Polycystic ovary syndrome is a complex health condition that affects millions of women all over the world. The cause of PCOS isn’t clear – in fact, it’s a bit of a chicken and egg situation. With a lot of PCOS comorbidities, we don’t know if they’re the root cause or a symptom. That uncertainty is at the heart of the topic we’ll discuss today: What are the 4 types of PCOS?
What Is PCOS and What Are Its Symptoms?
PCOS stands for Polycystic Ovarian Syndrome. It’s a health condition that affects women and people assigned female at birth. Its characterized by overproduction of androgens, the male sex hormones, cysts on the ovaries, and irregular menstruation. If two of these three factors are present, your doctor may diagnose you with PCOS.
The most common PCOS symptoms are the following:
- Infertility or trouble conceiving
- Irregular or infrequent periods
- Severe PMS symptoms
- Weight gain or difficulty losing weight
- Hirsutism (facial or body hair growth)
- Male-pattern hair loss
- Acne
If you experience some of these symptoms, consider speaking to your doctor about PCOS.
The 4 Types of PCOS
These are the main types of PCOS. Understanding them can help guide your treatment and achieve better results.
Insulin-Resistant PCOS
Insulin resistance and PCOS often go hand in hand, making this one of the more common types of PCOS. Insulin resistance is when cells in the body don’t respond to the insulin hormone, leading to its overproduction and high blood sugar.
That extra insulin inhibits sex-hormone binding globulin, which causes more free testosterone to cycle through the body, and potentially stimulates more androgen production by the ovaries. Testosterone then increases insulin resistance, and here we have a cycle that’s difficult to break.
It’s unclear whether insulin resistance triggers PCOS or whether PCOS leads to insulin resistance. What is clear is that by reducing the body’s resistance to insulin, we can mitigate some of PCOS’ worst symptoms and outcomes.
Lifestyle changes are critical for treating insulin-resistant PCOS. Without addressing the lifestyle factors that worsen insulin resistance, many women develop type 2 diabetes or heart disease.
Adrenal PCOS
Normally, PCOS is caused when the ovaries overproduce androgens, although in some cases, the adrenal glands might be at fault. This is called adrenal PCOS.
The adrenal glands are responsible for DHEA-S, a type of androgen different from testosterone. When we’re very stressed, our adrenal glands produce more cortisol which stimulates more androgen production. Because of this, you can think of adrenal PCOS as “stress PCOS.”
In addition to normal symptoms, it’s also common to experience fatigue, sleep issues, and even muscle or joint pain.
Often, adrenal hormones are overlooked during PCOS testing. As a naturopathic doctor, I take a more comprehensive approach when diagnosing and treating patients, to make sure I have a better understanding of what underlies their PCOS.
Treatment usually requires reducing stress and limiting activities that elevate cortisol levels.
Inflammatory PCOS
Inflammation is another factor that can stimulate the production of androgens, and it’s very common in PCOS patients. In fact, it’s so common that it’s hard to call inflammatory PCOS its own type. That said, addressing inflammation is almost always useful when treating PCOS.
In PCOS, patients often have chronic, low-grade inflammation even when they’re otherwise healthy. The inflammation usually corresponds with higher levels of androgens as well as a higher risk of insulin resistance.
For patients with low-grade inflammation, I always recommend a healthy, anti-inflammatory diet and supplements.
Post-Pill PCOS
Some women develop PCOS-like symptoms after stopping hormonal birth control. This technically doesn’t count as PCOS but as Post-Birth Control Syndrome, although it can look very similar. The main difference is that it’s temporary.
Basically, after you stop hormonal birth control, your body has to learn how to regulate its hormones in a new way. You may experience some menstrual irregularities as well as some of the PCOS symptoms we described above.
Similar instances of PCOS can also occur in women post-pregnancy, because of a similarly dramatic change in how the body produces hormones.
Symptoms can last for up to 6 months. The same lifestyle changes that help with PCOS will also help with post-pill issues. If the situation is severe, your hormones are not balancing naturally, or you’d like to resolve your symptoms more quickly, a naturopathic doctor can absolutely help you treat your post-pill PCOS.
Accurate PCOS Diagnosis & Treatment
The 4 types of PCOS are useful to know about, but they’re not all there is to it. In fact, as a naturopath, I find that more often than not, PCOS stems from a few factors, like both inflammation and adrenal fatigue or inflammation and insulin resistance.
That’s why I treat each PCOS patient individually, with a focus on understanding exactly what’s going on inside your body. As part of my treatment approach, I always start by ordering a range of diagnostic PCOS tests that provide the full picture of your hormonal balance, nutritional deficiencies, and inflammatory markers.
In traditional medicine, PCOS is often only diagnosed through symptoms, a physical exam, or very basic hormonal testing. This often leads to underdiagnosis or shallow, one-size-fits-all treatment.
As a naturopath, my approach is more holistic. With a deeper understanding, I can work with you to develop a PCOS treatment plan that includes lifestyle changes, tailored nutrition, and supplements that will help to address the precise type of PCOS you’re dealing with.
Through holistic treatment, we can redefine PCOS: Positive Change Over Suffering. Book your first consultation today.