The Link Between Insulin Resistance, PCOS, and Fertility Challenges

Did you know?: The United States Senate designated September as "Polycystic Ovary Syndrome Awareness Month," with such goals as improving patients’ quality of life and outcomes and increasing awareness and education.

If you’re one of the millions of women with Polycystic Ovarian Syndrome (PCOS), you know the dramatic toll this hormonal condition can take on your fertility. This condition is caused by hormonal imbalances, affecting ovulation, menstruation, and pregnancy. Patients may also have issues utilizing the crucial hormone insulin, worsening symptoms and increasing risks for diabetes and other conditions. While PCOS is incurable, you and your physician can discuss ways to treat its symptoms and preventive measures for effective management.

The Hormonal Impact PCOS Poses

PCOS is the most common female infertility cause, shown to affect about 5-6 million Americans. It’s also the most common hormonal disorder among women of reproductive age. With PCOS, multiple small, fluid-filled sacs (cysts) grow along the ovaries’ outer edges. The more common symptoms, which may differ among patients, include menstrual issues (i.e., heavy, long, intermittent, unpredictable, or absent periods), acne or oily skin, excessive facial or body hair, male-pattern baldness or hair thinning, and weight gain, particularly around the belly.

While its exact causes are unknown, PCOS may be linked to hormonal concerns affecting the ovaries. Excess androgens (male hormones), found in 60-80% of girls and women with PCOS, may contribute, possibly due to communication issues between the brain or pituitary gland and the ovaries.

The PCOS and Insulin Resistance Connection

These higher androgen levels may occur because of insulin resistance or elevated insulin, occurring with hormonal imbalances. Produced in the pancreas, insulin has the vital responsibility of helping your body convert blood glucose into usable energy. PCOS patients are often insulin-resistant, in which they have a decreased sensitivity to the hormone. As your body can make insulin, it cannot use it effectively. This may raise patients’ type 2 diabetes risks, with more than 50% estimated to become diabetic or prediabetic before age 40.

Due to insulin resistance, PCOS patients may experience higher blood sugar levels, increasing levels of male hormones, like testosterone, and worsening symptoms. These hormonal imbalances are associated with low levels of progesterone, a female hormone that helps to regulate menstruation and maintains pregnancy.

PCOS’ hormonal aspects can also disrupt the development of a woman’s endometrial lining. Your ovarian follicles will still have eggs, but they won’t develop and mature normally, preventing ovulation or egg release, a process called anovulation. PCOS is the most common anovulation cause and can make pregnancy difficult. Being a hormonal condition, women in menopause, itself hormonal, are still subject to its symptoms, as they produce less estrogen and progesterone, stopping ovulation.

Understand How Hormonal Function Impacts PCOS and Fertility

Polycystic Ovary Syndrome, a serious threat to female reproductive health, is associated with hormonal function, particularly insulin. You and your physician can talk about treatments and preventive methods to manage its symptoms. If you’d like to schedule a PCOS consultation or for fertility questions, we encourage you to contact Washington Fertility Center today.