PCOS And Insulin Resistance: Know How Vitamin D Plays A Role In Improving This Condition

PCOS is also called Stein Leventhal syndrome. It is common in young reproductive age group. Unfortunately, polycystic ovary may be seen in about 20% of normal women, which requires immediate attention. The criteria for diagnosis used for PCOS is the Rotterdam's criteria. If there are two of the three criteria's the diagnosis of PCOS is made.

• Oligomenorrhea or Chronic anovulation
• Clinical or biochemical evidence of Hyperandrogenism- Acne, Alopecia or raised testosterone levels
• Polycystic ovarian pattern on ultrasound

Immediate relatives (daughter or sisters) of women with PCOS have 50% chance of having PCOS. type-2 diabetes is also very common in families of those with PCOS.

Insulin resistance and PCOS

One of the roles of insulin is to maintain the levels of glucose in the blood from after eating. If there is insulin resistance, body doesn't use the available insulin effectively to help keep the glucose levels stable.

Because the insulin is not working adequately, the body produces more insulin. These significant levels can increase the production of androgens such as testosterone, in the ovaries. This contributes to excessive hair growth and acne, and can contribute to symptoms such as irregular periods, trouble ovulating, excess facial hair growth and acne.

Symptoms and Signs:

• Irregular periods
• Acne
• Excessive male pattern hair growth in body
• Difficulty in conceiving
• Long term health problems linked to PCOS

Women with PCOS are prone to high risk of developing the following health problems:

• Insulin resistance (30 to 40 percent of women with PCOS may face this problem)
• Type-2 diabetes
• Cholesterol and blood fat abnormalities
• Cardiovascular disease including heart attacked and stroke
• Endometrial carcinoma (cancer)

Vitamin D:

Vitamin D is a fat-soluble vitamin. Its main function is to promote calcium and phosphate absorption in gut and helps in bone mineralization. It also plays other crucial roles in the body including reduction of inflammation as well as modulation of processes like neuromuscular and immune function, cell growth and glucose metabolism.

Body produces vitamin D from direct sunlight on skin. Vitamin D is also available in following foods like oily fish, red meat, liver, egg yolk. Daily Recommended Dietary Allowances (RDA) depends on the age group. For reproductive age group women, RDA is 600 IU (15mcg).

Relationship between PCOS and Vitamin D:

Vitamin-D deficiency may be responsible for pathogenesis of PCOS.

Vitamin D receptors are present on the pancreatic cells (the organ that produces insulin) and plays a key role in glucose metabolism. Vitamin D deficiency contributes to insulin resistance and there by linking PCOS and vitamin D deficiency.

Vitamin D has a role in the development and maturation of the follicle (egg) in the ovary

It has been confirmed that PCOS patients have high levels of Vit-D deficiency. Vitamin D deficiency is found in 67- 85 % of women with PCOS. Supplementation of vitamin D in women with PCOS has found to reduce the hormonal disturbances found in PCOS. Recently researchers have determined vitamin D supplementation as an adjuvant treatment for PCOS.

(Dr Nirmala Chandrashekar is a Consultant Obstetrics, Gynaecology and Gynaec Oncology at BGS Gleneagles Global Hospital, Bengaluru)

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