By Lucia Stansbie 

Polycystic Ovary Syndrome (PCOS) is often seen as a reproductive health disorder, primarily associated with irregular periods, fertility challenges, and excess androgens. However, the hormonal imbalances that define PCOS—particularly insulin resistance—reach far beyond reproduction, impacting metabolic health, cardiovascular function, and long-term well-being.

As a nutritional therapist working closely with women with PCOS, I noticed that many were only told about the fertility aspects of the condition. Yet, the underlying metabolic issues—especially insulin resistance—were often overlooked. Addressing this is not just about managing symptoms but about protecting long-term health and yes, very much about improving fertility outcomes, if that is what you came here for!

Understanding how insulin resistance fuels PCOS is key to preventing complications like hypertension, type 2 diabetes, and cardiovascular disease—conditions that affect many women with PCOS as they age.

The Chicken and Egg Dilemma: PCOS and Insulin Resistance

The relationship between PCOS and insulin resistance is a complex, bidirectional loop. Insulin resistance is both a cause and a consequence of PCOS:

• High insulin levels stimulate the ovaries to produce excess androgens, worsening symptoms like acne, hair thinning, and irregular cycles.

• Androgens further increase insulin resistance, creating a vicious cycle that disrupts blood sugar regulation, metabolism, and hormonal balance.

• Genetics and prenatal hormonal exposure also play a role, meaning some women may be predisposed to this imbalance before birth.

Notably, insulin resistance can worsen over time, even in women who initially test negative. Research shows that hyperinsulinemia tends to progress with age, even without an increase in androgens, emphasising the need for early intervention. In fact, up to 70% of women with PCOS either present with insulin resistance or develop it over time, making it one of the most critical—and often under-addressed—aspects of the condition.

Beyond Blood Sugar: The Health Risks of Insulin Resistance in PCOS

While insulin resistance is often discussed in the context of weight gain and energy crashes, its effects are far more systemic:

1. Cardiovascular Disease & Hypertension
   
   

• Women with PCOS are at triple the risk of hypertension and up to seven times the risk of a heart attack by their 40s and 50s.

• Atherosclerosis—a condition where arteries stiffen due to plaque buildup—is more prevalent in women with PCOS, even at a young age.

• Impaired blood vessel function is measurable even in teenagers with PCOS, highlighting how early these risks begin.

2. Chronic Inflammation & Metabolic Syndrome
   
   

• Inflammation is both a cause and effect of insulin resistance, with women with PCOS showing elevated C-reactive protein (CRP) levels.

• This chronic inflammation increases the risk of coronary heart disease and other metabolic disorders.

• Studies also show that Endothelin-1, a marker of poor blood vessel function, is elevated in PCOS but can be lowered through insulin-sensitising treatments.

3. Type 2 Diabetes & Impaired Glucose Tolerance
   
   

• Up to 70% of women with PCOS show signs of insulin resistance, with 31% developing impaired glucose tolerance and 7.5% developing type 2 diabetes.

• The body initially compensates for insulin resistance by overproducing insulin, but when the pancreas can no longer keep up, blood sugar levels rise, leading to diabetes.

Given these long-term health risks, addressing insulin resistance is about far more than just weight loss or symptom control—it’s about preserving overall health.

Addressing Insulin Resistance: Lifestyle, Nutrition & Herbal Support

Dietary Changes: The Power of Food in Balancing Blood Sugar

Nutrition is one of the most effective tools for improving insulin sensitivity. Research highlights the DASH diet (rich in complex carbohydrates, lean proteins, and healthy fats) as particularly effective in managing insulin resistance—often with results comparable to metformin.

Key strategies include:
✔ Reducing refined carbs & sugar to minimise blood sugar spikes.
✔ Incorporating fiber-rich foods like legumes, leafy greens, and whole grains to support gut health and glucose metabolism.
✔ Prioritising anti-inflammatory fats (avocados, olive oil, nuts) to combat oxidative stress and inflammation.

Exercise: A Natural Insulin Sensitiser

Both resistance training and aerobic exercise improve insulin sensitivity independently of weight loss, making movement an essential part of managing PCOS.

• Strength training helps build muscle tissue that absorbs glucose more efficiently.

•  Low-impact activities like walking or yoga can reduce cortisol levels, preventing stress-induced blood sugar spikes.

Herbal Support: A Trusted Companion

Herbal remedies have been used for centuries to support hormonal balance, blood sugar regulation, and inflammation reduction, but not all blends are created equal.

The SABI has crafted The Gentle Period Herbata with key botanicals that specifically support insulin sensitivity, circulation, and inflammation reduction, setting it apart from conventional cycle-supporting teas.

• Red Clover & Lady’s Mantle – Help regulate hormonal fluctuations and improve oestrogen metabolism, a key factor in PCOS.

• Oat Straw & Stinging Nettles – Rich in minerals like magnesium and iron, which support blood sugar balance, energy levels and act as gentle adaptogens to nourish the nervous system and build resilience from within.

• Raspberry Leaf & Holy Basil – Provide anti-inflammatory and adaptogenic benefits, helping regulate cortisol and insulin responses.

This carefully formulated blend nurtures hormone health beyond the menstrual cycle, making it an essential tool for long-term metabolic balance.

Additional Natural Support for Insulin Resistance

Emerging research highlights several herbs that may help manage insulin resistance in PCOS:

• Cinnamon & Fenugreek – Improve glucose metabolism and reduce fasting blood sugar levels.

• Aloe Vera & Green Tea – Support anti-inflammatory pathways and improve insulin sensitivity.

• Silymarin (Milk Thistle) – Enhances liver detoxification and reduces oxidative stress, both of which influence hormonal balance.

These natural interventions, alongside lifestyle changes, can significantly enhance insulin function and reduce PCOS-related complications.

A Holistic Approach to Insulin Resistance in PCOS

As someone who works with women navigating PCOS daily, I’ve seen firsthand how addressing insulin resistance can be life-changing—not just for symptom relief, but for long-term health and well-being. PCOS is a lifelong condition, but that doesn’t mean it has to control your life. By addressing insulin resistance proactively, we can reduce the risks of developing serious metabolic and cardiovascular complications while improving energy levels, hormone balance, and quality of life.

A well-rounded approach that includes nutrition, exercise, herbal support, and lifestyle modifications can help women with PCOS break free from the cycle of blood sugar imbalances and inflammation. Whether through dietary changes, movement, or powerful botanical blends like The Gentle Period, every small step toward balance is a step toward better health, now and in the future.

REFERENCES

• https://www.degruyter.com/document/doi/10.1515/bmc-2020-0005/html

• https://academic.oup.com/jcem/article/105/10/3346/5867491?login=false

• https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0034-1376990

• https://www.sciencedirect.com/science/article/pii/S0015028203007349?ref=pdf_download&fr=RR-2&rr=92afa48dfa908873

• https://www.tandfonline.com/doi/abs/10.1080/13813455.2018.1499120

ABOUT LUCIA STANSBIE

Lucia Stansbie is a certified Nutritionist and Nutritional Therapist based in London and the founder of Power Food Nutrition, a 1:1 nutritional therapy service. She specialises in identifying the root causes of health concerns, from fatigue, gut health, and weight management to endometriosis, PCOS, hormonal imbalances, and MCAS. A member of the Royal Society of Medicine, Lucia takes a personalised, science-backed approach to support clients in achieving lasting well-being. Her services are covered by HealthShield, Westfield Health, and WPA.

HORMONAL & PROUD

Created as a brand to help women navigate the toughest moments in pregnancy, childbirth, postpartum — and practically every stage of life –– The SABI is changing the narrative around our hormones from one of taboo, embarrassment, and loneliness to awareness and even, pride. As more than a wellness brand, The SABI offers a carefully-crafted line of products to carry you through your hormonal journey, including rituals, supportive tools, and ancient herbal remedies that have been tested time and time again by women and now come backed by medicine. The SABI is a blend of science and nature conceived by women who have experienced the joys and deep struggles of bringing a child into the world, the pains of a heavy, difficult period, miscarriage, and difficulty conceiving.

We invite you to get to know your body and its cycles better –– to really understand what is going on inside. Learn to use your hormones to your advantage no matter your stage of life, and know that you can support and balance your hormone levels. We are here to help with the information, understanding and natural tools to support your body and the emotional process along with it.

DISCLAIMER

The SABI blog and articles are not meant to instruct or advise on medical or health conditions, but to inform. The information and opinions presented here do not substitute professional medical advice or consultations with healthcare professionals for your unique situation.