Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes.
In addition to being the most common cause of infertility in women, Polycystic Ovarian Syndrome (PCOS) is strongly linked to insulin resistance and type 2 diabetes.
Serving itself up as a ‘double-whammy,’ type 2 diabetes and PCOS can be an unpalatable mix of sorts. Management of both diseases are intricately tied to one another — in a delicate dance that may be difficult to find a rhythm with.
One in ten-to-twenty women of childbearing age are diagnosed with PCOS in their lifetime; this disease is not only prevalent but can be downright frustrating to live with as well.
What is PCOS?
In an ideal world, small fluid filled sacs (follicles) in a woman’s ovaries hold eggs until they’re mature and released to travel to the uterus for possible fertilization. With PCOS, follicles bunch together and eggs aren’t released causing cysts to form.
The cause(s) of PCOS remains questionable.
According to Womenshealth.gov PCOS can affect a woman’s:
• menstrual cycle
• ability to reproduce
• cardiac health
• physical appearance
There’s certainly no finger pointing here, but according to Medscape, both type 2 diabetes and PCOS are obesity related conditions. This surely isn’t the entire story as thin framed individuals develop PCOS — it isn’t a selective disease. There are few studies on PCOS’s association with type 1 diabetes but we do know it occurs in this sub-grouping as well.
• 34-46 percent of women with PCOS have signs of metabolic syndrome characterized by: insulin resistance, high blood pressure, high cholesterol and type 2 diabetes.
• Between 38-88 percent of women with PCOS are overweight.
• PCOS is most common among Caucasian pre-menopausal women.
• PCOS is characterized by: menstrual disturbances, infertility issues, hair loss or excessive male-pattern hair growth. (Data via Medscape)
PCOS and diabetes
This syndrome is marked by both high levels of “male hormones” called androgens and high levels of insulin. Women and men normally produce androgens, just in differing amounts — with excessive amounts of androgens in women, female traits may be affected. Ovaries, adrenal glands and fat cells produce androgens in women.
We see increased insulin levels when a woman is unable to utilize insulin properly according to researchers. Oddly enough, insulin levels also serve to increase androgen levels starting an unfortunate cyclical process — ultimately leading to a diagnosis of diabetes.
According to Diabetes.org: many women with PCOS have diabetes and “studies are examining the relationship between PCOS and the body's ability to produce insulin. There’s a lot of evidence that high levels of insulin contribute to increased production of androgen, which worsens the symptoms of PCOS.”
Disentangling non-obesity related factors involved with the birth of this complex condition is a priority for researchers.
Current treatment for PCOS
Identifying the condition is the first step toward treatment; this may happen with a thorough medical and physical history, pelvic exam, blood work or vaginal ultrasound.
Suggested treatment plans may include:
• Changes to diet
• Birth control pills (if one isn’t looking forward to starting a family)
• Fertility medications
• Diabetes medications
• Medications for excessive hair growth or to treat increased male hormone levels
• Weight loss can be very difficult when diagnosed with both of these conditions; however, a modest weight loss of 5 percent can lighten symptoms of PCOS.
The emotional effects of PCOS can be profound, dampening self-esteem. Seeking help for worry, embarrassment or depression is a vital component in managing PCOS.