Thin With PCOS: "How can I have PCOS if I'm not overweight?"
 Are you confused about your diagnosis of PCOS because you are thin?
Many people think that everyone with PCOS is overweight, but this is
not the case. In fact, at least half of women diagnosed with PCOS are
of normal weight or lean. Some women with PCOS are even underweight.
While insulin resistance is generally thought to be the underlying cause
of most cases of PCOS, there is disagreement in the medical community
about whether thin women with PCOS suffer from the same degree of insulin
resistance as their heavier counterparts.
Some studies support the presence of insulin resistance in both lean
and obese women with PCOS. Furthermore, lean women with PCOS do seem
to struggle with insulin-glucose regulation, even though it is not classified
strictly as "insulin resistance." Thin women with PCOS have
higher insulin levels in their blood than thin or normal weight women
without PCOS, according to researcher Vrbikova and associates in the
2004 article "Insulin Sensitivity in Women with Polycystic Ovary
Syndrome" published in The Journal of Clinical Endocrinology
and Metabolism. Moreover, even if the serum insulin levels are normal,
the ovaries of women with PCOS tend to be over-sensitive to the effects
of insulin, thereby leading to increased ovarian androgen output.
Oral contraceptives are commonly prescribed to women with PCOS, regardless
of whether they are overweight or of normal weight. However, using oral
contraceptives in women with
"lean PCOS," as it is termed, may increase the risk of weight
gain in this population and put them more at risk for insulin resistance
or other negative effects on insulin and glucose metabolism.
Women with lean PCOS have much in common with their heavier counterparts.
For example, lean women with PCOS may still have the same risk factors
for cardiovascular disease as overweight women, according to a study
conducted by Kravariti and colleagues and reported in the September 2005
issue of The Journal of Clinical Endocrinology and Metabolism. They
conclude that all women with PCOS, regardless of weight or BMI, should
work to prevent cardiovascular complications.
Another article by Tarkun et al published in The Endocrinology Journal in
October 2004 suggests that lean women with PCOS were at higher risk of
cardiovascular disease and anovulatory infertility compared to age-and
weight-matched healthy women without PCOS. Therefore all women with PCOS
should work to prevent complications like hypertension and diabetes mellitus.
This can be accomplished through a whole foods, low carbohydrate diet,
an exercise plan tailored to you, and certain nutritional and herbal
supplements.
Dr. Sari Cohen
 About
the author
Dr. Sari Cohen received her doctorate in naturopathic medicine with
High Honors from the Southwest College of Naturopathic Medicine, and
graduated cum laude from Dartmouth College. A clinical practitioner
in New Hampshire, where she sponsors a PCOS support group, Dr. Cohen
is the author of the prize-winning article "Melatonin, Menstruation
and the Moon" published in The Townsend Letter for Doctors
and Patients. A contributing author of the Board Review Study
Materials for the Naturopathic Physicians Licensing Examination, she
is also a member of Insulite Laboratories' Medical & Advisory team
where she undertakes research and provides professional guidance to
individuals with insulin-related disorders. Dr. Cohen has developed
the company's 52-week Customer Protocol and has co-authored The
Insulite Guide to Reversing Insulin Resistance and its Related Conditions.
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