Women's Health

Managing PCOS and Insulin Resistance

PCOS and insulin resistance go hand in hand for some patients. Regulating insulin through diet and exercise is an important part of managing PCOS symptoms.

Although the exact cause of polycystic ovarian syndrome (PCOS) is unknown, insulin resistance and hyperinsulinemia seem to affect many women with PCOS. This often leads to more severe symptoms, difficulty maintaining a healthy weight and heightened risks of developing other chronic conditions. You can help your patients with managing PCOS symptoms by providing some guidelines on nutrition and exercise.

The Connection Between PCOS and Insulin

Research in Fertility and Sterility found that about 65 percent to 70 percent of women with PCOS have insulin resistance. Although it is more prevalent among obese women, the research confirmed that insulin resistance seems to have an independent relationship to PCOS and is not wholly caused by obesity.

Common PCOS symptoms include heavy bleeding, irregular or painful periods, and infertility. PCOS can also cause acne, an increase in facial hair, weight gain around the waist and dark patches of skin in the neck, armpits, groin and waistline. High insulin levels worsen these symptoms by causing women to produce more testosterone. This leads to even more acne, hair growth and irregular or absent periods. Women with insulin resistance are also at higher risk for developing chronic conditions such as diabetes, obesity, heart disease and hypertension.

Managing PCOS symptoms is key to helping your patients achieve a better quality of life in the face of this condition. Controlling insulin levels is an essential component, as PCOS patients can easily find themselves in a cycle of spiking insulin levels, leading to more cravings for carbs and sweets.

Managing PCOS Symptoms Through Healthier Habits

Diet and exercise are the most fundamental ways for patients to manage insulin levels and control PCOS symptoms. Encourage them to engage in at least moderate exercise for 30 minutes a day to regulate blood glucose levels, even if all they can fit in is a walk at lunch.

Also provide general guidance for healthy eating. Discourage fad diets or any eating plan that is likely to lead to dramatic gains and losses. They do not need to be too restrictive; they just need to follow a balanced diet.

Start by sharing these tips.

  • Eat regularly throughout the day: Eating every few hours helps keep blood glucose levels stable. Fasting and calorie restrictions are not a good idea for women with PCOS and insulin resistance.
  • Choose whole foods: Whole fruits and vegetables, lean meats and healthy fats like oils, nuts, seeds and avocados are healthful eating choices. Dates and other dried fruit help curb a sweet tooth.
  • Read food labels: Teach your patients how to read food labels to understand fat, calories and protein, as well as how to look for added sugars and refined carbohydrates.
  • Stick to whole grains: Encourage your patients to opt for whole wheat, brown rice and oats rather than white bread or processed crackers and cookies. Remind them to limit carbohydrates and balance them with protein, fruits and vegetables.
  • Limit sweets: Controlling sugar is key to managing signs of insulin resistance and PCOS. The PCOS Nutrition Center recommends staying below 45 grams of sugar per day, which is still higher than the American Heart Association's recommendation of 25 grams per day. Patients should limit or avoid sugary drinks, desserts and other sources of added sugar.

PCOS affects about 5 percent to 10 percent of women in the United States, according to the American Diabetes Association. It is often diagnosed via a pelvic exam, clinical workup and an ultrasound to assess the ovaries. Patients' quality of life greatly decreases when symptoms get out of control. Talk to patients about the relationship between PCOS and insulin resistance symptoms, and emphasize the importance of diet and exercise to help keep those symptoms in check.