Andrew Huberman· PhD
As we get closer to menopause, we become more insulin resistant regardless of whether we had PCOS or not.
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The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
As we get closer to menopause, we become more insulin resistant regardless of whether we had PCOS or not.
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but at its core PCOS has insulin resistance and I'm sure you know all about insulin resistance
So, what is insulin resistance? The simple way of explaining it is when we eat carbohydrates and our body breaks it down into glucose, glucose stimulates our pancreas to release a hormone called insulin. The job of insulin is it goes to the cells in our muscle in our liver and it opens up the channels on these cells and pushes sugar into the cell where it can turn into energy. So basically insulin takes the sugar from the blood, pushes into the cell and turns it into energy. PCOS patients, 80% of them have insulin resistance.
And understand that inflammation, insulin resistance, and this brain ovary axis are the main drivers.
you were diagnosed with PCOS you were diagnosed with polycystic ovarian syndrome and we'll get into this it's a condition that is associated with insulin resistance and as we'll talk about because of your thyroid abnormalities you developed insulin resistance
do we know what the root cause is i don't know because we certainly have this spectrum of disease right a skinny pcos patients are the ones that you really you know start to scratch your head with because you know certainly the obese ones with androgenic symptoms it makes sense right that there's insulin resistance but the ones that have good actual peripheral insulin sensitivity but seem to have insulin resistance the level of the ovary are the ones that are a little harder to treat
the majority of PCOS polycystic ovarian syndrome is insulin resistance it's a hormonal imbalance
that there is molecular defects in insulin activities and PCOS that leads to impaired glucose tolerance and glucose insulin resistance and hyperinsulinemia Studies have shown that about 95 percent of obese women with PCOS and about 75 percent of lean women with PCOS has insulin resistance
We don't know exactly what causes it. [...] But it's definitely seen in almost all women with PCOS that they have higher androgen levels. And why is PCOS uh seemingly also highly associated with insulin resistance? Again, we don't know exactly, but we think the androgens um play a role. We think there might be some genetic factors that play a role.
But based on what you just said, if there is any causality between them, it's more likely that the PCOS is driving the insulin resistance than the other way around given the number of women that are insulin resistant who do not have PCOS.
And why is PCOS uh seemingly also highly associated with insulin resistance? Again, we don't know exactly, but we think the androgens um play a role. We think there might be some genetic factors that play a role. I don't know that we understand why, but we certainly have recognized in the last several decades that most women with PCOS also happen to be insulin resistant.