PCOS and Insulin Resistance

When I was 19, I embarked on my big OE to America, Canada and Europe. I had been placed on the oral contraceptive pill (the pill) at age 16. For what reason, I’m not entirely sure of but it seemed to be the done thing for teenage girls back then. Not wanting the hassle of taking my pill while traveling and changing time zones, I decided to stop taking it. This was the start of my reproductive issues.

During my 6 months over seas my period never arrived, I knew I wasn’t pregnant so I put it to the back of my mind and told my self I would deal with it when I arrived home.

After various tests I was told by my childhood GP that I had a condition called Poly Cystic Ovarian Syndrome (PCOS). She said that all I could do was go back on the pill and my ‘period’ would return. My lovely mum and I were not happy with the advice we were given so we went straight to the library (obviously didn’t have the internet back then) and took out all the books we could find on the condition.

“A ‘period’ while on the pill is not proper menstruation, it is caused by a break in the synthetic hormones you are taking”

I spent years reading into PCOS and my interest and passion into natural health and nutrition was born. I then went on to study personal training and nutrition and years later gained my Naturopathic qualification, specialising in reproductive health.

What exactly is PCOS?

PCOS is a condition where your endocrine system, which contains glands, organs and hormones that basically controls your body, doesn’t communicate properly. BUT the main underlying cause of the condition is INSULIN RESISTANCE, insulin is like the key that allows glucose to move from your blood into your cells, a very important process! My GP never mentioned this to me at the time but I soon realised this condition had nothing to do with cysts, the cysts are just a symptom of PCOS along with excess hair growth, weight gain, acne and amenorrhea.

Symptoms of PCOS are quite varied but typically include menstrual cycle irregularities, infertility, signs of androgen (male hormones) excess, and weight gain.

It is estimated that between 50-75% of women with PCOS have some degree of insulin resistance, it was originally thought that only obese women with PCOS would develop insulin resistance but it is now accepted that women in a healthy weight can still be insulin resistance.

Insulin resistance causes an increase in insulin in an attempt to move the glucose into the cells. Elevated insulin levels increase the storage of adipose (fat) tissue while inhibiting the release of fat for energy production. (Not ideal, right). Increased Insulin also increases ovarian and adrenal androgen production, this means your body makes more testosterone than it should, which leads to the symptoms mentioned and PCOS. On top of this an increase in Luteinising hormone, as seen in PCOS, also stimulates the ovaries to make more androgens.

Elevated androgens disrupt normal follicle development, which leads to the cysts on the ovaries and no ovulation. When there is no ovulation there is no corpus luteum so there is no progesterone produced. No ovulation means infertility and irregular menstrual cycles.

When I stopped taking the contraceptive pill once and for all, it took 11 months for my menstrual cycle to return. I have altered my diet and lifestyle to manage this condition, which has lead to a regular cycle and minimal symptoms!

So to stop this vicious cycle you need to reduce your chance of developing insulin resistance and here is how you can do that. But first of all I want you to know any changes are a lifestyle change, something that you need to be able to maintain for ever and not some fad diet that confuses you and your body and leads to disappointment. My motto is to find a way of eating, moving and thinking that works for you and serves you well for the rest of your life.

• Maintain a healthy body weight, research has shown that a 5% weight loss, if over weight, can start to dramatically improve symptoms.
• Exercise is not only an important part of the healthy body weight equation, it will also make you feel happy and relieve stress!
• Limit carbohydrates, yes I’m talking bread, pasta, wraps, rice etc. A high intake of carbohydrates increases blood glucose levels and subsequent insulin levels. Supercharged whole grains such as quinoa are still good for you so just stay away from all of the highly processed and white stuff.
• Reduce sugar intake so stay away from cakes, biscuits and sweets. Fat free products are high in sugar so be aware of these.
• Load up on plenty of fresh vegetables, fruit, lean protein, nuts and seeds.
• Include protein with every meal and snack! very important.
• Don’t go longer than 4 hours with out eating. If you eat lunch at 12 and don’t have anything until dinner at 7pm you WILL crave a sugar hit around 3-4. So avoid this by being prepared and having a snack that contains protein.

Key nutrients that assist in the regulation of blood glucose levels:

• Magnesium – Needed for over 300 enzymatic reactions in the body including almost all hormone reactions.

Food sources – Cacao powder, brazil nuts, eggs, kelp, legumes, tahini, almonds, oat bran, pine nuts, hazelnuts, spinach, banana.

Supplementation – 400-600mg per day.

• Chromium – Key mineral in controlling blood sugar regulation and the metabolism or fat and protein.

Food sources – Asparagus, brewers yeast, egg yolk, raw parsley, potato, olives, spinach, cheese, apple

Supplementation – 200-400mcg per day

• Omega 3 essential fatty acid – Protective of the cardiovascular system and through a series of complicated processes supports blood glucose regulation.

Food sources – Salmon, sardines, mackerel, flaxseeds, chia seeds and walnuts.

Supplementation – 1-3g per day

Herbs to support blood glucose regulation:

• Galega officinalis (Goats rue) is used to regulate blood glucose levels and the pharmaceutical metformin contains a constituent found in this plant.
• Gymnema sylvestre (Gymnema) regulates blood sugar levels and reduces sweet cravings.
• Trigonella foenum-graecum (Fenugreek) has been found to decrease insulin resistance in type 2 diabetics.

There are many other treatment considerations with PCOS so I recommend getting individual advice as here I have focused on the underlying driver of PCOS.

Nikki x