Women’s Health Watch: Low-Carb Diets and PCOS

One in ten women has polycystic ovary syndrome (PCOS), the most common reproductive abnormality in premenopausal women, putting them at higher risk for both cardiovascular disease and diabetes. PCOS is also the most common cause of infertility.

One of the major biochemical features of PCOS is the combination of insulin resistance and hyperinsulinemia (elevated insulin levels). The ability of obese women with PCOS to use glucose (sugar) is significantly impaired, and they have a marked reduction in insulin sensitivity.

A new study from the Center for Androgen-Related Research and Discovery at Cedars-Sinai Medical Center has shed even more light on the hormonal irregularities of PCOS. Seems that fat tissue in women with PCOS behaves somewhat differently from fat tissue in women without the syndrome.

Here’s why that matters: Fat tissue is actually a kind of endocrine gland. In fact, it’s the body’s largest hormone-producing organ. Far from sitting passively on your hips and thighs, fat cells actually produce a wide range of hormones and other chemicals which affect metabolism and health, impacting appetite, bowel function, brain function and the metabolism of both sugar and fat.

According to the study, the fat tissue in women with PCOS produces an inadequate amount of an important hormone known as adiponectin. Adiponectin helps the body to make use of insulin, helping to metabolize fats and sugars and also- not incidentally- reducing inflammation. Women with PCOS produce less adiponectin than women without PCOS. Higher levels of adiponectin also reduce the risk of type ll Diabetes, which makes total sense since adiponectin makes your cells more insulin sensitive (which is exactly what you want). Diabetics, on the other hand, tend to be insulin resistant.

PCOS gets a lot of attention in the low-carb community because a low-carb diet is the diet of choice for women with PCOS. One major reason is that low-carb diets lower circulating insulin.

The insulin connection may also account for why women with PCOS have sex-hormone related issues like excess hair growth and polycystic ovaries. Here’s why: When your body is insulin resistant, the muscle cells tend to not accept insulin (and sugar), leaving you with elevated levels of both. Eventually even the fat cells can become resistant. But the cells of the ovaries tend to remain insulin-sensitive. So now your body’s producing all this insulin, which is bathing the poor ovaries in the stuff.

One of the responses to all that insulin hitting the ovaries is that they over-produce testosterone and androstene, which leads to acne, “male” hair issues (like hair loss on the head and hair growth where you don’t want it!), and the other familiar symptoms of PCOS.

I discuss the use of low-carb diets for PCOS in my new book, “Living Low Carb: Controlled Carbohydrate Eating for Long-Term Weight Loss”.