7 FAQs to Help You Understand PCOS and Insulin Resistance

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!

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.

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.

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.

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 develop MetS, and teens with PCOS are over three times more likely 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 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 to have a major heart event, like a heart attack or stroke, in the future compared to women without 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.

Even small weight loss (5-10% of body weight) 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!

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.

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.

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.