Types of PCOS
Erica Armstrong
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Aug 22, 2022
Polycystic ovary syndrome (PCOS) is the most common metabolic and hormonal disorder in women of reproductive age. Depending on the criteria for diagnosis, PCOS may affect up to 20 percent of all women, although an estimated 70 percent of women with this condition may be undiagnosed (1).
In this article, we’ll explain the four types of PCOS: insulin resistance, adrenal, post-pill, and inflammatory.
Insulin Resistance PCOS
Insulin resistance is the most common type of PCOS. In fact, up to 70 percent of women with PCOS may have some degree of insulin resistance (2). Insulin is a hormone responsible for controlling your blood sugar levels, among other things. By moving glucose (broken-down carbohydrates) into your cells, insulin lowers your blood sugar levels back to normal after a meal. Insulin resistance occurs when your cells do not respond properly to insulin.
Signs and Symptoms
- Frequent sugar cravings
- Fatigue after meals
- Weight gain or difficulty losing weight
- Constant hunger
- Acne
- Unwanted hair loss and/or growth
- Fasting insulin level > 7
Treatment
Insulin resistance leads to high insulin levels in the bloodstream and causes the ovaries to produce and release more testosterone. High testosterone levels cause PCOS symptoms like acne, facial hair, and hair loss. Excess testosterone also disrupts and/or prevents ovulation which may lead to irregular menstrual cycles, infertility, and polycystic ovaries.
The goal of treatment in this type of PCOS is to normalize blood sugar and insulin levels. This will also help lower your testosterone levels. We may treat this type of PCOS by eating for blood sugar balance using our Root Plate™ method, optimizing sleep and stress management, and using targeted supplements like Ovasitol.
Our PCOS bundle is especially helpful for insulin resistant PCOS.
Adrenal
Adrenal PCOS is due to a prolonged and abnormal stress response causing in increase in cortisol (a stress hormone) and DHEA (a sex hormone). DHEA is an androgen, like testosterone, but is only produced by the adrenal glands. An increase in cortisol levels, as seen during stressful events, also inadvertently increases DHEA-S levels. Between 20 to 30 percent of patients with PCOS have high DHEA-S levels (3).
Signs and Symptoms
- Chronic stress
- Insomnia
- Anxiety
- Acne
- Unwanted hair loss and/or growth
- High or abnormal cortisol levels
- High DHEA levels
Treatment
Cortisol and DHEA-S disrupt the balance of other hormones in your body that lead to PCOS symptoms like irregular periods, acne, and unwanted hair growth or hair loss.
The main goal in treating adrenal PCOS is to promote normal levels of cortisol and DHEA-S. Helpful interventions include prioritizing healthy sleep and stress management, eating an anti-inflammatory diet, and considering supplements that may reduce DHEA-S. We created our Adrenal PCOS supplement bundle with Ovasitol, magnesium, and resveratrol to provide calming and nourishing nutrients to address this type of PCOS.
Read more about adrenal PCOS.
Post-Pill
Post-pill PCOS usually shows up about one to two months after stopping the birth control pill. Most women with this type of PCOS had normal periods before going on the pill. Since the pill suppresses androgen levels, stopping this medication may result in “androgen rebound” and cause typical high androgen symptoms like acne, hair loss, and/or hair growth on face/chest.
Signs and Symptoms
- Symptoms show up a month or two after stopping the pill
- Acne
- Unwanted hair loss and/or growth
Treatment
While post-pill PCOS is usually temporary, a number of factors can influence how long these symptoms last after stopping the pill. Eating an anti-inflammatory diet, optimizing gut health, and replacing nutrients commonly depleted from the pill (like the B-complex vitamins) is crucial in this type of PCOS.
Inflammatory PCOS
Chronic inflammation occurs when your body’s response to injury lingers for a longer period of time. A variety of factors can cause chronic inflammation like diet/lifestyle, poor gut health, and environmental toxins. However, insulin resistance, high cortisol levels, and the birth control pill all drive inflammation as well. So in this case, an individual may have overlapping types of PCOS.
Signs and Symptoms
- Digestive issues
- Autoimmune conditions, like Hashimoto’s thyroid
- Joint pain
- Weight gain or difficulty losing weight
- Acne
- Unwanted hair loss and/or growth
- HS-CRP lab test > 2.0
Note: one of the most important blood tests for measuring inflammation is called high-sensitivity C-reactive protein (HS-CRP). An HS-CRP higher than 2.0 tells us inflammation is present in the body.
Treatment
The goal in treating inflammatory PCOS is to identify and address the underlying cause of inflammation. Inflammation may be caused by insulin resistance, poor gut health, or chronic stress and adrenal dysfunction. You can lower inflammation by eating an anti-inflammatory diet, optimizing gut health, and using appropriate supplements like omega-3 and n-acetyl cysteine (NAC).
There is likely some component of inflammation related to all types of PCOS. Our PCOS bundle is helpful for lowering inflammation.
Key Takeaways: Types of PCOS
PCOS is a complex condition with a variety of root causes. The four types of PCOS include insulin resistance, adrenal, post-pill, and inflammatory PCOS.
If you feel overwhelmed in managing PCOS on your own, we’re here to help. Our doctors and dietitians can help you identify the root cause of your PCOS when you join our membership.
Easy PCOS Lab Ordering
Our PCOS panel is designed to uncover the root causes of common PCOS symptoms like weight loss resistance, acne, skin and hair changes, low energy, and irregular periods. Join Root Access to get started.
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