The Link Between PCOS And Insulin Resistance: Know How To Improve Insulin Sensitivity

With PCOS, many small sacs of fluid form along the ovary's outer edge. Early detection and treatment, as well as weight loss, may reduce the risk of long-term issues like type 2 diabetes.

(Representational Image)

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New Delhi: 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."

Additionally, Dr. Shweta Wazir, who is an Obstetrician and Gynecologist, at Motherhood Hospital said, "When insulin resistance occurs, the body produces more insulin to try to lower blood sugar, but this can negatively affect other hormones and organs. In particular, high insulin levels can stimulate the ovaries to produce more androgens (male hormones), which can disrupt ovulation and cause PCOS symptoms."

"Improving insulin sensitivity can help manage PCOS and prevent or delay diabetes.", she further added and suggested some ways to improve insulin sensitivity:

Ways To Improve Insulin Sensitivity:

• Losing weight if overweight or obese
• Eating a balanced diet that is low in refined carbohydrates and high in fibre, 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 haemoglobin 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.