PCOS & PCOD

Glucose Monitoring for PCOS: How Does That Work?

Parul Dube

November 23, 2022

Polycystic Ovary Syndrome or PCOS is a hormonal condition experienced by several women. It occurs because the ovaries produce excess androgens, the male sex hormones. Women usually have deficient levels of androgens, but those with PCOS have abnormally high levels of it.

They tend to have lower levels of progesterone, the female sex hormone. PCOS also leads to insulin resistance, a condition where the body makes insulin but cannot use it effectively. PCOS also negatively affects the body’s metabolism.

A study found that around 4-20% of women of reproductive age worldwide suffer from PCOS. This number is steadily increasing. Although the exact causes aren’t known, PCOS can result from being overweight, family history, and insulin resistance.

PCOS also serves as one of the leading causes of infertility. Because of increased insulin levels, women with PCOS may gain weight. However, according to one study, losing even a small amount of weight can reduce the severity of PCOS.

An effective way to prevent and reduce PCOS symptoms would be to monitor glucose levels. It would help understand the effect of insulin on the body. At the same time, monitoring glucose levels can also help maintain or reduce weight.

The HealthifyPro, with its 5-stage support, can be excellent support. It would help to reduce the risk of not only PCOS but also obesity or being overweight.

The Continuous Glucose Monitor (CGM) measures glucose levels and their fluctuations in real time. Furthermore, highly qualified experts analyse this information and give you personalised suggestions regarding your diet. Implementing these insightful suggestions will improve metabolic health and prevent the risk of various diseases like diabetes, metabolic syndrome and PCOS.

Polycystic Ovary Syndrome (PCOS)

PCOS is a lifelong condition that occurs because of hormonal imbalances. The three features of PCOS are irregular menstruation, polycystic ovaries, and imbalances in androgens, progesterone, and insulin.

A woman can experience the symptoms of PCOS during her late adolescence and early 20s. However, some women do not experience all the symptoms.

The symptoms of PCOS include the following.

  • Irregular periods or no periods at all
  • High levels of male hormones cause excess hair growth on the face, chest, etc.
  • Polycystic ovaries where ovaries have several cysts 
  • Weight gain
  • Difficulty getting pregnant because of problems with ovulation
  • Hair loss
  • Acne-prone or oily skin
  • Fluctuations in mood
  • Darkening of skin under the armpits, back of the neck, or under the breasts

Causes of PCOS

The exact causes of PCOS are not known. However, hormonal imbalances, family history, and being overweight or obese might be the most significant causes. Here are some of the reasons that can lead to PCOS.

Insulin

Insulin is responsible for maintaining glucose levels in the body by allowing glucose to enter the cells. This blood glucose/sugar then converts into energy the body uses to function.

People with PCOS experience an increased level of glucose because the body cannot use the produced insulin effectively. The body produces more insulin when your organs do not get glucose easily. Therefore, it results in insulin resistance, where blood sugar levels are high. The condition where the body produces more insulin is called hyperinsulinemia. It is associated with metabolic problems.

Sometimes, even with increased amounts of insulin, the blood sugar levels are not under control, resulting in conditions like diabetes or glucose intolerance.

One study found that insulin resistance frequently occurred along with PCOS and type-2 diabetes. Over 50-70% of women with PCOS and 80-100% of those with type 2 diabetes have various degrees of insulin resistance. It proves that insulin plays a significant role in PCOS.

Androgens

Androgens (e.g., testosterone) are a group of male sex hormones responsible for facial and body hair growth. The hormone is also responsible for the deepening of voice in men.

These also regulate several organs and influence metabolism. Androgens are also present in women. It helps to initiate hair growth during puberty and maintain the strength of bones and muscles.

Irregular menstruation increases Luteinizing hormone (LH) and Follicle Stimulating Hormone (FSH) levels. These increased levels, combined with insulin resistance, cause an increase in androgens levels in women with PCOS.

A woman with more than normal amounts of androgens might experience acne, abnormal periods, excess hair growth, infertility, and obesity. Subsequently, these are also some symptoms of PCOS.

Progesterone

Progesterone is an essential female hormone for menstruation, menopause, and pregnancy. It aids in strengthening the pelvic wall muscles for childbirth.

The egg’s release from any one of the ovaries leads to the production of progesterone. It strengthens the uterus wall and prepares it for a possible pregnancy.

During this process, the progesterone levels are high. However, in the case of improper fertilisation of the eggs, the progesterone levels drop. It results in the endometrium (lining of the uterus) shedding, causing a menstrual period. 

Women with PCOS have abnormal progesterone (lower) levels. It causes problems in ovulation (where an egg that has matured goes out of the ovary). If ovulation doesn’t happen, it leads to the formation of small cysts in the ovaries. These cysts that are full of fluids produce abnormal levels of androgens. However, sometimes, women with PCOS might not have cysts.

Obesity or Overweight

According to WHO, a person with a Body Mass Index (BMI) above 30 is considered obese. At the same time, if the BMI is above 25, the person is considered overweight.

Obesity is a prevalent issue worldwide and is a significant risk factor for cardiovascular diseases like stroke, heart disease, etc. The number of people with obesity has continuously increased, and in women, there has been a 2.5 times increase in the last 40 years. Furthermore, research shows that obesity is closely associated with PCOS, as about 38-88% of women with PCOS are obese or overweight.

High-calorie diet and lack of regular exercise might also contribute to why women with PCOS might be overweight or obese. One reason obesity is associated with PCOS might be irregular insulin levels.

Whether obesity causes PCOS is not well researched yet, but it is closely related to this disease. Several women who are overweight or obese do not have PCOS, but they have an increased risk of getting PCOS.

Stress and Anxiety

Women with PCOS might experience stress and anxiety because of symptoms like excess facial hair. Since PCOS affects fertility and women’s fertility is considered important, this might cause acute stress in those with this condition.

One study also found that anxiety was about three times higher in women with PCOS. The participants also had increased depressive symptoms.

Another study found that stress influenced fat distribution in the body. For example, women with PCOS had more fat stored in the waist area. It might increase the risk of obesity, cardiovascular diseases, and metabolic syndrome.

Genetics/Family history

Genes strongly influence PCOS. Since it is a very complex disease, no single gene or group of genes cause it. Research has found that the genes that affect the ovaries, either directly or indirectly, are related to PCOS.

Several genes influence androgen levels, luteinising and follicle-stimulating hormone levels, and insulin levels. If a parent has PCOS, it is possible to assess the risk that the child might also have it. 

The HealthifyMe note

PCOS is a complex disease whose causes are not well known. Based on the symptoms, hormonal levels of androgens, progesterone, and insulin primarily affect PCOS. Stress and genetics also serve as causes of PCOS. Obesity or being overweight strongly influences the risk of having PCOS.

Diagnosis of PCOS

If the symptoms persist, a healthcare expert will ask for blood test results and ultrasound results. The blood test will assess the levels of androgen and other hormones. Also, doctors use ultrasound to determine if the ovaries have cysts and the size of the cysts. It might also determine the thickness of the endometrium.

Usually, doctors do not use insulin levels to diagnose PCOS because insulin levels might be high in women who are obese but don’t have PCOS.

There is also no range or levels of insulin specific to PCOS. However, your doctor will ask for a glucose and cholesterol test if PCOS is confirmed. The test results will show whether a woman with PCOS has diabetes or prediabetes.

PCOS doesn’t have a fail-proof treatment method, so it is important to consult doctors regularly. Regular consultation and your doctor’s advice will help improve reproductive health and ensure good metabolism.

Treatment for PCOS 

The treatment depends on factors like age, gender, the severity of the symptoms, whether or not the woman is trying to get pregnant, and general health.

Since insulin and being overweight/obese play a significant role in causing PCOS, treatment usually includes lifestyle changes to reduce weight.

It will help to regulate insulin and glucose levels. Doctors might also give medications to induce ovulation, reduce skin problems, or regulate insulin levels if you also have diabetes. However, some of the natural ways to control PCOS symptoms are:

Lifestyle Changes

A study found that obese women losing just 5% of their body weight reduced the symptoms of PCOS and regulated insulin levels. However, no significant changes occurred when they lost less than 5% of their body weight. Therefore, you should implement lifestyle changes such as physical exercise, regular sleep routines, and dietary changes.

Physical Exercise 

According to a study, physical exercise plays a role in reducing insulin sensitivity and resistance. This study concluded that physical training is essential to treat and prevent insulin sensitivity.

Another study found that structured exercise training and dietary modifications effectively increased fertility and reduced body weight, body mass index, and waist circumference.

Regular exercise also regulates the levels of insulin and other hormones. In addition, exercise changes the sedentary lifestyle bringing about better metabolic functioning. 

Dietary Modifications 

One study assessed the effects of different diets on women with PCOS who weren’t taking medications. They found subtle differences among the diets followed by women with PCOS.

Monounsaturated fat helps to decrease levels of bad cholesterol. A diet high in these fats was effective for weight loss. A low glycemic index diet helps reduce glucose and maintain insulin levels. Following this diet was found to be effective for getting regular periods. A high protein diet reduces the symptoms of depression and increases self-esteem in those with PCOS. 

Another study found that no specific diet was better than other diets in reducing weight. It suggests that no diet works similarly for all. Hence, one should look for personalised diet plans to lose weight effectively. 

Improving sleep quality

Sleep deprivation results in impaired physiological and metabolic functioning. A study found that sleeping for a short duration reduces leptin levels and increases ghrelin levels. It might cause an increase in appetite, resulting in an increased BMI. This study found negative implications if the sleep duration was less than 8 hours per day. 

In another study, obese women who lost weight consumed an optimal, low-calorie diet. But it was successful only if they had regular sleep patterns (around 6-8hours per day). It highlights the importance of good sleep for reducing weight, which will help maintain PCOS.

Medications

Doctors might give medications to induce ovulation to improve the chances of conceiving. However, it might result in multiple births, e.g., twins or triplets. It can also overstimulate the ovaries, which can cause problems. Sometimes, doctors also prescribe diabetes medications to tackle insulin resistance.

It might help to reduce androgen levels, regulate ovulation and decrease excess hair growth. In addition, doctors might give targeted medications to reduce excess hair growth in some women. Weight loss medications or surgery (for obese women) are also potential treatment options.

Prevention of PCOS through Glucose Monitoring

Insulin resistance and imbalances are significant causes of PCOS and obesity. So constantly monitoring glucose levels is essential. It will help maintain normal glucose levels.

Glucose monitoring is also crucial if a person has any risk factors or symptoms. After this, you can implement lifestyle changes centred around regulating glucose levels. No specific diet will be effective for everyone because of differences in personal goals. Accordingly, in one research review of several studies, no particular diet was better than others.

Blood Sugar Metre

Everyone is aware of the use of blood glucose metres. The monitor displays the blood sugar after a few seconds of inserting the strip. However, this has advantages and disadvantages. It is a small and portable device that can measure glucose levels anywhere. However, it requires pricking the finger each time to measure the blood glucose levels. Therefore, it might not be ideal for routine glucose testing.

Continuous glucose monitoring (CGM) for PCOS

CGM comes with a sensor that sticks to your arm and continuously measures blood glucose levels. Earlier, it was typically used by people with type 1 diabetes. Now, the usefulness of this CGM technology has gone up, and it also comes in handy for other purposes.

These include using CGM to prevent diabetes, metabolic syndrome, PCOS, obesity, etc. You can also use CGM to increase metabolism and optimise it for everyday functioning.

The modern CGM measures glucose levels for up to 3 months and sends the information to a mobile app. Using these insights, you can create personalised treatment or prevention plans with the help of medical professionals.

A study found that in women with PCOS, glucose levels after three meals were higher than those without PCOS. The researchers used CGM to measure these changes and suggested using CGM to measure the changes in glucose levels in PCOS sensitively.

CGMs are different from blood sugar meters because they measure glucose levels constantly. The blood sugar meter does it only when the person tests the glucose levels. There is also an alarm feature if the blood sugar levels are too high. 

Combined with individual dietary suggestions and fitness plans, CGM will be highly effective in managing PCOS and other related conditions. Therefore, consulting healthcare specialists regarding this will improve health and metabolism for PCOS individuals. 

The HealthifyMe Note

You can follow a nutritious diet, regular physical exercise, and healthy sleeping routines to manage and prevent PCOS. Since abnormal insulin levels cause PCOS, monitoring insulin and the dependent glucose levels is necessary for treatment. Continuous Glucose Monitoring (CGM) is an effective and modernised way to measure how glucose levels change with personalised diets and exercise routines.

Conclusion

PCOS is characterised by irregular periods, weight gain, high levels of androgens, excessive hair growth, and polycystic ovaries. It is a prevalent condition affecting 1 in 10 women of reproductive age.

It is one of the leading causes of infertility, and it might result from hormonal imbalances of androgens, progesterone, and insulin. If a woman is overweight or obese, it might increase the risk of getting PCOS.

It can be managed by following a nutritious diet, regular exercise, and monitoring glucose levels. Since insulin resistance influences PCOS, controlling glucose levels and making lifestyle changes are essential. 

About the Author

Parul holds a Masters of Medical Science in Public Health Nutrition from the University of Glasgow, Scotland, and has worked across the globe from the U.K to New Zealand (NZ) gaining her License with the Health Professionals Council (HPC, UK) and the NZ Nutrition Council. From being a Gold medalist in Clinical Nutrition to being awarded an internship with World Health Organisation (WHO, Cairo, Egypt) and Contracts with CDC Parul has had a wide spectrum of work experiences. She is very passionate about Nutrition and Fitness and holds strong to her guiding mantras ‘ Move more’ and ‘Eat Food that your grandmother can recognize’!


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