Insulin Resistance and PCOS: Signs, Symptoms, and Treatment Options

Insulin-Resistant PCOS Type

Insulin resistance is by far the most common root cause of PCOS. 

At least 80% of Cysters have some level of insulin resistance, including those who don’t have excess body weight (often referred to as “lean PCOS”). 

Weight gain is only one symptom of insulin resistance, and it doesn’t happen for all Insulin-Resistant PCOS Cysters.

 If you’ve been told you don’t have a problem with insulin because you’re not overweight, you might be missing out on the correct treatment for your PCOS.

When researchers used the most sensitive insulin resistance tests to compare women with and without PCOS (controls), they found an interesting difference.

75% of lean women with PCOS had insulin resistance compared with only 24% of lean women controls. 

The same study found insulin resistance in 95% of overweight women with PCOS, compared with only 62% of overweight controls.

This study reveals that the insulin resistance associated with PCOS is independent of weight gain. 

In other words, weight gain isn’t the cause of insulin resistance in PCOS.

 In fact, the opposite is true – insulin resistance is often the cause of weight gain. 

If you aren’t overweight, there is still a significant chance that insulin resistance is driving your symptoms. 

PCOS significantly increases our chances of having issues with insulin, regardless of weight.

My PCOS fertility journey

Unfortunately, the fact that you can have insulin resistance with-out weight gain in PCOS isn’t common knowledge.

Many doctors believe that if you have PCOS and don’t have weight gain as a symptom, there is nothing that you can do. 

I experienced this first hand when I began my PCOS fertility journey.

I visited my doctor, excited to get my body ready to try for a baby in the next few months. 

I asked her what I could do to support my hormones and increase my chances of falling pregnant naturally. 

By this point, I had been working on my PCOS for years and had achieved a healthy weight and clear skin, but my cycles were still a little wonky.

I was told that because I wasn’t overweight there was nothing else I could do naturally. 

I left with a referral in my hand to a fertility specialist and the advice that I would probably need fertility drugs to fall pregnant. 

We hadn’t even started trying for a baby yet! 

I was crushingly disappointed to hear the road ahead would be so difficult.

Fast forward nine months, and that referral sat unopened on my desk. 

I had improved my insulin and stress hormones naturally, regulated my cycle and was six weeks pregnant after three months of trying naturally.

This isn’t to say that fertility drugs aren’t helpful or necessary in some cases.

However, all too often I have seen women pushed down this path before working on some of the most basic lifestyle factors like what you eat, how you move, and how you manage stress.

If you have received the same advice as I did, I urge you to dedicate the next six months to implementing the advice in this post first. 

Even if you don’t fall pregnant naturally, you will have significantly higher success rates with fertility interventions and an easier, healthier pregnancy and baby.

How insulin resistance causes PCOS symptoms

 Insulin resistance happens when our cells become “deaf” to the signals of insulin telling them to open up and let sugar from our blood inside for storage. 

Insulin is like a key that fits into the lock on the cell door. 

In insulin resistance, this key has become a little rusty, and it takes a lot of fiddling to get the door open.

This extra time taken to open the cell door means that insulin stays raised in the blood for a lot longer than it should. 

If you have high levels of insulin for a long time, it triggers your ovaries to start producing extra testosterone and other androgens.

Excess insulin also lowers an important protein called sex hormone binding globulin (SHBG). 

I like to think of SHBG as a hormone sponge. Its main role is to mop up excess hormones and keep levels balanced. When you have higher levels of androgens floating around, combined with lower SHBG, it’s a recipe for disaster.

Instead of being mopped up, the androgens run free and get into your scalp hair follicles, killing them and making them fall out. 

They get into the pores in your skin, clogging them and causing acne. 

And they get into your face and chest hair follicles and change your unnoticable baby hairs into thick, coarse, black hairs. 

To make matters worse, high testosterone levels trigger even more insulin production, creating a frustrating spiral where androgen levels continue to rise.

High insulin also causes your brain to secrete less follicle stimulating hormone (FSH). FSH is needed to trigger your follicles (baby eggs) to grow to the right size needed for you to ovulate. 

Without enough FSH, you either fail to ovulate altogether (meaning your period disappears) or it takes much longer to ovulate (causing very long gaps between periods).

Finally, high insulin levels cause another key hormone involved with ovulation, luteinizing hormone (LH), to be secreted in high levels. 

In the right amounts, LH is needed to trigger ovulation. When levels are too high, your body shuts down or delays ovulation, further contributing to missing or irregular periods.

Signs and Symptoms of Insulin Resistance

Take the quiz below to rate the likelihood of insulin being a root cause of your PCOS.

 Each time you answer yes, give yourself one point.

If you said yes to four or more of the points above, there’s a high chance insulin resistance is the root cause of your PCOS. 

If you aren’t sure or would like to confirm this with testing, see below for the best tests to diagnose insulin resistance. Testing is optional.

Problems with Common Tests for Insulin Resistance

You might not know if you have insulin resistance because your doctor didn’t order the most sensitive tests. 

The most commonly used tests are fasting glucose and HbA1C. 

These tests are unfortunately not sensitive enough to pick up on early stage insulin resistance, and are better at diagnosing severe insulin resistance like that in type 2 diabetes.

A 2014 study found that HbA1C missed 45% of people with type 2 diabetes, which is a more severe form of insulin resistance. 

This means that this test has a high likelihood of missing early stage insulin resistance.

Fasting blood glucose is another commonly used test, however the upper “normal” limits set by most pathology laboratories are likely far too high. 

The commonly accepted upper limit for fasting blood glucose is 100mg/dL (meaning that a number below 100 is considered normal). 

A 2005 study showed that people with fasting blood glucose levels between 91-99mg/dL went on to develop type 2 diabetes.

If you’ve ever had an oral glucose tolerance test before (OGTT), you likely haven’t forgotten it! 

This test involves drinking a sickly sweet drink and having your blood taken every hour for two to three hours to measure the rise and fall in your glucose levels. 

It’s commonly used in pregnancy to diagnose gestational diabetes.

Whilst more accurate than the two previous tests, an OGTT also won’t pick up the early stages of insulin resistance because it measures glucose rather than insulin. 

An interesting study showed that OGTTs missed up to 50% of people with diabetes.

The reason that blood glucose is often normal in insulin resistance is because your insulin is being secreted at incredibly high amounts in order to keep glucose low. 

This means that when all we look at is your glucose levels, they appear normal. 

However, behind the scenes, your insulin is working overtime to keep glucose balanced. 

Only testing glucose means you could miss out on the correct diagnosis and treatment for your PCOS.

If your doctor has ruled out insulin resistance by testing your fasting blood glucose, HbA1C, or OGTT and you feel it could still be an issue for you, don’t be afraid to ask for further testing. 

I’ve covered the best tests to ask for below.

Free 3 min Quiz 

PCOS? Which Type Do You Have?

About The Author - Tamika Woods

Tamika Woods | PCOS Author | Nourished Natural Health
Tamika Woods, Clinical Nutritionist (B.HS; B.Ed), Bestselling Author

For a decade, Tamika battled chronic acne, irregular cycles, mood swings, hair loss, painful periods, severe digestive issues and Polycystic Ovary Syndrome (PCOS). You name it - she's been there!

Tam was finally able to clear her skin, regulate her cycle, be free of period pain and fall pregnant naturally with her daughter in 2020. It took Tam 10 years and tens of thousands of dollars in tertiary education to get the answers she needed to get better.

She didn’t want other women to suffer as long as she did which is why she has dedicated her life to helping women in the same position as she was.

Tam helps women interpret what their bodies are trying to communicate through frustrating symptoms, and then develop a step-by-step roadmap to find balance again. She's here to help you get on track!

Tamika Woods is the author of the Amazon best seller PCOS Repair Protocol. She holds a Bachelor of Health Science degree (Nutritional Medicine) as well as a Bachelor of Education, graduating with Honours in both.

She is a certified Fertility Awareness Method (FAM) Educator and a certified member of the Australian Natural Therapists Association (ANTA).

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References used for this article

DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in
the polycystic ovary syndrome using the homeostasis model assessment. Fertil
Steril. 2005;83(5):1454-1460.

Stepto NK, Cassar S, Joham AE, et al. Women with polycystic ovary syndrome
have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum
Reprod. 2013;28(3):777-784.

Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism
and implications for pathogenesis. Endocr Rev. 1997;18(6):774-800.
Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic
ovary syndrome. Hum Reprod Update. 2008;14(4):367-378.
Guo F, Moellering DR, Garvey WT. Use of HbA1c for diagnoses of diabetes
and prediabetes: comparison with diagnoses based on fasting and 2-hr glu-
cose values and effects of gender, race, and age. Metab Syndr Relat Disord. 2014;12(5):258-268.

Tirosh A, Shai I, Tekes-Manova D, et al. Normal Fasting Plasma Glucose Lev-
els and Type 2 Diabetes in Young Men. N Engl J Med. 2005;353(14):1454-1462.

Kraft JR. Detection of Diabetes Mellitus In Situ (Occult Diabetes). Lab Med.

DiNicolantonio JJ, Bhutani J, OKeefe JH, Crofts C. Postprandial insulin assay
as the earliest biomarker for diagnosing pre-diabetes, type 2 diabetes and
increased cardiovascular risk. Open Heart. 2017;4(2):e000656.

Siavash M, Tabbakhian M, Sabzghabaee AM, Razavi N. Severity of Gastro-
intestinal Side Effects of Metformin Tablet Compared to Metformin Capsule in Type 2 Diabetes Mellitus Patients. Journal of research in pharmacy practice.

Softic S, Stanhope KL, Boucher J, et al. Fructose and hepatic insulin resis-
tance. Crit Rev Clin Lab Sci. 2020;57(5):308-322.

Donga E, van Dijk M, van Dijk JG, et al. A single night of partial sleep depri-
vation induces insulin resistance in multiple metabolic pathways in healthy subjects. J Clin Endocrinol Metab. 2010;95(6):2963-2968.

Venkatasamy VV, Pericherla S, Manthuruthil S, Mishra S, Hanno R. Effect of
Physical activity on Insulin Resistance, Inflammation and Oxidative Stress in
Diabetes Mellitus. J Clin Diagn Res. 2013;7(8):1764-1766.

Entringer S, Wüst S, Kumsta R, et al. Prenatal psychosocial stress exposure
is associated with insulin resistance in young adults. Am J Obstet Gynecol.

Garcia-Vargas L, Addison SS, Nistala R, Kurukulasuriya D, Sowers JR.
Gestational Diabetes and the Offspring: Implications in the Development
of the Cardiorenal Metabolic Syndrome in Offspring. Cardiorenal Med.

Caricilli AM, Saad MJA. The role of gut microbiota on insulin resistance.
Nutrients. 2013;5(3):829-851.
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Gold Standard Tests for Insulin Resistance

Blood Test

The most accurate test for insulin resistance is a Glucose Tolerance with Insulin Assay. 

This is similar to an OGTT, but measures insulin as well as glucose. 

You will have your blood taken fasting and then at one and two hour intervals after drinking a glucose drink. 

This test has been shown to be 75% more effective at detecting diabetes and pre-diabetes than the traditional OGTT.

Ideally, your fasting insulin should be less than 10mlU/L (60pmol/L). 

At the one- and two-hour marks after your sugar drink, your insulin should be less than 60mlU/L (410pmol/L). 

If it’s higher than this, it indicates insulin resistance is a problem for you. 

This test is far less common than a standard OGTT, fasting glucose, or HbA1C, so don’t be surprised if your doctor hasn’t heard of it. 

Keep asking or find a new practitioner who can support you to get access to the right testing to rule in or out insulin resistance.

Measure Your Waist

Insulin resistance can cause weight to be deposited around your mid section. The higher your waist circumference is, the more likely you are to have insulin resistance. 

Grab out your tape measure and place it at the top of your hip bone. Then bring the tape measure around your body in line with your belly button. 

Make sure it’s straight and even. Take a breath in and out and relax your belly (make sure you’re not holding it in).

Check the number on the tape measure. For women, a measurement of 80cm (32 inches) indicates a higher likelihood of insulin resistance. 

The risk increases the further above 80cm your waist measurement is.

Remember that there is a misconception that being overweight causes insulin resistance. 

This means that you don’t have to have a high waist measurement or be overweight to have insulin resistance – it just increases your chances. 

The signs and symptoms listed above also give us a clear indication of whether insulin is a problem for you.


If you are overweight or have been diagnosed with insulin resistance, there’s a good chance you’ve been offered Metformin – the leading insulin-sensitizing drug. 

Metformin helps to improve your body’s sensitivity to insulin and can be really helpful in treating this root cause for some women.

Unfortunately, this drug is associated with a high rate of side effects –more than 50% of women report gastrointestinal side effects (nausea, diarrhea, and vomiting).

Metformin is also well known to cause vitamin B12 deficiency, so if you are using this drug to manage your insulin levels, I highly recommend a daily B12 supplement to combat this.

Whether or not to use Metformin for your PCOS is a personal choice. You can achieve the same results – if not better – as Metformin by following the diet and lifestyle changes in this post. 

If you are noticing side effects from Metformin and would like to try an alternative, inositol has been shown head-to-head against Metformin to achieve higher success in weight loss, restoring regular ovulation and natural pregnancy, without the side effects.

"Changing what you eat, how you move and which supplements you take is the most effective way to reverse insulin resistance and thrive with PCOS."

SPOTLIGHT: Maria’s intense sugar cravings

Maria joined my group program in 2019 after struggling with lean PCOS for most of her life. 

A few weeks into the program, Maria reached out to me, incredulous. 

We had just covered how eating a diet high in sugar can trigger insulin resistance and a light bulb had gone off for her. Maria had always thought about food as something for pleasure. 

Because she didn’t deal with weight gain as a symptom of her PCOS, she had never considered the importance of what she was eating. She ate pastries and bread every day, had a self proclaimed sweet tooth, and rarely ever ate vegetables. 

She told me “in all the years that I’ve had PCOS, no one ever told me that food could be impacting my symptoms!”.

Over the next few weeks, we made some simple tweaks to how Maria created her meals, and before long her reliance on sugar disappeared. 

Her cycle regulated and her hair stopped falling out. Maria now knows she doesn’t need sugar for energy and can choose to enjoy pastries on special occasions without feeling out of control.

What causes insulin resistance?

Developing insulin resistance is usually a combination of your genetics (being “predisposed”) and your environment (what you eat, how you move, sleep, and stress). 

Similar to the way that we end up with PCOS, you are probably born with a higher likelihood of developing insulin resistance – this is why you saw a family history of diabetes or pre-diabetes as one of the quiz questions earlier in this post.

Just having a family history or genetic predisposition doesn’t necessarily mean you will end up with insulin resistance, however. 

It’s how you eat, move, sleep, manage stress, and many other factors in your environment that switch on this condition. For example, a diet high in fructose (a type of sugar) has been shown to increase the risk.

Sleep quality is another risk factor. Just a single night of sleep deprivation has been shown to reduce insulin sensitivity the following day, and chronic sleep deprivation increases the risk of developing lasting insulin resistance.

Not exercising regularly is another area researchers are exploring as movement helps to sensitize your muscles to insulin. 

Your mother’s pregnancy with you might also be a factor. Researchers are finding links between mothers who experienced a major stressful life event during pregnancy and their adult children’s risk of developing insulin resistance, even without a family history of diabetes.

If your mother had gestational diabetes during her pregnancy with you, your risk also increases for insulin resistance later in life.

Even your gut bacteria play a role in your sensitivity to insulin and improving gut health can reduce insulin resistance.

While we can’t change your genetics or your mother’s pregnancy with you, there is so much we can do to tweak the other environmental factors in your favor. 

Simple changes to your meals, exercise, mindfulness, sleep, gut health, and supplement regime can be foundational in reversing your insulin resistance. 

In the next section of the post, we’ll cover the most impactful changes you can make to support this root cause so you can thrive with PCOS.

The PCOS Plate Method

Until now, you have been focusing on following the PCOS Repair Breakfast principles and eating your normal meals for the rest of the day. 

Once you are feeling confident with your breakfast changes, it’s time to move on to lunch and dinner.

While we’ve kept your breakfast free of carbohydrates like starchy vegetables, grains, and fruit (except berries), enjoying some carbs in your lunch and dinner is really important. 

Contrary to what some social media influencers might have told you, women with PCOS actually need to eat carbs in order to ovulate.

Whether your goal is to get pregnant at some point in the future or not, ovulating regularly should be every Cysters goal because ovulation is the way we make progesterone. 

Progesterone keeps our skin clear, energy levels high, and weight stable, promotes sleep and relaxation, and protects against endometrial and breast cancer. 

Not only that, but progesterone naturally inhibits 5-alpha reductase – the enzyme responsible for converting testosterone into its very potent cousin, DHT. 

Producing enough progesterone helps to grow hair on our head faster and thicker, reduces skin oil and acne, and stops unwanted hair growth. 

The reason I never tell my clients to 100% remove carbs from their diet (even in severe insulin resistance) is because, as women, we have what’s known as a “carbohydrate set point”. 

This relates to a tiny part of our brain called the hypothalamus, which has an important role in constantly assessing our environment for signs of food shortage that would make reproducing dangerous. 

Your hypothalamus looks for sufficient calorie intake overall, as well as carbohydrate intake specifically. 

Research suggests that every woman has a unique carbohydrate level that her brain determines as sufficient to ovulate.

If you eat below this level of carbs for a long time, your brain perceives this as a lack of available food, and shuts down ovulation in order to prevent you from getting pregnant. 

While it might not feel like it, it’s doing this to protect you because carrying a pregnancy to term requires an additional 75,000 calories – not ideal in a famine!

Both myself and my colleagues have observed that when women (particularly younger women) eat under a certain amount of carbs, even when there are sufficient calories from protein and fat such as in the ketogenic diet, they often lose their periods. 

There are very few studies in this area to date, however a 2003 study that put 45 people on a ketogenic diet for six months found that 45% of female participants lost their period or had irregular cycles.

This phenomenon is not the same for men as they do not carry the same life-or-death decision to reproduce. 

This is why your male partner might have had incredible results following a ketogenic diet while you felt worse.

Because of this carbohydrate set point, I encourage you to keep your carbohydrate intake very low at breakfast time in order to promote stable blood sugar and insulin for the day, but to include a portion of gentle starch in your lunch and dinner meal.

By gentle starch, I mean starchy foods that don’t cause inflammation in your body. 

All women with PCOS (regardless of your PCOS type) have increased body-wide inflammation in comparison to the general population, so sticking to anti-inflammatory foods is a great way to manage your symptoms.

Gentle starch sources include rice, oats, quinoa, buckwheat, and root vegetables (like sweet potato, white potato, pumpkin, squash, carrot). These types of carbs are not inflammatory. 

When paired with a protein source and healthy fat in a balanced meal, gentle carbs don’t lead to insulin resistance.

Carbohydrates are important for sleep, which is why I encourage all PCOS types to include a moderate portion of gentle starch before bed.

When you eat starch at night, it tops up your liver supply of glycogen (the storage form of carbohydrates) and helps to keep your blood sugar stable while you sleep. This is important for restful, restorative sleep and lowered stress levels.

Okay, so you’re including some gentle carbs in your lunch and dinner meals to support your energy levels and ovulation, but how should you structure this? 

I created a simple method I call the PCOS Plate Method to help you adapt any meal to make it PCOS-friendly.

The PCOS Plate Method

When putting together a main meal, follow this simple hack to keep your macronutrients (carbs, fats, and proteins) in the right ratios to support hormone balance. Eating this way will support insulin sensitivity, keep stress hormones level, and lower inflammation – the three leading root causes of PCOS.

When you follow the ratios below, you will find that almost any meal can be made PCOS-friendly with just a few simple tweaks. 

See your PCOS-Friendly Food Formula bonus resource for ideas on foods to put in each category to build a meal. Ideally, opt for animal-based protein sources (like meat, fish, chicken, or eggs) as these contain high amounts of protein and minimal levels of carbohydrates.

Around one quarter of your plate should be made up of animal-based protein (this includes meat, fish, chicken, and eggs). Around one quarter should be starch – opt for “gentle carbs” to keep inflammation low.

The last half of your plate should be made up of non-starchy vegetables.

Finally, include a serve of healthy fat with your meal. 

You can drizzle this over your plate or use it to cook your protein or vegetables.

If you choose to eat plant-based proteins like lentils or chickpeas, remember that all plant proteins (except tofu) contain carbohydrates bound up with the protein. 

This means that legumes and beans fall somewhere in the middle of our protein and starch categories.

If you would like to include a plant-based protein in your meal, simply reduce your starch portion by around half, and up your non-starchy vegetables to fill the gap (see the diagrams below). 

For example, if you are eating a Mexican-style meal with beans, vegetables and guacamole, you will only need a small portion of rice or corn to go with your meal. 

If you had the same meal but with shredded chicken instead of beans, you could include a larger serve of rice or corn.

 If you are choosing tofu, follow the regular plate guidelines above as tofu contains mostly protein.

In your PCOS-Friendly Food Formula bonus resource, I’ve made following the PCOS Plate Method super simple. 

You’ll find lists of foods for each plate category, plus some of my favorite PCOS-friendly meals.

The PCOS Plate Method

Now that you know the PCOS Plate Method, let’s cover some important tweaks to be mindful of based on your root cause.

If you have identified Adrenal, Inflammatory, or Post-Pill as your PCOS type, following the PCOS Plate Method will be helpful in managing your symptoms, however it is not the most crucial step in healing your root cause.

I want you to do your best to be mindful of the guidelines above, however if following the PCOS Plate Method method above too strictly is causing you stress, I’d rather you put your energy into the Core Treatmenthave outlined for your unique root cause throughout the rest of this post.

The Core Treatment is the number one change that will be most impactful in reversing your root cause. 

This should be your primary focus for the next few weeks. 

Once you feel like you are getting the hang of your Core Treatment, you can come back to these PCOS Plate principles and continue to implement them as you heal your root cause.

If you have Insulin-Resistant PCOS, the principles in this post are the most important change you can make for your root cause – they are your Core Treatment. 

Along with a few extra guidelines in the next later in this post, the most impactful thing you can do for Insulin-Resistant PCOS is to work on what you are eating.

Following the PCOS Repair Breakfast principles along with the PCOS Plate Method will dramatically improve your body’s insulin sensitivity and begin reversing hair loss, acne, weight gain, and irregular cycles.


I’m getting hungry after my meals following the PCOS Plate Method ratio. What should I do?

If you find you are getting hungry, try increasing your healthy fat source and opt for solid forms of fat like avocado, nuts, and seeds rather than oils. 

These are often more satiating because they take up more room in your stomach.

What about sugar, dairy, gluten, caffeine, and alcohol? Should I cut these out?

Cutting out foods can lead to feelings of deprivation and decrease the chances of you sticking with your changes. 

I only want you to focus on this if it will truly lead to big changes in your symptoms.

 For now, let’s focus on the changes we’ve covered so far and, if necessary, we can add on another change when we come to it in the next section.

Can I eat fruit?

Whilst healthy, fruit contains fructose and glucose – two naturally occurring forms of sugar. 

Eaten in excess or alongside a large portion of starchy carbohydrates, fruit can cause a sharp rise in your blood sugar levels, which triggers excess insulin production, worsening insulin resistance.

If you have Adrenal, Inflammatory, or Post-Pill PCOS, enjoying any fruit in moderation should not be a problem for you, so long as you pair it with a healthy fat or protein source. 

For example, a snack of berries with coconut yogurt, a banana with some almond butter, or apple slices with peanut butter. 

You can also enjoy one serve of fruit alongside a meal like those outlined in the PCOS Plate Method above. 

The main meal will provide the protein and fat sources to blunt the rise in glucose.

If you have Insulin-Resistant PCOS, keeping carbohydrate and sugar levels lower is much more important for you. 

You can still eat fruit, but need to be mindful of balancing this with your starch intake. 

One serve of fruit can be swapped out for the starch portion of your meal.

For example, you might feel like having a piece of fruit for dessert after your lunch or dinner. 

To accommodate this, you could leave out the starch in your meal and up your non-starchy vegetables, and enjoy an
apple or banana after your meal.

If you felt like a smaller portion of starch plus fruit for dessert, you could reduce your serve of each by half. For example, half a serve of rice with your main meal and half a banana for your dessert.

The exception to this rule is berries like raspberries, blackberries, and strawberries. 

These fruits are low in sugar and high in fiber, which means they can be enjoyed after a main meal without needing to
reduce your starch component.

I never want you to cut anything out of your diet 100% because I know how this can lead to that familiar feeling of deprivation. 

Finding ways to still enjoy your favorite foods whilst balancing their ratios will be key in making this style of eating a long-term habit, not just another yoyo diet.

Insulin-Resistant PCOS Core Treatment

Changing what and when you eat, along with adding in some targeted nutritional supplements and finding joyful movement, is the Core Treatment for Insulin-Resistant PCOS. By now, you already know the principles to create insulin-friendly meals. 

Following these principles closely is a key focus to heal your insulin resistance and therefore reverse your PCOS symptoms. 

The Repair Breakfast Principles and PCOS Plate Method (above) are Core Treatment #1 and Core Treatment #2 for Insulin-Resistant PCOS.

Core Treatment #3: Reduce high-dose fructose

High amounts of a type of sugar called fructose can cause or worsen insulin resistance and abdominal weight gain.

Reducing high-dose fructose in your diet is an important step in healing insulin resistance.

High-dose fructose is found in table sugar (the kind that’s used to bake cookies and cakes and added to your coffee and tea) and high-fructose corn syrup (the kind that you’ll find in popular sodas). 

It is also found in some natural sweeteners that are often touted as being a “healthy alternative” like coconut sugar, agave, fruit juice, honey, dates, and dried fruit.

Fructose is present in whole fruit, however this doesn’t contribute to insulin resistance because the amount is much lower than the processed sugars above. 

Whole fruit also contains fiber and other nutrients that negate the effects of fructose. 

This type of sugar is low-dose fructose and is not a concern.

SPOTLIGHT: How does high-dose fructose worsen insulin resistance?

When you eat an apple, the fructose present must be converted to glucose in your small intestine in order to be sent to your liver to be stored as energy. 

Low-dose fructose, like that in a single apple, isn’t a problem and has actually been shown to improve insulin sensitivity when paired with regular exercise.71

High-dose fructose, like what you get when you eat a bliss ball or paleo dessert made with dates, contains so much fructose that your small intestine gets overwhelmed. 

All of the sugar isn’t able to be broken down to glucose, and so it arrives at your liver and in your large intestine as fructose. 

This excess fructose contributes to fatty liver, oxidative stress, inflammation, and increased risk of insulin resistance.

It also affects your microbiome (the good gut bugs in your large intestine) and further contributes to insulin resistance.

If you have Insulin-Resistant PCOS, you don’t need to stop eating fruit.

This is one of the biggest myths I see perpetuated in the PCOS community. 

While you are healing your insulin resistance, I don’t encourage you to eat huge bowls of fruit salad, however a serve of fruit once or twice a day paired with protein or healthy fat is perfectly okay for PCOS and insulin resistance. 

Yes, you can eat bananas when you have PCOS!

Another common PCOS myth is that you need to cut out carbs while you are recovering from insulin resistance. 

When I first started healing my PCOS, I was literally terrified of potatoes. 

It sounds funny to me in hindsight, but at the time I felt lost about what I could and couldn’t eat. 

I was so scared that carbs would make my PCOS worse that I would skip out on the rice or potato in my dinner, only to binge on a dessert made with “natural” sugars like agave syrup or dates. 

These “healthy” desserts were actually high in fructose, worsening my insulin resistance and PCOS symptoms.

Now I know that I am much better off having the carbs, feeling satiated and not needing a large dessert to “hit the spot.”

I include some gluten-free pasta, potato, or rice in my dinner and find all I need is a cup of peppermint tea and a square of 85% dark chocolate to feel completely satisfied. 

Not being controlled by sugar cravings after meals is incredibly freeing and I can’t wait for you to enjoy this as well!

Instead of worrying about never eating a banana or potato again, I want you to focus on cutting all dessert foods and added sugars out of your diet for the next four weeks. 

I have found four weeks to be the ideal amount of time to reverse insulin resistance and get rid of cravings and reliance on sugar.

How to break up with sugar

If you feel like you are addicted to sugar – you aren’t alone. 

Insulin resistance makes our brain crave more sugar and this can be incredibly hard to ignore. 

If you find yourself giving in to sugar cravings, I want you to know it’s not because of your lack of willpower. It’s because of your hormones.

Having suffered from severe sugar cravings myself, I know how all-consuming these feelings can be. 

What’s important to remember is that strong cravings usually subside within 20-25 minutes, and after seven days of being sugar free, your cravings will likely disappear altogether.

"Once we get your insulin functioning better, you won’t have intense cravings anymore and you’ll find you can easily maintain your energy levels and focus throughout the day."

For the next four weeks, your goal is to cut all sweet drinks (sodas, flavored milks, mixers), added sugar, and dessert foods out of your diet.

This isn’t forever – it’s just for four weeks while we reset your blood sugar and insulin levels. 

This includes “natural” sugars like those in paleo desserts, bliss balls, and other treats that use dried fruit, agave, or coconut sugar. 

It also includes sweetened yogurt, granola bars, and protein bars.

You can still enjoy one or two serves of whole fruit paired with protein or healthy fat. 

If you need a sweetener while you are adjusting, try stevia or monk fruit as these are natural sweeteners that won’t spike your blood sugar levels. 

You can also enjoy one to two squares of 85% or higher cacao chocolate as this is naturally very low in sugar.

While you are completing these four weeks, make sure you are having full, sustaining meals and snacks with plenty of protein. 

This will help to keep you feeling satisfied and reduce cravings for sugar. 

Remember that once we have reversed your insulin resistance, you won’t have cravings for sugar anymore.

To help make quitting sugar easier, I’ve put together a bonus resource for you: Kick Your Sugar Cravings. There, I’ve covered many more tips to make this transition easier.

After the four weeks are up, you can test your body’s response to small amounts of sugar. 

I suggest enjoying one dessert or sweet food once or twice a week and really savoring the experience. 

Pick the day you are going to have a sweet treat and choose what you will make or buy.

When you are ready to enjoy your sweet, sit without distractions and really be present while you eat it. 

Being mindful will reduce cravings for more sugar.

Once your insulin is functioning normally again, you can adopt the 80/20 rule.

This means enjoying a balanced, sugar-free diet 80% of the time, and choosing special occasions to enjoy small amounts of sugar or other foods that are less helpful for insulin.

Having insulin resistance now means you will always have a tendency to develop it again even after you have reversed it following the principles in this post. 

Finding a long-term, sustainable way to keep up these habits without feeling deprived is what will make all the difference to your symptoms.

Experiment with the 80/20 rule and find what works best for you. 

Ultimately, we want the PCOS Repair Protocol to form the habits you will follow for the rest of your life, instead of being another diet that you ditch for your old ways of eating after a few weeks because you felt unsatisfied or deprived.

Core Treatment #4: Choose your Meal Times

I am not a fan of intermittent fasting for PCOS

Skipping breakfast can worsen PCOS by increasing cortisol and insulin levels. 

However, research shows that a gentle, 12-hour break between dinner and breakfast can be helpful for insulin resistance.

This might look like dinner by 7pm and breakfast at 7am. 

Because you are ideally eating breakfast within an hour of waking to support your insulin levels, getting 12 hours between your dinner and breakfast might mean moving your dinner time meal a little earlier or cutting out after-dinner snacking.

This 12-hour window isn’t a hard-and-fast rule – do your best, but don’t let the timing cause undue stress. 

It will be more impactful to cut sugar for four weeks and focus on the balanced plate principles, so if this is all you can manage for now, start there.

Core Treatment #5: Consider Supplementing for Insulin Resistance

Along with changing your diet, adding one or two targeted nutritional supplements can greatly improve your body’s sensitivity to insulin.

A blood sugar stabilizing supplement like PCOS Blood Sugar Balance can greatly improve your sensitivity to insulin, reduce sugar cravings and help you find a healthy weight. 

I designed this vitamin to complement the diet changes outlined above. 

The unique combination of cinnamon, magnesium, gymnema, and chromium has been shown to powerfully increase insulin sensitivity as well as reduce sugar cravings.

Magnesium deficiency has been found to contribute to insulin resistance and supplementing daily has been proven to improve insulin resistance.

Chromium supplementation has demonstrated an ability to eliminate sugar and carbohydrate cravings, and reduce excess food intake leading to a healthy weight.

You’ll find all of these ingredients in the PCOS Blood Sugar Balance supplement.

As well as this, you might like to consider an inositol supplement. 

As we covered earlier, inositol is a naturally occurring nutrient that has been shown to work more effectively than Metformin in sensitizing your cells to insulin, decreasing sugar cravings, restoring regular ovulation, and promoting weight loss. 

My top recommendation is the Ovasitol brand as this contains the well-researched combination of myo-inositol
and D-chiro-inositol. 

You can purchase Ovasitol here.

Core Treatment #6: Find Joyful Movement

Moving your body is an important way of improving your muscle’s sensitivity to insulin. 

Because of this, you might have been told that you need to do high intensity exercise to reverse your PCOS. 

Or other PCOS influencers might have told you that slow, weighted workouts are the only way to go. 

The truth is the research shows that any form of exercise is better than none.

My opinion is always: the best exercise for PCOS is the one you’ll actually do.

Yes, there are forms of exercise that have been shown to improve insulin resistance more efficiently, but at the end of the day, I want you to find a style of movement that brings you joy. 

We’ll cover the best types of exercise for PCOS later, but for now, start experimenting with movement that feels good and where you’re not watching the clock.

Remember that we are creating a plan that you can follow for the rest of your life, not just a few weeks. 

We need to find a form of exercise that you actually look forward to and can stick to in the long run. 

This could be walking with a friend, gardening, playing in the backyard with your kids, swimming in the ocean, or dancing to your favorite music. 

It doesn’t have to be traditional “exercise,” so long as it gets you sweating!

SPOTLIGHT: Shannon’s Life Changing Journey

Shannon joined my group program after first receiving her PCOS diagnosis in her early thirties. 

As a teenager, she suffered from horrendously painful and heavy periods, which would last for two weeks and then disappear for four to six months at a time. 

She had excruciating cystic acne on her face, chest, back, and hairline and suffered the confidence-destroying effects of this for much of her life.

Her doctor prescribed the pill in her teens and she remained on this medication until she got married and decided it was time to start trying for a family in her early thirties. 

After many months and no positive pregnancy tests, Shannon visited her doctor and was finally diagnosed with PCOS.

Her doctor told her she had two choices: to take fertility medication to get pregnant, or to go back on the pill because she was at risk of endometrial cancer due to her irregular periods.

Shannon knew there had to be a better way, so joined my program to learn how to reverse the root cause of her PCOS naturally.

Over the next 12 months, Shannon’s life completely changed. 

She improved her insulin resistance by following the protocols in the program. 

Her acne cleared. Her cycle regulated to a predictable 30 days. 

Her period became completely pain free. 

And she found a beautiful balance between following the Protocol and enjoying her favorite foods without guilt.

Whilst on this journey to recover her health, Shannon also rediscovered herself. 

She turned her life around, separated from her husband, and found an incredible new partner. 

And at the time of writing this post, Shannon is blissfully pregnant with a healthy baby without the need for fertility interventions.

Still having symptoms?

If you are following the Repair Breakfast Principles, PCOS Plate Method for lunch and dinner, meal timings, and low fructose guidelines but still experiencing symptoms of insulin resistance after several weeks – this section is for you. 

Try following the Repair Breakfast Principles for your lunch meal as well (i.e., low starch, high protein for breakfast and lunch). 

Make sure to still include a gentle starch portion in your dinner meal to top up your liver glycogen stores overnight. 

This will allow you to benefit from the effects of a low carbohydrate diet on insulin, whilst also ensuring you eat enough starch to ovulate, produce energy, and sleep well.

Summary: Core Treatments for Insulin-Resistant PCOS

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About The Author - Tamika Woods

Tamika Woods | PCOS Author | Nourished Natural Health
Tamika Woods, Clinical Nutritionist (B.HS; B.Ed), Bestselling Author

For a decade, Tamika battled chronic acne, irregular cycles, mood swings, hair loss, painful periods, severe digestive issues and Polycystic Ovary Syndrome (PCOS). You name it - she's been there!

Tam was finally able to clear her skin, regulate her cycle, be free of period pain and fall pregnant naturally with her daughter in 2020. It took Tam 10 years and tens of thousands of dollars in tertiary education to get the answers she needed to get better.

She didn’t want other women to suffer as long as she did which is why she has dedicated her life to helping women in the same position as she was.

Tam helps women interpret what their bodies are trying to communicate through frustrating symptoms, and then develop a step-by-step roadmap to find balance again. She's here to help you get on track!

Tamika Woods is the author of the Amazon best seller PCOS Repair Protocol. She holds a Bachelor of Health Science degree (Nutritional Medicine) as well as a Bachelor of Education, graduating with Honours in both.

She is a certified Fertility Awareness Method (FAM) Educator and a certified member of the Australian Natural Therapists Association (ANTA).

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