Polycystic Ovaries; PCOS Insulin Resistance

Stein Leventhal Syndrome PCO Fertility and Hormonal Issues

Nov 4, 2009

Polycystic ovarian syndrome, also known as Stein Leventhal Syndrome, polycystic ovaries, or PCOS is a common hormonal disorder that affects between 5-10 percent of women.

Many people associate PCOS with infertility problems, and while PCOS, the most common hormonal problem found in women, can cause infertility, the disorder also affects women in a number of other serious ways, from raising cholesterol and increasing heart disease to causing adult onset diabetes.

Causes of Polycystic Ovary Disease (PCOS); Insulin Resistance in PCOS

There’s no clear consensus on what causes PCOS; up to half the women with PCOS are overweight, but most doctors feel that PCOS causes overweight rather than the other way around. Insulin resistance, a problem with the body’s ability to make insulin and process sugars and starches can lead to an overproduction of male hormones (androgens). Insulin resistance in PCOS leads to the symptoms of PCOS. There may also be a genetic link for PCOS.

Symptoms of PCOS from Increased Androgens, Insulin Resistance

Diagnosing PCOS; ASRM Symptoms of Polycystic Ovaries Necessary for Diagnosis

According to ASRM, the American Society for Reproductive Medicine, women have PCOS if they have two out of three of the following problems:

Testing for PCOS may show elevated glucose, insulin and free testosterone levels, low thyroid levels, and a ratio of the hormones luteinizing hormone(LH) and follicle stimulating hormone(LH) of 2:1; the normal LH:FSH ration is 1:1.

Treatment of PCOS With Insulin Lowering Drugs, BCPs and Diet to Decrease Insulin Resistance

PCOS is treated with insulin-lowering medications often used to treat adult onset (Type II) diabetes, such as pioglitazone (Actos), rosiglitazone (Avandia) or metformin (Glucophage). These drugs take several months to start decreasing symptoms, but within six months, 90% of women are having regular menstrual cycles. Birth control pills can also be effective in treating PCOS in women not trying to become pregnant.

A low carbohydrate diet, with emphasis on foods with low glycemic index can help control blood sugar levels and increase weight loss. This is because insulin resistance decreases the amount of carbohydrates removed from the blood into the cells, which results in high blood sugar. Weight loss also lowers insulin resistance, as does regular exercise.

PCOS and Infertility; Getting Pregnancy With Polycystic Ovaries

Ovulation is essential for pregnancy, and women with PCOS don’t ovulate at all, or don’t ovulate often. They may start to develop follicles, but the imbalance between LH and FSH results in the egg not being matured, and the follicle gets stuck to the surface of the ovary. If insulin lowering drugs like Avandia, Actos or Glucophage don’t result in pregnancy, ovulation induction drugs like clomiphene citrate (Clomid) may be used. If these don’t work, gonadotropins to stimulate the ovaries may be tried, in conjunction with in vitro fertilization (IVF).

Women with PCOS who do get pregnant have a higher than normal chance of miscarriage, and are also more likely to develop gestational diabetes during pregnancy.

Living With the Disease of PCOS; Polycystic Ovaries and Overall Health

PCOS can cause serious health problems from heart disease and diabetes. Managing polycystic ovary syndrome can be complicated; being under the care of an endocrinologist, taking medications prescribed, diet with low carbohydrates and regular exercise can all keep women with PCOS healthy.

Abstracts of the 22nd annual meeting of the ESHRE, Prague, Chech Republic,, 18-21 June 2006

The copyright of the article Polycystic Ovaries; PCOS Insulin Resistance in Women’s Health is owned by Sharon Perkins. Permission to republish Polycystic Ovaries; PCOS Insulin Resistance in print or online must be granted by the author in writing.