If you’ve been told you have PCOS and insulin resistance, or you suspect the two might be connected, you’re not imagining things, and you’re certainly not alone.

In my work with women navigating PCOS, insulin resistance is one of the most common and most misunderstood drivers behind symptoms like irregular cycles, stubborn fatigue, cravings, and fertility struggles. It’s also one of the areas where gentle, well-informed support can make a meaningful difference.

This guide is here to help you understand PCOS and insulin resistance in clear, human language — without fear, blame, or extremes — and to explore realistic ways to support your body over time.

Polycystic Ovary Syndrome (PCOS) is often described as a reproductive condition, but that description only tells part of the story.

PCOS is typically diagnosed using the Rotterdam criteria, which include:

• Irregular or absent ovulation

• Elevated androgen (male-type hormone) levels

• Polycystic-appearing ovaries on ultrasound

However, PCOS also affects metabolism, inflammation, stress hormones, and how the body processes energy. For many women, these metabolic shifts are just as impactful as reproductive symptoms, if not more so.

This is where insulin resistance becomes relevant.

Insulin is a hormone produced by the pancreas that helps move glucose from the bloodstream into cells, where it can be used for energy.

Insulin resistance occurs when cells become less responsive to insulin’s signal. To compensate, the body produces more insulin to keep blood sugar levels stable.

Over time, this can lead to:

• Persistently elevated insulin levels

• Blood sugar instability

• Increased fat storage

• Disrupted hormone signalling

Importantly, insulin resistance can be present long before blood glucose levels become abnormal [1].

One of the most frustrating parts of PCOS is that insulin resistance doesn’t always fit a stereotype.

You can have insulin resistance even if:

• You are not overweight

• Your fasting glucose is normal

• You eat well and exercise regularly

In PCOS, insulin resistance appears to be influenced by genetics, ovarian signalling, and hormonal sensitivity, not simply lifestyle factors [4].

This is why overly restrictive approaches often backfire, increasing stress hormones and further disrupting metabolic balance.

Some women notice clear symptoms, while others experience more subtle patterns.

Common signs include:

• Strong cravings for carbohydrates or sugar

• Energy crashes between meals

• Difficulty feeling satisfied after eating

• Weight gain around the midsection

• Irregular or absent periods

• Brain fog or afternoon fatigue

These symptoms are not a reflection of willpower, they’re physiological signals.

For women trying to conceive, insulin resistance is one of the most important, and often overlooked, barriers to ovulation and healthy egg development in PCOS.

Ovulation depends not only on reproductive hormones, but also on metabolic signals. When insulin remains elevated, it interferes with communication between the brain, ovaries, and developing follicles.

High insulin levels can:

• Disrupt follicle maturation

• Increase ovarian androgen production

• Reduce sensitivity to follicle-stimulating hormone (FSH)

• Increase oxidative stress within ovarian tissue [5]

This helps explain why some women with PCOS ovulate irregularly or release eggs that struggle to mature fully — even when cycles appear regular on the surface.

Crucially, insulin resistance can affect fertility regardless of body size. When insulin sensitivity improves, many women experience more predictable ovulation and improved cycle quality.

Many women are told their results are “normal” despite ongoing symptoms. This happens because early insulin resistance is often missed by standard tests.

• Fasting glucose: Often normal until insulin resistance is advanced

• HbA1c: Reflects long-term glucose averages but misses insulin spikes

• Fasting insulin: Helpful, but reference ranges are broad

• HOMA-IR: A useful calculation, but still a snapshot

• Oral glucose tolerance test (OGTT): Often reveals exaggerated insulin responses even when glucose remains normal [1]

Symptoms often appear before lab values shift. This is why context matters as much as numbers.

Improving insulin sensitivity doesn’t require perfection. It requires consistency and safety.

Rather than restriction, focus on balance:

• Pair carbohydrates with protein and fat

• Eat regularly to avoid long fasting windows

• Prioritise fibre-rich foods

• Consider a balanced breakfast if cycles are irregular

Stability matters more than precision.

Helpful movement options include:

• Walking

• Strength training

• Pilates or yoga

• Low-impact interval training

Over-exercising can increase cortisol and worsen insulin resistance in PCOS [6].

Chronic stress and poor sleep increase cortisol, which raises blood sugar and insulin output.

Supporting the nervous system through rest, routine, and recovery is not optional — it’s foundational.

Supplementation can be helpful when it supports physiology rather than overriding it.

Myo-inositol has been shown to:

• Improve insulin sensitivity

• Support ovulation

• Reduce androgen levels

• Improve cycle regularity [7]

Chromium supports insulin receptor activity and glucose transport [8].

These nutrients support hormone metabolism, nervous system regulation, and methylation pathways.

For women looking for a structured, evidence-aligned option, MyOva’s award-winning Myoplus was formulated specifically to support insulin-resistant PCOS.

Myoplus combines:

• Myo-inositol for insulin sensitivity and ovulation

• Chromium for glucose regulation

• Vitamin B6 for hormone and stress support

• Folate for reproductive and metabolic health

Rather than forcing change, it supports the body’s signalling systems over time.

While everyone is different, common timelines include:

• 4–6 weeks: improved energy stability

• 8–12 weeks: cycle or ovulation changes

• 3–6 months: deeper hormonal regulation

Progress is rarely linear — and that’s normal.

Yes. Some women have inflammatory or adrenal-driven PCOS without significant insulin resistance [9].

Insulin sensitivity can improve significantly with consistent, supportive care.

Not necessarily. Insulin resistance can occur at any weight, and restriction often worsens symptoms.

Not always. Some women benefit from medication, while others see improvement through lifestyle and nutritional support.

Understanding insulin resistance is often the first step — but PCOS rarely exists in isolation.

• Inflammatory PCOS: How Chronic Inflammation Affects Hormones

• Adrenal PCOS: The Role of Stress and Cortisol

• Myo-Inositol and PCOS: What the Research Shows

• PCOS and Irregular Periods: Understanding Cycle Signals

PCOS and insulin resistance are not personal failures — they are physiological patterns shaped by hormones, genetics, and environment.

When insulin sensitivity improves, many women feel steadier, more trusting of their cycles, and more hopeful about their fertility.

Small, consistent shifts, paired with understanding and patience, can restore balance over time.

1. Reaven GM. Diabetes. 1988.

2. Diamanti-Kandarakis E et al. Endocrine Reviews. 2012.

3. Dunaif A. Endocrine Reviews. 1997.

4. Goodarzi MO et al. Nature Reviews Endocrinology. 2011.

5. Legro RS et al. NEJM. 2007.

6. Stener-Victorin E et al. Human Reproduction Update. 2020.

7. Unfer V et al. International Journal of Endocrinology. 2017.

8. Anderson RA. Diabetes. 1997.

9. Escobar-Morreale HF. Human Reproduction Update. 2018.