PCOS and Low Blood Sugar (Hypoglycemia)

Disease is associated with exaggerated insulin response

PCOS and low blood sugar
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If you have polycystic ovary syndrome (PCOS), the chances are good that you have experienced low blood sugar (hypoglycemia) at one point or another. It's a common symptom of PCOS wherein the body's inability to regulate insulin results in sudden dips in blood sugar levels, affecting both the health and quality of life of women living with the disease.

Symptoms of Hypoglycemia

While a glucose meter can tell you exactly how low your blood sugar is, most people can recognize the symptoms of hypoglycemia the moment they happen.

The most common include:

  • Headaches
  • Anxiety or nervousness
  • Sweating, chills, or clamminess
  • Irritability
  • Dizziness
  • Nausea
  • Confusion
  • Fatigue
  • Hunger

Causes of Hypoglycemia

All in all, the body does a pretty good job of regulating glucose levels in the blood. When the levels rise in response to stress, the body will type release insulin to transport the glucose from the blood to cells where they are stored for future use.

But it doesn't always work perfectly, and there are things that cause glucose to drop suddenly and dramatically. Among them:

  • Exercising far more than usual
  • Waiting too long between meals or skipping meals
  • Not eating enough food or carbohydrates
  • Drinking excessive alcohol
  • Taking medications that can lower blood sugar, including beta-blockers, MAO inhibitors (antidepressants), Bactrim (an antibiotic), and Metformin (used to treat diabetes)

It is not unusual for women with PCOS to experience hypoglycemia even if they do not have diabetes.

PCOS is associated with an exaggerated insulin response wherein the body releases excessive amounts of insulin when certain foods are eaten. High levels of insulin then push glucose quickly into cells, causing blood sugar levels to plummet.

Diagnosis of Hypoglycemia

Doctors will regularly check the insulin and glucose levels in women with PCOS to look for diabetes and evidence of insulin resistance (the inefficient use of insulin).

These may include glucose tolerance and fasting glucose level tests.

In women with PCOS, the risk of insulin resistance runs higher for those who are over 40, overweight and have high blood pressure. Women of Hispanic, African American, or Native American origin tend to be at higher risk than either white or Asian women. Worsening insulin resistance can eventually lead to diabetes.

How toTreat Low Blood Sugar

To treat an episode of hypoglycemia, you will need to increase blood sugar rapidly. This can usually be done by eating 15 to 20 grams of fast-acting carbohydrates which are low in fiber and enter the blood almost immediately. Examples include:

  • Two tablespoons of raisins
  • Four ounces (1/2 cup) of juice or regular soda
  • Eight ounces of nonfat or low-fat milk
  • One ounce of pretzels
  • Six large jelly beans
  • A small granola bar
  • Half of a banana

If you experience low blood sugar regularly, you should carry these snacks with you (or leave some in your office or car) so that they are always on hand.

How to Prevent Low Blood Sugar

The best way to prevent hypoglycemia if you have PCOS is to manage your diet and focus on healthy lifestyle choices, including:

  • Eating every three to five hours
  • Starting the day with a balanced breakfast soon after waking
  • Avoid skipping meals
  • Including protein, fat, and a sensible portion of carbohydrates at every meal
  • Limiting refined carbohydrates such as sugary cereals, drinks, and sweets
  • Exercising shortly after eating
  • Reducing alcohol intake
  • Stopping smoking, the habit of which is associated with insulin resistance


American Diabetes Society. "Polycystic Ovary Syndrome (PCOS)." Washington, D.C.; updated July 2, 2014.