Understanding Sugar Cravings Linked to PCOS: Solutions for Insulin Resistance

Sugar cravings may seem harmless, but they can be particularly challenging for those with polycystic ovary syndrome (PCOS). Sugar, often seen as the number one enemy for PCOS, exacerbates symptoms and complicates the management of the condition. In this article, we explore the reasons behind these sugar cravings, the impact of sugar on PCOS, and the medical solutions—such as Metformin® (Glucophage® and Stagid®)—or natural alternatives like berberine, which can play a crucial role in managing them.

For a long time, I was completely addicted to sugar. I even developed an obsession with food, and I would panic if I didn’t know where I would eat at noon. Today, in my profession, my clients often tell me, "I crave sugar all the time."

First of all, I want to emphasize that there is absolutely nothing wrong with enjoying sweets. Absolutely nothing. I firmly believe that appreciating sweets without guilt or restriction is part of a healthy eating pattern. For some, this might mean indulging occasionally, while for others, it could be every day. In either case, no one is wrong! We are all different and have needs that are unique to each of us.

Why is Sugar Problematic for PCOS?

A diet high in sugar and processed foods promotes weight gain, inflammation, and insulin resistance, leading to complications like type 2 diabetes. Women with PCOS often have chronic silent inflammation, which worsens the symptoms of the condition. When they consume carbohydrates, their blood sugar levels spike, prompting the pancreas to release more insulin. This excess insulin stimulates androgen production, which can worsen symptoms like acne, hirsutism, and alopecia.

We know that excessive consumption of refined sugars, along with other dietary and lifestyle factors, can negatively impact our health.

A diet high in sugar can contribute to an increased risk of non-alcoholic fatty liver disease, heart disease, reduced insulin sensitivity, blood sugar abnormalities, and weight gain due to excessive calorie intake (especially from sugary drinks). We also know that the spikes and crashes in blood sugar levels caused by excessive refined sugar consumption can negatively impact mood, cognition, and energy levels. Research has also shown that consuming high-sugar foods can reduce blood levels of antioxidants.

Why Are Sugar Cravings Common with PCOS?

Fluctuations in blood sugar levels can trigger sugar cravings. In cases of insulin resistance, the body struggles to regulate blood sugar levels, leading to spikes followed by significant drops, which trigger uncontrollable sugar cravings. Stress, fatigue, and emotions often exacerbate this excessive sugar consumption.

Here are some key reasons for sugar cravings:

• Overly Restricting or Avoiding Sugar: When we finally indulge in a food we've been avoiding, we tend to crave it even more and often overeat it. So what's the best way to break this cycle? Allow yourself to eat and enjoy sweets mindfully!
• Insufficient Fat Intake: Good fats are your friends! Fats like avocado, nuts, nut butter, seeds, and olives take longer for your body to digest. Including healthy fats from whole foods in meals and snacks helps stabilize blood sugar, promote satiety, and slow down the digestion and absorption of sugars.
• Stress: If you tend to reach for sweets when you're stressed, you're not alone! I like to call this "reactive eating." Reactive eating is impulsive and typically happens when we're trying to distract ourselves from feelings like stress, sadness, or boredom. If you continually turn to sweets in response to stress or other emotions, it might be time to pause and explore other coping mechanisms.
• Insufficient Sleep: A lack of sleep affects the body's hunger and satiety hormones, leading to increased hunger. Remember, your body sees sugar as a quick energy source, which is why you may crave these foods when you need an energy boost. Insufficient sleep can also lead to elevated cortisol levels (your body's stress hormone), disrupting blood sugar levels and causing sugar cravings. Sleep is the cornerstone of good health. I recommend aiming for 7 to 9 hours per night.

How to Reduce Sugar Cravings with PCOS

To manage sugar cravings, it's essential to:

• Identify and Eliminate Sources of Added Sugars: Limit sugary drinks, pastries, ice cream, and processed foods containing added sugars.
• Manage Blood Sugar Levels: Adopt a low-glycemic diet, balanced with proteins, fiber, and omega-3s. Always balance your meals by pairing carbs with vegetables and proteins. Start your meals with vegetables and/or proteins. My team and I particularly enjoy the blog and recipes from Megalowfood.
• Prepare Snacks in Advance: Opt for snacks rich in proteins and omega-3s, such as yogurt with fruits, almonds with dark chocolate, or vegetable sticks.
• Avoid Artificial Sweeteners: They maintain the need for sweetness and provide no nutritional benefits.
• Manage Cravings: In case of a sugar craving, eat proteins. Here are some ideas: skyr with berries, or practice deep breathing exercises to calm yourself. If cravings become too difficult to manage and make you think of eating disorders, don't hesitate to talk to your doctor.

Insulin Resistance in Women with PCOS

Insulin resistance is characterized by the difficulty cells have in responding to insulin, making it harder to regulate blood sugar levels. This can cause significant fluctuations in blood sugar, leading to strong sugar cravings during blood sugar crashes. Insulin resistance, therefore, becomes a biological trigger for sugar cravings caused by hypoglycemia.

This can become a vicious cycle: if a person starts eating more frequently throughout the day to avoid blood sugar crashes, they continue to experience intense cravings, leading to overeating. This worsens insulin resistance and the intensity of cravings. In summary: Eat balanced meals favoring proteins and low-GI carbs.

PCOS is strongly associated with the development of depression, anxiety, and eating disorders. All the negative emotions associated with PCOS can also worsen cravings and eventually lead to binge eating episodes if no other coping mechanisms are put in place to manage these moments with care and compassion.

Herbal Remedies to Help with Sugar Cravings:

Berberine & PCOS: 

Berberine is a plant that shows great promise in treating and preventing many difficult and frustrating complications and symptoms associated with PCOS. According to a study published in June 2021, it:

• Reduces insulin resistance,
• Activates the insulin signaling pathway,
• Promotes glucose utilization,
• Reduces serum androgen levels,
• Improves sex hormone-binding globulin levels,
• Inhibits androgen synthesis.

Our dietary supplement Glycemic Index Boost helps you manage your PCOS naturally, thanks to the berberine it contains.

Metformin® Prescribed for PCOS

Metformin-based medications include: Glucophage® and Stagid® (metformin alone), as well as their generic forms. There are also commercial preparations combining metformin with other oral antidiabetics, such as Velmetia®, Janumet®, Eucréas®, Komboglyze®, Glucovance®, Synjardy®, Xigduo®, and their generics.

Metformin, an antidiabetic medication, is widely prescribed in managing PCOS due to its effects on insulin resistance and hyperandrogenism.

Effects on Clinical Hyperandrogenism

Metformin® is prescribed to reduce hyperandrogenism and can thus help many women reduce acne, seborrhea, and moderate hirsutism, especially in those who are overweight and suffer from insulin resistance. Although it is less effective than oral contraceptives for these conditions, it can be combined with them to improve outcomes.

Effects on Chronic Anovulation

Metformin® improves ovulation and pregnancy rates compared to a placebo. Although less effective than clomiphene citrate (CC) for ovulation, the combination of metformin + CC is more effective than CC alone in inducing ovulation in patients resistant to CC. It also improves clinical pregnancy and birth rates when combined with gonadotropins.

Use in IVF-ICSI

Patients treated with Metformin as part of a long GnRH agonist protocol have shown a significant increase in pregnancy rates. Metformin® also reduces the risk of ovarian hyperstimulation syndrome (OHSS), particularly in patients with a BMI over 26.

What Are the Side Effects of Metformin?

The side effects of metformin often appear early in treatment and tend to diminish after a few weeks. They are less pronounced if metformin is taken with or after a meal, or if the treatment begins with gradual doses. The most common side effects include diarrhea, nausea, vomiting, abdominal pain, and loss of appetite. More rarely, metformin can cause a metallic taste in the mouth, skin rashes, and lactic acidosis. We often recommend taking probiotics alongside metformin.

Lactic acidosis is a rare but serious complication of metformin. It occurs more frequently in cases of renal insufficiency, hepatic insufficiency, or excessive alcohol consumption.

Berberine and Its Benefits for PCOS

What Is Berberine?

Berberine is a molecule from the alkaloid family, found in plants such as barberry, goldenseal, and Mexican prickly poppy. Recognized for millennia in Chinese and Ayurvedic medicine, berberine is traditionally used to alleviate digestive disorders, regulate blood sugar levels, and cholesterol.

Management of Insulin Resistance and Sugar Cravings

Insulin resistance is common in women with PCOS. This means that cells do not respond effectively to insulin, forcing the pancreas to produce more insulin to maintain normal sugar levels. This can lead to hyperglycemia, fatigue, weight gain, and hormonal issues. Berberine appears to mimic insulin action by increasing glucose uptake by fat and muscle cells, independently of insulin. It also inhibits a protein that negatively regulates insulin signaling.(1)

Berberine Promotes Weight Loss (PCOS) and Naturally Reduces Inflammation

By improving insulin sensitivity, berberine helps control weight gain in women with PCOS. It lowers blood glucose levels, affects fat metabolism, and reduces appetite. Studies confirm that berberine decreases leptin levels in patients with metabolic syndrome. Lower leptin levels, often high in obesity, help restore satiety and better control food intake. (2)

Berberine has anti-inflammatory properties that can be beneficial for certain inflammation-related conditions such as acne and obesity. Specifically:

• Berberine reduces inflammatory markers, which can help alleviate inflammation involved in acne.
• It also inhibits cellular apoptosis (cell death), a process involved in acne lesions.
• Additionally, berberine modulates the expression of inflammation-related proteins, potentially reducing skin inflammation causing acne.
• For obesity, the anti-inflammatory properties of berberine may help reduce chronic low-grade inflammation associated with this condition.

By targeting inflammatory processes through various mechanisms, berberine appears to improve symptoms related to inflammation.

Improvement in Ovulatory Function

Berberine seems beneficial in improving reproductive function in women with PCOS. It helps regulate menstrual cycles, increases ovulation chances, and optimizes conditions for sustaining a pregnancy. However, ANSES recommends not taking berberine supplements during pregnancy.

Reduction of Androgens Responsible for Acne, Hirsutism, and Hair Loss

By lowering free androgen levels and increasing SHBG, berberine helps reduce symptoms related to hyperandrogenism in women with PCOS, such as:

• Hirsutism (excessive hair growth)
• Acne
• Obesity

With all this information, we developed our supplement, Glycemic Index Boost, combining pure berberine with chromium picolinate and Ceylon cinnamon for a synergistic effect on blood sugar levels.

Conclusion

Understanding the reasons behind sugar cravings and taking steps to control them is essential for individuals with PCOS. Metformin and berberine, in conjunction with dietary changes and stress management strategies, offer effective solutions for improving PCOS symptoms and managing associated metabolic complications. By adopting a proactive and well-informed approach, it is possible to reduce sugar cravings, improve overall health, and better manage PCOS.