PCOS & Infertility: Diet, Weight Loss & Medications
As many as 1 in 10 women in the United States have a condition known as polycystic ovary syndrome (PCOS). This health problem can affect a women’s menstrual cycle and fertility. It is one of the most common reasons for ovulatory infertility and affects between 5 and 10 percent of women.
PCOS is not a disease, it is a syndrome with many signs and symptoms that stem from underlying problems. Common symptoms include: irregular or non-existent menstrual periods, excess facial and body hair and enlarged ovaries with many small resting follicles (which your doctor will see on ultrasound). PCOS also creates a heightened risk for type 2 diabetes and heart disease.
A woman is diagnosed with PCOS if she has 2 of the following:
– High levels of androgens (male hormones) detected by a blood test or by excess body or facial hair, thinning of the hair on the scalp or acne
– Issues with ovulation which is usually appears as long or irregular menstrual cycles, no period at all or cycles when the woman does not ovulate
– Enlarged ovaries with many resting follicles
Other features that women commonly experience include excess weight (especially around the mid-section) and insulin resistance. Insulin is secreted by the pancreas and helps cells absorb blood sugar (glucose) from the bloodstream. Insulin resistance occurs when cells require more and more insulin to do their job. When this happens, levels of blood sugar and insulin climb higher than they are supposed to be. When the level of insulin is chronically high the ovaries are stimulated to overproduce male hormones, such as testosterone.
PCOS often causes testosterone overload. In the ovaries, cells known as theca cells convert cholesterol into testosterone and other androgens or male hormones. Some of these are converted into estradiol. In PCOS patients, high levels of insulin push the androgen making process into overdrive. When this happens, at the time of ovulation the ovaries do not release an egg because the development of the follicles has been shut down. On top of not ovulating, the extra androgens that are made in the ovaries get into the bloodstream, circulate within the body and stimulate symptoms such as growth of body hair, thinning of hair on the scalp and acne.
What can you do about this?
Weight loss: can significantly help overweight women with PCOS. Studies show that a loss of even 5 % of one’s starting weight can make an impact on health. If your current weight is 160 pounds losing 8 pounds could help improve your body’s sensitivity to insulin, lower male hormones, improve menstrual regularity and ovulation and help to clear any acne or hair growth issues. You can lose weight with a combination of cutting calories and exercising more. Any weight loss will improve your reproductive functions and is essential for overweight women who are trying to become pregnant.
Diet: Choose whole grain and high fiber carbohydrates. Minimize rapidly digesting carbs, soda and sugar. Doing this will help you to keep control of your blood sugar and insulin levels. Eat more fruits, beans, vegetables, and nuts. Read our nutrition handout for more information on this.
Medications: Some patients may require medications to help manage insulin resistance. There are two classes of medications used to treat diabetes that improve blood sugar and promote ovulation in women with PCOS. Speak to a fertility specialist about Metformin and Clomid to help you become pregnant.