Diabetes and PCOS (Polycystic Ovary Syndrome) in women are two conditions that have been identified rather frequently in recent times. PCOS, as the name suggests, emerges when the ovaries are laden with cysts. It impacts the endocrine system in women, causes disruption of the menstrual cycle, makes pregnancy difficult, leads to obesity, and increases the production of acne among other things.

Diabetes is the body’s inability to breakdown blood glucose, causing its accumulation in the body; this is elevated as the body becomes resistant to the hormone, insulin. Insulin resistance is closely associated with an imbalance of hormones that are required for healthy reproductive function in women thus, increasing significantly the risk factor for PCOS.

Both PCOS and diabetes are associated with infertility in women. It becomes challenging for such individuals to conceive naturally.

The presence of diabetes in women of reproductive age has been found to decrease their reproductive window—or the age when they can conceive a child—by 17 percent. This is because it delays the age at which they attain puberty (or menarche) and hastens the age at which their menstrual cycle ends altogether (or menopause).

In their menstrual years, women with diabetes can experience several problems with their periods. They have been found to have irregular periods, absence of periods for a few months (or secondary amenorrhea), or a lack of menstruation altogether (or oligomenorrhea). Diabetes also fastens the rate at which the ovary ages, that is, the rate at which the quality and quantity of eggs deteriorate at a very rapid pace. This decreases the probability of conceiving naturally as well as raises the possibility of miscarriage and stillbirth.

Diabetes can often be linked to the presence of PCOS in women however, one is not always a result of the other.

One of the most common experiences of women with PCOS is irregular periods. The formation of cysts in ovaries causes a hormonal imbalance with increased levels of the male testosterone hormone, luteinizing hormone (LH), and estrogen; there is also a marked decrease in the levels of follicle-stimulating hormone (FSH). These are some factors that contribute to an irregular menstrual cycle.

Moreover, an irregular menstrual cycle indicates that the time of ovulation is irregular, making a normal conception difficult. In women with PCOS, an egg is not released during ovulation; in the absence of fertilization, a pregnancy thus, cannot occur.

Women with PCOS and diabetes are more likely to add extra kilos to their body weight. A follow-up impact of this is the emergence of cardiovascular diseases, high blood pressure, and in some cases, endometrial cancer.

Since diabetes and PCOS share common symptoms, lowering insulin resistance, maintaining a healthy weight, and regaining fertility are often the goals of treatment. Because each patient has different priorities for their care, the treatment objective and suggestions are highly personalized. These treatments may take several months before a health improvement is seen.

Several preventive steps can help keep these conditions at bay or even control them. Before diabetes develops, several actions can be taken to detect insulin resistance. Healthy lifestyle choices can help avoid diabetes. Understanding one’s nutritional requirements, body conditions, and even a blood glucose test is crucial since they help with understanding what to eat, how much physical activity should be added in, and whether one needs to make any medication or insulin additions and/or adjustments.

It has also been demonstrated that a healthy, balanced diet that is low in fat and sugar, and high in whole grains, low-fat dairy, fruits, and vegetables lowers the chance of developing diabetes and PCOS. Losing weight will enhance insulin sensitivity, which will have a knock-on effect on the progression of PCOS, helping to restart ovulation and increasing one’s fertility. Exercise also aids in reducing high blood sugar levels and makes cells more responsive to insulin since it helps maintain a healthy weight.

Stress is another significant contributor to insulin resistance. Stress can result from lengthy work hours as well as problems affecting one’s emotions professionally and personally. Understanding when to take a break, ensuring work-life balance, and communicating with dear ones are some important practices. Additionally, one must be open to the idea of taking the help of a psychologist when signs of stress are observed.

Women with diabetes and PCOS can benefit from adopting healthy lifestyle habits. However, it may be that one continues to experience complications with conceiving. In such cases, women can opt for assisted reproductive technology (ART) such as in vitro fertilization (IVF) to have a child. Early detection of symptoms can help with early treatment and hence, better success rates. Therefore, depending on the symptoms and risk factors, one might also choose to speak with a gynecologist, reproductive endocrinologist, or endocrinologist.

About the author- Dr. Kshitiz Murdia, Co-Founder& CEO, Indira IVF