Insulin is one of the most important hormones in your body. Among other things, it affects your hunger and appetite, as well as your body weight, body fat percentage and muscle development. It therefore also influences numerous bodily processes that can affect your fertility. If you are insulin-resistant, then your body does not respond strongly enough to the hormone insulin. This can lead to what is known as PCOS and make it more difficult to conceive, as you will have fewer fertile days as a result.
Being overweight and metabolic disorders such as PCOS (polycystic ovary syndrome) are a common cause of infertility. PCOS is also frequently associated with impaired glucose metabolism. The hormone insulin regulates glucose metabolism. It is produced in the pancreas and stimulates the body’s cells to absorb glucose from the blood and use it as an energy source. If the cells become resistant to insulin, as in type 2 diabetes, blood glucose levels rise. Elevated blood sugar levels damage blood vessels and are a risk factor for cardiovascular disease.
In insulin resistance, the effectiveness of the hormone insulin in the body is impaired. Due to a disruption in insulin binding to a cell, insufficient sugar reaches the cell to provide energy, whereupon the pancreas increases insulin production. This leads to elevated insulin levels in the blood. In addition to PCOS, insulin resistance occurs primarily in patients with type 2 diabetes and various pre-diabetic conditions. A higher body weight can be an early sign of impaired insulin utilisation. In particular, fat in the abdominal area causes an increased release of hormonally active substances that promote insulin resistance.
PCOS can have various causes. It is important to be aware of these in order to determine the right treatment. Find out about the four different types if you have PCOS.
Insulin resistance manifests itself through the following symptoms:
Pregnancy can also increase the risk of glucose metabolism disorders. Risk factors for gestational diabetes include being overweight, polycystic ovary syndrome (PCOS), the mother being over 30 years of age, or a family history of diabetes. Dietary management and plenty of exercise can improve glucose metabolism during pregnancy, but insulin therapy may also be initiated. Glucose metabolism usually returns to normal after childbirth.
A healthy glucose metabolism promotes egg maturation. Later on, a balanced glucose metabolism is essential for the embryo to implant in the uterus at all and to develop without complications.
Insulin resistance causes the pancreas to release too much insulin (hyperinsulinism), which, via the pituitary gland, stimulates luteinising hormone (LH), which in turn leads to increased production of male sex hormones (androgens) in the ovaries. At the same time, insulin resistance disrupts the production of progesterone in the ovaries, resulting in an excess of androgens. This leads to external changes such as increased body and facial hair and can also result in infrequent or absent ovulation. If the hormonal balance is disrupted in this way, it throws the entire menstrual cycle into disarray. Insulin resistance can therefore affect fertility and stand in the way of the desire to have children.
For women with polycystic ovary syndrome (PCOS) who also have insulin resistance, the antidiabetic drug metformin is usually prescribed to help them conceive. The drug improves the body’s response to insulin and regulates glucose metabolism. This restores hormonal balance, allowing ovulation to resume despite insulin resistance. Treatment with the drug also normalises LH and FSH levels and, in overweight women with PCOS, leads to a significant reduction in body weight. Both of these factors have an additional positive effect on fertility. A change in diet aimed at reducing body weight can also help to improve fertility.
If you think you might be suffering from insulin resistance, you should discuss this with your gynaecologist. They can carry out the necessary tests and select the best treatment method for you, so that nothing stands in the way of your desire to have children.
Every cycle is as unique as every woman herself. There are 9 different cycle types, each with different symptoms and causes. The better you understand your cycle type, the more consciously you can live in tune with your own cycle.
Briden L. 4 Types of PCOS. https://www.larabriden.com/4-types-of-pcos-a-flowchart/ Zugriff: 10.11.2020
González F. 2012. Inflammation in Polycystic Ovary Syndrome: Underpinning of insulin resistance and ovarian dysfunction. Science Direct. https://doi.org/10.1016/j.steroids.2011.12.003
Insulite Health PCOS. The Phenotypes of PCOS. Which type are you? https://pcos.com/did-you-know/ Zugriff: 10.11.2020
Stiefelhagen P. Bei PCOS besteht oft eine Insulinresistenz. Info Diabetol 13, 49 (2019). https://doi.org/10.1007/s15034-019-1482-xYou are currently viewing a placeholder content from Facebook. To access the actual content, click the button below. Please note that doing so will share data with third-party providers.
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