
If you’ve ever felt confused, frustrated, or even hopeless about your irregular cycles, you’re not alone. For many women, getting a period feels like playing hormonal roulette—you never know when (or if) it will show up. And for those with PCOS, it can feel even more out of control.
But what if I told you that your irregular cycles might not be a random mystery? What if there’s a very clear reason behind why your periods are all over the place—and better yet, something you can actually do about it?
Let’s talk about insulin.
What a Normal Menstrual Cycle Looks Like
In a healthy, ovulatory cycle, your hormones follow a beautiful rhythm.
- Early in the cycle, FSH (follicle-stimulating hormone) helps your follicles grow.
- Around mid-cycle, LH (luteinizing hormone) spikes and triggers ovulation.
- After ovulation, your ovaries produce progesterone, which helps prepare your uterus for a potential pregnancy and supports a healthy cycle.
This delicate dance of hormones only works if ovulation happens.
What Happens in PCOS: Anovulatory Cycle
In PCOS, many women don’t ovulate regularly. And when there’s no ovulation, this whole hormonal rhythm falls apart.
- Instead of a clear LH surge, LH stays chronically high, which actually prevents ovulation.
- If you don’t ovulate, there is no egg to fertilize and pregnancy cannot occur.
- Without ovulation, progesterone never rises—leaving estrogen unopposed.
- This leads to irregular bleeding (or no bleeding at all), and symptoms like mood swings, bloating, and fatigue.
It’s not that your body is failing—it’s just overwhelmed by a deeper issue: insulin resistance.
The Hormone Behind the Hormones: Insulin
Most people don’t associate insulin or their diet with their menstrual cycle. I was that person, even as a Registered Dietitian. But insulin is actually one of the most powerful hormones in your body, and it affects all the other hormones—including the ones that control your cycle.
When insulin levels are high:
- Your ovaries get stimulated to make more testosterone
- This throws off the balance of estrogen and progesterone
- Ovulation is disrupted (or doesn’t happen at all)
- Your cycle becomes long, unpredictable, or even absent
This is why insulin resistance is so common in women with PCOS. And it’s also why traditional hormone treatments (like birth control or Clomid) often miss the root cause.
What Does This Look Like in Real Life?
If you’re insulin resistant—even if your blood sugar looks totally normal—you might notice:
- Irregular cycles (longer than 35 days)
- Skipping periods altogether
- Signs of high testosterone (like acne or facial hair)
- Fertility struggles
- Heavy bleeding (when periods do come)
It’s all connected. And insulin is often the missing piece of the puzzle.
The Solution Isn’t More Hormones—It’s Lowering Insulin
You don’t fix irregular periods by covering them up with birth control. That might give you a fake, scheduled “period,” but it’s not solving the underlying issue.
If insulin resistance is the real problem, then lowering insulin is the real solution.
When insulin comes down:
- Testosterone levels drop
- Ovulation resumes
- Progesterone rises
- Cycles become regular
- Your body starts working with you again
This doesn’t happen overnight. It could take a few months for ovulation to return, but it’s absolutely possible.
You Are Not Broken
It’s easy to feel like your body is working against you when your cycle is irregular or you’re not ovulating. But your body isn’t broken—it’s doing the best it can under difficult circumstances.
The good news is, you can change those circumstances.