Diabetes and Polycystic Ovary Syndrome: What’s the Link?

This common disorder raises your risk for diabetes and other diseases

A healthy beginning—During her pregnancy, Kimberly Guerriere of Bangor was closely monitored to ensure her gestational diabetes caused by polycystic ovary syndrome didn’t harm her baby. Today Julia, age 1, is a happy and healthy little girl. Read her story.

PCOS Symptoms

No menstruation within two years of breast development
Skipped menstrual periods or periods more than six weeks apart
Severe acne
Male-pattern hair growth or hair loss
More than a year of trying to get pregnant without success
Obesity accompanied by any of the above

If you’re a woman of childbearing age and struggle with infertility, irregular menstrual periods, acne, or excess weight gain or hair growth, you could be one of four million women with polycystic ovary syndrome (PCOS), a complex metabolic disorder that could put you at high risk for developing diabetes and heart disease.

Though the long-term consequences of the disorder are more serious, it’s usually the syndrome’s cosmetic effects that bring women to the doctor. “Acne, excess hair growth and weight are symptoms everyone can see,” says endocrinologist Marc Vengrove, D.O., of Lehigh Valley Hospital and Health Network. “PCOS can be a very frustrating problem for young women.”

What is PCOS?

PCOS occurs when high levels of androgens, or male hormones, interfere with normal ovulation and metabolism (the process by which our bodies produce energy). PCOS is the most common endocrine disorder among women of childbearing age, although the exact cause is still unknown.

“Forty percent of women with PCOS are insulin resistant, so they don’t metabolize glucose normally. That puts them at extremely high risk for developing diabetes,” Vengrove says. Researchers think insulin resistance may be one of the main reasons PCOS occurs.

Diagnosing the syndrome

Unfortunately, there is no one single test for PCOS. To help diagnose the disorder, your doctor will take a medical history, perform a physical exam and check your hormone levels. Despite its name, PCOS doesn’t necessarily cause multiple ovarian cysts, so doctors may or may not order an ultrasound.

“But a glucose tolerance test is very important because of the potential diabetes risk,” Vengrove says. The results can tell your doctor whether you’re insulin resistant by measuring your body’s ability to properly use the carbohydrates you’re consuming.

Finding relief

Treating PCOS depends on your insulin resistance and other symptoms. Here are some options your doctor may discuss with you.

Medication. “If you’re insulin resistant, the first line of treatment often includes the diabetes medication metformin, which helps your body become more sensitive to the insulin it’s producing,” says Vengrove’s colleague, reproductive endocrinologist Wendy Schillings, M.D.

Ovulation induction. If fertility has been a problem, most women with PCOS can get pregnant with treatment to help their eggs develop normally. “There’s definitely hope,” Schillings says. But women should be carefully monitored by their obstetrician or maternal-fetal medicine specialist (physicians who specialize in complicated pregnancies) as they are at higher risk for miscarriage, and gestational diabetes and hypertension.

Diet and exercise. “Regular exercise and a healthy diet are mainstays of treatment,” says diabetes educator and dietitian Deb Maurer, of Helwig Health and Diabetes Center. “Exercise and weight loss help control insulin production. It also can elevate your mood, making it easier to stay motivated with a diet.”

Weight loss. Although losing weight can be even more challenging for women with PCOS, many do begin to ovulate again and get pregnant on their own after losing just 10 percent of their body weight.

Birth control pills. To help regulate irregular periods, your doctor may recommend birth control pills. Women shouldn’t take them if they smoke, or have a history of blood clots, heart disease, stroke or certain types of cancer.

Hair removal. If excess hair growth is an issue, talk to your doctor about laser hair removal, a permanent and effective treatment.

The rewards are many

Treatment enables many women to become pregnant, lose weight, have more regular periods and get rid of unwanted hair. “It’s rewarding to work with these women because they’re motivated to make changes that affect their health,” Vengrove says. “And they’re especially pleased when they start seeing positive changes.”

As wonderful as the outward changes may be, women with PCOS also reduce their risk of developing diabetes by adopting lifestyle changes and treating insulin resistance early.

Concerned you might have PCOS? Call 610-402-CARE to find a physician who can help.