The Connection Between PCOS and Insulin Resistance

Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions affecting women of reproductive age. It’s often associated with irregular periods, infertility, acne, and unwanted hair growth. But what many don’t realize is that insulin resistance—a condition more often linked to diabetes—is at the heart of PCOS for many women.

At Sheen Vein (Aesthetics and Functional Medicine) here in St. Louis, we often see women who are frustrated by weight struggles, fatigue, and hormone imbalances tied to PCOS. Understanding how insulin resistance drives these symptoms is the first step to better treatment and long-term health.

What Is Insulin Resistance?

Insulin is a hormone produced by the pancreas that helps move glucose (sugar) from the bloodstream into your cells for energy. When the body becomes less responsive to insulin—a state known as insulin resistance—blood sugar and insulin levels both rise.

Over time, high insulin levels can:

  • Trigger inflammation
  • Increase fat storage (especially around the belly)
  • Drive hormonal imbalances
  • Raise the risk for type 2 diabetes and heart disease

How Insulin Resistance Contributes to PCOS

PCOS is a complex condition, but insulin resistance is one of its core drivers. Studies show that up to 70% of women with PCOS have some degree of insulin resistance, even if they are not overweight.

Here’s how it works:

  1. Excess Insulin Stimulates the Ovaries
    High insulin levels signal the ovaries to produce more androgens (male-type hormones such as testosterone).
  2. Hormonal Imbalance Disrupts Ovulation
    Elevated androgens interfere with normal ovulation, leading to irregular or missed periods. This is why many women with PCOS struggle with fertility.
  3. Symptoms Develop
    High androgen levels cause acne, thinning hair on the scalp, and unwanted facial or body hair (hirsutism). Insulin resistance also makes it easier to gain weight and harder to lose it, worsening PCOS symptoms.
  4. Long-Term Health Risks Increase
    Left unchecked, insulin resistance and PCOS raise the risk of type 2 diabetes, high cholesterol, hypertension, and cardiovascular disease.

Signs You May Have Both PCOS and Insulin Resistance

Women with both conditions often describe a combination of reproductive, metabolic, and skin-related symptoms. These may include:

  • Irregular or absent menstrual cycles
  • Difficulty conceiving
  • Weight gain, especially around the midsection
  • Fatigue and energy crashes
  • Acne or oily skin
  • Excess hair growth on the face, chest, or abdomen
  • Thinning scalp hair
  • Dark, velvety skin patches (acanthosis nigricans), often on the neck or underarms

If these symptoms sound familiar, a comprehensive evaluation can help identify whether insulin resistance is contributing to your PCOS.

How PCOS and Insulin Resistance Are Diagnosed

At Sheen Vein (Aesthetics and Functional Medicine), evaluation begins with a thorough medical history, lab testing, and sometimes ultrasound imaging of the ovaries. Blood work may include:

  • Fasting glucose and insulin
  • Hemoglobin A1c (a measure of long-term blood sugar control)
  • Testosterone and other hormone levels
  • Lipid panel to check cholesterol and triglycerides

This functional approach helps us address the root cause, not just mask symptoms.

Treatment Approaches

The good news: by addressing insulin resistance, many PCOS symptoms improve significantly. Treatment often includes a combination of lifestyle changes, targeted nutrition, and medical therapies.

Lifestyle and Nutrition

  • Balanced diet: Focus on whole foods, lean protein, high-fiber vegetables, and reduced refined carbohydrates.
  • Exercise: Regular strength training and cardiovascular activity improve insulin sensitivity.
  • Weight management: Even a 5–10% reduction in body weight can improve cycles and fertility in women with PCOS.

Medical Therapies

  • Metformin: A medication that improves insulin sensitivity, often used in PCOS.
  • Hormonal therapies: Birth control pills or bioidentical hormones may help regulate cycles and reduce androgen symptoms.
  • Supplements: Inositol, omega-3 fatty acids, and vitamin D can support hormone balance and metabolic health.

Functional Medicine Approach

At our St. Louis clinic, we go beyond conventional treatment by also evaluating gut health, micronutrient status, thyroid function, and inflammation—factors that often worsen PCOS and insulin resistance.

Why Early Treatment Matters

Because PCOS and insulin resistance are long-term conditions, early recognition and management are critical. Addressing insulin resistance not only improves fertility and menstrual regularity but also reduces the risk of diabetes and heart disease later in life.

Final Thoughts

PCOS and insulin resistance are deeply interconnected. High insulin levels drive hormonal imbalances, which in turn fuel the reproductive, skin, and metabolic symptoms that make PCOS so challenging. But with the right approach, it’s possible to restore balance, improve fertility, and protect long-term health.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we provide a personalized, root-cause approach to PCOS that addresses both hormone health and metabolic function. If you’re struggling with symptoms of PCOS, we invite you to schedule a consultation—because you deserve answers and real solutions.

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