The Link Between PCOD and Insulin Resistance
Polycystic Ovarian Disease (PCOD), also known as Polycystic
Ovary Syndrome (PCOS), is a common endocrine disorder affecting millions of
women worldwide. While many associate PCOD primarily with reproductive issues
like irregular periods and infertility, its roots run much deeper—particularly
into the body’s metabolic processes. One of the most significant and
well-established connections is between PCOD and insulin resistance.
Understanding Insulin Resistance
Insulin is a hormone produced by the pancreas
that enables cells to absorb glucose from the bloodstream for energy. In insulin
resistance, the body’s cells become less responsive to insulin, forcing the
pancreas to produce more of it. Over time, this can lead to elevated insulin
levels (hyperinsulinemia), higher blood sugar, and eventually type 2 diabetes.
How Insulin Resistance Drives PCOD
Insulin resistance is not just a side effect of PCOD—it’s a
central driver of the condition. Studies show that:
- 70–95%
of women with obese PCOD and 30–75% of those with lean PCOD have insulin
resistance.
- High
insulin levels stimulate the ovaries to produce more androgens (male
hormones), such as testosterone, which can disrupt ovulation, cause
irregular periods, acne, and excess hair growth.
- Insulin
resistance is also linked to increased inflammation, weight gain, and a
higher risk of developing type 2 diabetes and cardiovascular disease.
The Vicious Cycle: Obesity, Insulin, and PCOD
Obesity amplifies insulin resistance. In women with PCOD,
excess adipose (fat) tissue releases substances called adipokines, which
further disrupt insulin signaling and hormone balance. This can worsen both
metabolic and reproductive symptoms of PCOD, creating a vicious cycle.
Testing and Diagnosis
Because insulin resistance is so common in PCOD, testing for
it is often recommended. Common tests include:
- Fasting
insulin
- HOMA-IR
index
- 2-hour
insulin glucose challenge test
These tests help distinguish PCOD from other conditions with
similar symptoms and guide treatment.
Managing PCOD and Insulin Resistance
Addressing insulin resistance is a cornerstone of PCOD
management:
- Lifestyle
changes: Diet, exercise, and weight loss can significantly improve
insulin sensitivity, reduce androgen levels, restore ovulation, and
improve fertility.
- Medications:
Metformin is commonly prescribed to improve insulin sensitivity and lower
blood sugar. It can also help with weight loss and reduce androgen levels.
- Other
agents: Thiazolidinediones (like pioglitazone) are sometimes used but
have limitations due to side effects.
Long-Term Health Risks
Women with PCOD and insulin resistance face an increased
risk of:
- Type
2 diabetes: More than half of women with PCOD develop it by age 402.
- Heart
disease and metabolic syndrome: Due to chronic inflammation, abnormal
cholesterol, and high blood pressure.
- Gestational
diabetes: Higher risk during pregnancy.
Conclusion
The link between PCOD and insulin resistance is strong and
multifaceted. Recognizing and addressing insulin resistance is crucial for
managing PCOD symptoms, improving fertility, and reducing long-term health
risks. Early intervention with lifestyle changes and, if necessary, medication
can make a significant difference in outcomes for women with PCOD.
Dr. Praveen Kumar N S
MBBS, MD (Gen. Med.), DNB (Endocrinology)
Consultant Endocrinologist & Diabetologist
Dr. Praveen's Endocrine Centre
Mysuru, Karnataka. 570009.
References
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