Diabetic Polycystic Ovarian Syndrome
When PCOS and Type 2 Diabetes Combine

Diabetic polycystic ovarian syndrome is a combination of two hormonal disorders, and they will make a woman's life miserable. It is much worse if you have no clue what is causing your misery.

Diabetes is a disease, and PCOS is a syndrome. What's the difference?

If you have all the symptoms it is called a disease. If you have some symptoms but not all, you have the syndrome.

You may only have two out of three of the markers for polycystic ovarian syndrome, but it means you have the hormone disorder that causes it.

And diabetic polycystic ovarian syndrome is a combination of two problems with an inflammatory root. If you have PCOS you may be a borderline diabetic.

What is Diabetic Polycystic Ovarian Syndrome?

PCOS was discovered in 1935 and its discoverers gave it their names. It was called Stein-Leventhal syndrome for a while, but today we know it as PCOS.

The name is misleading, giving you the idea that this is a gynecological disorder. But it is not. Just like type 1 and type 2 diabetes, it is a hormone or endocrine disorder that needs to be treated by an endocrinologist.

The name is confusing, and doctors have tried to think of something else to call it, but the name PCOS has stuck.

That's even though many women with polycystic ovarian syndrome have normal ovaries.

The cause of polycystic ovaries seems to be that hormones are not working correctly. The cysts are cavities in the ovary where an egg has formed.

Those eggs are supposed to be released, but in PCOS that doesn't happen.

So more and more of these cysts form around the outside of the ovary, giving it a bumpy appearance on an ultrasound. But removing ovaries does not cure PCOS or make it better.

This is an endocrine disorder, and cysts on your ovaries are only one symptom. But diabetic polycystic ovarian syndrome is a leading cause of infertility in women, affecting 5% to 10% of us because it does not let eggs fall into the uterus.

As a result you may have irregular or absent menses (periods), very heavy periods or prolonged ones that require a D&C, or just regular periods with spotting from a thickened lining of the uterus that bleeds a little.

Symptoms of Diabetic
Polycystic Ovarian Syndrome

Women with PCOS often have terrible PMS (premenstrual syndrome) with back pain, carbohydrate cravings, mood swings, depression and sleep disturbance.

Having your hormones out of whack can lead to other things as well. You may grow extra body hair and develop acne as well as male pattern baldness on the top of your head.

Having the cysts on your ovaries may cause you no physical pain, but if sudden fever and pain do occur, you must go to your gynecologist quickly.

A cyst may have ruptured, or the ovary became twisted. This is a life-threatening situation.

But most women don't have symptoms to let them know they have PCOS. That is, until they have infertility problems. Or they may miscarry.

There is a high rate of this because of lowered progesterone levels. Progesterone is needed especially in the first trimester of pregnancy.

How PCOS and Type 2 Diabetes Connect

Diabetic polycystic ovarian syndrome connects at the metabolic syndrome and hyperinsulinemia.

Women with PCOS often test positive for hyperinsulinemia even if they have a normal blood glucose level. So getting your insulin levels checked can help to diagnose both PCOS and prediabetes.

Women with polycystic ovarian syndrome have carbohydrate sensitivity, leading to weight gain. Some women gain huge amounts very quickly.

The PCOS diet and diabetes diet resemble each other in many ways. You should eat fewer high glycemic carbohydrates but eat lots of fiber, plenty of antioxidants and good protein.

Another similarity is that both diabetics and PCOS sufferers tend to have thyroid problems. That's not surprising because the thyroid is a hormone regulator.

Hashimoto's thyroiditis is four times more likely to appear in women with PCOS. This particular thyroid problem is an autoimmune disorder where white blood cells attack the thyroid.

So doctors look for the antibodies that are present in Hashimoto's to diagnose it. Thyroid malfunction is also seen in type 1 and type 2 diabetics.

Signs of low thyroid include sleep disorders like insomnia and sleep apnea, hair loss, weight gain, ridged nails and dry skin. Low thyroid leads to dermatitis, depression and mental confusion.

But Hashimoto's is different from low thyroid in that you might have lows and then sudden high thyroid as the destruction of the thyroid progresses.

Treating Hashimoto's helps some of the symptoms of PCOS, but it does not address the metabolic syndrome, insulin resistance or hyperinsulinemia. So the progression from PCOS to type 2 diabetes can happen anyway.

Sadly, there are other complications of PCOS besides type 2 diabetes. One is endometrial cancer that may be caused by the lack of progresterone to balance out estrogen.

Then there are infertility, miscarriage and a tendency for eating disorders. The list also includes high blood pressure, high triglycerides and heart disease.

If those last three sound familiar, it's because they are complications of type 2 diabetes as well.

What Causes Diabetic Polycystic Ovarian Syndrome?

As with most other autoimmune disorders, inflammation is the source, and at this time no one knows the trigger for it.

Some factors are excess insulin, low grade inflammation and white blood cells interfering with normal organs, what many think causes insulin resistance too.

Heredity is another factor. Either parent can pass on the genetic marker for PCOS.

If there is a family history of thyroid disease and insulin resistance the chances of PCOS are higher. And if you have PCOS, your sisters have more than a 50% chance of having it too.

Some research is showing that exposure to excessive androgen while you are in the womb can lead to "gene expression," changes that make you more likely to have abdominal fat, insulin resistance and low grade inflammation.

But instead of dwelling on how it may have happened, perhaps you would rather know what can be done about it.

Diagnosing Diabetic Polycystic Ovarian Syndrome

Endocrine doctors look at your history first. Are there menstrual problems, miscarriages or polycystic ovaries in your family history or your personal history?

Do you struggle with obesity? Half of women with PCOS do. Do you have skin tags or velvety brown discoloration in skin folds or on your neck?

An ultrasound and blood tests will help, but you will need an endocrinologist for treatment because this is an endocrine disorder. Your doctor will rule out other endocrine problems, because PCOS is a "diagnosis of exclusion."

If there are no other causes and you have some of the symptoms you will be diagnosed with PCOS whether you have multiple cysts on your ovaries or not.

Next comes the treatment, and it does not include gynecological intervention. A hysterectomy won't fix PCOS.

Diabetic Polycystic Ovarian Syndrome Treatment

You will be asked to change your lifestyle to a PCOS diet that avoids high glycemic carbohydrates. This lowers hyperinsulinemia. You will need to control your weight and manage your stress. Exercise will help with all of that.

Even if you do not have insulin resistance you might be started on metformin (Glucophage). This diabetic medication has been shown to help women become fertile, especially if it accompanies weight loss.

The combination of metformin, a low glycemic diet and exercise have led to an 85% improvement in menstrual cycles and ovulation.

As with diabetes there is no true cure for PCOS, just things that have been found to help manage the symptoms. All inflammatory syndromes are helped the most by the diet that avoids AGEs. We know that AGEs not only start autoimmune reactions but fuel their progression.

The same antioxidant rich diets and exercise help diabetics and PCOS sufferers alike. If you have PCOS and type 2 diabetes, there are forums with exercise ideas, recipes and personal stories that will encourage you.

Please watch out for depression and self-pity. They are our worst enemies.

A woman facing PCOS has a lot to deal with, and if you are a type 2 diabetic as well, the challenge may be overwhelming. It might help to remember that the only ones who fail are the ones who stop trying.

Mark Twain - "What would men be without women? Scarce, sir, mighty scarce."

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