Doctors Explain Insulin Resistance and Its Role in Worsening PMOS Hormonal Symptoms
A 2025 study published in Scientific Reports tracked 200 women with the hormonal condition now called PMOS and found that more than half (57.5%) were dealing with insulin resistance. That single number reframes how millions of women should think about their cycles, their skin and their long-term risk of type 2 diabetes. If your body is struggling to handle insulin, it is almost certainly driving the symptoms you are trying to treat at the surface.
Here is why insulin resistance is so tightly tied to PMOS — the condition previously known as PCOS — and what specialists recommend doing about it.
How Insulin Resistance Works in the Body
Insulin is the hormone your pancreas releases to move sugar out of your bloodstream and into your cells, where it is used for energy. When cells stop responding the way they should, blood sugar climbs and the pancreas pumps out more insulin to compensate.
“Insulin is like a key that opens cells and lets glucose in. Glucose is the fuel our bodies use for energy. In people with insulin resistance, the insulin becomes less effective at conveying glucose into the cells properly. This results in a buildup of glucose in the bloodstream and fat cells, which raises the risk of diabetes and obesity,” Melinda Cater, a clinical dietitian at Johns Hopkins’ Sibley Memorial Hospital, says.
Why Insulin Resistance and PMOS Are So Tightly Linked
PMOS — Polyendocrine Metabolic Ovarian Syndrome, formerly PCOS — drives irregular periods, acne, excess facial or body hair and difficulty getting pregnant. Cleveland Clinic calls insulin resistance “one of the root physiological imbalances in most, if not all, cases of PMOS.”
The connection is hormonal. “As it would happen, insulin is a fat-storage hormone that concentrates fat in your abdominal region,” Dr. Ula Abed-Alwahab told Cleveland Clinic. “High insulin levels can tell the ovaries to make more testosterone. That’s why some women with PMOS have symptoms of excess androgens, like dark hairs on the face and belly.”
Johns Hopkins estimates that between 35% and 80% of people with PMOS experience insulin resistance. The 2025 Scientific Reports study found the metabolic problem showed up across every PMOS phenotype the researchers examined, even when intensity varied — suggesting the underlying driver is the same regardless of which “version” of the syndrome a patient has.
What This Means for Long-term Health
Banner Health warns that untreated insulin resistance in PMOS patients can progress to type 2 diabetes, weight gain and infertility. That is why monitoring blood sugar response to diet and daily habits matters as much as treating the visible symptoms.
The 2025 study put it directly: when the body struggles to process insulin, it triggers an overproduction of androgens — the hormones behind acne and cycle irregularities. Addressing the metabolic root cause, the researchers concluded, is likely the most effective way to start feeling better.
How Doctors Recommend Managing PMOS and Insulin Resistance
Treatment starts with food and movement, not medication. “We treat it by focusing first on nutrition and exercise,” Dr. Christina E. Boots, a reproductive endocrinologist at the Northwestern Medicine Center for Fertility and Reproductive Medicine in Chicago, told HealthCentral.
Dr. Abed-Alwahab suggests a whole-foods approach: “There’s a large subset of women with PMOS who will thrive on a low-grain or grain-free food plan – similar to a paleo way of eating. Start with a JERF (Just Eat Real Food) diet consisting of whole, unprocessed, unrefined foods.”
Cater pushes back on the idea that cutting carbs entirely is the answer. “Eliminating carbohydrates is not something I recommend,” she says. “However, choosing carb containing foods that include fiber, such as whole grains, beans and non-starchy vegetables can be helpful because they cause less of a surge in blood sugar compared to more refined options. The goal is to keep blood sugar stable and avoid big dips and spikes. Smaller, more frequent meals may help, and including a protein source with meals and snacks can also be beneficial.”
Her bottom line for anyone newly diagnosed: “If you are diagnosed with Polyendocrine Metabolic Ovarian Syndrome, it doesn’t mean that you are destined to have poor health. There is a lot you can do to take charge, minimize symptoms and improve your [health].”
This article was created by content specialists using various tools, including AI.
