Excess insulin causes particularly distressful problems for women, mainly because of its effects on sex hormones. 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 an “hourglass” body shape.
It turns out that the ovaries also secrete small amounts of testosterone, so-called male hormone. The problem is that excess insulin often causes the ovaries to secrete too much testosterone. A little testosterone is healthful for women. It promotes bone and muscle strength and enhances sex drive. However, too much 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 interferes with ovulation, causing late periods, missed periods even infertility.
In a normal menstrual cycle, the ovaries produce an egg, which grows to maturity then is released from the ovary for possible fertilization. Testosterone prevents the egg from maturing and being released. Instead, it shrinks into a ball of scar tissue. After several months, these “cysts” accumulate in the ovaries, which is why the condition is called polycystic (“many cysts”) ovary syndrome (PCOS.)
Testosterone excess may be mild, causing an occasional late period, acne breakouts or stray body hair. Or it can be severe with persistent acne, unsightly hair growth, thinning scalp hair and persistent infertility. PCOS is invariably accompanied by increased belly fat, even among women who are not overweight.
The number of women in America who have PCOS has exploded in the last 50 years along with our epidemics of obesity and diabetes . Approximately 10 percent of women, 28 percent of overweight women, have PCOS. It is now America’s leading cause of infertility. Unfortunately, most women with PCOS don’t know they have it. This is a missed opportunity because PCOS is highly treatable with lifestyle measures that reduce insulin secretion or with medication.
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