A significant number of the women who experience issues with fertility also suffer from a medical condition known as polyendocrine metabolic syndrome (PMOS, formerly polycystic ovarian syndrome, or PCOS). Unfortunately, PMOS affects as many as 1 in 5 women of reproductive age, and most of these women will have difficulty becoming pregnant.
Many women who are diagnosed with PMOS have multiple small cysts in their ovaries, which can lead to hormonal imbalances and cycle irregularity. But the presence of cysts on the ovaries is just one of the signs of this syndrome. The PCOS label has long obscured the condition's metabolic, cardiovascular, dermatological, and psychological dimensions contributing to delayed diagnosis, fragmented care, and stigma.
The new name repositions it as the complex, multisystem endocrine disorder it is. PMOS is characterized by a wide array of symptoms, including acne, weight gain, loss of hair, abnormal hair growth (typically seen on the face, back, or fingers), miscarriages, and sleeping problems.
While there is still much to learn about PMOS, it is now believed that the symptoms listed above, including the development of multiple cysts in the ovaries, appear when the ovaries are stimulated to produce excessive amounts of male hormones, particularly testosterone. And, what stimulates the ovaries to produce abnormally large amounts of male hormones? The answer: insulin.
What exactly does it mean to be insulin-resistant?
Insulin is a hormone that is produced by the pancreas and participates in the metabolism of carbohydrates, lipids, and proteins. On the surface of each cell of the body there are insulin receptors, little doors that open and close to regulate the flow of glucose (the sugar that is used by your body's cells for energy) into the cell. These receptors, or doors, are activated by insulin. Women who have PMOS often have insulin receptors that do not function efficiently. This causes a condition known as insulin resistance, which forces the pancreas to produce more and more insulin to push glucose into the cells. These elevated insulin levels have the detrimental effects described above. It's estimated that anywhere from 30-50% of women with PMOS experience insulin resistance.
How is insulin resistance controlled?
Recently, I've seen quite a bit of discussion surrounding the benefits (or lack thereof) of taking the prescription medication known as Metformin for PMOS and insulin resistance. Metformin is a drug used to help control blood glucose in three ways; it decreases the absorption of dietary carbohydrates through the intestines, it reduces the production of glucose by the liver, and it increases the sensitivity of muscle cells to insulin. Simply stated, it lowers insulin, glucose, and testosterone levels, which results in a decrease in the symptoms associated with PMOS. Therefore, addressing insulin resistance helps many women with PMOS restore cycle regularity and increase their chances of conception.
There is also a large amount of information available about lifestyle changes that could help control insulin resistance. Weight loss has shown to be helpful for women that may be overweight, yet weight loss can be more difficult for those with PMOS. The combination of dietary changes and more aerobic exercise has been shown to help even if weight loss is not achieved. What dietary changes are most helpful? Eliminating high-glycemic carbohydrates such as refined sugars, white bread, and refined corn and potato products and incorporating high-fiber foods (whole grain bread and brown rice) and nonstarchy vegetables (broccoli, asparagus, green beans, etc.) is recommended.
For women with PMOS who are trying to conceive, herbal supplements (such as PQQ+ Myo + D-Chiro Inositol) can help to restore hormonal balance and encourage cycle regulation.
