Insulin Resistance in PCOS, Menopause and Pregnancy

Women experience unique hormonal shifts during puberty, pregnancy and menopause — all of which influence how the body responds to insulin. These hormonal changes can make women more likely to develop insulin resistance at certain stages of life.

Insulin resistance in women is closely linked to PCOS, weight gain around the abdomen, fertility challenges, gestational diabetes and worsening symptoms during menopause.

Internal link: What is insulin resistance?

Up to 70% of women with PCOS have insulin resistance. High insulin levels stimulate the ovaries to produce excess androgens (male hormones), which leads to:

• Irregular periods
• Excess facial or body hair
• Acne
• Difficulty losing weight
• Fertility challenges

Improving insulin sensitivity is one of the most effective treatments for PCOS and often reduces symptoms even before weight loss occurs.

External source: Journal of Ovarian Research — insulin resistance in PCOS.

During pregnancy, hormones from the placenta naturally make the body more resistant to insulin. This ensures the growing baby receives enough glucose. But if the pancreas cannot keep up with the increased insulin demand, blood glucose rises.

This can lead to gestational diabetes, especially in women who already have underlying insulin resistance.

Women are at higher risk if they:

• Had gestational diabetes in a previous pregnancy
• Have PCOS
• Have a family history of type 2 diabetes
• Carry excess abdominal weight

Internal link: Diagnosing gestational diabetes

After menopause, oestrogen levels drop significantly. Oestrogen helps the body use insulin effectively, so lower levels can worsen insulin resistance.

This often leads to:

• Weight gain — especially around the abdomen
• Higher fasting glucose
• Increased cholesterol and triglycerides
• Greater risk of type 2 diabetes

Even women with previously stable weight and glucose levels may notice changes after menopause.

Internal link: Risks of insulin resistance

The most effective strategies for reducing insulin resistance in women include:

• Regular exercise — particularly resistance training
• Balanced, lower-GI meals
• Weight reduction (5–10%) if overweight
• Managing stress and improving sleep
• Metformin or other medications when medically appropriate

These steps support hormonal balance, lower inflammation and improve long-term metabolic health.

CTA: Learn personalised strategies in our Diabetes Masterclass.