Insulin resistance is a condition that can shut down the ovulation process and cause menstrual disruption and irregularities, as well as other physiolgic and health issues. In insulin resistance, body tissue becomes desensititzed to insulin and thus responds to this hormone less. This causes a number of metabolic changes. And, the body begins to produce more insulin to compensate, resulting in high levels of blood insulin (hyperinsulinemia). This condition stimulates ovarian tissue and, in some women, causes multiple small cysts to develop in the ovary (one of the clinical findings that, along with insulin resistance, helps to define a syndrome called polycystic ovarian syndrome).
Syndrome X is also a closely related set of clinical factors, and being overweight or obese automatically implies a certain level of hyperinsulinemia. Only in recent years, has research shed additional light on the interrelationships of these complex factors.
|A silent process, widespread in the population, insulin resistance can disrupt ovulation and menstruation, and lead to other health problems. But Lourdes reproductive endocrinologists can identify and treat the condition.|
Indications for Testing
Lourdes reproductive gynecologists are careful to evaluate for insulin resistance in the non-ovulating woman. Unlike diabetes, insulin resistance does not by definition produce abnormal blood sugar levels. This is due to the compensation effects of abnormally high levels of insulin. However, insulin affects other organs and will stimulate the ovaries to produce testosterone.
If a patients shows signs of possible excess of androgens (male hormones), the Lourdes team tests for blood levels of these factors. If these hormones prove high, the specialists evaulate the patient for insulin resistance, using a glucose tolerance test lasting several hours, during which time the insulin level in blood specimens is measured.
While this evaluation will occassionally reveal the undiagnosed case of diabetes, more often it confirms hyperinsulinemia. Ultrasound to check for cystic, enlarged ovaries may also add to the diagnosis, although not all patients with insulin resistance have polycystic ovaries.
A Program to Reverse High Insulin
The patient with insulin resistance then requires a process of counseling and care aimed at lowering her insulin levels to normal range. This regimen includes recommendations on diet and exercise, and sometimes the use of medication that lowers insulin levels by increasing the sensitivity of tissue to insulin.
If a woman’s insulin levels normalize, then testosterone levels fall back to normal and, frequently, normal ovulatory function and regular menstruation return. A healthy amount of weightloss can also beneficially accompany this treatment approach. In addition, any acne or excessive hair growth (hirsutism) will resolve when the testosterone levels are back in the normal range.
Improviing insulin levels also decreases the patient’s risk of developing type II diabetes, or at least can delay the onset of this disease in many patients with this metabolic syndrome. It also decreases risk of heart disease and high blood pressure.