INSULIN RESISTANCE IN POLYCYSTIC OVARY SYNDROME: CLINICAL IMPLICATIONS AND IMPACT ON QUALITY OF LIFE — A NARRATIVE REVIEW

Abstract

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine and metabolic condition affecting women of reproductive age. While historically conceptualized as a reproductive disorder, current evidence indicates that PCOS extends beyond ovulatory dysfunction and hyperandrogenism to include significant metabolic, psychological, and quality of life consequences. Insulin resistance represents a core pathophysiological feature of the syndrome, contributing to hyperinsulinemia, exacerbation of androgen excess, menstrual irregularities, and long term metabolic risk. This narrative review synthesizes current literature on the mechanisms and clinical implications of insulin resistance in PCOS, drawing from peer reviewed studies, systematic reviews, meta analyses, and international guidelines. Evidence shows that insulin resistance is prevalent across PCOS phenotypes, including in women without obesity, and is strongly associated with impaired glucose metabolism, dyslipidemia, metabolic syndrome, and increased cardiometabolic vulnerability. Psychological burden is also substantial, with many women reporting depressive and anxiety symptoms, body image concerns, fertility related distress, and reduced overall wellbeing. Interactions between metabolic dysfunction, emotional health, and lifestyle factors further contribute to diminished health related quality of life. Collectively, these findings highlight the need for early metabolic assessment, individualized therapeutic strategies, and interdisciplinary care models addressing both physiological and psychosocial dimensions of PCOS. A comprehensive approach to insulin resistance may improve reproductive, metabolic, and psychological outcomes and support more patient centered long term management.