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Premenstrual Syndrome (PMS) is a condition that affects many women in the days leading up to their menstrual period. Characterized by both physical and emotional symptoms, PMS can disrupt daily life and make the menstrual cycle more challenging to navigate. In this blog, we’ll explore what PMS is, how to identify its symptoms, the underlying causes (with a focus on hormonal health), and natural ways to manage it. We’ll also highlight herbal remedies and discuss related conditions often associated with PMS. 

Take charge of your hormonal wellness by diving into the concerns that matter to you. Discover actionable insights backed by real stories and science, all tailored for you.

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Real talk, Expert tips, Early drops, and Sisters who get it.

The (Sisterhood)

We’ve all done it.
Stood in front of a shelf lined with powders, serums, tinctures, and supplements hoping this might finally be the thing that makes us feel like ourselves again. In some ways, that shelf is comforting. When nothing else is working, a purchase can feel like a promise. Like proof that we’re trying. That we’re doing something.
But control isn’t the same as care.

Control is about fixing. Care is about staying in conversation - with your body, your needs, your rhythms. And when it comes to our health, we need more of the latter.
I remember once standing in the supplement aisle, Googling ingredients for energy, stress, and sleep simultaneously. I didn’t know what I needed, just that I needed something. That’s the trap of shelf care: it mimics empowerment while masking confusion.
But the truth is : shelf care alone isn’t always self-care.
In today’s wellness economy, it’s easy to confuse the two. We conflate health with purchase decisions, effort with aesthetics. The tray full of adaptogens, the mindfulness books, the colour-coded pill box; everything that feels like progress. And sometimes they are. But other times, they’re checkboxes we tick, hoping they will fix something we can’t quite name.
And who can blame us?
We live in a culture that rewards productivity over presence, and aesthetics over inquiry. We’re told to “listen to our bodies” but also to optimise, hustle, and never fall behind. Shelf care offers quick wins in a world that rarely pauses long enough to notice how we really feel. It’s not shallow—it’s survival. But when care becomes a to do list, it stops being care.

Shelf care is easy to measure.
It photographs well. Fits into routines. It can be tracked, logged, reordered.
Self-care? That’s murkier.
You can’t bottle boundary-setting. You can’t photograph emotional regulation. You can’t TikTok your way through perimenopause. And so it becomes the part of care we ignore, not because it’s less important, but because it’s harder to measure or monetize.

But here’s the truth: shelf care is only as powerful as the self-care you pair it with.
That nightly supplement won’t help if your nervous system is running on empty. That serum won’t reverse the effects of chronic stress. And no ritual is complete without intention. In our rush to optimise, we’ve forgotten to observe. In our obsession with products, we’ve stopped asking whether they’re even working.
Self-care is the system around the shelf.
It is the wind-down routine before bed.
It is the pause before reacting.
It is the small, unglamorous, often invisible ways we learn to live in alignment with ourselves.It doesn’t always feel like progress - but it lays the foundation for it.
And perhaps most importantly, self-care is labour.
Not the kind that gets applause, but the kind that keeps us grounded. For many women especially, it’s a form of invisible maintenance: the quiet work of checking in with your body before it screams, of staying whole in a world that keeps asking you to split yourself in two.
Let’s be clear: this isn’t a takedown of supplements or wellness tools.
It’s not a call to clear your cabinets. It’s a reminder that these products work best when they’re part of something bigger. A practice. A rhythm. A relationship - with your body, your energy, and your needs.
Because when shelf care and self-care meet, something powerful happens.
You stop outsourcing your health to trends and start tuning into what you really need.
You stop chasing fixes and start cultivating rituals.
You stop asking, “What should I take?” and begin asking, “What do I need right now?”
Because self-care isn’t about doing more.
It’s about doing what matters - with clarity, not urgency.
That shift, from reaction to reflection is where real change lives.
So no, it’s not either/or.
It’s both.
Together.


Shelf Care vs Self Care (And Why It’s Not Either/Or)

It starts subtly. You’re feeling more tired than usual. Your skin is breaking out in ways it never used to. You’re gaining weight even though your routine hasn’t changed. Your sleep is disrupted, your moods are unpredictable, and you feel constantly off but you can’t explain why.
You go to the doctor, and after a cursory glance and a few lab tests, you hear the line that has become a modern medical cliché:
“You’re just stressed.”
But what if you’re not?
What if what’s happening isn’t “just” stress but a deeper physiological shift that no one’s been trained to look for?
The misdiagnosis of women’s symptoms
For decades, women’s symptoms especially those that are chronic, cyclical, or hard to quantify have been dismissed as emotional exaggerations. Fatigue? Probably stress. Brain fog? You’re overworked. Bloating? Try probiotics. Anxiety? Maybe it’s just PMS.
What’s often missed in these quick assessments is a basic truth: stress may be a trigger, but hormones are often the amplifier. And unless you look beneath the surface, you’ll keep treating the smoke while ignoring the fire.
Hormonal disruptions whether due to PCOS, thyroid dysfunction, insulin resistance, perimenopause, or even micronutrient depletion can all manifest like stress. But they’re not solved by meditation and magnesium alone.
The invisibility of internal chaos
The problem is compounded by the fact that many hormonal conditions don’t show up in routine checkups. They fluctuate. They require pattern recognition. They speak in clusters of symptoms, not singular, easy-to-spot flags.
Women often sense something’s wrong long before it’s measurable. But instead of being taken seriously, they’re told to relax. To sleep more. To be less anxious. And over time, many stop asking questions altogether, choosing quiet resignation over constant invalidation.
This dismissal isn’t just frustrating. It’s dangerous. Because it delays diagnosis. It increases the emotional toll. And it trains women to override their own intuition.
Listening, not labeling
What we need is a fundamental shift in how we engage with women’s health. One that stops labeling everything as “stress” and starts listening to symptoms as information.
This means:
Recognizing that unexplained symptoms often have hormonal roots.
Asking better questions: When did this start? Does it follow a cycle? What else do you notice when this happens?
Moving from short-term fixes to long-term understanding.
Equipping women with tools to track, observe, and make connections between lifestyle, cycles, nutrition, and mental health.
Because in many cases, what looks like stress is really a sign that the body is trying to restore balance and no one’s helping it do that.

What I’m building instead
At Terrapy, we’re building systems that help women decode their own health stories, symptom by symptom, cycle by cycle. Our platform doesn’t stop at “you’re stressed”. It asks why. It offers support based on biology, not assumptions.
Because women deserve better than blanket statements.
They deserve clarity.
And that starts by asking the simple question medicine so often skips:
What if it’s not just stress? What if it’s something your body has been trying to say all along?



“You’re Just Stressed”  But What If You’re Not?

“You’re Just Stressed” But What If You’re Not?

We’ve all heard the phrase “listen to your body.” It sounds empowering until you realise no one ever taught women how.
Especially when it comes to hormones.
Hormones govern everything from sleep and stress to metabolism, mood, digestion, and libido. They are the quiet conductors of our daily lives—subtle but powerful, complex but never random. And yet, when a woman feels off—bloated, fatigued, anxious, foggy, inflamed—she’s far more likely to be told she’s imagining it than to be encouraged to investigate.
We don’t just have a hormonal imbalance epidemic. We have a hormonal illiteracy epidemic.
When symptoms are signals, not noise
Let’s say your energy crashes every afternoon. Or your skin breaks out the week before your period. Or you wake up at 3 a.m. every night with your heart racing. These aren’t quirks or coincidences. They’re biochemical breadcrumbs.
But most women are never taught to see them that way. Instead, they push through, dismiss, normalize, or self-blame. And when they do seek help, the responses are often dismissive: “Just manage your stress,” “It’s probably your lifestyle,” “This is normal for your age.”
The problem isn’t just that women are unheard. It’s that our systems aren’t trained to hear hormones at all.
The cost of silence
Ignored symptoms turn into chronic conditions. PCOS goes undiagnosed. Thyroid issues spiral. Anxiety is misdiagnosed. Perimenopause sneaks up unannounced. And across all of this, women spend years trying to make sense of what their bodies are telling them often without tools, language, or guidance.
We tell women to track their periods, but we don’t teach them what patterns to look for. We celebrate cycle syncing in theory but offer little structure to do it meaningfully. We call it “just PMS” when it could be a real hormonal shift with nutritional, metabolic, or emotional roots.
We don’t need more control over our bodies. We need more clarity within them.
Listening means learning
To truly support hormonal health, we need to shift from symptom suppression to systemic listening. That means:
Treating mood swings, acne, fatigue, weight gain, and bloating as data—not drama.
Encouraging women to observe, track, and reflect—not just medicate.
Equipping providers to ask the right questions—not just prescribe cycle regulators.
Using technology to map patterns—not reduce health to step counts or calorie burn.
Hormones don’t lie. But they whisper. And if we want to change outcomes for women, we need to teach both women and the systems around them how to listen better.
A new kind of care
At Terrapy, we’re building that listening system. One that’s designed to decode daily symptoms, support cyclical rhythms, and guide women in making intuitive, science-backed decisions about their health. It’s not just about solving for one moment but about tuning into a lifelong conversation between body and mind.
Because your hormones have always been talking. It’s time the world gave women the tools and the respect to understand what they’re saying.




Your Hormones Are Talking Are You Listening?

You’re in the middle of a good laugh or picking up a grocery bag when it happens—a small, unexpected leak and the dampness that means only one thing - your bladder lost control again! Embarrassing? Absolutely. Uncommon? Not at all. Many women experience these moments, especially as they hit their 30s. But what if you had a way of preventing that with a simple, science-backed solution?

The pelvic floor, more commonly called your “core” muscles, is a vital but often overlooked group of muscles. It supports your bladder, bowel, and uterus, ensures proper control over bathroom habits, and even enhances your sexual health. Yet, like any other muscle in your body, it needs a workout to stay in shape.

This is where pelvic floor exercises come in. Whether you’re recovering from childbirth, navigating hormonal changes during menopause or simply aiming to future-proof your health, these exercises are a great addition to your routine. 

In this blog, we’ll explore how pelvic floor workouts can add to your quality of life, giving you confidence, control, and a stronger core—all with just a few minutes of effort each day. Let’s dive in!

Why Pelvic Health Should Be on Every Woman's Radar

Imagine a hammock stretched tightly across your pelvis, cradling vital organs like the bladder, uterus, and bowel. This "hammock" is your pelvic floor—a network of muscles and tissues that support your body’s most essential functions. These muscles wrap around your vagina, urethra, and anus, acting as a gatekeeper for urinary and bowel control while playing a crucial role in sexual function.

But their job doesn’t stop there. The pelvic floor is also key to your body’s core stability. Together with your diaphragm, deep abdominal muscles, and back muscles, it helps maintain posture and control intra-abdominal pressure. 

>My doctor explained that having a strong pelvic floor means more than avoiding leaks—it impacts everything from feeling steady while lifting or bending to enjoying pain-free, confident sex,” says Meera* 34, housewife. “ It’s one of those things you don’t realise you rely on until it needs attention!

[Female pelvic floor muscle - 3D animation](https://www.youtube.com/watch?v=q0_JAoaM6pU )

Anatomy 101: The Pelvic Floor at a Glance

As women age, the pelvic floor is subjected to wear and tear from various life events and body changes:
- **Pregnancy and childbirth**: The weight of a growing baby and the strain of delivery can stretch and weaken these muscles.
- **Hormonal changes**: Declining estrogen levels during perimenopause and menopause can reduce the elasticity and strength of pelvic tissues.
- **Lifestyle factors**: Obesity, heavy lifting, or prolonged sitting can strain the pelvic floor.
- **Ageing**: Like other muscles, the pelvic floor loses tone and strength with time if not exercised.

Without proper care, these changes can lead to various pelvic floor dysfunctions that may disrupt your daily life.

How the Pelvic Floor Changes Over Time

The results can be frustrating, painful, or even debilitating when the pelvic floor muscles lose their ability to contract and relax effectively. Some common signs include:

1. Stress Urinary Incontinence (SUI):
[One in three adult women](https://my.clevelandclinic.org/health/diseases/22262-stress-incontinence) will experience stress urinary incontinence (SUI) at some stage in their lives. It happens when the pelvic floor muscles, which generally tighten to counteract pressure on the bladder, are too weak to hold back urine. Simple actions like sneezing, coughing, or brisk walking can become anxiety-inducing moments.

2. Overactive Bladder (OAB):
The bladder muscles become too active, contracting before the bladder is full. This leads to a sudden, uncontrollable urge to urinate, frequent trips to the bathroom, and disrupted sleep patterns. Many women feel like their bladder has taken over their day (and night).

3. Pain During Sex:
For some women, intimacy becomes a source of discomfort rather than connection. Pain during sex often stems from tension in the pelvic floor muscles, which may feel tight or strained. This tension can create a sensation of pressure or even sharp pain, making what should be a pleasurable experience feel frustrating and isolating. 

4. Chronic Back or Pelvic Pain:
Do you ever feel a persistent ache in your lower back or a heavy, dragging sensation in your pelvis? Weak or overworked pelvic floor muscles are often the culprits. Because these muscles are part of your body’s core, their dysfunction can strain surrounding areas, leading to chronic discomfort. 

5. Organ Prolapse:
A feeling of heaviness or bulging in your pelvic area can be alarming, almost like something is “out of place. Pelvic organ prolapse (POP) is common, affecting 40–50% of women. It occurs when weakened pelvic floor muscles can no longer support the bladder, uterus, or bowel, causing them to shift downward. Everyday activities like standing for long periods, lifting objects, or even coughing can worsen the sensation.

Although these issues may sound alarming, you can take steps to prevent them before symptoms even begin. Pelvic floor exercises can deliver impactful results, empowering you to feel in control at any age. Let’s dive into how to do them and seamlessly add them to your routine.


Symptoms of Pelvic Floor Dysfunction

Pelvic floor exercises, often called Kegels, are a powerful tool for improving and maintaining pelvic health. They help prevent issues like urinary leaks, pelvic organ prolapse, and even improve core strength. 

The best part? They’re easy to do once you get the hang of them. Here’s how to get started and make them part of your daily routine.

**Step 1: Find Your Pelvic Floor Muscles**

Before you can start exercising, it’s important to locate the right muscles. Here are two simple ways to identify them:

- Method 1: Try to stop the flow of urine midstream (but just as a test). The muscles you use to do this are your pelvic floor muscles.
- Method 2: Imagine tightening the muscles that stop you from passing gas. These are the same pelvic muscles you’ll be working.

**A Quick Tip**
Don’t make it a habit to stop your urine flow regularly, as this can lead to bladder issues over time. Use this method only for identification purposes.

**Step 2: How to Perform Kegel Exercises**

Once you’ve identified your pelvic floor muscles, it’s time to start exercising.

**1. Basic Kegels:**
- Tighten your pelvic floor muscles and hold the contraction for 3–5 seconds.
- Fully relax for the same amount of time (3–5 seconds).
- Repeat this 10 times for one session.
- Aim to do three sessions per day—morning, afternoon, and evening.

**2. Progression for Strength:**
- As your muscles get stronger, increase the duration of the hold to 10 seconds, followed by a 10-second relaxation.
- Gradually add more repetitions as it becomes easier.

**3. Quick Flicks for Urgency:**
- Rapidly squeeze and relax the muscles several times in a row.
- This technique is especially helpful for controlling sudden urges to urinate.


**Step 3: Best Practices for Success**

**Start Simple**: If you’re new to these exercises, begin while lying down—it’s easier to focus without the added challenge of gravity. As you improve, practice in sitting and standing positions to train the muscles for different activities.

**Stay Focused**: Make sure you’re only engaging your pelvic floor muscles. Avoid squeezing your thighs, stomach, or buttocks.

**Breathe Naturally**: Don’t hold your breath during contractions. Relax and breathe normally to avoid straining your muscles.

**Don’t Overdo It**: Too much of a good thing can backfire. Stick to the recommended repetitions, as overworking these muscles can cause fatigue and even increase leakage.

**Step 4: Track Your Progress**

What to Expect: With regular practice, you should notice small improvements in about 4–6 weeks. Significant changes, like better bladder control or less urgency, may take up to 3 months.


**Step 5: When to Get Professional Help**

If you’re unsure whether you’re doing the exercises correctly or if you’re not noticing results, don’t hesitate to seek help from a gynaecologist or pelvic floor physical therapist. These specialists can:

- Teach you the right techniques.
- Use tools like biofeedback to track your muscle activity.
- Tailor a program to address your specific needs, whether it’s strengthening weak muscles or relaxing overly tight ones.


A Simple Guide to Pelvic Floor Exercises

While Kegels are a cornerstone of pelvic floor exercises, there’s much more you can do to support your pelvic health. 

**Core-Strengthening Exercises**
Consider adding these exercises to your routine:

**Squats**: Engage your glutes and core while keeping your pelvic floor muscles active. Squats help strengthen the entire lower body while supporting pelvic health.

**Bridges**: Lie on your back, knees bent, and lift your hips toward the ceiling. This move activates the glutes, core, and pelvic floor simultaneously.

**Yoga Poses**: Child’s Pose: A gentle stretch that relaxes the pelvic floor and reduces tension.
Happy Baby: A pose that stretches and releases tight pelvic floor muscles while calming the mind.

**Pilates**: Known for its focus on core engagement, Pilates exercises like the “Pelvic Curl” or “Hundred” integrate pelvic floor strengthening with overall core stability.

**Relaxation Techniques**

Not all pelvic floor issues stem from weakness; some result from tension or overactivity. Relaxation techniques can help release tight muscles and restore balance:

- Practice diaphragmatic breathing, inhaling deeply, expanding your abdomen, and exhaling fully. This reduces pelvic tension and calms the nervous system.
- Guided meditations or body scans can help you become more aware of and consciously relax your pelvic floor.

**Lifestyle Adjustments**

Small, consistent changes in your daily habits can make a significant difference in pelvic health:
Maintain a healthy weight, eat fibre-rich foods to prevent constipation, use proper lifting techniques to avoid strain, and stay active with low-impact exercises like walking or swimming to support your pelvic floor and core strength.





Beyond Kegels: A Holistic Approach to Pelvic Floor Health

Pelvic floor exercises are a simple habit that can make a big difference in your quality of life. Whether it’s preventing leaks, improving your posture, or even enhancing your intimate experiences, these small daily efforts can empower you to feel more in control of your body—at any age. Give it a try, and let the results speak for themselves!

Why It’s Worth the Effort

1. The pelvic floor supports essential functions like bladder control, bowel movements, and sexual health and plays a vital role in core stability.
2. Weak or tight pelvic floor muscles can lead to stress urinary incontinence, overactive bladder, pain during sex, chronic pelvic pain, and pelvic organ prolapse.
3. Regular pelvic floor exercises, such as Kegels, can prevent or manage symptoms, strengthen core muscles, and enhance confidence and comfort in daily life.
4. Beyond Kegels, activities like yoga, Pilates, deep breathing, and lifestyle changes (like maintaining a healthy weight and eating fibre-rich foods) support overall pelvic health.
5. With consistent practice, noticeable improvements can be seen in 4–6 weeks, and additional help from a pelvic floor therapist can tailor solutions for individual needs.


Key Takeaways

Stronger Core, Better Life: Why Women Over 30 Swear by Pelvic Floor Exercises

Adhesive Capsulitis is the scientific name of this painful, stiff sensation in the arm, and its something no one wants to endure. But frozen shoulder – as it’s commonly known – isn’t just caused by a muscle pull due to excessive workouts or injuring yourself while playing a sport. If your pain is persistent, it can be a huge indicator of many underlying health issues you may not even know you have. Learn more about what could be causing pains in your shoulder joint, so as to get timely diagnosis and adequate treatment:




If you’re prone to high sugar and your diabetes is poorly controlled or ignored, you’re probably twice as likely to develop frozen shoulder. Collagen in the system holds the joints of the shoulder together, and its this collagen that gets triggered by high blood sugar and becomes sticky, leading to stiffening of the shoulder muscles. Up to 29 per cent people who have diabetes – whether undetected or poorly controlled – can develop frozen shoulder over time, usually in one arm. Regular diabetes medication and a proper diet to keep sugar levels as low as possible help a lot, along with frequent simple exercises like yoga to keep the shoulder joints flexible and mobile.

Diabetes:

While it’s not totally clear why thyroid-related issues result in frozen shoulder syndrome, it's assumed to be the common factor of the production of cytokines – proteins that serve as ‘messengers’ between cells. Increased presence of cytokines stimulate inflammation, which lead to both an overactive thyroid (hyperthyroidism) and a frozen shoulder. Studies have also found that many people suffering from a frozen shoulder do have a high level of hypothyroidism (under-active thyroid). Those with benign thyroid nodules also tend to have a higher risk of developing frozen shoulders over time, so it’s wise to get your TSH (thyroid-stimulating hormone) levels checked frequently so any disorder can be caught early and treated adequately.

Thyroid Disorders:

Your heart is the most important organ of your body – and it’s the one that most don’t seem to care for enough. Cardiovascular diseases and other heart-related issues like hypertension and high cholesterol are also huge risk factors for other ailments like developing frozen shoulder. While studies are still being conducted to find out the relationship between the two, researchers note that the risk factors caused by heart disease may reduce blood flow to some parts of the body, including the delicate shoulder area, leading to pain and stiffness in the joint thereafter. Studies show that the more heart disease factors a person tends to have, the more likely they will have shoulder issues – so controlling your blood pressure levels and other heart risk factors are key in reducing the risk of frozen shoulder as well. 

Cardiovascular Disease:

Many know that Parkinson’s is a degenerative disorder that affects the central nervous system and leads to a slow decline of a person’s motor skills, memory and life skills over time. But few are aware that frozen shoulder could be an early symptom of Parkinson’s disease (PD) as well. In some patients, it’s seen that frozen shoulder that lasts for months or years has been the very first symptom of PD, sometimes years before other typical symptoms follow. If you have a genetic predisposition to Parkinson’s and have a persistent frozen shoulder or stiffness, it’s worth getting tested to get your symptoms checked early on.

While the treatment for frozen shoulder involves a combination of medication, physical therapy and surgery in some severe cases, it’s worth noting that being aware of the various factors that lead to this painful and debilitating condition can help to figure out if your pain is just that, or something much deeper.

Parkinson's Disease:

Everything You Need to Know About Frozen Shoulder

You may have recently received a prescription for hormonal birth control pills, which may have not been prescribed, in your case, for contraception. For many conditions, such as irregularity in periods, PCOS, and even if you are facing fertility struggles, frequently the first line of treatment is a few cycles of hormonal birth control pills.

While clinically proven effective, it may not always be the right choice for you. Knowing what the pill is, and its long-term effects, can help you make a more informed decision for your health.


Birth control pills contain a variant of natural estrogen and progesterone. Some pills only contain progesterone. 

They are taken daily (with a week’s gap every month) to suppress natural ovulation and prevent pregnancy. When used as per their instructions, birth control pills have only a [4% to 7% failure rate](https://jamanetwork.com/journals/jama/fullarticle/2787541), or chance of pregnancy. 

However, because of its composition of hormones, similar composition to our menstrual cycle hormones, birth control pills are often prescribed for other [hormonal-related conditions](https://www.ncbi.nlm.nih.gov/books/NBK430882/). These include irregular periods, painful periods, fibroids, and endometriosis. Oral contraceptive pills are also sometimes prescribed to manage physical and mental health [symptoms of PMS](https://pmc.ncbi.nlm.nih.gov/articles/PMC7648490/#:~:text=Although%20our%20study%20established%20a,evidence%5B16%2C32%5D.).

While there might be immediate benefits in short-term use of the pill in these cases, based on its adverse effect profile, does it warrant use at all without treatment of underlying medical conditions?

Community take:

>I had never been to a gynecologist before. I am 23 and didn’t know whom to have the contraception discussion with, for fear of being judged as sexually active without being married. I found a doctor in my locality and went in for a prescription. I wasn’t asked many questions and recommended oral contraceptive pills to be taken for 28 days with a week’s break every month. Seemed easy enough. A few months in I noticed I had been frequently getting severe headaches. I didn’t initially link it to the pill. As soon as I stopped using them the headaches vanished too.



What are birth control pills?

Hormonal birth control pills, while beneficial for many, are not without their side effects. 

The pill has both long and short-term effects. To understand these, it is important to talk about your predisposing factors with your healthcare provider before you start yourself on the pill. Sometimes doctors neglect to have these conversations, but you shouldn’t.

There are some absolute contraindications to the birth control pills (and other hormonal contraception), which include:
- If you have a history of blood clots or are predisposed to them
- Have hypertension
- Are a heavy smoker
- Have a history of migraines
- Have breast or endometrial cancer

In all these cases, taking oral contraceptives can worsen disease, and increase risk of fatality. While the range of [contraindications falls between 6 - 42%](https://www.sciencedirect.com/science/article/abs/pii/S1877575620302275), many continue to take the pill because of over-prescription without a detailed health evaluation.

Additionally, even if you do not have any of these risk factors, birth control pills can result in other adverse effects. Short-term effects include:
- Nausea or rarely vomiting
- Breast tenderness
- Changes to your period flow
- Headaches
- Pain in your limbs
- Spotting in between periods

Long-term use of birth control pills [increases your baseline risk](https://pubmed.ncbi.nlm.nih.gov/25534509/) for cardiovascular disease and breast cancer. Another [systematic review](https://pubmed.ncbi.nlm.nih.gov/12686037/) shows an increased risk of cervical cancer. 

Conversely, birth control pills lower the risk of ovarian and endometrial cancers. 

It is crucial to understand that birth control pills only increase risk, not determining whether you will have the disease in the future or not. This risk subsides once you stop taking the pill.



What are the side effects of birth control pills?


Most imbalance is when our hormones lose their natural ability to sync to our bodies' requirements. Often this results from our daily stressors.

The first would be improving your daily nutrition for better health. Add more protein, lower sugar intake, add probiotics, and consume healthy fats. Next, a healthy weight, regular exercise managing stress and adequate sleep complete the list of lifestyle essentials for naturally balancing your hormones.

If you have already been prescribed the pill for an underlying health condition such as PCOS, consider talking to your healthcare provider about your alternatives. While PCOS benefits from lifestyle and nutrition changes, natural supplements such as [inositol](https://rbej.biomedcentral.com/articles/10.1186/s12958-023-01055-z#Sec19), a variant of vitamin B, are seen to lower testosterone levels and improve ovulation.

Similarly, a nutrition change such as a plant-based diet over a high-fat diet has been [beneficial for patients with endometriosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC9983692/#s5), lowering estrogen activity and promoting anti-inflammatory effects.

What are my alternatives to the pill?

Clinical studies have proven the pill safe for use. However, many women experience significant adverse effects after starting the pill. Continuous exposure to these external hormones increases your risk for cardiovascular disease, and breast and cervical cancer. For underlying imbalance, discuss alternative options to the pill to naturally improve hormonal irregularities.


Takeaway

Why the pill may not be your first choice in the management of your hormonal imbalance 

Living with **PCOS** can feel like a puzzle you just can’t solve! You’re doing everything you can—eating healthy, staying active, managing stress—but it still feels like your body isn’t cooperating.
What makes it even harder is that **insulin resistance**, a key driver behind many PCOS symptoms, often goes unnoticed. It’s at the root of those stubborn issues like weight that won’t budge, irregular periods, and constant fatigue.
Here’s the good news: once you understand **how insulin resistance and PCOS** are connected, you can start making changes that actually work. Whether it’s simple tweaks to your routine or finding the right medical support, every step you take can help you feel better.

Let’s make it easier for you to take charge of your health—here are 7 simple FAQs to guide you through managing **insulin resistance and PCOS**. You’ve got this!


Introduction

Insulin resistance occurs when your body’s cells don’t respond effectively to insulin—a hormone that helps regulate blood sugar levels. 

Think of insulin as a key and your cells as locks. In a healthy system, insulin (the key) fits perfectly into the locks on your cells, allowing sugar (glucose) from your bloodstream to enter the cells and provide energy.

In insulin resistance, the locks on your cells become "rusty" or damaged, so the key (insulin) doesn’t work as well. Your body senses this problem and produces more keys (insulin) to open the locks.

This overproduction of insulin keeps blood sugar levels somewhat under control for a while, but eventually, the system becomes overwhelmed. This leads to higher levels of both insulin and blood sugar, setting the stage for more severe PCOS symptoms, Type 2 diabetes, and weight gain.



FAQ 1: What Is Insulin Resistance?

When insulin levels are higher than they should be, it sets off a chain reaction in your body. One of the biggest effects is that it causes your ovaries to produce more androgens (male hormones) than normal. This hormonal imbalance can show up in ways that feel frustrating and difficult to manage, like:

- Weight gain that seems resistant to even your best efforts with diet and exercise.
- Irregular periods that make it hard to predict or track your cycle.
- Persistent acne, unwanted hair growth in areas like the face or chest, or thinning hair on your scalp.

>I’ve tried countless diets and exercise routines, but the weight just wouldn’t budge. It felt like my body was stuck in a cycle I couldn’t control,” says Ritika*, 23, a law student. 

FAQ 2: Why does insulin resistance matter in PCOS?

Insulin resistance can be tricky because it doesn’t always come with clear symptoms. However, some signs could indicate your body is struggling to process insulin properly:

1. Frequent Fatigue:
Feeling tired all the time? Insulin resistance can leave you drained, even after a full night’s sleep. You might notice the fatigue hits hardest after meals, especially if they’re heavy in carbs or sugar.

2. Cravings for Sugary or Starchy Foods
If you find yourself constantly reaching for sweets, bread, or snacks, it could be a sign. When your body isn’t efficiently using sugar for energy, it often leads to intense cravings for more.

3. Skin Changes
One telltale sign of insulin resistance is dark, velvety patches of skin, often on the neck, underarms, or groin. This condition, called acanthosis nigricans, is a common but lesser-known symptom.


FAQ 3: What Are the Symptoms of Insulin Resistance?

If left unmanaged, insulin resistance in PCOS can lead to serious health problems. Here's what the research shows:

1. Metabolic Syndrome: 
This cluster of conditions includes high blood pressure, elevated blood sugar, excess abdominal fat, and abnormal cholesterol or triglyceride levels. Together, these factors significantly increase the risk of heart disease, stroke, and type 2 diabetes. 

About [26% of women with PCOS](https://pmc.ncbi.nlm.nih.gov/articles/PMC6088762/) develop MetS, and teens with PCOS are over [three times more likely](https://link.springer.com/article/10.1007/s43032-022-00864-8) to have MetS than those without the condition. 

2. Type 2 Diabetes:
Chronic insulin resistance can progress to type 2 diabetes, identified by high blood sugar levels.

Women with PCOS are [5–10 times more likely](https://www.sciencedirect.com/science/article/pii/S0015028202031114#:~:text=The%20relative%20risk%20of%20type,data%20need%20to%20be%20confirmed.) to develop type 2 diabetes than women of the same age and weight without PCOS.

3. Cardiovascular (Heart) Diseases: 
The combination of insulin resistance, metabolic syndrome, and elevated androgen levels in PCOS contributes to a higher risk of heart disease. 

Women with PCOS are [twice as likely](https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovarian-syndrome-how-your-ovaries-can-affect-your-heart#:~:text=PCOS%20risk%20factors%2C%20like%20being,or%20stroke%2C%E2%80%9D%20she%20says.) to have a major heart event, like a heart attack or stroke, in the future compared to women without PCOS.

FAQ 4: What Are the Long-Term Risks of Ignoring Insulin Resistance in PCOS?

Insulin resistance in PCOS can result from a mix of genetic, hormonal, and lifestyle factors. Let’s break it down:

1. Genetic Predisposition:
If you have a family history of PCOS or insulin resistance, you may already be at a higher risk. Some people inherit genes that make their cells less responsive to insulin. It’s not something you can control, but it helps explain why insulin resistance is common in PCOS.

2. Lifestyle Factors:
Your diet and activity levels also play a big role. Eating lots of refined carbs, sugary foods, and processed snacks can overwhelm your body’s ability to manage blood sugar. Combine that with a lack of regular exercise, and your cells become less sensitive to insulin over time

3. Chronic Inflammation:
PCOS often comes with low-grade inflammation in the body. This inflammation interferes with how your cells respond to insulin, making it harder for them to absorb sugar from your blood. It’s like a feedback loop—PCOS causes inflammation, and the inflammation worsens insulin resistance.

4. Hormonal Imbalances:
Excess androgens (male hormones) and irregular fat storage patterns are hallmarks of PCOS. Together, they disrupt your body’s normal metabolism, further reducing how efficiently insulin works. This is one reason why insulin resistance and hormonal issues often go hand in hand with PCOS.

By understanding these causes, you can see how different factors—some within your control and some not—contribute to insulin resistance. The good news? Targeted lifestyle changes and medical support can help manage these effects.



FAQ 5: What Causes Insulin Resistance in PCOS?

Even small weight loss ([5-10% of body weight](https://diabetesjournals.org/care/article/45/11/2753/147671/Management-of-Hyperglycemia-in-Type-2-Diabetes#:~:text=Weight%20loss%20of%205%E2%80%9310,2021%20consensus%20report%20(51).)) can significantly improve insulin sensitivity. That’s why small lifestyle changes can lead to big impacts. Let’s explore a few options. 

**1. Balanced Nutrition:**

What you eat plays a huge role in managing insulin resistance. Low glycemic index (GI) foods release sugar slowly into the bloodstream, helping to keep blood sugar levels steady. They’re especially helpful for managing insulin resistance and PCOS. Some common examples are: 
- **Whole Grains**: Brown rice, jowar, bajra, whole wheat roti.
- **Legumes**: Lentils (dal), chickpeas (chana), kidney beans (rajma).
- **Vegetables**: Spinach, methi (fenugreek), broccoli, cauliflower.
- **Other Options**: Quinoa, oats, nuts, and seeds.

**Practical Tip:**
Replace white rice with brown rice or quinoa and choose whole wheat rotis instead of refined flour (maida).

Reducing sugary snacks and processed carbs can make a big difference. Start simple—replace a sugary mid-afternoon snack with a handful of nuts or a piece of fruit.

>I didn’t realize how much-processed food was part of my routine. Just prepping my lunches at home helped me avoid last-minute junk food runs," shares Priya, a working mom managing PCOS.

>Anti-inflammatory foods are also known to help with the symptoms of insulin resistance and PCOS. Here are a few examples you can find in your kitchen:
**Antioxidants** help neutralise harmful free radicals that can damage cells and increase inflammation.
**Vitamins** (like Vitamin C and E) boost your immune system and reduce inflammation.
**Healthy Fats**, like omega-3 fatty acids, directly combat inflammation.

**A few sources of anti-inflammatory foods are:**

Fruits: Guava, amla (Indian gooseberry), papaya, and pomegranate.
Vegetables: Spinach (palak), methi (fenugreek leaves), broccoli, and cauliflower.
Healthy Fats: Coconut oil, mustard oil, almonds, cashews, and flaxseeds (alsi).
Proteins: Fish like rohu, hilsa, and pomfret, as well as dals (lentils) like moong dal and masoor dal.
Spices: Turmeric (haldi), ginger (adrak), garlic (lahsun), and cinnamon (dalchini).

**Practical Tip:**

Use haldi and ginger in your daily sabzis, snack on almonds and cashews, or swap out regular cooking oil for mustard or coconut oil to naturally add anti-inflammatory power to your meals.

**2. Exercise:**

You don’t need a gym membership to improve insulin sensitivity. Movement is key.
Activities like walking, swimming, or cycling are great for overall insulin sensitivity. If time is tight, start with 10-15 minutes of brisk walking after meals. It’s doable even for busy schedules.

>As a new mom, I couldn’t commit to long workouts. So I started taking 15-minute walks with my baby in a stroller after dinner. It helped me feel more energetic and manage my cravings," says Aditi, 29.

>However, building muscle helps your body use insulin more effectively. Even two days a week of strength training with light weights or bodyweight exercises can make a difference. 

**3. Stress Management:**

Stress is a sneaky contributor to insulin resistance. When you’re stressed, your body produces more cortisol, which can worsen blood sugar regulation.


- Simple breathing exercises, meditation, or yoga can lower stress levels. Even a 5-minute break to breathe deeply can help.
- If you’re overwhelmed, say no to unnecessary commitments. Protecting your mental space helps regulate your hormones, too.

>I started doing yoga twice a week after work. It’s my time to reset, and I’ve noticed fewer sugar cravings," shares Meera, a working professional.

**Practical Tip:**

If weight loss feels overwhelming - forget the scale—focus on the basics: eat smart, drink water, and sleep well. Your body will thank you!



FAQ 6: How Can Lifestyle Changes Help Manage Insulin Resistance in PCOS?

Sometimes, managing PCOS and insulin resistance requires more than just lifestyle changes. Medical help can make a big difference—not just in relieving symptoms but also in preventing long-term complications like type 2 diabetes or heart disease. Here’s how to approach it:

Which Doctors Should You Consult?

Your first stop for PCOS-related concerns is a gynaecologist. They can assess your hormonal imbalances, menstrual irregularities, and fertility issues. An endocrinologist, an expert in hormone-related conditions, can help manage insulin resistance and assess its impact on overall health.

How to Prepare for Your Appointment

1. Track Your Symptoms:
Write down your symptoms—when they started, how often they occur, and their severity. For example:
- Irregular periods: how long, how heavy.
- Unwanted hair growth: where and how noticeable.
- Fatigue, cravings, or difficulty losing weight.

2. Keep a Log of Your Cycle:
Use a period-tracking app or a simple calendar to note the length and regularity of your menstrual cycles.

3. Note Your Concerns:
Be ready to discuss any struggles with weight management, acne, or mood changes. The more specific you are, the better your doctor can help.

What Treatments Are Recommended?

Inositol is a naturally occurring substance that acts like insulin in your body. It’s often recommended as a supplement to improve symptoms. Birth control pills are commonly used to regulate periods and manage hormonal imbalances. They can also reduce androgen levels, easing symptoms like acne and unwanted hair growth. 


FAQ 7: When Should You Call in the Experts for PCOS or Insulin Resistance? 

Managing **PCOS and insulin resistance** may feel like a challenge, but every small step you take brings you closer to balance and better health. 

With the right knowledge and support, you can feel more in control of your body and your future. You’re not alone in this journey—and you’ve got the tools to take charge.


Summing It Up

1. Insulin resistance is a key driver of PCOS symptoms, including weight gain, irregular periods, and fatigue.
2. Small dietary changes—like choosing low-glycemic foods—can help stabilise blood sugar levels and improve insulin sensitivity.
3. Regular movement, even 15 minutes daily, and strength training can make a big difference in managing symptoms.
4. Stress management is crucial—yoga or mindfulness can help regulate cortisol and insulin levels.
5. Professional support from a gynecologist or endocrinologist is essential for personalized care and effective treatment options, such as inositol supplements or hormonal therapies.


7 FAQs to Help You Understand PCOS and Insulin Resistance

The World Health Organization records most women going through menopause between 45 to 55 years of age. In 2011, 96 million Indian women were estimated to be above 45, according to the Office of the Registrar General and Census Commissioner. This number is projected to be [401 million in 2026](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320842/#ref17), most of them likely going through menopause.

During this transitional phase, knowing your unique symptoms can help you seek the support you desire for menopause. Additionally, surrounding yourself with people who will understand and ease your transition can help with healthy aging through menopause. 


According to a survey taken by Ipsos in 2018, only [24% of Indian women visit a doctor](https://www.statista.com/statistics/913376/india-frequency-of-visits-to-obstetricians-gynecologists/) once a year. Approximately 50% cited less often or never as their responses. 

By the time you reach menopause, you have probably visited your gynecologist a few times over the years for routine check-ups. Making your current gynecologist, someone well aware of your medical history, the ideal choice for you during menopause.  

>**Community take:** 
In my late 40s, it had been years since I visited a gynecologist. I had my babies in my late 20s and 30s. Now and then I would go in for a pap smear, but regular check-ins rarely happened. And here I was drenching in sweats and overnight insomnia. I thought it was something I had to go through at this age. But when I talked to my gynecologist, I felt reassured. She guided me through the expected changes in this time, and what can help me. She provided me with some supplements and asked to check back in a few months. Having someone to talk to, and know I need help has been a game-changer during perimenopause.
 
With strides in telemedicine, doctors are now accessible online. So even if this means you have to find a new physician (especially if you have never consistently been to one before) there are some factors to keep in mind. 

Enlisting expert help: How to choose the right physician for you?

Understanding your unique menopause symptoms and how they affect your daily functioning is a _first step_. This can help guide your initial interviews in finding the right physician, by feeling at ease to relay your symptoms to your physician without concern of being dismissed for what you are experiencing during menopause. 

Knowing what you need help with

If you have not visited the same gynecologist over the years, talk to your friends or peers about their experiences with their physician. You can also do some research on gynecologists specializing in menopause in your locality, making it easier for routine menopause visits. If you have a gynecologist you visit yearly, you can start discussing what to look out for during perimenopause leading to menopause. Based on your medical history your doctor can advise you on lifestyle steps for nutrition, stress, and exercise required for the transition. 

Get some referrals or start talking menopause with your OB-GYN 

A Female Founders Fund survey, highlighted [32% of their respondents](https://blog.femalefoundersfund.com/suffering-in-silence-the-biases-and-data-gaps-of-menopause-e5f131b4b581) experiencing a lack of confidence in the knowledge and openness of menopause discussions with their healthcare providers.  

This indicates that there is still significant stigma surrounding perimenopause, and its symptoms leading up to menopause. In India, most women still believe that physical changes related to their menstrual cycles and hormones should be coped with in silence. However, universally the dialogue on menopause is progressing. Individually, if you are suffering from your symptoms seek a physician who will listen to you. You should not be dismissed for what you are experiencing as a normal part of aging.  

Ideally, the right doctor will listen, be accessible, and provide individualized care to suit your unique symptoms and lifestyle for better health during menopause.

Advocate for your health during menopause 

During menopause, both physical and psychological changes can impact your daily quality of life. While your doctor can guide you, it becomes vital to form a support system that is easily accessible to help you through this transitional phase.  

Community participation and having a sense of community have been [linked](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953512/#sec4-ijerph-19-03261title) to improving quality of life and mental health, promoting healthy aging.  

Whether it is a local support group, your kitty party, or an online forum, finding your safe space with women going through a similar journey can be as important as having the right physician for menopause. Such groups often provide practical advice on dealing with symptoms during menopause. This can include tips on nutrition, with local ingredients available, or even enlighten on groups meeting up for discussions. 



>**Community take:** 
No one ever spoke to me about menopause. I thought it was something women go through in their 50s. Basically, their periods stop. When I had night sweats and started packing on weight, I was so confused. While my doctor explained these (and more changes) would happen during perimenopause, the discussion seemed so technical. When I researched online, I found a local group of women who met once a month and regularly talked about their concerns. It was that day I stopped feeling alone. I realized that talking to everyday women removes the isolation from your perimenopause symptoms. I have also received some practical tips that have worked when it comes to managing those pesky hot flashes that come in the day!

A [2023 review of literature](https://www.mdpi.com/2673-4184/4/1/5) showcased that women forming high social support for themselves, through family, friends, and communities experienced a reduction in the severity of their psychological and urogenital menopause symptoms. A key dynamic is the increased education on menopause by both the women and their families which promotes better health outcomes during menopause.

Harnessing the power of community: how to build the right support system for yourself 

Going through perimenopause to menopause and beyond is a long journey, which can often feel lonely if you don’t have the right support. Talking to different physicians about their experience with menopause, and openly discussing your symptoms can help you assess if your healthcare provider is right for you. Do not hesitate to take some time, while talking to several doctors before finding the right one for you. Once you reach perimenopause, start seeking and building your support system, of friends, family, and women themselves going through menopause who can help you transition into this new phase of your life. 

Takeaway 

Pausing for menopause: Finding the right physician, building your community, and knowing when to seek help

Perimenopause is the transitional phase into menopause. The median [onset of perimenopause](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082400/) is 47 years. However, you may notice symptoms of perimenopause as early as your late 30s. Perimenopause lasts for a few years before menopause arrives. For some women, symptoms can carry on for decades.  

While some symptoms are manageable, many are significantly distressing affecting your daily functioning. Knowing when to meet your healthcare provider and simple ways to manage your symptoms at home can help with your transition to menopause.

Perimenopause (_peri_- meaning around), is the transitional phase to menopause, when your periods would have stopped completely. 

So one of your first signs that you might be in perimenopause is period irregularities. This can be coupled with classic symptoms such as hot flashes, vaginal dryness, or significant fluctuations in your mood.  

However, many of these signs may not be textbook versions of what you expect. Such as recently, [actress Halle Berry spoke out about being misdiagnosed for herpes](https://abcnews.go.com/GMA/Wellness/halle-berry-doctors-misdiagnosed-perimenopause-herpes/story?id=108551685), when she was experiencing the burning sensation of vaginal dryness of perimenopause.  

_The slow decline in estrogen is responsible for the fluctuation in such symptoms, and also its differing presentations among women._  

Similarly, some women may experience a [burning sensation in the mouth](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4520363/), tinnitus (ringing in the ears), new skin reactions, heart palpitations, or recurrent UTIs as indicators for perimenopause.

What are the symptoms of perimenopause? 

Whenever you notice your first perimenopausal symptoms would be an ideal time to check in with your doctor. Your physician will assess whether your symptoms are because of declining estrogen of perimenopause or another underlying medical condition.  

An example of this possibility is the common hot flashes experienced by [85% of menopausal women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/). In some instances, [hot flashes can be reported](https://www.ncbi.nlm.nih.gov/books/NBK539827/) with certain cancers, thyroid disease, or certain medications you are taking. 

If your perimenopause symptoms affect your day-to-day functioning, your doctor can help you understand the reasons for it and suggest ways to manage your symptoms. While certain lifestyle changes can help, some women may need [hormonal supplementation](https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061559) to assist with debilitating physical symptoms of perimenopause.  

Additionally, the erratic decline in estrogen during perimenopause may cause significant fluctuations in your mood. Perimenopausal women are [two to four times more likely to experience a depressed mood](https://www.sciencedirect.com/science/article/abs/pii/S187620182100037X?via%3Dihub) than women who are not in perimenopause. This likelihood increases if you have had depression in the past.  

Any feelings or emotions you cannot cope with should prompt you to reach out for professional help. 

>**Community take:** 
I never had PMS mood changes. What women described as irritability, anger, and frustration before their periods just never happened to me. And then one day I was angry all the time. Even in situations I had no reason to be. I thought it was PMS, since I was still having my periods, even though it was not so regular. When it was starting to affect my interactions at home, I thought I’d see professional help. My doctor explained that all these changes (I was also having hot flashes which I ignored) were perimenopausal and related to my hormones. I talk to a therapist once a week, and that has helped provide a third person’s view to what I’m experiencing. If you feel different and are in your 40s, talk to a doctor. It is often not just in your head.

When should I see a doctor for my symptoms?

While you may not know exactly when you are going to transition to menopause, knowing the symptoms and how they might affect you can prepare you for perimenopause.  

In your 30s (not a bad idea to start in your 20s), optimize your nutrition and exercise regularly to encourage healthy aging. With the hustle of daily life, these are the first things to falter, causing the most damage to our physical and mental health. Additionally, routinely adding more [strength training workouts](https://pubmed.ncbi.nlm.nih.gov/36675477/), along with supplementing your diet with sources of iron, [magnesium, and calcium](https://jmscr.igmpublication.org/home/index.php/archive/214-volume-11-issue-07-july-2023/10716-a-comparative-study-of-serum-calcium-and-magnesium-in-post-menopausal-and-pre-menopausal-women) is beneficial for reducing the severity of perimenopausal symptoms and long-term negative effects of declining estrogen levels. 

Another key is managing your stress levels during perimenopause. While the symptoms of perimenopause can be worrisome, [added stress](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840006/), and a consistently elevated cortisol level can worsen symptoms. Tackling your stress, through exercise, meditation and even regular therapy helps tremendously through perimenopause.

What are some routine practices to follow for my perimenopausal symptoms?

Perimenopause is a transitional phase in a woman’s life. Hallmark of perimenopause is the fluctuation in physical and mental health symptoms, which can worsen affecting daily functioning during this transitional phase. Consider checking in with your doctor for help, along with incorporating simple routine practices to favor healthy aging.