PCOS and Insulin Resistance
Do you have PCOS? Do you often feel tired and sluggish? Do you have trouble sleeping? Do you have mood swings? Read on....
Top things to know:
The majority of people with polycystic ovary syndrome (PCOS) have insulin resistance or high insulin
High insulin is both a symptom of PCOS and an underlying physiological driver
Testing for insulin resistance can be helpful to rule out other conditions that are commonly misdiagnosed as PCOS
Polycystic ovary syndrome (PCOS) sounds like it’s exclusively a disease of the ovaries, but it’s not. While PCOS does affect the ovaries and ovulation, it’s actually a full-body endocrine and metabolic disorder that is closely tied to insulin resistance.
What is insulin resistance?
Under normal conditions, the hormone insulin rises briefly after eating. It stimulates the liver and muscles to take up sugar from the blood and convert it to energy. That then causes blood sugar to fall, and then insulin to fall. With normal insulin sensitivity, both sugar and insulin are normal on a fasting blood test.
With insulin resistance, blood sugar may be normal, but insulin is high. Why? Because the pancreas has to make more and more insulin to try to get its message through. Too much insulin generates inflammation and causes weight gain. It can also lead to Type 2 diabetes and heart disease. Too much insulin is also an underlying physiological driver of PCOS.
The relationship between insulin resistance and PCOS
Insulin resistance is a key feature of both obese and lean PCOS.
High insulin is not just a symptom of PCOS—it is also a major driver of the condition. High insulin can impair ovulation and cause the ovaries to make excess testosterone.
Conventional treatment of insulin resistance and PCOS
Conventional treatment recommendations for the insulin resistance aspect of PCOS include weight loss, aerobic exercise, and the diabetic drug metformin, which improves insulin sensitivity. Resistance training may also be effective.
Oral contraceptives are the other officially-recommended treatment for PCOS, but they can interfere with sugar regulation and insulin resistance that underlies PCOS. The link between PCOS, insulin resistance, and oral contraceptive pills has been dubbed a “modern medical quandary” in need of further research.
Nutritional supplements for insulin resistance and PCOS
Inositol is an intracellular messenger involved in insulin signaling and can be taken as a nutritional supplement (myo-inositol and di-chiro inositol). A 2018 meta-analysis of ten randomized trials found that inositol significantly improves markers of insulin resistance and “appears to regulate menstrual cycles, improve ovulation and induce metabolic changes in polycystic ovary syndrome”. The dose used in most of the randomized trials ranged from 1.2 to 4 grams per day.











