How Diet and Exercise Can Improve Insulin Resistance in PMOS

October 22, 2026

Polyendocrine metabolic ovarian syndrome, or PMOS, affects up to one in eight women of childbearing age. The condition is associated with changes in hormone levels and can affect menstrual cycles, ovulation, skin, hair growth and fertility. It can also cause metabolic issues such as insulin resistance and weight gain.

Formerly called polycystic ovarian syndrome (PCOS) because of the multiple cyst-like structures often seen on the ovaries, PMOS is a complex condition that affects the whole body, not just the ovaries. There is currently no cure, but symptoms can improve substantially with treatment, says University Hospitals OB/GYN and lifestyle medicine physician Steven Galun, MD.

The PMOS-Insulin Connection

Insulin resistance is one of the primary causes of PMOS symptoms. With insulin resistance, the body doesn’t respond normally to insulin, the hormone produced by your pancreas that helps turn blood sugar into energy.

When you eat, your body breaks down carbohydrates into glucose, or blood sugar. Insulin helps glucose move from your bloodstream into your cells, where it can be used for energy. However, sometimes insulin doesn’t work as well, so the body responds by producing more insulin.

Excess insulin in the body can cause the ovaries to produce more androgens, or male hormones. These hormones contribute to common PMOS symptoms such as irregular periods, oily skin, acne, facial or body hair growth, and infertility. Insulin resistance also puts you at risk for developing metabolic diseases such as diabetes, high blood pressure and cardiometabolic disease later in life.

Lifestyle Medicine for Insulin Resistance

Treatment options for PMOS will depend on your goals and the symptoms you want to address. Medications can be prescribed for specific symptoms, such as birth control pills for irregular periods, spironolactone for excess hair growth or metformin for insulin resistance. If the goal is pregnancy, ovulation medications such as letrozole may be prescribed.

Though these medications are helpful, some people prefer to try managing their symptoms with lifestyle changes. Lifestyle medicine – which includes diet and exercise – can have a profound effect on insulin resistance, which can help manage many of the symptoms associated with PMOS, says Dr. Galun.

“Many patients think they just need to lose some weight and everything will be better, but we’re trying to change that narrative,” says Dr. Galun. “Lifestyle medicine is a foundational part of PMOS treatment and there are many things we can do to address and manage symptoms. Weight loss many be a happy side effect but it’s not the be-all, end-all of PMOS.”

Diet

Diet changes for PMOS involve eating more whole foods and cutting back on processed and fried foods, refined grains, sugar, red meat and alcohol. A diet rich in whole foods will help prevent blood sugar spikes so the body won’t have to produce as much insulin.

A diet to improve insulin resistance may include more plant-based options and eating a variety of healthy whole foods such as:

Lean proteins: Chicken, fish, eggs, tofu, Greek yogurt
Fiber-rich carbohydrates: Oats, quinoa, legumes (beans and lentils), fruits and berries
Non-starchy vegetables: Leafy greens (such as kale and spinach), broccoli, peppers
Healthy fats: Nuts, seeds, avocado, olive oil

Exercise

Exercise is another way you can help manage insulin resistance in PMOS. In addition to aerobic exercise, it’s also important to focus on resistance training to make your muscles stronger.

“Think of your muscles as sponges,” says Dr. Galun. “When your muscles are stronger, the blood sugar from the foods you eat goes right to the muscles to be used as energy.”

Dr. Galun says that many people worry that they don’t have time to fit exercise into their busy lifestyles. However, research has found that short bursts of exercise can be just as effective as longer sessions.

“We call them ‘exercise snacks,’” says Dr. Galun. “If you’re crunched for time, try standing up every 45 minutes and doing 15 air squats. This can be just as beneficial as walking briskly for 30 minutes every day.”

Small Changes Can Have a Big Impact

If you’re feeling overwhelmed by the lifestyle changes you need to make, remember that making small, realistic changes can be more impactful than trying to completely overhaul your diet and exercise routines all at once.

If you feel stuck or frustrated, it may be worth consulting with a dietitian to go over your current diet and help you form healthy eating habits. Dr. Galun says a health coach can also help with realistic goal setting and making changes more manageable.

If you want to get started with lifestyle medicine to improve insulin resistance, Dr. Galun offers five changes you can make right now.

Finish meals 2-3 hours before bedtime when possible. An overnight fast can help with insulin resistance. In addition, not eating close to bedtime can decrease cortisol levels and improve sleep.
Take a 10-minute walk after big meals. This will lower the glucose spike from the meal and make you less insulin resistant.
Live by the 80-20 rule. Aim to eat a clean, whole-food diet 80 percent of the time. But don’t feel guilty about indulging in foods you enjoy as long as it’s 20 percent of your diet or less.
Prioritize sleep. Aim for 7-8 hours of sleep every night and set a consistent time for waking up and going to bed, even on the weekends. This will help stabilize circadian rhythms for better sleep.
Resistance train for stronger muscles. Resistance training 2-3 times a week can help build stronger muscles and improve insulin resistance.