Polycystic Ovary Syndrome (PCOS) and Blood Glucose Levels

September is national polycystic ovary syndrome (PCOS) awareness month. In the spirit of raising awareness about this important health issue that affects millions of women, we’ll look at this condition and how it can affect other areas of health.

There are three primary symptoms associated with PCOS:

Irregular periods

• Defined as a cycle that last longer than 35 days on a consistent basis or lack of a period altogether

Excess androgen

•  High levels of virilizing hormones can cause excess facial or body hair or acne

Polycystic ovaries

• Ironically, these are not cysts, but fluid-filled sacs known as follicles on the ovaries

How is someone diagnosed with PCOS?

If someone has any two of the above symptoms, they can be diagnosed with PCOS. The cysts in the name are just an incidental finding when a healthcare practitioner images the ovaries; they aren’t known to cause any symptoms on their own. Around half of women with PCOS don’t have any symptoms at all – many of these women are diagnosed by the presence of follicles since they wouldn’t seek medical attention for the problem itself in the first place.

Other sex hormone changes associated with PCOS

However, since PCOS is so common, even though it only becomes symptomatic in half of the women who have it, it’s still the single most common cause of infertility in women. Although PCOS only occurs in women, its effects on the female body are not limited to reproductive changes. High testosterone levels can cause excessive hair growth, known as hirsutism, usually on the face, chest, or back. Likewise, high testosterone can cause male pattern baldness, or thinning hair and hair loss from the head, typically along a receding hairline. Finally, these same high testosterone levels can cause oily skin or acne.

Other endocrine changes associated with PCOS

Outside the realm of sex hormones, however, there are other endocrine changes associated with PCOS. Although we don’t know exactly why, PCOS is associated with insulin resistance, in which the body stops responding as well to the hormone insulin. This is very important because insulin is how the body takes glucose from the blood into cells to use, so if there’s a problem here, it can affect your whole body.

If cells don’t get the energy they need from the blood, it can affect energy levels and make someone more fatigable, so simple tasks can start to feel impossible. Conversely, if glucose is trapped in the blood, it can cause damage to multiple organ systems and require aggressive and invasive management in later life. PCOS is also associated with high cholesterol levels, which pairs exceptionally poorly with the vascular changes secondary to long-term insulin resistance.

How can PCOS be treated or managed?

Although there is no specific cure for PCOS, there are a few ways to make the symptoms more manageable. Androgen blockers can usually blunt the worst virilizing effects like body hair and acne, while fertility treatment is often successful. There are some surgical options if medical management is ineffective, but these are rarely used since treatment is usually symptomatic. Many people with PCOS, and its accompanying insulin resistance, are also either overweight or obese. Carrying too much weight can also increase the amount of insulin your body produces, as more cells demand energy transport from the blood. So, if someone with PCOS and a broader waistline takes steps to control the part they generally can control, the overall problem is less severe. Weight control is most often a question of lifestyle modifications, and avoiding persistently elevated blood glucose levels is essential for optimal health outcomes.

How can I keep a closer watch on my insulin and blood glucose patterns?

Healthy foods, such as whole vegetables and meats, can form the backbone of a nutritious and fulfilling diet. In addition to nutrition, regular and either low or moderate-intensity aerobic exercise, getting enough sleep, and avoiding spikes in stress levels is also important. Although it’s not the only thing to consider, knowing how your blood glucose levels respond to these inputs’ daily ups and downs can be a valuable tool in managing your energy balance and avoiding long-term health complications. Continuous glucose monitors (CGMs) can help automate the process of monitoring blood glucose levels and give you a long-term picture of your trends.

CGMs can also show you how specific foods affect you in ways they might not affect everyone equally. For some people, whole grain pasta is easily digestible and immediately becomes available as glucose in the blood – if this applies to you, it might be worth considering substituting it for another food. Or, if you tolerate it exceptionally well, you might want to replace other starches you handle less well with whole-grain pasta. Taking advice from a Registered Dietitian will also help, as they can both inform and orient you to how your body handles energy throughout the day. If you have to walk a long road, bring a friend.