PCOS and slim women

[Amber]

I have been doing some investigation into insulin resistance and slim women and have found the following article below. It is obviously very new research but as it is from the BMJ, it will be good evidence to take to a GP if necessary.

hth
Amber


Even lean women with PCOS are insulin resistant
Balen and colleagues imply that insulin resistance and hyperinsulinaemia are not usually present in lean women with polycystic ovarian syndrome (PCOS) unlike in those who are obese.1 In fact, data show that lean women with the syndrome are usually also insulin resistant,2 3 and such data were crucial in establishing that insulin resistance and hyperinsulinaemia are fundamental, causal factors of the syndrome.4 5

Cite this as: BMJ 2009;338:b954



Steven L Shumak, professor of medicine1

1 University of Toronto, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5


--------------------------------------------------------------------------------
Competing interests: None declared.

References

Balen A, Homburg R, Franks S. Defining polycystic ovary syndrome. BMJ 2009;338:a2968. (13 February.)[Free Full Text]
Chang RJ, Nakamura JM, Judd HL, Kaplan SA. Insulin resistance in non-obese patients with polycystic ovarian disease. J Clin Endocrinol Metab 1983;57:356-9.[CrossRef][ISI][Medline]
Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance independent of obesity in polycystic ovary syndrome. Diabetes 1989;38:1165-74.[CrossRef][ISI][Medline]
Barbieri RL, Smith S, Ryan KJ. The role of hyperinsulinaemia in the pathogenesis of ovarian hyperandrogenism. Fertil Steril 1988;50:197-212.[ISI][Medline]
Poretsky L. On the paradox of insulin-induced hyperandrogenism in insulin resistant states. Endocr Rev 1991;12:3-13.[Abstract/Free Full Text]

[Vedrana]

I am living proof of this since i weight only 52 kilos and i am insulin resistant! it took me forever to get the doctors to send me fot the OGTT to prove it. many of my friends think im anorexic and that why i wont touch sweets and stuff hehehhe

[FIREFIGHTER]

U r so lucky I'm on the other side 16 st 9 1/2 pounds.

Jealous already

[Vedrana]

yea i know im lucky when it comes to weight, but it seems that all i am ´missing˝ in kilos i got in Hair all over hahahahah.... its really frustrating but i try to make fun of it, makes me feel better.
But you will get there Firefighter im sure!

[Amber]

I do have to work hard at keeping the weight off by exercising lots and eating healthy all the time. The most frustrating thing is that most of the solutions given is to loose weight. Trouble is symptoms don't always go away by being normal weight. I have not had a real AF for over a year and still have troublesome skin.

I have found a forum for thin women with PCOS on the Soul Cysters website which is the Amercian version of verity.

[kavidhai]

Hi,Am 30 yr old,51kgs,With PCOS ,married,tryin hard to conceive.....The article suggested is very useful....How many thin people with PCOS like me are sufferin frm infertility???pls do share ur experiances.....

[gemmah]

hi im 24 yrs and ive just been diagnosed with pcos im only 9 st so not over weight the only symptoms i have r really irregular periods sometimes not for 5 to 6 months and i had the scan and i have slightly enlarged ovarys and more than 12 cysts on each ovary im scared and confused and the gncologst is like here this is what uve got u could get diabetes so watch ur weight and here is the pill ahhh i feel so alone could they be wrong i do want childen someday and im worried any help please x x

[Vedrana]

You should really see about IR and maybe get a OGTT. the pill is not the solution to our problems. it will only mask the symptoms. dont be scared. there are planty of us who can help answer your questions since the doctors dont really do that. feel free to ask anything.

[ellen1]

i am 27 and have not had period for about 8 months...they have always b been irregular...its is only now doc taking serious after blood test showed elevated testosterone levels..i have scan in ten days and will be v surprised if not pcos..i have put on weight, i am9 stone ish although still slim...i was 8 stone before..my biggest worry is children as so want kids, love children so much..very scared...from what ive been reading sounds like you need more than pill...are you getting periods at the moment??? hope you feel better

[A]

I am slim too and I also got all the excess hair and skin problems etc... And trying to conceive...

[emmadenny]

Hi guys, after all tests etc consultant reckons im pcos as hints of cysts on ovaries and completely absent periods. Ive got my weight up to a bmi of 19 now, but am v restrictive with food and generally eat a great deal of fruit and veg, but little protein and no bread, pasta, rice etc. Consutlant wants me to go away for 2 months and have alot of protein 3 times a day with only a little veg/salad and no snacks in between...i feel i dont know where to begin!!! Could anyone help or give any advice? Thanks! Emma xx

TTC for over 3yrs

[Annoldie]

Hi Emma, welcome. If you have only just got up to a BMI of 19 your low weight and lack of an adequate well balanced diet is probably a cause of your lack of periods and infertility - but I am sure you know that. I don't think you should be worrying about a diet for pcos until you have put a little more weight on. Can you get some help from a dietition, this is just my opinion but I feel that you need some specialist help to look at your eating problems. A growing baby would need calcium, protein and some carbohydrates as well as what it would get from fruit and vegetables so you need to get your diet sorted before you embark on a pregnancy. Sorry if this is not what you want to hear, but hope it helps. Ann

[emmadenny]

Hi Ann,

Thank you for your opinion. I have been various weights throughout my life and have never had a cycle;,apart from when on the contraceptive pill. I think due to this fact, this is why he is getting me to focus on my diet;he said he wanted to try this before prescribing metformin. I did think about seeing a nutritionist? Emma x

[Annoldie]

That sounds like a good idea to me. If you were to take Metformin with such a low carbohydrate intake I think you could be quite ill. Have you had a glucose tolerance test done or seen an Endocrinologist?

[emmadenny]

Is this the blood test which can confirm elevated insulin levels? If so then currently no. My pct do not fund that( not that that would have stopped mr has I been told it has to be done yest) and consultant pretty sure that this is the issue, so wants to give this a go for 2 months before any further action. All other tests I have had done have been clear; ovarian ultrasound showed signs of possible cysts on ovaries.
I think it's the trying to think of what to have and when now!! He said eat 3 times a day with no snacks, but upon doing research on this today, it was often stated that eating 5 times- 3 meals and 2 snacks was best. Ifs just all so stressful. Just want a child so badly!