Category Archives: Reproductive Health

The second trimester is often called the golden period of pregnancy. Energy levels usually improve, morning sickness fades, and you finally start to feel that pregnancy glow. But if you have PCOS, you might still be navigating some unique challenges—especially when it comes to insulin resistance.

As pregnancy progresses, your body naturally becomes more insulin resistant to make sure you store fat and your baby gets enough nutrients. That is completely normal. But if you already had insulin resistance before pregnancy, this shift can make things trickier. Managing insulin levels during the second trimester is just as important as it was in the first, and keeping them in check can help prevent complications down the road.

How Insulin Resistance Changes in the Second Trimester

If you have PCOS, you are probably familiar with insulin resistance. But pregnancy takes it to another level. As hormones shift, insulin resistance increases, which means your body has to work harder to regulate blood sugar. For women with PCOS, this can increase the risk of certain pregnancy complications.

• Gestational diabetes. Since insulin resistance peaks in the second trimester, this is when many women are diagnosed with gestational diabetes. Women with PCOS have a higher risk, so it is important to monitor insulin levels early.
• Pre-eclampsia. High insulin levels can contribute to high blood pressure, which increases the risk of pre-eclampsia. This condition can affect both mom and baby, so keeping insulin in check is a key part of prevention.
• Fetal overgrowth. If insulin levels are too high, babies tend to produce more of their own insulin, which can cause excessive growth (macrosomia). This can make delivery more complicated and increase the risk of a C-section.

The good news? Managing insulin resistance through diet, movement, and lifestyle choices can help keep these risks low.

The Role of Inflammation in Pregnancy

Another thing to consider in the second trimester is inflammation. While some inflammation is normal and even necessary for immune function, too much can cause problems.

• By week 20, your antibodies start crossing the placenta, giving your baby passive immunity until their own immune system matures.
• If inflammation is too high, it can interfere with this process, making it harder for your baby to get the immune protection they need.

Since high insulin levels drive inflammation, keeping insulin stable can also help lower overall inflammation and make sure your baby has a strong immune system.

Managing PCOS in the Second Trimester

The second trimester is an important time to stay on top of insulin resistance. Here are some simple ways to help keep things in balance.

• Test insulin levels early. Don’t wait until a gestational diabetes test at 24 to 28 weeks. Insulin resistance starts much earlier, so checking insulin levels in the first trimester (or even before pregnancy) can help you get ahead of any issues.
• Follow a Low Insulin Lifestyle. Avoiding foods that spike insulin can help keep insulin levels stable and prevent unnecessary spikes. Instead, focus on non-starchy vegetables, lean proteins, healthy fats, nuts, seeds, and whole fruits.
• Move your body daily. You don’t need intense workouts—just keep moving. Walking, stretching, or prenatal yoga can all help improve insulin sensitivity and keep inflammation in check.
• Lower stress when you can. Chronic stress increases cortisol, which can drive insulin levels higher. Small things like deep breathing, relaxing in the evening, or even just getting outside for some fresh air can help.

Supporting a Healthy Pregnancy

The second trimester is such an exciting time, and managing insulin resistance now can make a huge difference in how you feel as your pregnancy progresses. The goal is not perfection—it is just about making small, consistent choices that support your health and your baby’s health.

Following a Low Insulin Lifestyle before and during pregnancy can make a world of difference. For women with PCOS, managing insulin resistance is one of the most powerful ways to support a healthy pregnancy and give their baby the best possible start.

 

References:

Puttabyatappa M, et al. Developmental programming of insulin resistance: are androgens the culprits? J Endocrinol. 2020. Read more

Karcz K, Królak-Olejnik B. Impact of Gestational Diabetes Mellitus on Fetal Growth and Nutritional Status in Newborns. Nutrients. 2024. Read more

Thinking about starting a family? If you have PCOS, there are a few key things to focus on before trying to conceive. One of the most important is lowering insulin levels.

Most people don’t realize that insulin plays a major role in fertility. High insulin levels don’t just affect metabolism—they impact ovulation, embryo implantation, and even the health of the placenta. Addressing insulin resistance before pregnancy can significantly improve your chances of conceiving and carrying a healthy baby to term.

This applies to both parents. While PCOS is often discussed in terms of female fertility, insulin resistance also affects male fertility. If you and your partner are trying to get pregnant, it is important that both of you work toward optimizing insulin levels.

Let’s dive into why keeping insulin low before pregnancy is one of the most important things you can do for your future baby.

How High Insulin Levels Affect Fertility

Most people with PCOS already struggle with insulin resistance, which means the body has to pump out more insulin to compensate. This high insulin environment can interfere with reproductive health in several ways.

1. Egg Quality Suffers – High insulin levels can negatively impact egg quality, making it more difficult for fertilization and healthy embryo development.

2. Ovulation Becomes Irregular – Insulin resistance can throw off the delicate balance of hormones that regulate ovulation. High insulin levels signal the ovaries to produce more androgens (male hormones), which can lead to irregular or even absent ovulation. If you are not ovulating regularly, getting pregnant becomes much more difficult.

3. Embryo Implantation is More Difficult – High insulin levels also affect the lining of the uterus. The endometrium needs to be thick and receptive for an embryo to implant successfully. Insulin resistance can make the uterine lining less favorable for implantation, leading to lower chances of conception and a higher risk of early miscarriage.

4. Abnormal Placental Development – High insulin levels can also interfere with proper placental development, increasing the risk of complications during pregnancy.

5. Higher Risk of Gestational Diabetes – If insulin resistance is present before pregnancy, it often worsens during pregnancy. This increases the likelihood of developing gestational diabetes, which can lead to excessive fetal growth, delivery complications, and a higher risk of metabolic issues for the baby later in life.

Why Insulin Levels Matter for Pregnancy Outcomes

Even after conception, keeping insulin low in early pregnancy is just as important as getting it low before pregnancy. High insulin levels in the first trimester have been linked to pregnancy complications, including:

• Miscarriage, as high insulin levels can disrupt placental development and trigger an overactive immune response, leading the mother’s body to mistakenly reject the pregnancy.
• Gestational diabetes, which can lead to a larger baby, delivery complications, and long-term metabolic issues for the child.
• Preeclampsia, a dangerous rise in blood pressure that can lead to serious complications for both mother and baby.
• Preterm delivery, which increases the risk of respiratory and developmental challenges for the baby.

The good news is that these risks can often be reduced by improving insulin sensitivity before pregnancy.

Insulin Resistance Also Affects Male Fertility

This is not just about moms—dads’ health matters too.

Insulin resistance in men has been linked to:

• Lower testosterone levels, which can reduce sperm production and quality.
• Increased DNA damage in sperm, leading to lower fertility rates and higher miscarriage risk.
• Genetic changes in sperm that can influence the long-term metabolic health of the baby.

Both partners should focus on lowering insulin levels before trying to conceive.

How to Improve Insulin Sensitivity Before Pregnancy

If you are planning for a baby, following a Low Insulin Lifestyle is one of the best things you can do for fertility.

Here are some key strategies to get insulin under control:

• Prioritize protein and healthy fats. Lean meats, eggs, nuts, seeds, and healthy oils help stabilize blood sugar and reduce insulin spikes.
• Eat non-starchy vegetables and whole fruits. These provide fiber and nutrients without spiking insulin.
• Avoid high-insulin foods. Starches like bread, pasta, rice, and potatoes, along with most dairy products and added sugars, all raise insulin levels.
• Incorporate movement. Walking, strength training, and yoga improve insulin sensitivity and support hormone balance.
• Monitor insulin levels. Checking fasting insulin to help keep track before and during pregnancy.

The Bottom Line

If you are trying to get pregnant, addressing insulin resistance should be one of your top priorities. Lowering insulin levels before conception can improve ovulation, increase implantation success, and lower the risk of pregnancy complications like gestational diabetes and preeclampsia.

If you are considering pregnancy and have PCOS, adopting a Low Insulin Lifestyle before and during pregnancy can help create the healthiest environment possible for you and your baby. Taking proactive steps now can make all the difference in your fertility journey and set your child up for a healthier future.

 

Congratulations! You are embarking on one of the most exciting and transformative journeys of your life. Pregnancy is a wild ride, and if you have PCOS, it comes with a few extra considerations—especially when it comes to managing insulin levels.

The first trimester is a time of rapid development for your baby. While you might be battling nausea, exhaustion, or food aversions, behind the scenes, your baby is forming everything from their brain to their tiny fingers. And believe it or not, your insulin levels play a big role in this process.

Why Insulin Levels Matter in the First Trimester

The early weeks of pregnancy are crucial for fetal development. Your baby is not just growing; they are also laying the foundation for their long-term metabolic health. Research shows that high maternal insulin levels can impact gene expression in the fetus, setting the stage for potential metabolic issues later in life.

This is called fetal programming, and it explains why maintaining lower insulin levels during pregnancy is so important. By keeping your insulin levels in check, you are not just protecting your own health—you are giving your baby the best possible start in life.

How Insulin Impacts Pregnancy Outcomes

The first trimester is more than just morning sickness and cravings. The way your body regulates insulin in these early weeks can influence how the rest of your pregnancy unfolds.

When insulin levels are too high in the first trimester, they can increase the risk of:

• Gestational diabetes (which can lead to larger babies and delivery complications)
• Preeclampsia (a dangerous rise in blood pressure)
• Preterm birth (leading to potential health concerns for your baby)

The good news? You have control over this. Making the right choices early on can reduce these risks and help you feel better throughout your pregnancy.

Managing PCOS and Pregnancy Hormones

Pregnancy itself naturally increases insulin resistance, and if you have PCOS, you are already more prone to it. This means staying on top of your insulin levels is more important than ever.

At the same time, your hormones are all over the place. Progesterone is rising to support the pregnancy, estrogen is increasing, and your body is adjusting to a completely new reality. This can lead to:

• Extreme fatigue
• Food aversions
• Nausea
• Cravings for carbs and sugar

It is totally normal to feel like you are barely keeping it together some days. But small, strategic choices can help keep insulin stable, even when pregnancy symptoms make things feel unpredictable.

You Are Not Eating for Two

One of the biggest myths about pregnancy is that you need to “eat for two.” In reality, your body only needs a slight increase in calories, and overeating—especially on insulin-spiking foods—can do more harm than good.

By the first trimester, your baby is still tiny, and their calorie needs are minimal. Your nutritional needs increase, but that does not mean doubling portion sizes or indulging every craving without mindfulness. What matters most is quality over quantity. Instead of focusing on eating more, focus on eating the right foods that keep insulin stable and support healthy fetal development. Take your prenatal vitamin!

Tips for Keeping Insulin in Check During the First Trimester

1. Eat to Manage Insulin, Not Calories
   This is not the time for restrictive eating. Instead, focus on foods that keep insulin low and provide steady energy:
   • Lean proteins like eggs, poultry, and fish
   • Non-starchy vegetables like zucchini, peppers, and leafy greens
   • Healthy fats like avocado, nuts, and olive oil
   • Whole fruits (because yes, fruit is fine!)

If you are struggling with nausea, just do the best you can and keep insulin in mind. It’s not about being perfect.

2. Listen to Your Body, But Stay Mindful of Cravings
   Pregnancy cravings are very real, and they often lean toward high-carb, starchy foods. If you are craving carbs or sugary foods, try some of the desserts in the Recipe section.

3. Rest When You Need To
   Your body is working overtime right now, and stress increases insulin levels. If you need extra naps or downtime, take it. Prioritizing rest helps keep cortisol and insulin in balance, which is important for both you and your baby.

4. Keep Moving in a Way That Feels Good
   Exercise can help improve insulin sensitivity, but this is not the time to overdo it. Gentle movement like walking, stretching, or prenatal yoga can help keep insulin stable without adding unnecessary stress to your body.

5. Advocate for Insulin Testing
   Most doctors focus on glucose levels, but insulin resistance starts long before glucose levels are affected. If you have PCOS, asking for an insulin test early in pregnancy can give you a better picture of your metabolic health. You can also test your insulin levels using a Lilli Metabolic Testing Kit.

You Are Already Doing So Much Right

If you are reading this, you care about your health and your baby’s health—and that means you are already doing an amazing job. No pregnancy is perfect, and some days will be harder than others. Do what you can, give yourself grace, and remember that every small step toward keeping insulin levels in check makes a difference.

By sticking to a Low Insulin Lifestyle, prioritizing nutrient-dense foods, and listening to your body, you are giving your baby the best possible start. This is your journey, your pregnancy, and your body—and you are already an incredible mother.