Susan B. Sloane, BS, RPh, CDE, has been a registered pharmacist for more than 20 years and a Certified Diabetes Educator for more than 15 years. Her two sons were diagnosed with diabetes, and since then, she has been dedicated to promoting wellness and optimal outcomes as a patient advocate, information expert, educator, and corporate partner.
Polycystic ovary syndrome (PCOS), an endocrine disorder seen in women primarily of childbearing age (ages 12 to 45), is associated with insulin resistance and can, in some cases, cause diabetes. Some people previously diagnosed with diabetes develop PCOS, so it may not always be clear which came first.
The prevalence of women with PCOS is between 10 and 30 percent. The statistics aren't exact because many women remain undiagnosed.
PCOS is a leading cause of fertility problems in women because it causes irregular ovulation or anovulation. A diagnosis of PCOS oftentimes is only after ruling out other infertility causes, such as thyroid disease or other endocrine syndromes.
Some criteria for diagnosing PCOS are anovulation, obesity, excess androgen production, and hyperinsulinemia. There are also cysts seen on the ovaries in many cases. Symptoms are related to hormonal imbalance and may include mood swings, weight gain, menstrual irregularities, and excessive facial hair. It may also be difficult to conceive due to hormonal imbalance and cystic ovaries.
Genetics and PCOS
PCOS also seems to have a genetic component. If a woman has PCOS, for example, her sister has upward of a 50 percent chance of developing the disorder. Because insulin resistance is associated with PCOS and more insulin gets produced to compensate for this, the pancreas can gradually lose the ability to produce sufficient insulin because it gets “worn out.” If the insulin cannot properly convert the food we eat into energy, it gets stored as fat. This, of course can lead to overt diabetes.
PCOS can be treated, and fertility can be restored in many cases. Since obesity contributes to insulin resistance, weight loss is encouraged. This can be a difficult task because excess insulin production makes it more difficult to lose weight, so metformin is often used to help with blood sugar irregularities. Exercise is encouraged, and many practitioners suggest a low-glycemic diet.
The acne associated with this disorder can be especially difficult on teenage girls who may already be overweight and struggling with body image issues. Many clinicians use oral contraceptives as a method of helping control the androgen imbalance. These are not the progestin-only products, but oral contraceptives that contain estrogen to restore hormonal balance. Another drug, spironolactone, has been used to prevent the action of androgen, but its use for this purpose is considered “off-label,” as the manufacturer recommends this drug to treat hypertension.
There are also many supplements touted to provide relief from PCOS, ranging from saw palmetto to Vanadyl. Do your homework, ask what may have worked for others, and check with your healthcare team before trying any of these. Try to avoid caffeine and other stimulants, such as nicotine, which can make symptoms of PCOS worse. Stress reduction techniques, such as massage and acupuncture, have been helpful for some people as well.