Insulin-resistant PCOS is one of the most common and well-researched types of polycystic ovary syndrome. It occurs when your cells become less responsive to insulin, a hormone that helps regulate blood sugar levels. As a result, your body produces more insulin than it needs, which can lead to weight gain, hormonal imbalances, and increased production of androgens (male hormones).
From my experience working with women with hormonal disorders for over 12 years, insulin resistance often goes undiagnosed for years. Many women are told to “just lose weight,” without understanding that their body is actually fighting against them due to this imbalance.
Studies show that up to 70% of women with PCOS have some form of insulin resistance, even if they are not overweight. That’s why this type of PCOS requires a targeted approach to exercise, nutrition, and lifestyle—not just general advice.
Symptoms & Diagnosis: Recognizing Insulin Resistance in PCOS
The symptoms of insulin-resistant PCOS often overlap with other PCOS types, but there are some key signs to look out for. These include:
- Persistent fatigue, especially after meals
- Cravings for sugar or carbohydrates
- Difficulty losing weight, even with diet and exercise
- Frequent skin tags, especially around the neck or underarms
- Darkened patches of skin (acanthosis nigricans)
- Irregular periods or absence of periods
- Excess hair growth (hirsutism), particularly on the face or body
- Mood swings or low mood
If these symptoms sound familiar, it’s worth getting tested. A combination of blood work (fasting insulin, glucose, HbA1c), as well as an oral glucose tolerance test, can help identify insulin resistance. Unfortunately, many women with PCOS are never offered these tests unless they specifically ask—so don’t be afraid to advocate for yourself.
Recent research (2023, Journal of Clinical Endocrinology & Metabolism) confirms that insulin resistance may be present even in lean women with PCOS, challenging the outdated belief that only those who are overweight are at risk.
Exercise for Insulin-Resistant PCOS: What Works Best
Exercise is one of the most effective tools for managing insulin resistance—and the best part? It doesn’t need to be extreme. Consistency is what counts.
From working with many women with this PCOS type, I’ve seen that the best approach is a balanced, sustainable plan—not a high-stress routine that drains your energy or spikes your cortisol.
Here’s what I recommend:
- Strength training 2–3 times per week: Building muscle helps your body use insulin more effectively. Full-body workouts using dumbbells, resistance bands, or gym machines are ideal.
- Daily walking: Aim for at least 8,000–10,000 steps per day, ideally including short walks after meals. Post-meal movement helps lower blood sugar and reduce insulin spikes.
- Mobility and recovery: Include yoga, Pilates, or stretching at least once or twice a week. These help reduce inflammation and support your nervous system.
One of the best things you can do for yourself is to work with a personal trainer who understands PCOS. Too often I see women being given generic “weight loss” programs filled with endless cardio and little structure. For insulin-resistant PCOS, this can backfire—leading to fatigue, frustration, and worse cravings. A knowledgeable trainer will help you build a realistic and sustainable plan that works with your body, not against it.
Here’s an example weekly routine:
- Monday – Full-body strength workout
- Tuesday – Walk + yoga
- Wednesday – Strength or resistance band circuit
- Thursday – Long walk or hike
- Friday – Rest or mobility
- Saturday – Strength workout or bodyweight session
- Sunday – Gentle walk + prep for the week
Nutrition for Insulin-Resistant PCOS: Stabilising Blood Sugar
Nutrition plays a critical role in managing insulin resistance. It’s not about cutting out all carbs or following a strict fad diet—it’s about eating in a way that stabilises your blood sugar and supports hormone balance.
Here’s what I teach my clients:
- Focus on whole, nutrient-dense foods: Build meals around protein, healthy fats, fibre, and complex carbohydrates. For example, grilled salmon with quinoa and roasted veg, or eggs with avocado and rye toast.
- Balance your plate: Each meal should include:
- A lean protein (like chicken, fish, tofu, or eggs)
- A healthy fat (like olive oil, avocado, or nuts)
- A fibre-rich carb (like sweet potato, brown rice, or lentils)
- Vegetables—as many as you like!
- Space your meals out: Try not to graze all day. Stick to three balanced meals and one snack if needed. This helps regulate your insulin response.
- Be cautious with sugar and refined carbs: These spike insulin and increase cravings. It doesn’t mean you can never have them, but save them for special occasions and pair them with protein or fibre to reduce the impact.
A note on gluten and dairy: Many women with insulin-resistant PCOS are told to cut them out entirely. While this works for some, it’s important to find out what works for you. Try this approach:
- Eliminate dairy for 5–7 days, then reintroduce it and watch for symptoms like bloating, fatigue, or skin breakouts.
- Do the same with gluten.
If you don’t notice negative effects, you don’t need to exclude them! There is no one-size-fits-all approach.
If you need guidance creating a tailored plan, I offer personalised PCOS nutrition & training plans, plus a free PCOS guide via my online store.
Lifestyle Tips for Long-Term Success with Insulin-Resistant PCOS
Managing insulin-resistant PCOS goes beyond just diet and exercise. It’s about creating sustainable habits that support your hormones day in and day out. Here’s a deeper look at key strategies:
- Review Your Environment
Take a moment to assess your surroundings. What in your daily routine adds stress or drains your energy?
- At Home: Is your space cluttered or chaotic? Take 10–15 minutes each evening to tidy up and create a calming environment.
- At Work: Can you adjust your schedule, take regular breaks, or organise your workspace to reduce stress?
- Commute: If your daily commute is a source of anxiety, consider small changes. Could you walk part of the way to unwind? Listen to a calming podcast? Practice deep breathing?
- Relationships: Have a look at your personal connections. Are there unresolved issues causing tension? Try having open, honest conversations about what’s on your mind. Holding onto stress affects cortisol, which directly impacts insulin sensitivity.
- Manage Stress Levels
Chronic stress raises cortisol, which can worsen insulin resistance. Incorporate daily stress-relieving activities like journaling, deep breathing, or a gentle walk in nature. Consider setting aside 10–15 minutes every evening to unwind and disconnect from screens.
- Prioritise Sleep
Poor sleep can increase insulin resistance and make it harder to control cravings. Aim for 7–9 hours of quality sleep per night. Create a calming bedtime routine: dim the lights, avoid screens an hour before bed, and consider magnesium or chamomile tea to wind down.
- Stay Hydrated
Insulin resistance can lead to dehydration, making it harder for your body to regulate blood sugar. Drink water throughout the day and limit sugary drinks that can spike insulin levels. Herbal teas like green tea or cinnamon tea can also help stabilise blood sugar.
- Track Your Progress, Not Just Your Weight
Instead of focusing solely on weight loss, track other markers of health:
- Energy levels
- Mood stability
- Reduction in sugar cravings
- Improved skin health
- More regular menstrual cycles
Celebrate these wins as they are all signs of improved insulin sensitivity.
- Work with a Specialist
Consider working with a coach, dietitian, or personal trainer who understands PCOS. A personalised plan can make a significant difference, especially when it comes to exercise selection and meal timing. If you’re unsure where to start, book a free consultation with me via my website.
Conclusion: Taking Control of Insulin-Resistant PCOS
Insulin-resistant PCOS can feel overwhelming, but with the right approach, you can manage symptoms, stabilise blood sugar, and regain control over your health. It’s not about drastic diets or extreme workouts—it’s about building a sustainable lifestyle that supports hormone balance.
Start with the basics:
- Incorporate strength training 2–3 times a week to build muscle and improve insulin sensitivity.
- Prioritise balanced meals with protein, healthy fats, and fibre to stabilise blood sugar.
- Look closely at your daily environment and routines—reduce stress where you can, prioritise sleep, and make time for movement.
Remember, progress takes time, and every small step counts. If you’re unsure where to start or want a personalised plan, check out my PCOS training and nutrition plans, along with a free PCOS guide, available here. You can also book a free consultation via my website.
