The Importance of Blood Sugar Regulation in Treating PCOS

Blood Sugar Regulation in Treating PCOS

Polycystic Ovarian Syndrome (PCOS) is a hormonal condition that brings about symptoms like irregular periods, acne, ovarian cysts, reduced ovulation, weight gain, excess hair growth, and hair thinning. The usual management tool offered to patients with PCOS is oral birth control, which artificially regulates hormone levels and reduces symptoms.  

As naturopathic doctors, our goal is to address the root cause of your symptoms to help you to achieve long-term improvements.

The Importance of Blood Sugar Regulation in Treating PCOS

Blood sugar dysregulation and insulin resistance are major factor underlying the hormonal symptoms of PCOS. When we consume simple carbohydrates and sugars, our blood glucose level rises, and insulin is released to bring the glucose into the cells for energy. 

Insulin resistance is a common issue in PCOS. 

It occurs when the body does not respond normally to insulin, which leads to an increase in insulin release to maintain healthy blood glucose levels. If you regularly include simple carbohydrates and sugars with meals, your blood glucose goes up, which requires your pancreas to release more and more insulin.  The high insulin level can then negatively impact your already imbalanced hormone levels.  

Insulin stimulates the ovaries to secrete testosterone, one of the primary hormones elevated in PCOS that triggers many symptoms. Insulin also inhibits the production of sex hormone binding globulin (SHBG), which normally binds testosterone and makes it less active.

With less SHBG, the already elevated testosterone becomes more free to be active. Lipolysis, the breakdown of fat cells for fuel, is inhibited by insulin, thus leading to difficulty maintaining a healthy weight. Prolonged elevated insulin contributes to increased testosterone levels and metabolic disruption and worsens PCOS symptoms.  As an aside, the birth control pill acts to increase SHBG to make testosterone less active, which is one of the reasons it helps reduce symptoms such as acne.

Balancing Blood Sugar and Regulating Insulin with Nutrition and Exercise

Nutrition plays a major role in blood sugar regulation and appropriate insulin release. Including protein, fiber, and healthy fat with each meal keeps blood sugar levels stable. Limiting refined sugars and carbohydrates such as candy, soda, white rice, white bread, and white pasta is extremely helpful.

These high glycemic foods trigger significant spikes in blood sugar, large secretions of insulin, and contribute to insulin resistance over time. Nourishing the body with nutrient-dense whole foods is key:

  • Fresh non-starchy vegetables: broccoli, asparagus, brussel sprouts, cabbage, tomatoes, zucchini, eggplant, bell pepper, celery, leafy greens
  • Low glycemic fruits: apples, oranges, strawberries, blueberries, grapes, pears
  • Whole grains: wild rice, buckwheat, oats, quinoa
  • Protein: fish, chicken, turkey, lentils, beans, nuts, seeds
  • Healthy fats: wild salmon, avocado, olive oil
  • Fiber: ground flaxseed, chickpeas, beans, lentils, apples, raspberries, cauliflower, broccoli

Interestingly, PCOS symptoms have also been shown to improve with consuming larger amounts of food in the morning and smaller amounts of food in the evening. This may be linked to eating in alignment with the body’s 24 hour circadian and cortisol rhythm. Aiming for a large breakfast, medium lunch, and small dinner is another beneficial strategy for hormone balance.

Exercise & Blood Sugar Regulation

Exercise improves blood sugar levels and promotes insulin sensitivity, resulting in less insulin required for blood sugar regulation. This is extremely helpful for supporting hormone balance in PCOS.

Some options include:

  • walking
  • swimming
  • cycling
  • high intensity interval training
  • weight training
  • dancing
  • yoga
  • and tai chi

Ideally a combination of higher intensity and endurance activities are ideal. 

However, it can be challenging to implement regular exercise if time and energy are limited. The best strategy is to choose an activity that’s enjoyable to start with. It’s much easier to stay consistent when having fun! Starting with shorter exercise sessions and gradually increasing duration over time as your body adapts and strengthens is best.

PCOS can lead to multiple difficult symptoms, but it can be well-managed with a natural and holistic treatment approach that targets hormone balance and blood sugar and insulin regulation through nutrition, lifestyle, and herbal medicines. 

Schedule a 10 minute consultation at

Dr. Caitlan Gignac
Naturopathic Doctor San Jose


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