It is estimated that between 5-10% of women in North America have polycystic ovarian syndrome (PCOS). The name PCOS gives the impression that this syndrome results from an issue in the ovaries. However, PCOS is actually a metabolic condition associated with insulin resistance, hormonal imbalance and inflammation.
Current research suggests that insulin resistance is the root cause of up to 70% of all cases of PCOS(1). Why these women are prone to insulin resistance is unknown but it is likely related to a genetic predisposition leading to abnormalities in the cellular action of insulin and its receptor(2).
The insulin resistance these women experience is directly related to the symptoms of hyperandrogenism that women with PCOS struggle with. These include symptoms such as; hair loss, hair growth where it is definitely not wanted, acne, and long menstrual cycles. When insulin levels are abnormally high they cause the theca cells within the ovary to overproduce male hormones, known as androgens, leading to the above signs and symptoms.
So if you are a woman with PCOS, what do you do with this information?
1. Check your insulin status.
The best test is the insulin-glucose challenge test. The second best option is fasting insulin and fasting glucose measured at the same time.
2. Modify your diet.
The first-line treatment for all women with PCOS driven by insulin resistance is dietary modification. Reduce foods that drive insulin and blood sugar to the greatest amounts. These include sugary sweets, white bread, pasta, rice, and dairy. Move towards a plant-based diet and try to get protein from plant sources instead of animal sources(3).
3. Exercise.
When our muscles are active we are able to move blood sugar into our cells without the need for insulin. This leads to improved insulin resistance in addition to all of the wonderful things we know exercise does for our mental and cardiovascular health. If exercise is new to you, start simple with 20 minutes of cardio or HITT three times a week and work your way up.
4. Supplement with Myo-inositol.
This naturally occurring compound is my first-line treatment for women with insulin resistant PCOS. It has been consistently found in research to increase insulin sensitivity, reduce androgen levels and improve ovulation rates(4). Myo-inositol has also been found to improve egg quality, fertilization rates and embryo quality in women with PCOS who are going through IVF(5).
References
(1) https://www.ncbi.nlm.nih.gov/pubmed/27510482
(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277302/
(3) https://www.nature.com/articles/s41387-018-0067-4?WT.ec_id=NUTD-201811&sap-outbound-id=87BDE7AD182649D76973C87EFDC09B2E4BAA45E3
(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655679/
(5) https://www.ncbi.nlm.nih.gov/pubmed/27635136