Infertility Treatments

Help For PCOS And Weight Gain

PCOS and weight gain

A common symptom of Polycystic ovarian syndrome (PCOS)  is gaining weight, and many patients ask us how to help manage their PCOS and weight gain. But first, why does PCOS cause weight gain in the first place?

PCOS and Insulin Resistance

Insulin is the key that opens the door and allows the sugar to transit from outside the cells to the inside. Excess fat cells drive insulin resistance (where the cells don’t react to the presence of insulin and act as if they are starved).  As a result of this insulin resistance, insulin resistance continues to increase. Imagine, if the cells think they are starving, surely they send a message to the brain and body to ask for more food.  Unfortunately, the release of more sugar (glucose) into the bloodstream, does not satiate the cells because they are resistant to insulin. Recall, the key that opens the door is not present and the cells don’t realize it.

This insulin resistance drives hyperinsulinemia causing the pancreas to work harder and make more and maintain high levels of insulin – exhausting, literally. As a result, this elevated but ineffective insulin (the body is resistant) meanders around the body and affects other organs. It can raise available androgen (male hormone) levels (chin hair and hair loss) and almost paralyze normal ovulatory function (no periods).

Medication for PCOS Weight Gain

For women who demonstrate insulin resistance, Metformin (off-label) was one of the triads of treatment along with effective diet and exercise. However, recent studies in women with PCOS (polycystic ovarian syndrome) have mimicked the data present in other adults with insulin resistance. There exists an alternate class of medications that help sensitize the body to insulin – (if the key doesn’t work, there is always a window to sneak through). This class is called the dipeptidyl peptidase-4 inhibitor and the medications most often end in the name “-gliptin”. One member of the class, saxagliptin, was studied compared to and in combination with, Metformin. The combined forces of saxagliptin and Metformin lead to increased insulin productivity and decreased insulin resistance. Less insulin resistance translates to better metabolic profiles. The body engine switches to burning the fat off instead of storing it.

It is a short-term fix, in conjunction with diet and exercise (for which there is no substitute). It is also about gaining an equal playing field in the quest for metabolic normalcy.
If you have questions about how we can help, please contact us! We are here for you.

Elkind-Hirsch, et. Al.  Fertility and Sterility. Vol 107, No1. January 2017. 253.

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