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PCOS and Insulin Resistance: What is the Relationship?

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The correlation between polycystic ovarian syndrome (PCOS) and Insulin resistance (IR) isn’t universal. However, PCOS patients having IR is high, isn’t a standard for every woman. Reports suggest that around 30-40% of PCOS patients develop insulin resistance often left undiagnosed.

High insulin (paired with a metabolic disorder like PCOS) is an underlying physiological driver. Most gynecologists and fertility specialists working with PCOS patients often opt for insulin level testing as the first resort to rule out any negative implications.

PCOS is primarily a condition related to the ovaries; however, its implications affect the entire body, leading to metabolic dysfunction, endocrine abnormalities, and so much more.

If you are confused about the connection between PCOS and Insulin resistance, this article is here to clarify all your queries.

Also Read: PCOS in Lean and Obese Females: Nutritional Strategies to Treat Polycystic Ovarian Syndrome in Women

Insulin Resistance – Definition

The typical insulin level in the body during fasting is < 25 mIU/L. This can then increase to 30-230 mIU/L 30 minutes after glucose administration.

Insulin levels rise after eating because it stimulates the liver and the muscles to work in overdrive and take up the excess glucose from the bloodstream. This absorbed glucose undergoes different physiological processes to break down the glucose into energy in the form of ATP.

Normal insulin sensitivity regulates and manages the blood glucose and blood insulin levels in proportion. That doesn’t happen when a patient has insulin resistance.

Although their blood glucose levels are normal in patients with insulin resistance, their insulin levels are high. This happens due to overworking of the pancreas, leading to low-grade inflammation, weight gain, and many other physiological abnormalities in the body.

Also Read: OZiva HerBalance for PCOS: What Does the Research Say, Is It Good or Bad, Side Effects and More

What is the Connection Between PCOS and Insulin Resistance?

Although the average blood sugar levels for PCOS should be standard in a healthy human, studies suggest PCOS as a possible risk factor for diabetes. There are chances that the prevalence of IR in the body could lead to PCOS development in women.

Most of the patients think that PCOS is the contributing factor to IR, but 9 out of 10 times, it is the other way around. The chronic heightened insulin levels in the body are related to persistent signs of inflammation and other metabolic disorders.

However, despite all these connections, remember that just because one has insulin resistance doesn’t mean that one will have PCOS and vice-versa. It is a subjective condition and will depend on the individual’s physiological functions.

Since obesity is a crucial marker in insulin resistance, studies have found a direct link between obesity, insulin resistance, and PCOS. Obese patients with PCOS tend to have unregulated hypothalamus and pituitary gland functions, which lead to excess androgen production and hence cause PCOS.

Also, the production of high insulin levels is correlated to anovulation. This results in excess androgen production in the system, leading to PCOS.

The combination of PCOS with IR has irreparable impacts on a woman’s fertility. The combination of the drastic hormonal imbalance in the body due to PCOS and IR leads to implantation issues. It can even lead to ectopic pregnancies and miscarriages due to obstructed fetal nutrition supply.

Also Read: Bilateral Polycystic Ovaries: What Does It Mean in Ultrasound Abdomen Scan Report for PCOS

How can One Test for Insulin Resistance?

Despite having PCOS or not, testing for insulin resistance is essential. However, if you are medically diagnosed with PCOS, testing for IR is not just an option but a necessity. The quicker the diagnosis, the better the treatment for PCOS and IR.

Some of the common ways a patient can test for Insulin resistance include:

Type of TestPurpose
Fasting blood glucose testThis is done early in the morning after your night of sleep to check the blood sugar levels during the fasting period. If the levels are higher than usual (99 mg/dL or lower), the doctor advises the following tests.
Glucose Tolerance TestInitial fasting blood sugar levels are monitored. The patient is then given a sugary drink to finish. Once done, the blood sugar level is checked at designated intervals to check the efficiency of the cells to process the consumed sugar. Prolonged high glucose levels in the bloodstream indicate higher fasting insulin levels with PCOS.
Glycosylated Hemoglobin A1CMeasures the average blood glucose levels over the past three months. Levels between 4-6% are considered normal.

How Will I know if I have Insulin Resistance?

If you are diagnosed with PCOS, your doctor will inadvertently prescribe a test for checking insulin levels. This is a combined diagnosis approach.

However, if you aren’t diagnosed with PCOS or Insulin resistance, there are some indicative symptoms you must keep an eye on. Keep in mind that if you are prediabetic or have diabetes in your family history, it is ideal for getting checked for insulin resistance beforehand.

Some of the common symptoms of insulin resistance include:

  • Feeling parched
  • Not feeling satiated, or feeling hungry quickly after a meal
  • Frequent urination
  • Tingling sensations in the extremities like feet, fingers, etc.
  • Lethargy or fatigue
  • Heightened risks of infections that take time to heal
  • High blood glucose levels

If you are experiencing any of these signs or symptoms, it is best to seek medical advice. Besides these physiological symptoms, skin conditions like acanthosis nigricans are also prevalent signs of insulin resistance.

Also Read: Ashokarishta for PCOS: What Does the Research Say, Benefits and Side Effects

Insulin Resistance and PCOS – Treatment with Nutritional Supplements

Like PCOS, even IR heavily depends on a person’s diet and lifestyle. Most specialists treating these conditions advise introducing substantial changes to one’s diet and lifestyle as the first line of treatment.

However, when it comes to nutritional supplementation for the treatment of PCOS and IR, two options stand out.

Inositol

Inositol is a carbocyclic sugar that plays a crucial role in insulin signaling. It acts as an intracellular messenger and can be taken as a  supplement for handling signs of insulin resistance. Studies have found promising impacts of this supplement in regulating menstrual cycles, improving ovulation, and eliminating the symptoms and consequences of PCOS.

Magnesium

Another nutritional supplement that has promising benefits in treating IR is magnesium. Magnesium deficiency is connected to the clinical diagnosis of IR. So, supplementing with the right amount has been found fruitful in treating IR and also the associated implications on PCOS patients.

FAQs

Conclusion

The connection between PCOS and IR is a lot common, the prevalence increasing with other trigger factors like obesity, poor diet, etc. Indeed, the ideal “cure” for insulin resistance and PCOS is still in the making. However, introducing lifestyle changes, following a nutritious and balanced diet, leading an active lifestyle, and following doctor’s advice can alleviate a lot of these complications.

If you are experiencing issues, don’t take things for granted. Seek medical advice before things take a turn for the worse.

References:

1- Overview | NIH 

2- What is the Connection Between PCOS and Insulin Resistance? |Journals.LWW

3- What is the Connection Between PCOS and Insulin Resistance? | Eureka Select

This content has been reviewed by Srujana Mohanty who is working in scientific & medical writing and editing since 2018. She is also associated with the quality assurance team of scientific journal editing.

Somapika Dutta (B.Sc Physiology, Honours)
Somapikar holds Bachelors Degree in Physiology from University of Culcutta. She has 6+ years of experience writing in different niches, including health, tech and lifestyle. An animal enthusiast and a raging foodie, experiencing life - one day at a time.

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