Worried girl.

The Connection Between PCOS and Insulin Resistance

PCOS (polycystic ovary syndrome) is a very widespread problem among women of reproductive age. About 70% of cases of this syndrome remain undiagnosed. It is associated with obesity, hyperandrogenism, and infertility. Women with PCOS are often insulin resistant, which leads to a range of metabolic and cardiovascular consequences. As both conditions are complex in nature, let’s take a closer look at them and their interrelationships.

PCOS and Insulin Resistance: Symptoms

PCOS and insulin resistance share a complex clinical picture, with one influencing the other. Insulin resistance is a condition where the body’s cells become less responsive to the effects of insulin. Elevated insulin levels stimulate the ovaries to produce excess androgens, such as testosterone, leading to disruptions in normal ovarian function.

On the other hand, PCOS manifests through a range of symptoms, including:

  • Irregular menses: One prominent sign is irregular menstrual cycles, where ovulation may be infrequent or absent.
  • Hyperandrogenism: PCOS is often associated with hyperandrogenism, which is characterized by elevated levels of male hormones. This hormonal imbalance can manifest externally with symptoms like acne and alopecia.
  • PCOS characteristics: Women with PCOS may also have multiple small cysts on their ovaries, visible through ultrasound.
  • Obesity: Insulin resistance in PCOS commonly coexists with obesity, forming a vicious circle where excess weight exacerbates insulin resistance and vice versa.

All of those symptoms create a loop that further disrupts the hormonal balance.

PCOS and Insulin Resistance: Causes

There are multiple causes of PCOS and insulin resistance, even though the direct cause is still unknown. To understand both conditions better, let’s take a closer look at each of them:

  • Genetic predisposition: There is a strong genetic component to PCOS, with a higher likelihood of its occurrence in individuals with a family history of the syndrome. 
  • Hormonal imbalance: PCOS is characterized by an imbalance in sex hormones, particularly elevated levels of androgens. 
  • Lifestyle factors: Environmental factors, such as poor dietary choices and a sedentary lifestyle, can contribute to insulin resistance. Excessive intake of refined carbohydrates and sugars, coupled with a lack of physical activity, leads to obesity. Excess weight often worsens insulin resistance and contributes to the development of PCOS.

PCOS and Insulin Resistance: Diet

Diet plays a key role in managing insulin resistance and PCOS, serving as the first line of defense in comprehensive treatment strategies. The link between insulin resistance and PCOS underscores the importance of dietary choices in regulating blood sugar levels and improving insulin sensitivity. A balanced, nutrient-rich diet improves insulin sensitivity. The most important aspect of diet involves reducing the intake of carbohydrates and the complete elimination of sugars. This prevents spikes in blood sugar levels, thereby reducing the demand for elevated insulin production. Low-glycemic foods based on quality proteins and healthy fats are recommended to stabilize blood sugar and manage insulin resistance effectively.

Antioxidants and Vitamins Can Help

For women with PCOS and insulin resistance, including vitamins and antioxidants to the diet provides additional benefits. Antioxidants help combat oxidative stress linked to insulin resistance and inflammation. Vitamin D, B-complex vitamins, and magnesium are crucial for hormonal regulation. Eating more meals high in fiber, minerals, and antioxidants can help manage PCOS and insulin resistance and enhance metabolic health. Dietary changes, along with adopting a healthy lifestyle, play an immense role in enhancing the overall well-being of women dealing with these conditions.

Possible Consequences

The potential consequences of PCOS and insulin resistance extend beyond hormonal disruptions and metabolic changes. They can be very serious and affect a person’s normal life.

  • Increased risk of type 2 diabetes: Both PCOS and insulin resistance heighten the risk of developing type 2 diabetes, as insulin resistance can progress to impaired glucose tolerance and eventual diabetes if not managed effectively.
  • Cardiovascular risks: The interplay of PCOS and insulin resistance contributes to cardiovascular risks, including high blood pressure and abnormal lipid profiles. These factors collectively elevate the likelihood of cardiovascular disease.
  • Infertility challenges: PCOS is a leading cause of female infertility. Hormonal changes cause irregular ovulation, which makes conception difficult.
  • Metabolic disturbances: The combination of PCOS and insulin resistance can lead to various metabolic disturbances and weight gain.
  • Complications during pregnancy: Women with PCOS may experience serious complications during pregnancy, including gestational diabetes, preeclampsia, and preterm birth.
  • Endometrial hyperplasia: Irregular menstrual cycles in PCOS, coupled with the absence of ovulation, may result in prolonged exposure of the endometrium to estrogen. That increases the risk of endometrial hyperplasia and, in certain, rare cases, endometrial cancer.
  • Mental health risks: These conditions not only impact physical health but can also lead to mental health issues. Hormonal fluctuations and the challenges associated with these conditions may contribute to increased stress, anxiety, and even depression.


Insulin resistance and PCOS are serious and chronic conditions. If you have a history of these diseases in your family, the best thing to do is seek professional help. It is important to note that a holistic approach is necessary for the effective treatment of both conditions. Changing unhealthy habits and taking proactive steps are necessary.


How do you fix insulin resistance in PCOS?

Addressing insulin resistance in PCOS involves adopting a comprehensive approach that combines lifestyle changes, dietary modifications, and, if necessary, medical interventions. Weight control is crucial, as even a small reduction in excess weight can improve insulin resistance. The main focus is on shifting to a low-glycemic diet to prevent rapid spikes in blood sugar levels. As a hormetic stressor, regular exercise contributes to improved insulin sensitivity and overall metabolic health.

Medications such as metformin, which enhances insulin sensitivity, may be prescribed in consultation with a healthcare professional. Additionally, treating vitamin D deficiency, managing stress, getting enough sleep, and regularly monitoring relevant health markers are integral components of a holistic approach to managing insulin resistance in PCOS.

What are the symptoms of insulin resistance with PCOS?

The symptoms of these conditions are often intertwined. Women with PCOS and insulin resistance usually exhibit signs of hormonal imbalance, such as irregular menstrual cycles and elevated androgen levels. As a result, acne and excess hair growth (hirsutism) appear. Key indicators of insulin resistance in the context of PCOS include difficulty in weight management, particularly a tendency to store excess weight around the abdomen. Individuals may also experience persistent fatigue and lethargy as the cells struggle to efficiently utilize glucose for energy. Skin issues such as acanthosis nigricans, characterized by darkened patches, are linked to insulin resistance. 

At what age does PCOS usually start?

PCOS can manifest at various ages, but it often becomes noticeable during the late teens or early twenties. The exact onset can vary among individuals, and some may experience symptoms as early as adolescence. Irregular menstrual cycles, one of the hallmark signs of PCOS, may become apparent shortly after the onset of menstruation. However, PCOS can also be diagnosed later in life, particularly when women seek medical attention for fertility, weight management, or other related issues. Early detection and management are crucial, as PCOS can have long-term implications for reproductive and metabolic health. Women who suspect they may have PCOS or are experiencing symptoms like irregular periods, acne, or excessive hair growth should consult with healthcare professionals for an accurate diagnosis and appropriate management strategies.


Disclaimer: This article is intended for educational purposes only. For professional advice, consult your physician.