Understanding Insulin Resistance and PCOS

Introduction to PCOS and Insulin Resistance

Polycystic ovary syndrome (PCOS) is a hormonal disorder affecting many women. It’s difficult to know precisely how many women have it. PCOS affects an estimated 8–13% of reproductive-aged women.

PCOS can lead to a range of symptoms caused by hormonal imbalances affecting the ovaries, which are the tiny organs that store eggs. These symptoms include irregular periods, excessive hair growth, acne, and weight gain. PCOS is often linked to insulin resistance. Understanding the connection between insulin resistance and PCOS is crucial for effective self-care and managing the condition.

Overview of PCOS

The precise cause of PCOS is unknown, although it is associated with hormonal imbalances, mainly androgen levels along with insulin. The condition is known to be hereditary, often passing from one generation to another in a family.

In PCOS, high androgen is the main reason for disrupted ovulation. Androgens are commonly referred to as male hormones. They are in lesser amounts even in women, but with high levels of androgens in women with PCOS, it affects the menstrual cycle and leads to insulin resistance. The three main features of PCOS are irregular periods, high levels of androgens in your body, and the presence of cysts on the ovaries.

What Is Insulin Resistance?

Insulin resistance means your body doesn’t correctly process insulin. This resistance leads to high glucose levels in your blood. It typically occurs when the cells in your muscles, fat, and liver do not respond effectively to insulin, making it difficult for them to absorb glucose from your blood. As a result, your pancreas produces more insulin to help the entry of glucose into your cells. This process will continue if your pancreas can generate enough insulin to compensate for the diminished response. 

How Insulin Resistance Relates to PCOS

PCOS doesn’t just affect the ovaries and ovulation; it’s a whole-body hormonal and metabolic disorder connected to insulin resistance. People with PCOS often have insulin resistance, so when their bodies make insulin, an essential hormone in balancing blood sugar, they can’t use it. Increasing insulin levels cause the ovaries to release male hormones or androgens, suppressing ovulation. Insulin resistance can lead to diabetes, and it is closely tied to PCOS. Being overweight or obese also increases the amount of insulin your body produces and makes PCOS symptoms worse.

Understanding Insulin Resistance in the Body

Under normal conditions, insulin levels increase briefly after eating. This rise in insulin stimulates the liver and muscles to take up sugar from the blood and convert it to energy. That makes blood sugar and insulin fall. However, this process in the body is altered in insulin resistance.

What Happens During Insulin Resistance?

In insulin resistance, blood sugar may be at expected levels, but insulin is high because the pancreas has to make more insulin for the body to respond. Chronic insulin resistance causes damage and inflammation. Too much insulin in the bloodstream causes weight gain, PCOS, type 2 diabetes, and heart disease.

Causes of Insulin Resistance

Researchers don’t fully understand what causes insulin resistance. However, certain inherited genetic disorders you’re born with can cause the condition for various reasons. These are rare but include type A insulin resistance syndrome and Donohue syndrome.

Acquired causes of insulin resistance include excess body fat, physical inactivity, poor food choices, and certain medications. Obesity, especially visceral fat around the belly, significantly raises the risk. A sedentary lifestyle and a diet high in processed foods and saturated fats also contribute. Additionally, medications like steroids and some blood pressure drugs can be linked to insulin resistance.

Hormonal disorders such as Cushing’s syndrome, which involves excessive cortisol, and hypothyroidism, which slows metabolism, can further impair insulin effectiveness.

How Insulin Resistance Impacts Hormones

Insulin resistance can also impact other hormones in your body, including:  

• Sex hormones: It can disrupt testosterone and estrogen production, leading to conditions like PCOS in women.  
• Stress hormones: Increased cortisol levels from chronic stress can further contribute to insulin resistance while disrupting adrenal hormones, causing fatigue, weight gain, and mood changes.  
• Thyroid hormones: Low thyroid hormone levels can slow metabolism, contributing to weight gain and insulin resistance.  
• Growth hormone: Reduced growth hormone can impair the body’s repair processes, which may further lead to insulin resistance.   

Link Between Insulin Resistance and PCOS Symptoms

When the body becomes resistant to insulin, it can lead to several metabolic issues, such as polycystic ovaries, insulin resistance, and other hormonal imbalances. 

Common Symptoms of Insulin Resistance in PCOS

Here are some common insulin resistance symptoms in PCOS:  

• irregular or light period or no periods at all
• difficulty getting pregnant
• excessive hair growth (hirsutism)
• weight gain
• thinning hair and hair loss from the head
• oily skin or acne
• difficulty losing weight

How Insulin Resistance Affects Ovulation and Fertility

Healthy insulin levels are vital for ovarian health, but insulin resistance negatively impacts fertility. It can:

• Interfere with ovulation: Excess androgens disrupt egg maturation and release, causing irregular or absent menstrual cycles.
• Contribute to polycystic ovaries: Insulin resistance can lead to cyst development.
• Increase the risk of metabolic disorders: It’s linked to conditions like type 2 diabetes, high blood pressure, and high cholesterol, complicating reproductive health.
• Reduce egg quality: High insulin levels can accelerate egg aging, diminishing its quality and viability.

Role of Insulin Resistance in Weight Gain and Difficulty Losing Weight

Insulin resistance plays a significant role in weight gain and difficulty losing weight. Insulin causes fat storage, and when the body becomes resistant, it produces more to compensate, causing more fat storage and weight gain. Insulin resistance also interferes with the body’s natural ability to regulate blood sugar, making it more difficult to lose pounds.

In addition, insulin resistance will lead to elevated cortisol production. This hormone promotes belly fat storage, worsening weight gain and making it more challenging to shed pounds. Addressing insulin resistance through lifestyle changes and diet can help alleviate weight-related issues.

Diagnosing Insulin Resistance in Women with PCOS

PCOS diagnosis involves a combination of physical exams, blood tests, and sometimes ultrasound scans. Doctors also consider whether there is a history of irregular periods and ovulation, polycystic ovaries may run in the family, or a family history of PCOS or type 2 diabetes when making a diagnosis. However, 70% of PCOS cases are undiagnosed. 

Key Tests and Indicators

Blood tests are essential for evaluating PCOS. The Glucose Tolerance Test (GTT) measures how effectively the body processes glucose. A hormone panel is also conducted to assess levels of hormones such as testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Additionally, an ultrasound may be performed to assess the ovaries’ structure and rule out any other underlying conditions.

Consider using the Mira app to track your period, symptoms, and hormonal patterns related to insulin resistance. This app helps women understand their reproductive health by monitoring hormone levels.

The Mira Panorama Fertility Lab Test offers a comprehensive overview of reproductive health. It tests five hormones that affect ovulation and fertility and provides personalized reports with actionable steps. Women can make informed fertility decisions by understanding insulin resistance’s impact on reproductive health.

At the Mira Hormone Health Clinic for Fertility, one-on-one management services are available for all stages of women’s reproductive lives. Coaches develop integrative, actionable plans based on hormone levels, offering tailored advice on lifestyle changes, medication, and fertility treatments for those with PCOS and insulin resistance.

Blood Sugar Levels and A1C

An A1C test is a blood test that reflects the average amount of sugar in your blood over the past three months. Doctors use it to diagnose diabetes and monitor blood sugar levels. This test is helpful in PCOS, as women with PCOS are at a higher risk for diabetes and would typically have high insulin and high blood sugar.

Importance of Early Diagnosis

PCOS is associated with reproductive issues and increased risks for metabolic and cardiovascular problems, primarily linked to insulin resistance, even in non-obese women. Finding PCOS earlier makes it possible for affected women to make necessary lifestyle changes and seek medical aid that improves hormonal balance and reduces long-term health risks.  

Managing Insulin Resistance Through Lifestyle Changes

Improving insulin sensitivity can help manage conditions like PCOS. Diet recommendations and lifestyle changes can make a difference. Talk to your doctor about what you can do to best manage it.

Dietary Changes and Nutritional Recommendations

A diet focused on reducing refined carbohydrates and sugars can help regulate blood sugar levels. It can significantly improve insulin sensitivity. Here are some fundamental dietary changes:

• Opt for foods slowly releasing glucose, such as whole grains, legumes, and non-starchy vegetables.
• Incorporate lean protein sources like chicken, fish, beans, and tofu to help stabilize blood sugar levels.
• To support hormonal balance, include sources of healthy fats, such as avocados, nuts, and olive oil.
• Limit processed foods and sugary drinks that can spike blood sugar levels and contribute to insulin resistance.
• Fiber-rich foods slow down digestion and help regulate blood sugar levels. Good sources include fruits, vegetables, and whole grains.

While dietary changes are essential, some women may benefit from specific supplements to support hormonal balance and insulin sensitivity. Here are some examples of PCOS supplements:

• Myo-inositol: This supplement can improve insulin sensitivity and regulate menstrual cycles.
• Vitamin D: Vitamin D deficiency is common in individuals with PCOS, so adequate vitamin D levels can help regulate hormones.
• Omega-3 Fatty Acids: These fatty acids can reduce inflammation and improve insulin sensitivity.
• Mira Fertility Tea: Mira’s fertility tea is made with high-quality, selected ingredients to naturally support your fertility wellness and help balance your hormones and cycle.

Exercise Tips for Insulin Sensitivity

Physical activity can enhance insulin sensitivity, manage insulin resistance, and promote weight loss. It helps your body become more sensitive to insulin by decreasing the amount of insulin you need to signal cells to lower blood sugar. Here are some practical exercise tips:

• Cardiovascular Exercise: Engage in activities like brisk walking, jogging, swimming, or cycling for at least 30 minutes most days of the week.
• Strength Training: Incorporate resistance training exercises to build muscle mass, which can improve insulin sensitivity.
• High-Intensity Interval Training (HIIT): Short bursts of intense exercise followed by rest periods can boost metabolism and insulin sensitivity.
• Moderate exercises: Exercises such as walking, jogging, pilates, and yoga can improve the function of insulin within the body

Importance of Sleep and Stress Management

Adequate sleep and stress management are crucial for health and hormonal balance. Aim for 7-8 hours of quality sleep and practice relaxation techniques like meditation or deep breathing to reduce stress.

A meditation playlist can be a valuable tool for stress reduction and help with PCOS self-care. Here are some popular meditation techniques:

• Guided Meditation: A guided meditation app or video can help you focus your mind and relax your body.
• Mindfulness Meditation: This practice involves paying attention to the present moment without judgment.
• Mira’s Fertility Meditation Playlist: Combines mantras, visualizations, breathing techniques, and yoga to enhance fertility and reduce stress.

Medical Treatments for Insulin Resistance in PCOS

There is no cure for PCOS, but treatments can improve symptoms. PCOS treatments may include lifestyle modifications and stress management. Medication may sometimes be necessary to regulate hormones and improve insulin sensitivity.

Metformin and Other Medications

Clomiphene Citrate is often the first treatment for women with PCOS trying to conceive, as it stimulates ovulation. If ineffective, metformin may be introduced to enhance menstrual cycles and reduce androgen levels. They can be used together. 

Alternative options include Letrozole, which also stimulates ovulation, and anti-androgen medications like birth control pills or spironolactone for managing symptoms such as hirsutism and acne. 

Weight-loss medications like Orlistat and cholesterol-lowering statins may be necessary if applicable. In some cases, IVF can be used to address ovulation issues by fertilizing eggs outside the womb before placing them back in.

Benefits and Side Effects

Metformin offers several advantages over first-line treatments like clomiphene. It can be used alone or in combination with clomiphene for those resistant to the latter. However, discussing potential side effects with your doctor is important, as Metformin may cause nausea, vomiting, stomach pain, diarrhea, and loss of appetite. If you use Metformin to manage insulin resistance, PCOS, or metabolic syndrome and aren’t actively trying to conceive, ensure you use appropriate contraception.

Working with Your Healthcare Provider

Although medications can effectively manage PCOS and insulin resistance, they should be combined with lifestyle modifications for optimal results. Working closely with your doctor to determine the best treatment plan for your needs is essential. They will consider age, weight, and specific symptoms to recommend the most appropriate treatment.

Frequently Asked Questions