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Relationship between insulin resistance and polycystic ovary syndrome: a literature review

Lucas de Castro Reuter, José Posturivo

South Health and Policy, 2025

Abstract

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, and insulin resistance is a key feature of its pathophysiology. This study aims to review the relationship between insulin resistance and PCOS, as well as to analyze the efficacy of insulin-sensitizing treatments (such as metformin and myo-inositol) compared to conventional hormonal therapies. Material and methods: A systematic review of clinical studies, meta-analyses, and reviews published in scientific databases such as PubMed and Scopus was conducted, focusing on the relationship between insulin resistance and PCOS, and the effects of insulin-sensitizing treatments. Only relevant, high-quality literature from recent years was included. Results: Insulin-sensitizing treatments, especially metformin and myo-inositol, have been shown to be effective in improving insulin resistance and reducing metabolic symptoms of PCOS. However, oral contraceptives, while useful for hormonal symptoms, do not have a significant impact on insulin resistance. Conclusion: Insulin-sensitizing agents remain the most effective treatment for insulin resistance in women with PCOS. Myo-inositol offers an alternative with fewer side effects compared to metformin, but more research is needed to define optimal combinations and dosages.

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