PCOS, insulin resistance and infertility

Poly-cystic ovarian syndrome (PCOS) has such a wide range and degree of symptoms that it is still under-diagnosed, but it is estimated between 4-12% of the female population has this endocrine disorder.  The Centers for Disease Control state PCOS to be the number one cause of infertility in pre-menopausal women.  Insulin is the hormone that is released by the pancreas when our brain senses we have an excess of glucose in our blood.  Some studies suggest insulin can affect ovarian and androgen hormones, and, as many women with PCOS have insulin resistance, similar to people with Type 2 Diabetes (T2DM), this can lead to an excess of insulin as the body tries to push the glucose into those resisting cells.  Therefore, if women with PCOS can reduce the amount of insulin released into their bloodstream, they may be able to improve their ovarian and androgen hormone levels, therefore improving fertility.  Of course, just like women without PCOS, there can be other causes for infertility so please see your GP for blood tests to confirm your blood sugar levels or other possible causes of infertility. 

Let me first better explain the role of insulin and then I’ll talk about suggesting a few changes to your diet that could really benefit you (and your pancreas and liver too).

 So, when we eat, foods made from proteins and fats start to get broken down when they reach our small intestine, however, carbohydrate foods, such as fruit, bread, rice and pasta, start to get broken down into glucose in our mouths and stomachs.  This is why carbohydrate-rich foods are often called ‘energy foods’ because they so quickly get broken down into glucose and get sent to our bloodstream to use to make the body’s fuel.  Once the glucose enters the bloodstream the brain senses the blood is now thick and sticky (imagine mixing honey with blood) and wants to get this glucose out of the blood so our bodies can use this energy and also reduce the amount of extra work our hearts have to do to push the thicker blood around our bodies (think increased blood pressure).  So, the brain calls out to the pancreas for help, which releases insulin.  Insulin’s job is to go knocking on all the doors of all the cells and ask them if they have room to take some of the glucose, but for people with insulin resistance, insulin has lost the ability to be heard by the cells so their knocking may go unanswered.  By this stage, the brain is freaking out so gets the pancreas to release even more insulin (the poor brain doesn’t realise there’s enough insulin already).  The insulin starts to panic too, so it takes the glucose back to the liver and asks the liver for help.  At this point, the liver decides to be the hero of the day and takes the glucose off insulin’s hands to either store as glucose or fat in the liver, or as fat stores around the body. 

Insulin’s other job is to promote fat storage so when the brain freaked out and asked for more insulin, your body actually became more effective at storing the excess glucose as fat, and less effective at using that glucose to make fuel.  So you are not only getting fatter, you’re also becoming more and more tired from not getting access to the glucose for fuel.  Plus, your poor, old pancreas is working overtime too.

So, what can be done to reduce the excess release of insulin after you eat?  Well, as I mentioned earlier, carbohydrates can be very quickly broken down into glucose, compared with fats and proteins, however, not all carbohydrates are equal and not all meals are equal.  Let me explain….  Like a person who has T2DM, the problem isn’t with eating carbohydrate-rich foods but more to do with the type of carbohydrate foods you consume.  Some carbohydrate foods still look pretty much how they did when we pulled them out of the ground, or off the tree.  These foods are often called complex carbohydrates and they take longer for the body to break down into simple glucose.  That’s because they have gone through no processing, or hardly any processing, before we eat them.  These kinds of complex carbohydrate foods are fruits and vegetables, and whole grains, and they’re full of fibre that our bodies can’t digest quickly.  On the other hand, in modern society, we are inundated by simple carbohydrate foods.  These are heavily processed foods and don’t really look anything like they did in their natural state.  For example doughnuts are made from wheat but can you see the little wheat grains?  No you can’t.  Nor can you see apples in apple juice, or cocoa beans in a chocolate bar or the potatoes in crisps.  You see, all that processing means our bodies don’t have to work very hard at all to extract all that glucose energy.  Because it’s so easy, it happens really quickly and our blood sugar levels rise really quickly too.  This makes your pancreas release a lot of insulin at once so that your blood sugar levels can be restored to a safer level.  This rush of insulin also makes you hungry faster because the glucose has been quickly removed from your blood.

So, instead of eating simple carbohydrates, we should be eating carbohydrate-rich foods that look like they did while they were still growing.  Great sources, as mentioned earlier, include fruit, vegetables, legumes such as lentils and beans, and whole grains such as quinoa and cracked wheat.

Another way of slowing the digestion of your meal down, and reducing the amount of insulin your pancreas releases, is by including some good quality proteins and healthy fats with every meal.  Again, these shouldn’t go through too much processing before you buy them.  Good sources of quality protein include lean cuts of meat, fish or poultry, and eggs.  Healthy fats and oils include olive oil, nuts and avocado. 

Convenience food is of course, very convenient, but if your goal is to improve your health, whether that goal is to lose weight, or improve your PCOS symptoms, or improve your fertility, then eating convenience food isn’t convenient.  It’s a weight, holding you back from success.  It’s a waste of your time because you aren’t achieving your goals as quickly as you could, and it’s a thief, robbing you of the chance to improve your health.  I find if I spend an hour each week planning my meals (I always cook double and eat leftovers for lunch the next day), then grocery shopping just once each week, then I know I have the right ingredients in my home to help me eat more healthily.  It’s really important to me so I make meal planning a priority.  I plan my breakfasts, dinners (and leftover lunches) as well as my snacks.  I look at my diary to see if I will need to take portable snacks with me if I’m going to be away from home or my desk.  I plan for the unexpected by always having a snack bag of nuts or a protein bar with me at all times. 

Try planning your weekly meals ahead of time for the next four weeks and see how you go.  Write down the goal you would like to achieve by the end of that four weeks.  If you already have insulin resistance, you might want to improve your blood glucose levels.  If you would like to lose weight, you might set yourself a goal of losing 2kgs in four weeks or losing 3cm off your waist.  I would love to know how you go, so leave me a message if you decide to take the challenge…. Good luck!!

Annie