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Polycystic ovary syndrome: PCOS, infertility and insulin resistance

Some women have a whole raft of symptoms – excess facial hair, acne, hair loss, easily accumulated “belly fat” and messed-up periods that only come regularly when hormonally managed with birth control pills. For others, the symptoms are more subtle, perhaps just limited to irregular or absent periods. What all these women may have in common is polycystic ovary syndrome, or PCOS, the most common hormonal problem seen in women of reproductive age. PCOS is the main cause of infertility due to problems with ovulation, and is a major risk factor for the development of diabetes, cardiovascular disease and endometrial cancer. Here’s what you need to know about PCOS and your reproductive health.

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PCOS symptoms often unrecognized

Because the symptoms of PCOS can present differently in different women, it can sometimes go unrecognized by health-care providers not familiar with diagnosing PCOS. For experienced clinicians, the PCOS diagnosis can emerge from a thorough history and physical, and analysis of a few telling blood tests.

PCOS treatment: Manage insulin resistance

Historically, the treatment has been to manage the symptoms – laser treatment or medication for facial hair, a trip to a dermatologist for the acne and oral contraceptives to regulate hormones and menstrual periods. Beginning in the 1990s, however, scientists began to unravel the root cause of PCOS, which we now understand to be insulin resistance. Insulin resistance in its most advanced form is what causes type 2 diabetes, but when detected early it can be managed with diet and exercise before it has a chance to develop into diabetes. Managing insulin resistance with diet, exercise and medications if needed is now the cornerstone treatment of PCOS.

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Insulin resistance causes hormonal imbalance

What is insulin resistance? Insulin is a hormone secreted by the pancreas in response to the release of glucose (a form of sugar) into the blood after you eat carbohydrates. Carbohydrates come from fruits, starchy vegetables (most vegetables are very low in carbs), grains, milk, yogurt and sweets. Glucose is the primary fuel source for our body’s cells, and pairs up with insulin to move out of the blood and into the cells. If all goes well, glucose is efficiently escorted into cells with the help of modest amounts of insulin. In insulin resistance, cells are resistant to insulin, increasing the amount needed to force glucose into the cells.

In PCOS, this excess insulin encourages the deposit of unhealthy belly fat and upsets the delicate hormonal balance in the ovaries needed for ovulation. It can also cause serious cravings for more carbohydrates!

Diet strategies for PCOS

While much about PCOS remains a mystery, insulin resistance can be managed by limiting sugars and replacing refined, “white flour” grains with moderate amounts of unrefined carbohydrates, like whole grains, vegetables and fruits. Pairing carbs with lean protein and a little heart-healthy fat also helps mute the post-meal insulin response, as does some daily physical activity.

If you have PCOS, certainly work with your doctor on the best treatment plan for your condition, but remember that following a healthy diet and getting regular exercise will improve your overall health.

More treatment options

Natural treatment for PCOS

Holistic medicine is a treatment option considered by many suffers of PCOS.

More on PCOS and women’s reproductive health

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