recent study revealed that even a weight loss of 7% can reduce the onset of type 2 diabetes by whooping 58%!
  • Physical activity: Lack of physical activity causes insulin resistance, and regular physical activity increases insulin sensitivity. Moreover, lack of physical activity also helps you put on some weight, which isn’t exactly good news as we’ve seen before.
  • Medications: In some cases, medication may be necessary to improve insulin sensitivity. Common options include metformin, which helps lower blood sugar levels and improve insulin function.

If you experience irregular periods or have trouble getting pregnant, or even have excess acne or facial hair, see your ob-gyn and get tested for PCOS. If the results turn out positive, consult your ob-gyn about getting tested for diabetes. Making healthy changes such as losing a few kilos, working up a sweat every now and then, and eating healthy can lower your risk of diabetes and prevent or delay the onset of other health problems. See you in another blog!


Can you fix PCOS insulin resistance?

While you cannot completely “fix” PCOS or insulin resistance, you can effectively manage and improve these conditions through lifestyle changes and, in some cases, medications. Managing PCOS often involves addressing insulin resistance since they are closely linked. Lifestyle modifications like maintaining a balanced diet, regular exercise, and weight management can help improve insulin sensitivity and reduce the symptoms of PCOS.

Is fasting good for PCOS?

It’s essential to approach fasting, where you restrict eating to specific time periods, with caution, especially if you have PCOS. Fasting can affect blood sugar levels and hormone regulation, which may impact PCOS symptoms. Before attempting any fasting regimen, consult with a healthcare provider or registered dietitian who can offer guidance tailored to your specific needs and health goals.

What foods should I avoid with PCOS?

In managing PCOS and insulin resistance, it’s important to avoid or limit foods that can exacerbate insulin resistance and hormonal imbalances. These include:

  • Fried foods
  • Red meats
  • Saturated fats
  • Highly processed foods
  • Alcohol

What comes first, PCOS or insulin resistance?

The relationship between PCOS and insulin resistance can vary among individuals. It’s not always clear which condition comes first, as they often develop simultaneously or intensify each other. Some women with PCOS may have underlying insulin resistance, while for others, insulin resistance may develop as a result of hormonal imbalances associated with PCOS.

Can I get pregnant with insulin resistant PCOS?

Yes, it is possible to get pregnant if you have insulin resistant PCOS. While insulin resistance and hormonal imbalances can affect fertility, many women with PCOS do conceive and have healthy pregnancies. If you’re trying to conceive and have PCOS, it’s advisable to consult a healthcare provider or fertility specialist who can provide guidance and personalized insulin resistance PCOS treatment options to support your fertility goals.

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