Honestly the insulin connection to PCOS is something I wish more doctors talked about with their patients upfront. My sister struggled with it for years and nobody once mentioned her diet could be a factor until she started eating low carb on her own and saw real changes in her cycles. It's wild how many conditions trace back to hyperinsulinemia when you start pulling the thread.
Hyperinsulinemia clearly plays a major role in many cases of PCOS. But I increasingly wonder whether insulin is sometimes less the root cause and more a signal of a deeper metabolic situation.
From a systems perspective, the key question might be even more fundamental:
Is energy reliably reaching the cells that need it?
When cellular energy access becomes unstable — whether due to insulin resistance, impaired signaling, or other transport limitations — the reproductive system may simply respond by dialing down ovulation. Reproduction is energetically expensive, so the body acts cautiously when the system cannot guarantee stable supply.
That might explain why very different interventions sometimes help PCOS: fasting, low-carb, exercise, metformin, weight changes. They do not all act through the same pathway — but they may all improve the stability of metabolic energy flow.
So perhaps hyperinsulinemia is one visible piece of a larger puzzle: a system trying to maintain metabolic balance under unstable conditions.
P.S. Yes, I had many problems with ovarian cysts, but I could not tolerate staying on BCP to try to regulate my cycles, due to it causing ear infections every time I was on BCP for more than a month.
I was never actually diagnosed with PCOS, but I never sought help for anything other than acne and ovarian cyst pain.
Great explanation! Nice to understand the pathway.
This is clearly true. Thank you for fighting the fights that need fighting.
Honestly the insulin connection to PCOS is something I wish more doctors talked about with their patients upfront. My sister struggled with it for years and nobody once mentioned her diet could be a factor until she started eating low carb on her own and saw real changes in her cycles. It's wild how many conditions trace back to hyperinsulinemia when you start pulling the thread.
Hyperinsulinemia clearly plays a major role in many cases of PCOS. But I increasingly wonder whether insulin is sometimes less the root cause and more a signal of a deeper metabolic situation.
From a systems perspective, the key question might be even more fundamental:
Is energy reliably reaching the cells that need it?
When cellular energy access becomes unstable — whether due to insulin resistance, impaired signaling, or other transport limitations — the reproductive system may simply respond by dialing down ovulation. Reproduction is energetically expensive, so the body acts cautiously when the system cannot guarantee stable supply.
That might explain why very different interventions sometimes help PCOS: fasting, low-carb, exercise, metformin, weight changes. They do not all act through the same pathway — but they may all improve the stability of metabolic energy flow.
So perhaps hyperinsulinemia is one visible piece of a larger puzzle: a system trying to maintain metabolic balance under unstable conditions.
Dr Fung, I only remember having periods every 21 days... this was pretty regular except for the timeframe I was on Accutane for acne in my 20s.
I managed to keep my weight down, most of my life, via determined dieting and exercise... but it never felt easy.
I was diagnosed with Premature Ovarian Failure by 38. I never had another period.
I have been Keto and Fast regularly.
I do feel that I battle with Insulin Resistance.
Are you aware of any correlation in my scenario??
Thank you for helping me in the past 7 years via all your knowledge you share specifically on fasting.
P.S. Yes, I had many problems with ovarian cysts, but I could not tolerate staying on BCP to try to regulate my cycles, due to it causing ear infections every time I was on BCP for more than a month.
I was never actually diagnosed with PCOS, but I never sought help for anything other than acne and ovarian cyst pain.
Dr Fung, I only remember having periods every 21 days... this was pretty regular except for the timeframe I was on Accutane for acne in my 20s.
I managed to keep my weight down, most of my life, via determined dieting and exercise... but it never felt easy.
I was diagnosed with Premature Ovarian Failure by 38. I never had another period.
I have been Keto and Fast regularly.
I do feel that I battle with Insulin Resistance.
Are you aware of any correlation in my scenario??
Thank you for have you have personally helped me in the past 7 years.