Understanding PCOS, Insulin Resistance & Women’s Hormonal Health

When it comes to women’s health, one condition often misunderstood is Polycystic Ovary Syndrome (PCOS). It’s not just a fertility issue—it touches metabolism, digestion, inflammation, hormones and more.

In Episode 21 of the Gut Check Podcast, Cory Ruth brings both her professional expertise and lived experience with PCOS to shed light on what many don’t realize: insulin resistance and the gut-hormone connection are central to many of the struggles women face.

PCOS Isn’t What You Think—It’s More Complex Than “Irregular Periods”

Often, PCOS is described narrowly: “you have cysts on your ovaries, your periods are irregular.” But as Cory points out, that framing misses much of the metabolic reality. youtube.com+1
Key insights:

• PCOS affects up to ~1 in 10 women of reproductive age. youtube.com

• It’s not only about fertility; it’s about long-term health risks such as insulin resistance, type 2 diabetes and cardiovascular issues. youtube.com+1

• The name “polycystic ovary” conceals deeper dysfunctions—hormonal imbalances, metabolic dysregulation and gut issues.

In other words: PCOS isn’t simply a “women’s reproductive issue”—it’s a whole-body issue.

Insulin Resistance: The Hidden Driver

One of the most important points raised is how insulin resistance can act as the root of many PCOS symptoms: weight gain (especially around the mid-section), elevated androgens, disrupted ovulation, and even gut symptoms. youtube.com+1
Some practical take-aways:

• When insulin is elevated chronically, androgen production tends to rise; this can manifest as acne, hair loss, excess body hair.

• Ovulation isn’t just about fertility—it’s a signal that your body is hormonally healthy. Missed ovulation can be a warning sign.

• Blood sugar regulation becomes foundational: stabilizing meals, avoiding large spikes, and paying attention to timing really matter.

Gut Health, the “Estro-bolome”, and Hormone Detox

Your gut isn’t just processing food—it’s also part of the hormone-recycling system. The term “estro-bolome” is used to describe the gut bacteria that influence estrogen metabolism. Cory highlights how imbalances here can lead to so-called “estrogen dominance” or hormone mis-regulation. youtube.com
Points to consider:

• Fiber matters—not just for digestion, but for hormone detox and gut microbial health.

• Ultra-processed foods, seed oils, constant grazing and chronic stress can disrupt gut flora, digestion and by extension hormonal health.

• Gut symptoms (bloating, irregularity, food sensitivities) are often seen in women with PCOS—so the gut symptoms aren’t unrelated side-effects. They may be part of the root issue. youtube.com

Nutrition, Life Stage & Moving Beyond Quick Fixes

The episode emphasizes that many women are taught generic strategies (calorie reduction, heavy cardio, strict diets) that just don’t work for PCOS and metabolic-driven conditions. Instead, a tailored approach is essential.
Highlights:

• Balanced meals including protein + healthy fats + quality carbs help stabilise blood sugar and support hormones.

• What worked in your 20s may not work at 35-45. Life stage matters. Hormonal shifts demand adjustments in training, nutrition and recovery.

• Rather than extreme “diet hacks,” consistent, manageable changes (meal timing, macro balance, fiber variety) often produce the better long-term results.

Testing, Birth Control & the Myth of “Just Lose Weight”

Important clinical lessons:

• Standard lab tests often miss what’s really going on (e.g., insulin resistance, SHBG, advanced androgen panels) so women with PCOS can be mis-diagnosed or under-diagnosed. youtube.com

• Hormonal birth control may temporarily “fix” a symptom (irregular period) without addressing the underlying root causes. This can delay true recovery. youtube.com

• Weight loss advice isn’t one-size-fits-all. For someone with insulin resistance and PCOS, aggressive calorie cutting can backfire. Instead, supporting metabolic health is more effective.

Actionable Insights You Can Use Now

• Track one week of your meals, energy levels, digestion and cycle (if applicable). See how you feel.

• Make one meal today with the combination: protein + healthy fat + quality carb & fibre. Notice your energy 2-3 hours after.

• Choose one habit to reduce gut/hormone disruption: maybe reduce grazing/snacking, avoid seed oils, increase one extra serving of fiber.

• If you have irregular cycles, acne, hair loss, belly fat stubbornness—ask: Could insulin resistance or gut dys-function be behind this? and bring that question to your next check-up.

• Approach your health with curiosity, not shame. PCOS isn’t a failure—it’s a signal. Understanding it gives you access to smarter strategies.

Final Thought

PCOS isn’t just “having cysts”—it’s a reflection of deeper metabolic and hormonal patterns. When you support your insulin sensitivity, nurture your gut, stabilise your nutrition and personalise your approach, you move from feeling stuck to feeling empowered.

For a deeper dive into these ideas, listen to the full episode of the Gut Check Podcast here:
👉 https://youtu.be/fmEVK-ZA3H8