Polycystic ovarian syndrome (PCOS) is a hormonal imbalance that occurs during the reproductive years, resulting in irregular periods. With PCOS, many small sacs of fluid form along the ovary's outer edge. Although the actual cause of PCOS is uncertain, it can result in infertility, acne, excess hair growth, ovarian cysts, and at times a higher risk of diabetes because of associated insulin resistance.
Early detection and treatment, as well as weight loss, may
reduce the risk of long-term consequences like type 2 diabetes and heart
disease.
Polycystic ovarian syndrome (PCOS) is a hormonal imbalance
that occurs during the reproductive years, resulting in irregular periods. With
PCOS, many small sacs of fluid form along the ovary's outer edge. Although the
actual cause of PCOS is uncertain, it can result in infertility, acne,
excess hair growth, ovarian cysts, and at times a higher risk of diabetes
because of associated insulin resistance.
Early detection and treatment, as well as weight loss, may
reduce the risk of long-term consequences like type 2 diabetes and heart
disease.
What
Insulin Resistance Is:
One of the common features of PCOS is insulin resistance,
which means that the body is unable to respond to insulin properly.
In this regard, Dr Vidya Pancholia MS, FICOG, FICMCH said,
"Under normal conditions, the hormone insulin rises briefly after eating.
It stimulates the liver and muscles to take up sugar from the blood and convert
it to energy. That then causes blood sugar to fall, and then insulin to
fall."
"With insulin resistance, blood sugar may be normal,
but insulin is high because the pancreas has to make more and more insulin to
try to get its message through. Too much insulin generates inflammation and
causes weight gain and it is an underlying physiological driver of PCOS.",
she further went on to say.
Dr Vinod Kumar, Consultant – Reproductive Medicine, Milann
Fertility & Birthing Hospital, JP Nagar, Bangalore also spoke on similar
lines and shared, "Some research suggests that insulin resistance may
actually cause PCOS, rather than the other way around. Insulin resistance can
also alter the function of the hypothalamus and the pituitary gland in the
brain, resulting in an increase in androgens that cause PCOS."
"Improving insulin sensitivity can help manage PCOS
and prevent or delay diabetes.", she further added and suggested some ways
to improve insulin sensitivity:
Losing weight if overweight or obese
Eating a balanced diet that is low in refined carbohydrates
and high in fiber, protein, healthy fats, and antioxidants
Exercising regularly and incorporating both aerobic and
resistance training
Managing stress and getting enough sleep
By improving insulin sensitivity, women with PCOS can also
improve their hormonal balance, menstrual regularity, fertility, skin health,
and overall well-being. Therefore, it is important to get screened for insulin
resistance if you have PCOS or suspect you might have it. A simple blood test can
measure your fasting blood sugar and insulin levels, as well as your
hemoglobin A1c (HbA1c), which reflects your average blood sugar over the past
three months.
The
relationship between insulin resistance and PCOS:
Insulin resistance is a key feature of both obese and lean
PCOS. It occurs in 70-95% of people with obese PCOS and 30-75% of people with
lean PCOS.
Testing
for insulin resistance:
It is to be done by checking fasting insulin, HOMA-IR
index, or a 2-hour insulin glucose challenge test.
Conventional
treatment of insulin resistance and PCOS:
Conventional treatment recommendations for the insulin resistance aspect of PCOS include weight loss, aerobic exercise, and metformin, which improves insulin sensitivity. Oral contraceptives are the other officially recommended treatment for PCOS, but they can interfere with sugar regulation and insulin resistance that underlies PCOS.
