The single most useful blood test for insulin resistance in PCOS. Enter your fasting glucose and fasting insulin and we will return your score with PCOS-specific interpretation bands and next steps.
Based on the 2023 International PCOS GuidelineLow-glycemic-load meals lower HOMA-IR in PCOS trials by roughly 20 to 30 percent over 12 weeks (Genazzani 2008, Asemi 2014). Get a plan calibrated to your phenotype.
Take the 60-second quizHOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a simple score derived from a single fasting blood draw. It captures how hard your pancreas is working to keep glucose normal. In PCOS, insulin resistance drives the ovarian theca cells to overproduce androgens (testosterone, DHEAS), which then drives most of the visible symptoms: irregular cycles, weight gain, hirsutism, acne, hair loss. HOMA-IR is the single most useful blood marker for that mechanism, more useful than fasting glucose alone because glucose can stay normal in PCOS while insulin runs high for years.
The 2023 International Evidence-based Guideline for the Assessment and Management of PCOS lists HOMA-IR as the recommended assessment for insulin resistance in women with PCOS, alongside fasting insulin and the 2-hour oral glucose tolerance test.
US units: HOMA-IR = (fasting glucose mg/dL × fasting insulin µIU/mL) / 405
SI units: HOMA-IR = (fasting glucose mmol/L × fasting insulin mIU/L) / 22.5
Both forms produce the same number. The divisors account for the different glucose unit (mg/dL vs mmol/L). Note that µIU/mL and mIU/L are mathematically identical (just different naming).
The general-population HOMA-IR bands used in metabolic research:
| HOMA-IR | Band | What it means for PCOS |
|---|---|---|
| < 1.0 | Optimal | Excellent insulin sensitivity. Insulin resistance is not driving symptoms. |
| 1.0 - 2.0 | Normal | Typical for most healthy adults. Some PCOS phenotypes still sit here. |
| 2.0 - 2.5 | Borderline | Threshold flagged in PCOS literature; watch the trend over 3-6 months. |
| 2.5 - 3.5 | Insulin resistance likely | Most clinical PCOS trials enroll women in this range. Diet, exercise, and inositol or metformin all move the needle. |
| > 3.5 | Insulin resistance very likely | Strong indication for active intervention. Combination therapy often needed. |
Population differences matter. Asian populations frequently use a lower cutoff (around 2.0), while many Western labs flag at 2.5 or 3.0. The exact threshold also depends on your insulin assay; same blood sample on a different machine can vary by 10-15 percent. Trend over time is more useful than a single absolute value.
Things with the strongest evidence for lowering HOMA-IR in PCOS populations:
Ask your GP, endocrinologist, or gynecologist for "fasting glucose plus fasting insulin." The two tests cost about $20-40 total with insurance in the US, more if cash-pay. Both must come from the same blood draw, after a true 8-12 hour fast (water only, no coffee, no chewing gum). Many labs also offer HOMA-IR as a computed value on the same panel; if not, plug your two numbers into this calculator.