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Writer's pictureDr. Adrian & Dr. Giulia

Polycystic Ovary Syndrome (PCOS):

How your insulin levels can damage your ovaries





PCOS is a syndrome that hits about 27% of women in their fertile age. However, percentages are actually higher due to the fact most PCOS can go undetected.

This syndrome prevents women to get pregnant.



As you may be already aware, hormones regulate many physiological functions taking place in our body. Specifically, menses in women are regulated tightly by hormonal control via and thanks to hypothalamus-hypophysis-ovary axis.



FSH, estrogen, LH and progesterone levels varies throughout the stages of menstrual cycles.

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) control ovulation. FSH stimulates the ovary to produce a follicle — a sac that contains an egg — and then LH triggers the ovary to release a mature egg.This mature egg then will be waiting to be fertilised and if does not occur menstruation takes place.



In women affected by PCOS this hormonal fluxes do not take place. The eggs never mature enough to trigger ovulation.

The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Estrogen and progesterone levels are lower than usual, while androgen (male hormones) levels are higher than usual.

Extra male hormones disrupt the menstrual cycle, so women with PCOS get fewer periods than usual.



Male hormones in PCOS are also responsible for: excess hair growth, acne, male-pattern-baldness.



How to diagnose it: since it is regarded as a syndrome it is usually characterised by cysts, irregular or skipped menses and high levels of hormones.

However, it can happen that this syndrome does not give any signs or symptoms and thus goes undiagnosed.



How is insulin connected to PCOS?


PCOS is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia.

Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, thus destroying physiological hormonal regulation.



Insulin acts by stimulating both hypothalamus and the hypothalamus-hypophysis-adrenal axes to increase the release of androgens.



You probably heard insulin resistance causes the cells in your body to become insensitive (not responding) to insulin anymore. This is true for most tissues apart form ovaries; ovaries remain sensitive to insulin and thus increase androgen production.



According to research, menstrual irregularities and anovulation appear to be more prevalent and severe in obese women with PCOS than in their nonobese counterparts. Weight loss, of at least 5%, tends to be associated with improvement of these conditions.


Given the development of insulin resistance, PCOS can increase the risk of developing dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease.



What to do then?


We must act by decreasing insulin. The first thing is changing your diets and number of meals.



2 meals a day are suggested to reduce the insulin spike which determine insulin resistance.

Moreover, you must cut all fonts of refined sugars and carbohydrates.

Shift more to a ketogenic like diet. In fact, fatty meals avoid insulin spikes as opposed to other diets.



Start physical activity. It is important to burn your adipose storage, not only to loose weight but also to decrease leptin resistance. Leptin resistance is favoured and favours further insulin resistance.



Let us know about you:

How do you manage PCOS and insulin ?






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