Why Blood Sugar Balance Actually Matters in Nutrition for PCOS
Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions among women of reproductive age. While it shows up differently from person to person—irregular cycles, acne, excess hair growth, or challenges with weight, one of the most consistent features of PCOS is insulin resistance. That’s why blood sugar balancing plays such an important role in managing symptoms and supporting long-term health.
As a PCOS dietitian, I often see how small, strategic changes in food choices and eating patterns can make a meaningful difference in restoring hormone balance. As someone that likes to understand the whole picture, it felt important to share WHY insulin resistance is a problem. So let’s dive into the connection between blood sugar and PCOS.
Why Blood Sugar Matters in PCOS
Blood sugar levels naturally rise after eating, and insulin is the hormone that helps move glucose from the blood into the cells for energy. In PCOS, the body’s cells often don’t respond to insulin as effectively, a state called insulin resistance. The pancreas compensates by making more insulin.
High insulin levels, in turn, can:
Stimulate the ovaries to produce more androgens (like testosterone) and allow more free (active) testosterone to float around. Unfortunately, high androgens then feed into even worse insulin resistance (a truly vicious cycle).
Disrupt ovulation and menstrual cycles by increasing the pituitary production of luteinizing hormone (LH).
Increase cravings and energy crashes.
Contribute to long-term risks such as type 2 diabetes and metabolic syndrome.
This is why nutrition for PCOS often focuses on stabilizing blood sugar. Not as a restrictive approach, but as a way to support more regular and predictable cycles and improved energy.
Signs Your Blood Sugar May Be Out of Balance
Everyone has occasional dips in energy, but consistent patterns may point to blood sugar swings. Common signs include:
Intense cravings, especially for sweets or refined carbs.
Feeling “hangry” if meals are skipped.
Afternoon energy crashes.
Difficulty feeling full, even after eating.
Recognizing these signs can help you identify where nutrition changes might bring more stability.
Practical Nutrition Strategies for PCOS
The goal isn’t a perfect diet but building consistency with balanced meals. Below are some evidence-based strategies that I use when guiding clients as a PCOS dietitian. I am well aware that you have likely heard/read some of these tips before, as they are foundational to PCOS. However, most people still aren’t following them in a way they should be.
Prioritize protein
Including protein at each meal helps slow the rise in blood sugar and keeps you fuller longer. If you’re struggling with this, start by getting enough protein at breakfast. I promise it will make you feel so much better.Prioritize getting 25 grams of fiber daily
One lesser-known piece of insulin resistance is poor gut health. Poor gut health can worsen insulin resistance, and insulin resistance can worsen gut health. A simple approach to supporting good gut health is ensuring that you are eating at least 25 grams of fiber per day, which, let me tell you, is NOT easy if you aren’t putting intention into it!Stop skipping meals… seriously
Long gaps between meals can lead to low blood sugar, followed by overeating or choosing quick, less-balanced options. Eating at regular intervals helps maintain stability. Even if you think it’s not impacting you negatively… it is.Include healthy fats
Foods like avocado, olive oil, nuts, and seeds not only help with satiety but also slow digestion, further supporting blood sugar balance.Quality carbohydrates
Carbs are not the enemy here. So often I see people trying to cut out carbs, so they eat less of the good stuff like sweet potatoes, beans, and fruit. However, we all have our moments, and so then they end up giving in to chips, pasta, and desserts. So now their only carbohydrates are coming from highly processed options that are digested quickly and can spike up our blood sugar… which is less than ideal.
Beyond Food: Lifestyle Supports
Blood sugar balance isn’t just about what’s on your plate, so you could definitely be missing out on a greater impact by ignoring other lifestyle factors. Movement, stress management, sleep, and environmental factors (toxin exposure) all play a role in insulin sensitivity. Activities like walking after meals, practicing relaxation strategies that support your nervous system, and aiming for consistent sleep can complement nutrition changes and further support better insulin levels.
Real-life example
Blood sugar balance is central to understanding and managing PCOS. By focusing on consistent, balanced meals and supportive lifestyle practices, I’ve been able to help women with PCOS, like Jessica, experience improvements in cycle regularity, energy, and overall health.
In January 2025, Jessica came to me with PCOS and a goal of having her 2nd child.
She had cycles lasting 45+ days, and felt tired and bloated most of the time. She felt like she ate healthy, but didn’t understand why her periods were never regular.
She was indeed eating really well when it came to the quality of her diet, but the quantity was off in regards to both calories and macronutrients. With this information she mad some adjustments to her meals. She also integrated some more movement that we felt was best to support her PCOS and metabolism.
After just 5 months of working together, here’s what Jessica has to say… “since working with Lauren in January, my cycles have become regular and every 29 days for the past 3 months! …bloating is minimal, and I feel great. I have confidence in knowing how to fuel my body with food and also comfort in knowing it’s okay to enjoy pizza night with my family”.
Not only that, but I got this update from her about 7 months after we started working together:
If you’re looking for personalized guidance, working with a PCOS dietitian can help you create a plan that aligns with your unique needs and preferences. I’d love to be a part of your journey - schedule a free discovery call today!