Polycystic Ovary Syndrome (PCOS) is a complex condition that affects far more than just the ovaries. It influences metabolism, hormones, inflammation, and long-term health risk.

While symptoms like irregular periods, acne, hair changes, and difficulty managing weight are what many women notice first, these are outward signs of deeper metabolic and hormonal patterns. Nutrition shapes many of those patterns, which is why it matters in PCOS management

In this article, we’ll explore how nutrition influences the key physiological processes involved in PCOS, particularly insulin resistance, hormone balance, inflammation, and metabolic health, so you can better understand why food matters in PCOS management.

Insulin Resistance & Blood Sugar Regulation

One of the most common features of PCOS is insulin resistance.

Insulin is a hormone that helps move glucose (sugar) from the bloodstream into cells for energy. When the body becomes resistant to insulin, cells stop responding properly to insulin, and the body needs to produce more insulin to keep blood sugar stable. Over time, chronically elevated insulin levels can disrupt ovarian function.

Higher insulin levels can:

• Stimulate the ovaries to produce more androgens (like testosterone) 
• Worsen irregular ovulation
  
• Contribute to weight gain, particularly around the abdomen
  
• Increase cravings and energy crashes
  

Nutrition directly influences blood sugar throughout the day. The types of carbohydrates you eat, meal timing, and overall dietary patterns can either help keep blood sugar stable or lead to repeated spikes and crashes.

For women with PCOS who have insulin resistance, stable blood sugar is especially important. When the body struggles to respond to insulin, even small spikes can trigger higher insulin levels. Because insulin resistance is present in many (though not all) women with PCOS, blood sugar regulation is often a foundational piece of management.

Hormone Balance

PCOS is characterized by elevated androgens (often referred to as “male hormones”), including testosterone. These hormonal shifts can contribute to symptoms such as acne, hair thinning, and irregular menstrual cycles.

Nutrition affects hormone balance in several ways:

• Insulin and androgens are closely linked. Elevated insulin can increase androgen production.
  
  
• Fat in the diet provides the building blocks your body uses to make hormones. For example, estrogen and progesterone are produced from cholesterol, which can come from the foods you eat.
  
  
• Nutrient status affects ovulation. Micronutrients such as B vitamins, zinc, magnesium, and vitamin D play roles in hormone signaling and ovarian function.

While nutrition alone does not “cure” PCOS, it can influence the hormonal environment in which the ovaries function.

Inflammation

Low-grade chronic inflammation is commonly observed in women with PCOS. Inflammation can:

• Worsen insulin resistance
• Interfere with ovulation
  
• Contribute to fatigue
  
• Impact mood and metabolic health

Dietary patterns influence inflammatory pathways in the body. Highly processed dietary patterns, frequent blood sugar spikes, and low intake of fiber and phytonutrients may contribute to inflammatory processes.

On the other hand, nutrient-dense dietary patterns rich in fiber, antioxidants, and healthy fats are associated with improved metabolic and inflammatory markers.

Metabolic Health & Long-Term Risk

PCOS is associated with an increased risk of:

• Prediabetes and type 2 diabetes
  
• Dyslipidemia (abnormal cholesterol levels)
  
• Cardiovascular disease
  
• Non-alcoholic fatty liver disease
  

Because of this, nutrition is important not only for symptom relief, but also for long-term metabolic protection.

Supporting stable blood sugar, healthy lipid levels, and body composition through nutrition can significantly impact long-term health outcomes for women with PCOS.

Appetite, Cravings & Energy Regulation

Many women with PCOS report:

• Intense carbohydrate cravings
  
• Afternoon energy crashes
  
• Feeling “out of control” around food
  

These experiences are often rooted in blood sugar instability and insulin dysregulation - not a lack of willpower!

When blood sugar fluctuates dramatically, the body responds by increasing hunger signals and cravings, particularly for quick sources of glucose. Understanding this physiological loop can reduce shame and shift the focus toward regulation rather than restriction.

Why This Matters

PCOS is complex and multi-factorial. It is influenced by genetics, environment, stress, sleep, movement, and more. But nutrition interacts directly with many of the core drivers of the condition:

• Insulin resistance
  
• Androgen production
• Inflammation
  
• Ovulatory function
  
• Metabolic risk

Instead of thinking of nutrition as a “diet” or a temporary fix, it’s more useful to see it as a tool that shapes the internal hormonal environment over time.

When we understand how nutrition affects PCOS at a physiological level, we can move away from extremes and focus on small, consistent changes that can make a meaningful difference in how you feel day to day.

Want to Learn More About PCOS & Blood Sugar?

On March 3rd, Dietitian Kaitlyn is hosting a free masterclass all about the connection between PCOS and blood sugar, where she’ll cover:

• The 3 different types of PCOS, and why knowing your type matters
• How blood sugar plays a major role in PCOS symptoms like cravings, fatigue, irregular cycles, acne and stubborn weight gain
• The biggest mistakes (and bad advice!) keeping you stuck with PCOS symptoms
• The most important daily habit shifts to support blood sugar, regulate your hormones, and feel more in control of your body

If you’ve ever felt confused about why typical nutrition and fitness advice doesn’t seem to work when you have PCOS, this session will help you connect the dots and learn the most important steps to start feeling better.

Tap here to learn more and register.