What You Really Need To Know About PCOS & Insulin Resistance

Photographed by Rockie Nolan.
Polycystic ovary syndrome is often described as a circle of symptoms. Symptom A triggers Symptom B, leading to Symptom C, which keeps Symptom A going. Complicating matters further is the fact that, while PCOS affects an estimated 10-20% of women worldwide, the syndrome manifests differently from case to case. For example, not all women diagnosed with PCOS actually have cysts on their ovaries (and many women without PCOS do), leading many in the medical community to call for a new name — one which, as one doctor put it, “reflects the complex interactions that characterize the syndrome.” So far, nobody’s come up with a winner.
But there is one symptom which appears more frequently than others: Approximately 65-70% of women with PCOS have insulin resistance. Sometimes referred to as “insulin insensitivity,” this is a condition in which the body fails to properly respond when insulin is released, leading to improper metabolization of carbohydrates and therefore elevated blood glucose. That can lead to things like rapid weight cycling, which can then trigger elevated androgen levels, which, of course, leads right back to greater insulin resistance, and the cycle continues.
Here’s the good news: While insulin resistance is one of the most common symptoms of PCOS, there are many ways to manage it — some of which you may have never heard about. Typically, patients are told that medication, weight loss, and carbohydrate restriction (or even elimination) are the only solutions. But, as with everything about PCOS, the answer isn’t simple. When it comes to understanding and treating this particular symptom, it’s a lot more complicated — and hopeful — than you’d think.