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Excess insulin causes some distressful problems for women namely because its effects on the ovaries. The ovaries normally secrete estrogen, so-called female hormone.” Among its many actions, estrogen redistributes fat away from the abdomen towards the buttocks and breasts, promoting the so-called hourglass body shape.  

It turns out that the ovaries also secrete small amounts of testosterone, so-called male hormone. The problem is that hyperinsulinemia can cause the ovaries to secrete too much testosterone. 

A little testosterone is helpful for women. It promotes bone and muscle strength and enhances sex drive. However, too much of it causes problems. It can bring on acne, stray hair growth and thinning scalp hair. Particularly distressful are its effects on the ovaries themselves. Excess testosterone often interferes with ovulation, causing late periods, missed periods even infertility.

In a normal menstrual cycle, the ovaries produce an egg, which grows to maturity over a couple of weeks then is released from the ovary for possible fertilization. Testosterone prevents the egg from maturing and being released from the ovary. Instead it shrinks up into a ball of scar tissue. After several months, these “cysts” accumulate in the ovaries, which is why this condition is called polycystic (many cysts) ovary syndrome (PCOS).   

Testosterone excess in women may be mild, causing an occasional late period, acne breakout or stray body hair. It may come and go over time. It can also be severe and persistent with severe acne, unsightly hair growth, thinning scalp hair and infertility. PCOS is invariably accompanied by increased belly fat, even among women who are not overweight.

The number of women with PCOS has exploded in the last 50 years along with our  epidemics of obesity and diabetes . It is now America’s leading cause of infertility. Approximately 10 percent of women–25 percent of overweight women–have PCOS. The problem is that most women with PCOS don’t realize they have it. This is unfortunate because PCOS is highly treatable with lifestyle measures that reduce insulin excess or with medication.

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