April 27, 2018

Insulin resistance and PCOS – or Polycystic ovary syndrome, often occur together. Many women that have PCOS never get tested for insulin resistance levels. Some do, but are told by their doctors that they have normal blood sugar levels. This could lead them to wonder what the cause behind the PCOS really is. Studies have indicated that up to 70% of women diagnosed with PCOS have insulin resistance. However, most women with PCOS report never having been tested for insulin resistance.

Insulin is the human body’s storage hormone. Upon consumption of food, the body detects a rise in blood glucose. Numerous vital organs like the liver, brain, heart, pancreas and eye cells can face damage if blood glucose levels are continually elevated. Insulin, therefore stores excess glucose in muscles and liver cells for future use. Insulin allows the cells to open up and let the glucose in. Without it, the body’s cells would starve. The hormone is secreted by the pancreas and binds to cell receptors that open up and allow glucose in. Its function is the same as that of a key unlocking a door. When the ‘key’ is too frequently used (or there is chronic low-grade inflammation), the lock often gets worn out and jammed, and the ‘key’ no longer fits in its assigned place. This phenomenon in the human body is known as insulin resistance.

Cells in the ovaries produce some essential hormones, like oestrogen and progesterone. In addition, these cells also secrete a minor amount of testosterone, which is actually essential for a number of bodily functions, such as libido and bone structure development.

Chronically high insulin levels cause the ovaries to overproduce testosterone. The human body usually has a mechanism in place to prevent hormone levels from fluctuating and getting too high. Unfortunately, this isn’t the case with testosterone and the body also cannot anticipate insulin’s role in making testosterone levels higher. As a result, there is no defence mechanism in the body that can prevent testosterone levels from spiralling out of control.

That is not the sole problem that insulin resistance causes in the body. Of all hormones in the human body, roughly 80% are attached to cells, while the remaining 20% roam freely through the body. It is these ‘free’ hormones that also wreak havoc in the functioning of the body. Excessively high levels of ‘free’ testosterone can:

– Enter hair follicles and cause it to shed.

– Settle into facial hair follicles, causing the growth of thick, dark hair.

– Block the skin’s oil glands and cause acne.

In most cases, the Sex Hormone Binding Globulin (SHBG) plays the role of a testosterone ‘sponge’, which binds itself to the excess testosterone and absorbs it, thus preventing it from causing such maladies. However, when the body also shows insulin resistance, it reduces the amount of SHBG, thereby causing a collapse of the check on testosterone levels.

While experts are still unsure of the effects that insulin resistance has on pregnancies, it has some confirmed effects on related processes:

• It affects the delicate balance between the Luteinizing Hormone (LH) and the Follicle Stimulating Hormone (FSH), which adversely affects the female body’s ovulation. Insulin resistance causes an abnormal rise in the LH levels, which unbalances the LH:FSH ratio.

Insulin resistance suppresses the levels of the FSH in the body, which means that all of the eggs produced in the body remain consistent in size, and no ‘superior’ egg can be released into the uterine tube. The undeveloped follicles are what appear as cysts upon examination of the ovaries. The increased exposure of the follicles to testosterone also hinders the possibilities of pregnancy.

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