PCOS, weight gain and diabetes

By Caroline J. Cederquist, M.D.
Guest Columnist
Columbus Post

Ovarian cysts can go unnoticed. On the other hand, if you are a woman who has ever had one burst, you’d never forget it. The rupture of an ovarian cyst can be excruciatingly painful. While generally harmless, medically speaking, the pain often sends women terrified to the emergency room, convinced their appendix has given out, or that something worse has happened. It’s not an experience you’d ever want to repeat.
But women with polycystic ovary syndrome (PCOS) often have to. Women with PCOS are far more likely to have insulin resistance, which makes them subject to higher rates of diabetes and heart disease. And not surprisingly, most women with PCOS are overweight.
The condition is both a hormonal and a metabolic disorder. Women with PCOS produce too much androgen, a male hormone. An excess of androgen can cause menstrual irregularities, weight gain, acne, excess hair growth, and the production of the ovarian cysts. They’re also overwhelmingly likely to have insulin resistance, a condition that develops over time and makes it harder and harder for the body to metabolize energy, so it kicks up its insulin production to compensate. People with insulin resistance gain weight more easily and have a harder time losing it. For women with PCOS, the more they gain, the worse PCOS symptoms become.
There’s something of a chicken-and-the-egg situation here. Researchers aren’t sure whether the condition makes a woman more likely to gain weight, or if it’s the weight gain that increases the likelihood of developing PCOS. A 2004 study showed that 32 percent of women with the condition were obese, and another 24 percent were overweight, but not yet obese.
As with many illnesses, there is a clear connection between excess weight and the risk of more pronounced symptoms or even progression to more serious conditions.
Whether the condition is the instigating culprit or not, the chances are that they’ll keep gaining, and if they do, that’s going to make their PCOS condition worse.

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