How are PCOS and diabetes linked in regards to female fertility?

PCOS (polycystic ovarian syndrome), just to recap, is associated with insulin resistance within the female body. Known as one of the most common causes of infertility in women, PCOS is characterized by an imbalance of the female sex hormones within the body and can lead to menstrual cycle irregularities, ovarian cysts and conception problems. Insulin resistance also plays a major role in the development of type 2 diabetes, so it’s not surprising that these two health issues are strongly correlated with one another. Insulin helps bodily cells remove and use glucose from our blood.

What is insulin resistance?

Found in up to 60% of obese women and 40% of non-obese women, insulin resistance is a physiological condition that causes the natural hormone, insulin, to become less effective at lowering blood sugars. Insulin is produced by beta cells, which are scattered throughout the pancreas. Insulin resistance can often be caused by obesity, pregnancy, various infections, severe illnesses, stress and steroid use. Insulin resistance occurs when our muscle and fat cells do not allow the removal and use of glucose. This triggers the pancreas to produce more insulin. What’s more, this cell resistance can increase in severity over time.

What’s the difference between type 1 and type 2 diabetes?

For those who suffer from type 1, no insulin is produced within the body. This is caused by the immune system malfunctioning and destroying all the insulin-producing cells of the pancreas. This is why those with type 1 diabetes must inject themselves with insulin to control their blood sugar levels. With type 2 diabetes, the pancreas still produces some insulin, but either the pancreas doesn’t produce enough of it or the body is unable to use the insulin properly. This is why type 2 diabetes can often be treated with dietary restrictions, proper nutrition and oral medications, but it is very common for type 2 diabetic women to be switched from pills to injections once they become pregnant.

So how exactly are insulin resistance and diabetes related?

As already mentioned, insulin resistance is often a precursor to type 2 diabetes, but can occur years apart from one another. But when the pancreas can no longer produce enough insulin to overcome insulin resistance, which continues to increase in severity over time, blood glucose levels begin to rise. More and more insulin is needed, especially after meals and eventually even during fasting periods. This level of insulin resistance is considered type 2 diabetes.

How does diabetes impact female fertility?

On average, young women with either type 1 or type 2 diabetes tend to start their periods a bit later than women who don’t. Additionally, women with diabetes are more likely to go into menopause earlier. These two factors significantly affect female fertility and shorten the window of opportunity to conceive as a result. And unfortunately, diabetic women can have a tough time getting and staying pregnant. Even if they succeed, many diabetic women can have what is considered a ‘high risk’ pregnancy. Miscarriages are fairly common when a pregnant woman’s blood glucose levels are above normal, which is something a growing fetus can’t handle very well. The high blood sugar damages the embryonic cells, which can cause the embryo to spontaneously abort just days after conception. Women who are trying to conceive and don’t know they have diabetes or don’t manage their diabetes well are at risk of experiencing recurrent miscarriages. We will be discussing gestational diabetes, type 1 diabetes and type 2 diabetes and how they can affect pregnancy in a subsequent post.

How does diabetes impact male fertility?

There are many ways in which diabetes can lead to male infertility. Recent studies have shown that the incidence of DNA sperm damage is higher in diabetic men. This can result in diminished sperm quality and cause various defects to the sperm that can hinder fertilization. Research has also shown a strong link between blood sugar levels and sperm quality. Studies have concluded that elevated blood sugar levels result in a higher incidence of malformed sperm, dead sperm and significantly diminished sperm counts. Several symptoms of diabetes can also severely reduce a man’s ability to reproduce. These include obesity, erectile dysfunction, diminished libido and fatigue. That being said, many diabetics can overcome many of these symptoms with the help of proper nutrition, exercise, weight management and insulin injection.

What can diabetic men and women do to increase their fertility?

As mentioned above, if you are trying to conceive and have diabetes, managing your diabetes properly will increase your chances of conception significantly. Meal plans should be strictly followed, blood sugar levels should be frequently tested and oral medications should be taken and injections administered religiously.

Meal plans for diabetic men and women typically revolve around the following guidelines:
  • Consult a physician in regards to your health and nutritional needs. Discuss your meal plan with him/her, so as to ensure good health and balanced nutrition
  • Limit your consumption of foods that are high in sugar
  • Eat smaller portions during meals, and be sure to spread them out
  • Eat less trans and saturated fats
  • Limit alcohol consumption
  • Limit your sodium intake
  • Eat a variety of whole-grain foods, fruits and vegetables
  • Keep tabs on your carbohydrate consumption daily

And of course, daily exercise offers a huge advantage to those seeking to increase their fertility and/or trying to conceive – diabetic or not.

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