Evidence-Based Rotterdam 2023 South Asian Calibrated 3 to 5 Min Free

Do You Have PCOS-Driven Insulin Resistance? India’s first physician-designed PCOS and metabolic risk assessment

Most Indian women with PCOS also have insulin resistance. Most do not know it. This assessment gives you three independent scores, an honest clinical picture, and a path forward.

Designed by a US-trained physician with 10+ years of GLP-1 and metabolic health experience across the American and Indian healthcare systems.

Start Free Assessment See How It Works

Rotterdam 2023 criteria

IADVL registered physicians

Your data stays private

7 clinics Kerala and Tamil Nadu

Who is this quiz for?

Women aged 18 to 50 who suspect PCOS-related insulin resistance based on symptoms: irregular periods, dark neck patches (acanthosis nigricans), hormonal acne, excess facial hair, or belly-dominant weight gain despite normal BMI by Western standards.

What does insulin resistance mean in PCOS?

Insulin resistance, defined by HOMA-IR at or above 2.0 on the South Asian threshold, affects 65 to 80 percent of PCOS patients and drives most visible symptoms: acanthosis nigricans, hormonal acne, hirsutism, and central weight gain. GLP-1 therapy addresses insulin resistance directly.

HOMA-IR Insulin Resistance Thresholds for Indian Women

South Asian calibrated HOMA-IR interpretation
HOMA-IR Value	Interpretation	Clinical Recommendation
Below 1.0	Optimal insulin sensitivity	Lifestyle maintenance
1.0 to 1.9	Normal range	Annual monitoring
2.0 to 2.9	Elevated (South Asian threshold)	Physician evaluation recommended
3.0 and above	Significant insulin resistance	Medical treatment discussion

Source: PMC9915858. South Indian population HOMA-IR study, Madurai, Tamil Nadu.

INTERACTIVE ASSESSMENT

Start your free assessment below

3 clinical scores. Takes about 3 to 5 minutes. Your answers stay on your device.

PCOS and GLP-1 clinical assessment.

Built on Rotterdam 2023 criteria and Indian metabolic thresholds. Reviewed by Dr. Rejeesh M. Menon, MD Internal Medicine. Takes about 5 minutes. Your answers stay on this device until you choose to share them.

Before we begin. Are you 18 years of age or older?

We built this tool to help you understand where you stand before you walk into the clinic. It is a starting point, not a diagnosis.

The Method

How This Assessment Works

Menstrual and skin pattern. Tell us about your cycle and the skin signals clinicians use to diagnose PCOS. Six questions covering periods, acne, hair, and skin changes.
Metabolic picture. Height, weight, waist circumference, and any blood sugar history you know. We use Indian thresholds, not Western ones.
Lifestyle and insulin resistance signs. Energy crashes, cravings, sleep, family diabetes. These symptoms often show up before lab tests catch insulin resistance.
History and safety. What you have already tried, and a short clinical safety screen. This protects you from inappropriate recommendations.
Goals and location. What you are hoping to improve, and where you are based.

Result. Three scores shown immediately on screen. A treatment ladder that respects clinical escalation. Recommendations tailored to your exact answers. The full report delivered to WhatsApp only if you ask for it.

Patient Profiles

Who This Assessment Is For

Profile 1. The thin-fat PCOS Indian.

You are not overweight by the number on the scale, but your waist is larger than it should be. Your periods are irregular. You have hair where you do not want it. Everyone tells you to eat less and exercise more. Nobody has told you that insulin resistance is likely driving all of it.

Profile 2. The PCOS patient who has gained weight despite effort.

You know you have PCOS. You have tried gym memberships, diet plans, maybe metformin. Nothing has moved the needle. This assessment helps you see whether GLP-1 therapy is the logical next step, and whether your profile fits the clinical criteria for it.

Profile 3. The skin-first PCOS presentation.

Dermatology is how you found out something was wrong. Persistent adult acne, hair loss you never expected, dark patches on your neck. The underlying hormonal and metabolic story is almost always the same. This assessment connects the dots.

DermaVue Positioning

What Makes This Different

Dermatology expertise plus GLP-1 authority in one clinic. No gynecologist can do laser hair removal or chemical peels for acanthosis nigricans. No endocrinologist can do PRP for PCOS hair thinning. We can.
The treatment ladder, shown to everyone. Before we recommend GLP-1, we always show the full four-step ladder: lifestyle, metformin, hormonal therapy, GLP-1. This is clinically correct per the 2023 international PCOS guidelines, and it means we never push the most expensive option first.
Built for Indian physiology. BMI 23 is already metabolic risk in a South Asian woman. Waist circumference matters more than BMI. HbA1c cutoffs should be stricter in our population. This assessment reflects that research.

Read our full guide to PCOS and GLP-1 in India →

Your Questions Answered

PCOS and Insulin Resistance: 8 Questions Patients Ask Me

Answered directly. Updated April 7, 2026.

1. What is PCOS insulin resistance and why does it matter?

PCOS and insulin resistance are two sides of the same coin in most Indian women. Insulin resistance means your cells stop responding properly to insulin, so your pancreas pumps out more of it. High circulating insulin tells the ovaries to make more testosterone, which drives irregular periods, acne, facial hair, and scalp hair loss. It also tells your body to store fat around the abdomen. The 2023 international PCOS guidelines confirm that around 70 percent of women with PCOS have measurable insulin resistance. In South Asian women the number is higher. Treating the hormonal picture without treating the metabolic picture is why most PCOS plans fail.

2. Can GLP-1 medications like Ozempic or Mounjaro help with PCOS?

Yes, and the evidence is now strong enough that I use them regularly. Semaglutide and tirzepatide both improve insulin sensitivity, reduce androgen levels, and restore ovulation in a meaningful share of PCOS patients. The STEP and SURMOUNT trials showed average weight loss of 15 to 21 percent, and smaller PCOS-specific studies have shown menstrual regularity returning in 6 to 9 months. Indian patients search for these as Osenpick, Ozentic, Wigobi, or Wagobi. The molecule is the same. GLP-1 is not first line. It sits at step four of the PCOS treatment ladder, after lifestyle, metformin, and hormonal therapy. This assessment tells you where you sit on that ladder.

3. What do dark patches on my neck mean if I have PCOS?

That is acanthosis nigricans and it is one of the most reliable clinical markers of insulin resistance we have. Velvety dark patches on the back of the neck, the armpits, or the knuckles almost always mean circulating insulin has been elevated for months or years. Patients come to me thinking it is dirt or a pigmentation problem. It is neither. It is skin tissue responding to insulin. The good news is that when insulin resistance improves with weight loss, metformin, or GLP-1 therapy, acanthosis fades in 4 to 8 months. Chemical peels and laser treatments can speed up the cosmetic clearance once the underlying metabolism is corrected.

4. Why should I see a dermatologist for PCOS and not just a gynecologist?

Because most of the visible suffering of PCOS is dermatological. Persistent adult acne, facial hair, scalp hair thinning, acanthosis nigricans, and stretch marks. A gynecologist manages your cycle and fertility. A dermatologist manages the skin and hair story that usually brought you to the mirror in the first place. At DermaVue we do both at the same table. We can do PRP or GFC for hair regrowth, laser hair reduction for hirsutism, chemical peels for acne scars, and prescribe metformin or a GLP-1 for the metabolic root cause. That integrated model is rare in India, and it is why women search for Wigobi or Osenpick alongside acne treatment in the same visit.

5. What blood tests should I get if I suspect PCOS with insulin resistance?

At a minimum I ask for fasting insulin and fasting glucose so I can calculate HOMA-IR, an HbA1c, a lipid panel, total and free testosterone, DHEAS, LH, FSH, prolactin, TSH, and 25-hydroxy vitamin D. A pelvic ultrasound looks for polycystic ovarian morphology but is not required for diagnosis under Rotterdam 2023 if the clinical and biochemical picture is clear. I also ask for a liver ultrasound in anyone with central obesity because fatty liver is common and changes the treatment plan. This assessment does not replace labs. It tells you whether labs are the next sensible step.

6. What is a normal HOMA-IR level for Indian women?

Western labs often report HOMA-IR below 2.5 as normal. That number is wrong for South Asian physiology. In Indian women I treat anything at or above 2.0 as insulin resistance that needs attention, and anything at or above 2.5 as a clear signal to act. The MASALA study and subsequent Indian cohorts have shown that South Asians develop insulin resistance and type 2 diabetes at lower BMIs and lower HOMA-IR thresholds than Europeans. If your report says 2.3 and your doctor said you are fine, a second opinion is reasonable. The assessment uses Indian thresholds throughout.

7. I have PCOS but my BMI is under 25. Can I still qualify for GLP-1 therapy?

Sometimes, yes. This is the thin-fat Indian PCOS presentation and it is under-recognised. A BMI of 22 with a waist of 86 cm, irregular periods, facial hair, and a HOMA-IR of 2.8 is a metabolically obese woman who does not look overweight. For patients like this I consider GLP-1 therapy when lifestyle and metformin have been tried honestly and the hormonal picture has not improved. Waist circumference and HOMA-IR matter more than BMI in this group. The assessment asks about waist specifically so it does not miss you the way BMI-only screens do.

8. How is this assessment different from the PCOS quizzes I find online?

Most online PCOS quizzes are symptom checklists written by content teams. They give you a yes or no answer and push you to buy a supplement. This assessment was built by a US-trained physician with more than 10 years of clinical experience in metabolic disease. It uses Rotterdam 2023 criteria, South Asian HOMA-IR thresholds, and Indian BMI and waist cutoffs. It gives you three independent scores covering the hormonal picture, the metabolic picture, and insulin resistance signs. It never sells you a product on the results page. The output is educational. The path forward is a physician consultation if you want one.

Reviewed by

A Physician With 10+ Years in Metabolic Disease Management

This assessment and its underlying scoring rules are reviewed and signed off by a DermaVue Clinics physician with more than a decade of clinical experience managing PCOS, obesity, type 2 diabetes, and metabolic disease across both the American and Indian healthcare systems. Credentials include ABIM board certification in Internal Medicine, a Clinical Assistant Professor appointment at the Washington State University College of Medicine, and peer-reviewed publications in metabolic health. The output of this assessment is educational. A consultation is required before starting any GLP-1 therapy or prescription medication for PCOS.