Endometriosis and Insulin Resistance: What Research Shows
Endometriosis is usually talked about as a condition that causes painful periods. But there may be more going on inside the body than pain alone.
Some research has started looking at the possible link between endometriosis and insulin resistance, a condition where the body does not respond to insulin as well as it should.
The connection is still being studied, and it is not as simple as saying one causes the other. So, what does the research actually tell us?
Here’s a clear look at the evidence, what researchers have found so far, and what still needs to be understood.
What Is Insulin Resistance?
Insulin is a hormone that helps move glucose, or blood sugar, from your blood into your cells, where it can be used for energy. Insulin resistance happens when the body's cells do not respond to insulin as well as they should.
At first, the body may make more insulin to keep blood sugar in a normal range. This means insulin resistance can develop before blood sugar becomes high enough to be called prediabetes. Over time, it can increase the risk of prediabetes and type 2 diabetes.
Insulin resistance symptoms are also not always obvious. Many people have no clear symptoms, which is why blood tests may be needed when there are concerns about blood sugar or diabetes risk.
What Does Endometriosis Have to Do With Insulin Resistance?
This is where things get interesting.
Researchers have started looking at whether endometriosis and changes in insulin sensitivity may be connected. A 2024 population-based study using US health data found that women with a higher triglyceride-glucose (TyG) index, a marker used to estimate insulin resistance, had a higher likelihood of endometriosis.
But there is an important point to remember: an association is not the same as a cause.
An association means two things appear to occur together. A cause means one directly leads to the other. The study found a link between the TyG index and endometriosis, but it could not prove that insulin resistance causes endometriosis.
Other studies have also reported similar associations, which is why the topic is getting more attention. At the same time, researchers say more work is needed to understand what is actually behind the relationship.
Why Could Endometriosis and Insulin Resistance Be Linked?
There is no single answer yet. Researchers are looking at several possible explanations.
Chronic Inflammation
Endometriosis involves ongoing inflammation in the body. Inflammation can also affect how the body responds to insulin.
This has led researchers to ask whether inflammatory changes could be one of the links between endometriosis and insulin resistance. Recent research continues to explore the relationship between inflammation and metabolic changes in endometriosis.
Hormonal Changes
Hormones may also play a part.
Endometriosis is closely linked to reproductive hormones, particularly oestrogen. Hormones can also influence how the body handles energy and responds to insulin.
However, the relationship between hormones, endometriosis and insulin resistance is not fully understood. More research is needed before a clear connection can be made.
Changes in Body Composition
Body composition may be another piece of the puzzle. Body fat, inflammation and metabolic health can influence each other, so researchers are looking at whether these factors help explain the link between endometriosis and insulin resistance.
This does not mean that being overweight causes endometriosis or that someone needs to have excess weight to develop insulin resistance. Both conditions can affect people with different body types.
Changes in Glucose and Energy Metabolism
There is another interesting area of research: the way endometriotic tissue itself uses glucose and produces energy.
Studies suggest that endometriotic tissue may have changes in its metabolism that help it survive and grow. But this is different from saying that the whole body has insulin resistance. Changes within endometriotic tissue should not automatically be treated as evidence of systemic insulin resistance.
Does Endometriosis Cause Insulin Resistance?
Current research does not establish that endometriosis directly causes insulin resistance.
Some studies have found a possible association, while other research has not shown clear evidence of systemic insulin resistance in people with endometriosis. Differences in study design, age, body composition, and other health factors can also affect the results.
So, for now, it is more accurate to say that there may be a connection worth studying, rather than saying that one condition causes the other.
Long-term studies involving larger groups of people will help researchers understand this relationship better.
What Does Current Research Actually Tell Us?
The research so far gives us some useful clues, but not a final answer.
Inflammation, hormonal changes, and body composition may all play a role in the relationship between endometriosis and insulin resistance. Studies using markers such as the TyG index have found associations between metabolic health and endometriosis.
At the same time, metabolic changes inside endometriotic tissue are not the same as whole-body insulin resistance.
In simple terms, the link is possible, but the science is still developing.
Endometriosis, PCOS and Insulin Resistance: Are They Connected?
Endometriosis and PCOS are two different conditions, but a person can have both. They can also affect reproductive health in different ways.
Insulin resistance is a recognised part of PCOS, and metabolic health is an important part of PCOS care.
Can Insulin Resistance Affect Fertility?
Insulin resistance can matter for reproductive health, particularly in PCOS, where it is linked with changes that can affect ovulation and fertility.
But that does not mean insulin resistance is the reason someone with endometriosis has difficulty getting pregnant.
Endometriosis itself can affect fertility through several different pathways. If you are trying to conceive and have endometriosis, PCOS or concerns about blood sugar, it is worth discussing your individual situation with a healthcare professional.
For someone with PCOS, supporting regular cycles and reproductive health may also be part of fertility planning. This is another area where a product such as NatXtra PCOS may fit into a broader health routine, alongside professional care.
What Can You Do If You Have Endometriosis and Are Concerned About Insulin Resistance?
Having endometriosis does not mean you automatically have insulin resistance. But if you have concerns about blood sugar or other risk factors, speak with your doctor.
They may suggest appropriate blood tests, such as an A1C or fasting blood glucose test, depending on your health history.
Simple habits can also support metabolic health. Regular meals, balanced food choices, physical activity, enough sleep, and healthy weight management can all help reduce the risk of insulin resistance and prediabetes.
Endometriosis and Insulin Resistance Are Still Being Studied
The possible connection between endometriosis and insulin resistance is an interesting area of research, but there is still a lot to learn.
Endometriosis does not automatically mean you have insulin resistance. Current evidence points to possible links involving inflammation, hormones, body composition and metabolism, but researchers are still working out how these factors fit together.
If you also manage PCOS, paying attention to metabolic and reproductive health can be especially important. NatXtra PCOS can be considered as part of a wider approach to supporting hormone balance, regular periods and reproductive health, alongside advice from your healthcare professional.