“I don’t eat much sugar. So why do I have insulin resistance?”
This is a common question among women with PMOS. To understand the answer, we first need to understand insulin.
Insulin is a hormone that helps glucose move from the bloodstream into our cells, where it can be used for energy. When cells become less responsive to insulin, the pancreas produces more insulin to compensate. This is called insulin resistance, and it is common in PMOS. It can occur in women with higher body weight as well as in those who appear lean.
But how does insulin resistance show up in PMOS?
Insulin resistance can affect the body in many ways
Metabolism: The body may produce higher levels of insulin, and over time this can increase the risk of prediabetes and type 2 diabetes.
Ovaries: Higher insulin levels can stimulate ovarian androgen production and contribute to disturbed follicular development, irregular ovulation and irregular periods.
Skin: Insulin resistance and associated hyperinsulinaemia may be associated with acanthosis nigricans- dark, thickened, velvety skin, commonly seen around the neck, underarms or groin. Skin tags may also occur.
Hair & acne: Increased androgen activity can contribute to acne, excessive facial/body hair and scalp hair thinning.
Weight & appetite: Insulin resistance may make weight management more difficult and is often associated with increased central or abdominal fat accumulation.
Importantly, insulin resistance does not mean you have diabetes, nor does every woman with PMOS have all these features.
What can you do?
The encouraging part is that insulin sensitivity can often be improved. Regular walking, strength training and aerobic exercise, balanced meals rich in protein and fibre, adequate sleep, stress management and avoiding frequent late-night heavy meals can all help.
So, PMOS is not simply a “period problem” or a “sugar problem.” The ovaries, skin and metabolism can all be connected through the same underlying hormonal and metabolic network.
Understanding that connection helps us move from treating individual symptoms to caring for the whole person.