my gyn checked LH, FSH, testosterone. never once ordered fasting insulin or an OGTT even though lean PCOS + insulin resistance show up together constantly in what I’ve read. so I bought a CGM out of pocket for two weeks just to see. cycle day 3 to 16 (follicular through ovulation) my glucose sat flat, maybe 85-95 most of the day, small predictable bumps after meals.
day 18 on, luteal phase, same exact breakfast started spiking to 145-150 and taking almost 2 hrs to come back down instead of 45 min. nothing else changed, same food, same portion, same walk after. spiro’s already brought my testosterone and LH down, progesterone’s climbing. but this glucose swing is a completely separate axis nobody’s tracking.
if progesterone rising in luteal phase is doing this to insulin sensitivity, that’s not something spiro touches at all, and it might explain why i still crash around 3pm every single day in the back half of my cycle regardless of what my androgen labs say. brought the CGM export to my endocrinologist appt, she actually paused and asked to see the raw data, first time anyone’s engaged with anything beyond the panel numbers. has anyone gotten fasting insulin or HOMA-IR checked specifically split by cycle phase, not just once? i’m wondering if a single fasting draw is basically useless if you catch it on a follicular-phase day.