Table of ContentsView AllTable of ContentsDelayed DiagnosisInsulin ResistanceFertility TreatmentLifestyle and DietWhat Should You Do?
Table of ContentsView All
View All
Table of Contents
Delayed Diagnosis
Insulin Resistance
Fertility Treatment
Lifestyle and Diet
What Should You Do?
Lean PCOS is polycystic ovary syndrome in people of normal weight. Up to 30% of women with the condition fall into this group.But since they are in the minority and excess weight is considered a classic symptom, those with lean PCOS may not be diagnosed right away.
Those who are lean with PCOS can face challenges, including fertility issues and a higher risk of undiagnosed diabetes and heart disease. Their increased levels ofandrogens(male hormones) can also lead to symptoms like acne,unwanted hair growth, andhair loss.
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PCOS affects between 6% and 12% of all women in the U.S.Up to 70% live withobesityor overweight status, which helps to explain why much of the information on PCOS focuses on patients with overweight status.
This means lean women with PCOS often go undiagnosed for years. Whereas women with excess weight and PCOS may be diagnosed while they are in high school, lean women with PCOS may not be diagnosed until they struggle to conceive a child.
The often-delayed PCOS diagnosis can have a domino effect, meaning that it can delay a finding of diabetes and heart disease, too.
Diabetes
Studies have found that 3% to 10% of lean women with PCOS have undiagnoseddiabetes.This can happen because healthcare providers don’t generally expect adults of normal weight to develop diabetes orinsulin resistance.
This said, women with obesity and PCOS do have a higher risk for diabetes compared to women of normal weight with PCOS.To play it safe, some experts recommend that all women with PCOS get their insulin levels checked, regardless of their weight.
Heart Disease
Lean women with PCOS are more likely to have a delayed or missed diagnosis of heart disease. Researchers have compared thecholesterol levels of normal-weight women with PCOSto women without PCOS.
They found that the healthy-weight women with PCOS were more likely to have lower levels of“good” cholesterol (HDL)and higher levels of“bad” cholesterol (LDL).The bad type of cholesterol is known to clog arteries, sometimes leading to heart disease.
How is PCOS diagnosed?PCOS diagnosisinvolves a physical exam, bloodwork to test hormone levels and to see if the patient is ovulating, and imaging tests. Healthcare providers sometimes perform anendometrial biopsyto check for endometrial cancer, which is more common in those with PCOS.
How is PCOS diagnosed?
PCOS diagnosisinvolves a physical exam, bloodwork to test hormone levels and to see if the patient is ovulating, and imaging tests. Healthcare providers sometimes perform anendometrial biopsyto check for endometrial cancer, which is more common in those with PCOS.
Insulin resistance is usually linked with obesity, but women of normal weight with PCOS also have an increased risk of developing insulin resistance.
Researchers say that 20% to 25% of lean women (those with abody mass indexunder 25) are insulin-resistant.
BMIThe most commonly used measure to correlate weight and height is thebody mass index(BMI). It uses weight and height to try and estimate body fat. The resulting number is then used to categorize people as underweight, normal weight, overweight, obese, or morbidly obese. BMI is not perfect, however, and does not account for other factors that determine body composition like age, muscle mass, or sex.
BMI
The most commonly used measure to correlate weight and height is thebody mass index(BMI). It uses weight and height to try and estimate body fat. The resulting number is then used to categorize people as underweight, normal weight, overweight, obese, or morbidly obese. BMI is not perfect, however, and does not account for other factors that determine body composition like age, muscle mass, or sex.
The connection between insulin levels and PCOS is not fully understood. Women with PCOS are not the only ones who can be insulin-resistant despite having their weight fall into the normal range for their height.
A commonality appears to beabdominal obesity.This occurs when the abdominal area has more fat than it should.
Abdominal obesity is more common among people with obesity. But it can occur in those of a normal weight, too.
Calculate yourwaist-to-hip ratioto be sure. Women are more likely to have elevated levels of insulin if their waist-to-hip ratio is higher than 0.85.
Calculate Your Waist-to-Hip Ratio
Impaired fertility is one of the most consequential effects of PCOS. Women are often prescribed:
The most common advice given to women with PCOS wanting to getpregnantis to lose weight. For women living with obesity, losing 5% to 10% of their current weight can make fertility drugs more effective.
However, this doesn’t apply to lean women with PCOS. They have much higher pregnancy rates with fertility treatments compared to their peers with overweight or obesity.
Metformin is sometimes used to help women with PCOS conceive. Metformin is not a fertility drug; rather, it’s intended for insulin resistance. However, it can improve ovulation in women with PCOS. (Regular ovulation can improve the chance of conception.)
One study compared the effects of metformin on women living with and without obesity who have PCOS. When treated with metformin, lean women with PCOS were twice as likely to see their regular menstruation and ovulation cycles return.
Being a woman of normal weight who has PCOS doesn’t mean you won’t struggle to conceive—or that fertility treatment is guaranteed. But you are more likely to have success compared to women with overweight or obesity with PCOS.
Lifestyle and Diet Solutions
Certain lifestyle and dietary habits can improve the overall health of lean women with PCOS, too.
Maintain Healthy Weight
It can be frustrating to develop PCOS despite maintaining a healthy weight and waist circumference. Still, maintaining that healthy weight is important for all women with PCOS. It can contribute to enjoying a healthier life.
Research has found that as women with PCOS get older, they are more likely to develop insulin resistance. This risk was lower among lean women.In other words, maintaining your weight can help reduce your diabetes risk.
Resistance Exercise
Resistance exercise can bolster your weight management efforts. Progressive resistance exercise is weight training specifically intended to increase strength and muscle mass.
A study of lean women with PCOS found that adding resistance training helped:
The last element is especially important. Many dietitians believe that people with greater muscle mass get hungry less often, which can help with weight control.
Counseling
Another potential way to improve your quality of life when living with PCOS is getting professional counseling, especially if you feelanxiousordepressed. Therapists are available to help you—in person and online.
Call For HelpA Place of Hopespecializes in helping people who are grappling with anxiety or depression. Call them at 1-888-771-5166.For a referral to a mental health professional in your area, you can call theSubstance Abuse and Mental Health Services Administrationhotline at 1-877-726-4727. SAMHSA is a division of the U.S. Department of Health & Human Services.
Call For Help
A Place of Hopespecializes in helping people who are grappling with anxiety or depression. Call them at 1-888-771-5166.For a referral to a mental health professional in your area, you can call theSubstance Abuse and Mental Health Services Administrationhotline at 1-877-726-4727. SAMHSA is a division of the U.S. Department of Health & Human Services.
A Place of Hopespecializes in helping people who are grappling with anxiety or depression. Call them at 1-888-771-5166.
For a referral to a mental health professional in your area, you can call theSubstance Abuse and Mental Health Services Administrationhotline at 1-877-726-4727. SAMHSA is a division of the U.S. Department of Health & Human Services.
If you have PCOS and you’re at a normal weight, certain steps can keep you on track for good health:
Summary
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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