PCOS and Insulin: Lifestyle Basics for Indian Women

Irregular periods, acne that won't settle, hair thinning on the head and growing on the chin, weight that sticks around the belly. For many Indian women, these show up in their teens or twenties, and the diagnosis is PCOS, polycystic ovary syndrome.

PCOS is common in India. Estimates vary with the diagnostic criteria used — from roughly 7% to nearly 20% in recent Indian studies — so "around 1 in 10" is a fair everyday summary, not a precise census. Search online and you'll be flooded with "cure PCOS in 30 days" programmes. There's no such cure. But there is a lot you can do.

Where insulin comes in

Insulin is the hormone that moves sugar from your blood into cells. In insulin resistance, the cells respond poorly, so the body makes more insulin to compensate. Many women with PCOS, including lean ones, have some degree of insulin resistance.

High insulin can push the ovaries to make more androgens (male-type hormones). That's linked with acne, extra hair growth, scalp hair thinning and irregular ovulation. It also raises the long-term risk of type 2 diabetes, which matters in a country where diabetes is already so common.

See a doctor first

PCOS is diagnosed by ruling other things out, like thyroid problems and high prolactin. A gynaecologist or endocrinologist may check hormones, an ultrasound, fasting sugar or HbA1c, and lipids. Treatment depends on your goals: regular periods, skin and hair, weight, or getting pregnant. Medicines like metformin or hormonal pills may be part of it. Lifestyle changes are the base under all of it.

Lifestyle changes with the best evidence

• Build a better plate. Half vegetables, a quarter protein (dal, paneer, curd, eggs, chicken or fish), a quarter grains. Swap some white rice and maida for millets, whole wheat or brown rice.

• Cut sugary drinks and sweets. Packaged juice, cold drinks and mithai cause big insulin spikes.

• Strength train. Muscle is the biggest user of blood sugar. Two to three sessions a week can improve insulin sensitivity.

• Walk after meals. A 10 to 15 minute walk after lunch and dinner is simple and may lower post-meal sugar.

• Small weight loss counts. If you're overweight, losing 5 to 10 per cent of body weight may help restore more regular cycles in some women.

• Sleep and stress. Poor sleep worsens insulin resistance. Aim for consistent sleep times.

About supplements

You'll hear about inositol, especially myo-inositol. Some trials suggest it may help with insulin sensitivity and cycle regularity in PCOS, but the studies are small and mixed. Vitamin D is worth testing, since low levels are common in Indian women. Spearmint tea, cinnamon and others have even weaker evidence.

Discuss any supplement with your doctor, especially if you're trying to conceive or already on metformin.

The short version

PCOS is a long-term condition, not a short-term problem to "cure." Get a proper diagnosis, focus on food, strength and sleep, and work with your doctor on the rest. Small changes held for months do far more than any 30-day plan.

This article is for general information only and is not medical advice. Supplements are not meant to diagnose, treat, cure or prevent any disease. Speak to your doctor before starting anything new, especially if you are pregnant, breastfeeding, on medication or managing a health condition.

References

1. Teede HJ, et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023.

2. Ganie MA, et al. Epidemiology, pathogenesis, genetics and management of polycystic ovary syndrome in India. Indian J Med Res. 2019.

3. Lim SS, et al. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2019.

4. Unfer V, et al. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol. 2012.