The Link Between PCOS and Insulin Resistance

by Deborah Maragopoulos FNP | Jan 19, 2023 | Blog, PCOS | 0 comments

Research has proven that PCOS, or polycystic ovary syndrome, is linked to insulin resistance.

It is believed that insulin resistance in people with PCOS is caused by the underlying problems contributing to polycystic ovary syndrome.

In this blog post, we are going to examine the factors that link PCOS and insulin resistance. 

First, PCOS occurs when a woman does not produce the proper amount of sex hormones.

The problem lies in their ovaries, specifically in a type of cell called theca cells, which produce testosterone which then gets converted into estrogen. 

Unfortunately, for women with polycystic ovary syndrome, theca cells produce excessive testosterone. Which for a woman, can induce insulin resistance. As a result, insulin resistance increases the amount of LDL (bad cholesterol) that a woman produces. This increases her risk of developing a fatty liver and gaining weight, particularly in her belly. 

Insulin resistance is when your cells no longer allow insulin to lock in. Insulin's job is to escort glucose into your cells to be converted into energy. Also, water, amino acids, and fatty acids are allowed into your cells when insulin locks into its receptor sites.

Insulin resistance means very little nourishment can get into your cells. This leads to cellular malnutrition and dehydration. 

Yet, insulin resistance is a protective measure. In the sense that when there is too much insulin and sugar floating around, tissues that cannot grow, like heart cells, become resistant to insulin. These cells have no way to store the extra glucose, and they can only use it for energy. As a result, they become insulin resistant. However, your adipose (fat cells) do not become insulin resistant. So the extra sugar, which your liver converts into triglycerides, gets stored in your fat cells. 

If you live in a harsh environment and don’t have enough food, you have to be able to store that extra body fat and live off it for the winter. If hibernating like a bear, insulin resistance is a survival adaptation. But in today's modern society, with food available to the majority of us all year long, insulin resistance is considered a disease and not an adaptation. 

Insulin resistance is much more common in someone with PCOS. And in fact, it's one of the hallmarks of polycystic ovary syndrome.

It's crucial that insulin resistance is addressed to help reverse the hormonal imbalance that someone with PCOS is experiencing. It is not easy living with PCOS and insulin resistance. Thankfully, there are many ways to deal with both conditions, which you can read about in my articles, How to Treat Polycystic Ovary Syndrome Naturally and How to Treat Insulin Resistance Naturally. 

If you have any questions about polycystic ovary syndrome or insulin resistance, I invite you to join me in our Hormone Support Group, which you can get access to through my free Hormone Reboot Training.

Frequently Asked Questions:

Can your hypothalamus cause weight gain?

Yes. The hypothalamus is the master regulator of metabolism, controlling how your body stores and burns energy through its signaling to the thyroid, adrenals, and pancreas. When the hypothalamus becomes dysregulated by chronic stress, poor sleep, inflammation, or blood sugar instability, it defends a higher weight "set point" — causing the body to hold onto fat regardless of diet or exercise. This makes hypothalamic dysfunction an upstream root cause of stubborn weight gain.


What is a weight set point and why won't mine move?

A weight set point is the body weight your hypothalamus works to defend, calibrated over time by stress, sleep, hormones, and inflammation. When you diet, the hypothalamus perceives scarcity and responds by slowing metabolism, increasing hunger hormones, and suppressing satiety signals to return you to that set point. This is why most people regain lost weight within two to five years of conventional dieting — the set point itself was never recalibrated, only temporarily overridden.


Why do I gain weight under stress even when I'm not eating more?

Chronic stress raises cortisol, which disrupts blood sugar regulation, promotes abdominal fat storage, and signals the hypothalamus that the body is under threat. In survival mode, the hypothalamus defends fat stores and slows metabolism — so weight can increase even without any change in calorie intake. The stress chemistry, not the food, is driving the weight gain, which is why stress reduction is essential to any lasting metabolic reset.


Why do I regain weight after stopping GLP-1 medications?

GLP-1 medications work peripherally on appetite and gastric signaling, but they do not address the underlying hypothalamic dysregulation that sets your defended weight. Because the hypothalamic set point is never recalibrated, the body resumes defending its original weight once the medication stops — leading to significant regain. Long-term success requires restoring hypothalamic regulation so the set point itself lowers, rather than relying on appetite suppression alone.


How long does it take to reset your metabolism?

Genuine metabolic recalibration takes a minimum of 90 days, because the hypothalamus needs consistent signals of safety and sufficiency before it will lower its defended set point. This differs from a diet, which produces temporary suppression the body quickly corrects. A 90-day reset typically moves through three phases: stabilizing stress chemistry (days 1–30), rebuilding metabolic efficiency (days 31–60), and lowering the weight set point (days 61–90).


Why does my thyroid feel slow even though my labs are "normal"?

Under chronic stress, the body converts thyroid hormone into reverse T3, which blocks active thyroid receptors and slows metabolism at the cellular level — even when standard lab values appear normal. This means you can experience genuine symptoms of slow metabolism, such as fatigue, cold intolerance, and brain fog, while your thyroid panel looks unremarkable. Addressing the upstream hypothalamic and stress signaling often improves thyroid conversion and symptoms.


Is stubborn weight gain a willpower problem?

No. Stubborn weight gain is a signaling problem, not a willpower problem. The hypothalamus governs weight through survival mechanisms that operate below conscious control — defending its set point by slowing metabolism and increasing hunger when it perceives threat. No amount of discipline can override this system; lasting change comes from restoring hypothalamic regulation through reduced stress, balanced blood sugar, restorative sleep, and targeted nutritional support.

About the Author - Deborah Maragopoulos FNP

Known as the Hormone Queen®️, I’ve made it my mission to help everyone - no matter their age - balance their hormones, and live the energy and joy their DNA and true destiny desires. See more about me my story here...

     

Last Updated: January 18, 2023

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