Ben Bikman: PCOS 2: Excess insulin disrupts the ovulation process and can prevent female fertility

InsulinIQ.com Youtube podcast June 29, 2021
The Metabolic Classroom
InsulinIQ.com

How does insulin make the normal physiological
process of ovulation become a pathophysiological process?

Dr Steve Cole: PCOS (polycystic ovary syndrome) has
three main categories of disorder:
1. Oligomenorrhea (longer, infrequent menstruation)
2. Hyperandrogenism (high testosterone)
3. Many cysts on the ovaries

In association with PCOS: insulin resistance is a major factor

In PCOS (polycystic ovary syndrome), the metabolic portion
of the syndrome is not part of the typical diagnosis...
but we inevitably see it

How does PCOS work?
-there is a genetic component
-there is a physiologic component, especially obesity

Some say you must have both: genetic predisposition &
insulin resistance to have this anovulatory outcome

-however, some people who have it are quite thin

All men have both androgen & estrogen and
all women have both; each sex needs them both,
but in different amounts...
women have much lower androgen & much higher estrogen
compared to men

Of the prototypical female sex hormones...
all came from testosterone;
it just depends on how much is converted

this is acted through the enzyme: aromatase
-ovaries converting at much higher level than testes, so
-women convert more testosterone into estrogen than men

All of the prototypical female sex hormones...
all came from testosterone;
it just depends on how much is converted

too much insulin has negative impact on:
-aromatase enzyme

Yes, particularly with cholesterol synthesis & distribution...
it is a fluid relationship between:
-estrogen; testosterone; estrone
-different forms of estrogen, some more potent
-same for testosterone, some forms more potent
-estradiol is most potent (converted through aromatase)

When insulin comes in at too high an amount,
have lower levels of estrogen production...

then the woman's estrogen is not high enough
to facilitate ovulation!

Insulin prevents the rise in estrogens!

-now all the ovary follicles who had been waiting
-to become the dominant ovulatory follicle...

But in absence of estrogen spike: We fail!

Dr Ben Bikman's playlist: https://youtube.com/playlist?list=PLYNYbPuk1AIxvP-Qrcfw1I23WAeJyBdfR