Let’s know About PCOS, Diabetes, and Infertility

Polycystic Ovary Syndrome – PCOS, diabetes, and infertility are health conditions that can significantly impact a woman’s life.  PCOS, affecting 6% to 12% of women of reproductive age in the United States according to the Centers for Disease Control and Prevention (CDC), is a hormonal imbalance that disrupts ovulation and can cause irregular periods, excess hair growth, and acne. Diabetes, a chronic condition where the body struggles to regulate blood sugar, comes in two main types. Type 1 diabetes is an autoimmune disease, while type 2 diabetes, affecting over 34 million Americans as per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), develops when the body becomes resistant to insulin, a hormone that helps control blood sugar. Infertility, defined as the inability to conceive after one year of trying, affects approximately 1 in 8 couples in the US based on the CDC.

An woman measuring blood sugar level using a glucometer.

While these conditions seem distinct, a surprising connection exists. Women with PCOS are at a significantly higher risk of developing type 2 diabetes, with studies suggesting over half of women with PCOS may develop it by age 40 (CDC). Additionally, PCOS is a leading cause of ovulation dysfunction and infertility, affecting up to 70% of women with PCOS (World Health Organization).  Understanding this connection can empower women with PCOS to take proactive steps toward managing their health and fertility.

Polycystic Ovary Syndrome (PCOS)

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance affecting women during their reproductive years. It disrupts the normal functioning of the ovaries, leading to irregular ovulation and a variety of symptoms. The exact cause of PCOS remains unknown, but it’s believed to be linked to a combination of factors.

Holding a replica of overy as a symbol of PCOS.

One hallmark of PCOS is an imbalance in the production of reproductive hormones. Women with PCOS often have excess levels of androgens, hormones typically present in higher amounts in men but also present in small quantities in women. This androgen excess can disrupt the development and release of eggs (ovulation) from the ovaries. Additionally, some women with PCOS may have multiple small cysts on their ovaries, although the presence or absence of cysts is not a definitive factor in diagnosing PCOS.

Symptoms of PCOS

The symptoms of PCOS can vary from woman to woman, and some may not experience any at all. However, some common symptoms include:

  • Irregular periods: This is often the most noticeable symptom, with periods being infrequent, heavy, or completely absent.
  • Excess androgen (male hormone) levels: This can manifest as unwanted hair growth on the face, chest, or abdomen, as well as acne and oily skin.
  • Ovarian cysts: While not a defining characteristic, some women with PCOS may develop small cysts on their ovaries.

Causes of PCOS

The exact cause of PCOS remains a mystery. However, research suggests several potential contributing factors:

  • Genetics: A family history of PCOS increases a woman’s risk of developing the condition.
  • Insulin resistance: This is a condition where the body struggles to use insulin effectively, a hormone that regulates blood sugar. Insulin resistance is a common feature of PCOS and may play a role in its development.

While the cause of PCOS remains elusive, understanding its symptoms and risk factors is crucial for early diagnosis and management.

The Link Between Diabetes, Polycystic Ovary Syndrome, and Infertility

Both PCOS and diabetes are related to each other and both diseases are also connected with infertility. 

Let’s see How…

There are about seven types of PCOS.

One of these is insulin-resistant PCOS, such patients are seen to gradually gain weight up to 8-30 kg for two to five years before developing PCOS. At one stage of weight gain, periods become irregular, and mood swings, depression, and other mental problems begin. Gradually the 25-31 day cycle goes from being irregular to 45-60 days and eventually, there is no period without the pill.

Blood sugar measurement shows that the blood sugar is in the prediabetic range. When measuring insulin resistance, it can be seen that the IR Index is between 2-5, which means, it can take the form of diabetes at any time.

To prevent blood sugar from rising, doctors usually advise to avoid or reduce the intake of sugary and oily foods.

But the excess insulin in the blood gradually increases the patient’s appetite and the patient’s control over the tongue gradually worsens despite the willpower.

Women with insulin-resistant PCOS can experience a range of sexual health challenges.  These can include a decrease in libido for some, while others may experience increased sexual desire or difficulty controlling sexual urges.  This hormonal imbalance can also lead to problems with arousal and lubrication. This problem has not only physical but also mental, social, and familial consequences which affect many people’s lives as a whole.

Infertility and PCOS

As we mentioned earlier, infertility is the inability to conceive naturally after one year of trying. It can be categorized as primary infertility, where a couple has never conceived, or secondary infertility, when a couple has previously conceived but is now struggling.

Sad Husband and wife while wife is suffering from Infertility.

For women with PCOS, achieving pregnancy can be more challenging due to the impact PCOS has on ovulation.  Normal ovulation involves the release of a mature egg from the ovary each month.  However, PCOS can disrupt this process in several ways:

  • Irregular periods: As discussed previously, irregular or infrequent periods often indicate a lack of ovulation. Without regular ovulation, there’s no egg available for fertilization.
  • Hormonal imbalances: The excess androgen levels associated with PCOS can interfere with the development and maturation of eggs within the ovaries, further hindering ovulation.
  • Insulin resistance: Present in many women with PCOS, insulin resistance can disrupt the delicate hormonal interplay necessary for ovulation.

These factors combined can significantly decrease a woman’s chances of conceiving naturally.  However, women with PCOS should not be discouraged.  Several fertility treatment options can significantly improve their chances of achieving pregnancy.  These options may include:

  • Ovulation induction medications: These medications stimulate the ovaries to produce and release mature eggs.
  • Metformin: This medication, commonly used for type 2 diabetes, can improve insulin sensitivity and potentially regulate ovulation in women with PCOS.
  • Surgery: In some cases, minimally invasive laparoscopic surgery may be used to address ovarian cysts and improve ovulation.

The specific fertility treatment approach will depend on the individual woman’s unique circumstances and will be determined in consultation with a healthcare professional. Many women with PCOS can successfully achieve pregnancy. with appropriate diagnosis, treatment, and management.

Management and Treatment

While PCOS is a chronic condition, it’s highly manageable with the right approach. Women with PCOS can significantly improve their overall health and manage their symptoms by implementing lifestyle changes. This includes:

  • Maintaining a healthy diet: Focusing on whole grains, fruits, vegetables, and lean protein can help regulate blood sugar and potentially improve insulin sensitivity.
  • Regular exercise: Aiming for at least 30 minutes of moderate-intensity exercise most days of the week can improve insulin sensitivity and overall well-being.
  • Weight management: Even modest weight loss can significantly enhance ovulation and improve PCOS symptoms. Medications can also play a role in managing PCOS. Some common medications include:
    • Birth control pills: These can regulate menstrual cycles, reduce androgen levels, and improve acne.
    • Metformin: As mentioned earlier, this medication can improve insulin sensitivity and potentially regulate ovulation.
    • Clomiphene (Clomid): This medication stimulates ovulation and is often a first-line treatment for infertility in PCOS patients.

The most effective treatment plan will vary depending on a woman’s individual needs and circumstances. Consulting a healthcare professional for a personalized approach is crucial for successful PCOS management.

Follow Some Additional Instructions Below if You Have Insulin Resistance PCOS

  • Do intermittent fasting.
  • Avoid sugar and sweet foods completely.
  • Avoid white rice, potato, and wheat food.
  • Sleep by 11 pm.
  • Use B vitamins, especially thiamine, folate, and inositol supplements.
  • Consult a clinical nutritionist at least 6 months before conception.
  • Do regular cardio + strength training.
  • Take professional consultation to reverse PCOS if needed.
  • Avoid calcium and iron supplements.
  • Take vitamin D supplements as needed.


PCOS, Diabetes, Fertility, and Nutrition Q&A | Nutritionist Hillary Wright

Final Words

The link between PCOS, diabetes, and infertility highlights the importance of understanding these hormonal imbalances. Although PCOS can increase the risk of diabetes and make pregnancy more challenging, it is a manageable condition. By adopting healthy lifestyle changes and seeking help from a healthcare provider, women with PCOS can improve their overall health, regulate their hormones, and increase their chances of a successful pregnancy. Don’t hesitate to seek professional guidance – early diagnosis and personalized treatment are key to living a fulfilling life with PCOS.

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