PCOS and Infertility: Is Insulin the Real Problem?
PCOS is the leading cause of female infertility. While most people have heard of it, many do not completely understand it and therefore do not receive the right treatment options. The two most commonly mentioned phrases by physicians addressing the treatment of PCOS are “you need to lose weight” and “you need to correct your hormone levels.” These are both very vague statements that do not address the questions within us, relating to this, which could potentially lead to recovery from the condition. Are you struggling with infertility related to PCOS? Have you ever wondered whether it is related to your body’s inability to produce enough insulin?
Let me explain how these two leading causes of infertility are directly linked to one another in scientific terms while still keeping the explanation of this very complex medical condition simple enough for everyone to understand.
Understanding PCOS: More Than Just Irregular Periods
An unresolved, complex endocrine & metabolic disorder that affects about 8-13% of women around the world of reproductive age, including various irregularities associated with their menstrual cycles (i.e. ovulation), high levels of male hormones (i.e. testosterone) and the presence of multiple (i.e. polycystic) ovaries. Some of the additional metabolic problems associated with this condition are insulin resistance, obesity and diabetes, among others.
Ultimately PCOS is more than just a “hormonal problem” – it is primarily a combined metabolic (or energy) and hormonal/androgenic (or reproductive) condition
Understanding PCOS: More Than Just Irregular Periods
An unresolved, complex endocrine & metabolic disorder that affects about 8-13% of women around the world of reproductive age, including various irregularities associated with their menstrual cycles (i.e. ovulation), high levels of male hormones (i.e. testosterone) and the presence of multiple (i.e. polycystic) ovaries. Some of the additional metabolic problems associated with this condition are insulin resistance, obesity and diabetes, among others.
Ultimately PCOS is more than just a “hormonal problem” – it is primarily a combined metabolic (or energy) and hormonal/androgenic (or reproductive) condition
The Insulin Connection: What Is Insulin Resistance?
Insulin is the hormone that allows your body to utilize glucose (sugar) as energy. Insulin resistance occurs when:
- Your cells become resistant to insulin; consequently, the body produces excess amounts of insulin (hyperinsulinemia).
- The excessive amounts of insulin have an adverse effect on the body’s blood glucose levels and can also affect your reproductive system.
This is where the relationship between PCOS and infertility begins.
How Insulin Resistance Drives PCOS
Research has found that about 85% of women with polycystic ovarian syndrome (PCOS) will also have some degree of insulin resistance. There are four major effects of insulin resistance on women with PCOS.
1) Increased Androgens
High insulin levels will stimulate the ovaries to create more androgens.
➝ Result:
- Acne
- Hirsutism
- Irregular cycles
2) Disruption in Ovulation
Excess androgens interfere with follicle development.
➝ Result:
- The eggs don’t develop properly
- Ovulation does not occur (anovulation)
3) Poor Egg Quality
Insulin resistance also negatively affects energy metabolism and oxidative stress.
➝ Result:
- Lower egg quality
- Lower chance of fertilization.
4) Endometrial Dysfunction
Insulin resistance also negatively affects the uterine lining.
➝ Result:
- Poor implantation of embryo
- Increase in miscarriage rate.
PCOS and Infertility: The Biological Link
There is no single cause of infertility in women who have polycystic ovary syndrome (PCOS); rather, there are multiple interconnected conditions that cause the problem. The list below outlines some possible reasons for infertility in PCOS:
- Ovulatory Dysfunction
- Hormonal Abnormalities
- Chronic Inflammation
- Metabolic Problems
There is a significant amount of scientific evidence that suggests insulin resistance plays a direct role in causing ovulatory dysfunction, as well as endometrial abnormalities and infertility.
But Is Insulin the ONLY Problem?
This is where we see a complex relationship between multiple factors that can influence both of these conditions.
While insulin resistance has a significant role in PCOS and infertility, there are many other reasons for their occurrence. These include but are not limited to:
– Genetics and epigenetics
– Chronic inflammation
– Imbalance of gut microbiome
– Stress/cortisol dysregulation
– Thyroid dysfunction
– Environmental toxins
In conclusion, since PCOS is considered a multi-faceted disorder, we can see this complex interplay of many different variables has contributed to both these disorders.
The Vicious Cycle: Insulin ↔ Hormones
The following represents an example of how PCOS produces a self-reinforcing cycle:
- Insulin Resistance -> Insulin Levels Rise
- Insulin Levels Rise -> Androgen Levels Rise
- Androgens Rising -> Insulin Resistance Increases
These recurring events make it much more difficult to resolve the problems associated with PCOS without proper medical assistance.
Can You Have PCOS Without Insulin Resistance?
This is Possible, but occurs Less Frequently than others.
There Are Various Different Forms Of Poly-Cystic Ovarian Syndrome (PCOS):
- Most common form of PCOS is due to Insulin Resistance
- Lean PCOS (may have some Insulin Resistance)
- Inflammatory PCOS
- Adrenal PCOS
Even with the Lean form of PCOS, Insulin Resistant Polycystic ovarian syndrome will sometimes show up as Insulin Resistant but may show as Hidden Insulin Resistance.
Why Treating Insulin Can Improve Fertility
Studies indicate that managing insulin resistance can:
- Allow the return of regular ovulation
- Allow for regularity of ovulation
- Allow for improvement of quality of eggs
- Assist in increasing the number of pregnancies achieved
In fact:
Women with insulin resistance will have lower conception rates and respond less well to fertility treatments if their insulin resistance is not treated properly.
Human Side of PCOS: It’s Not Just Biology
PCOS is more than just an issue with lab testing and results. PCOS affects:
– Your self-esteem (acne, body hair)
– Your mental well-being (anxiety, depression)
– Your relationships and opportunities to become pregnant
Many women with PCOS say, “I’m doing everything I’m supposed to be doing (eating healthy, exercising, taking medication), but nothing ever seems to work.” This is due to the fact that if you don’t fix the underlying metabolic dysfunction associated with this disorder, the symptoms will continue to occur over and over again.
How Lifestyle Impacts Insulin & PCOS
Here’s the good news about insulin resistance: it can be improved!
Here are some evidence-based strategies that are effective in modifying your insulin resistance:
- A well-balanced, low-glycemic diet
- Regular aerobic and/or resistance exercise
- Eating enough protein and fiber
- Managing your stress levels
- Optimizing your sleep
By implementing these five strategies, you will improve your insulin sensitivity as well as the outcomes of your reproductive health.
How Institute Nutrition Can Help
Generic recommendations will not help you if you are dealing with infertility and polycystic ovary syndrome (PCOS).
Institute Nutrition is where you can get your specific guidance to help you gain control over your health.
What makes Institute Nutrition unique from other programs?
- Individualized nutrition plans
- Customized around your metabolic profile instead of diet trends
- Addresses the root-cause of health issues
- Insulin levels, inflammation, gut health
- Offers evidence based dietary recommendations for PCOS
- Scientific support
- Offers holistic support to women trying to conceive
- Nutrition + lifestyle + hormonal balance
- Provides methods for sustainable results
- No quick fixes or fad diets
Rather than treating symptoms; INC provides you with the tools to provide correction to the underlying problem of your polycystic ovary syndrome; therefore you can regain control of your life.
Final Verdict: Is Insulin the Real Problem?
Insulin resistance is one of the most important contributors to PCOS and infertility, however it is not the only contributor. The truth is, PCOS is a metabolic/hormonal connected disorder, and insulin is one of those triggers, however getting results that stay, means to address all of the metabolically/hormonally connected systems holistic to this individual.
FAQs
- Will reducing the body’s insulin resistance result in a complete cure for polycystic ovarian syndrome (PCOS)?
PolyCystic Ovary Syndrome (PCOS) isn’t able to be fully cured; however, improvement of the body’s insulin sensitivity can lead to reduction in symptoms and may result in the restoration of ovulation.
- Can I conceive naturally if I have PCOS?
Most women with PCOS can conceive naturally through improving their ovulation with either lifestyle changes or through medical assistance.
- Does everyone with PCOS need to lose weight to improve their fertility?
No. Improving insulin sensitivity can improve fertility…even without weight loss.
- Do I need to take medication for insulin resistance?
Not necessarily. The first-line treatments for insulin resistance would be dietary modifications, physical activity and lifestyle changes. Medications may be used when the aforementioned methods are not effective.
- How long will it take for me to improve my fertility?
Improving one’s ovulatory cycles can, in general, take 3-6 months based on individual circumstances, provided the right course of action is being taken.
