The 4 Types of PCOS

There are 4 types of PCOS, and knowing the type of PCOS impacts the treatment or management of the condition. These are insulin resistant PCOS, post-pill PCOS, inflammatory PCOS and adrenal PCOS. We can often determine the type of PCOS based on your symptoms and medical history however sometimes we may need some additional blood tests as well. 

Here’s some more information of each of the types of PCOS:

Insulin Resistant PCOS

This is the most common type of PCOS, with approximately 70% of cases falling into this category. High levels of insulin prevent ovulation and cause the ovaries to create testosterone.  Insulin resistance is caused by:

• Having high levels of body fat (particularly in the abdominal area)
• Consuming a high-energy or high-sugar diet
• Participating in low levels of physical activity
• Taking high doses of steroids
• Chronic stress

It is important to remember you can have insulin resistant PCOS and be a normal weight.

In cases of insulin resistant PCOS, the goal of treatment is to increase insulin sensitivity and support the detoxification pathways to remove excess hormones from the body. Inositol, chromium and NAC are particularly useful supplements to support insulin sensitivity, along with foods such as cinnamon and vinegar.  

Post-Pill PCOS

This type of PCOS is developed due to the birth control pill suppressing ovulation and the HPO axis, connecting the brain, pituitary gland and ovaries, having trouble communicating again. If you experience regular and normal periods before starting the pill, this might be a sign of Post-Pill PCOS. For most women, this is temporary and lasts 3-4 months however if there hasn’t been a period for more than 3 months after ceasing the pill, it’s worth looking into post-pill PCOS. It isn’t a matter of just waiting until your period comes back, there are ways we can encourage the HPO axis to work effectively and bring back your cycle with minimal symptoms.

Supporting the nervous system with adaptogenic herbs and using natural anti-androgen supplements like zinc and DIM alongside foods such as spearmint tea can help address post-pill PCOS.

Inflammatory PCOS

High-levels of inflammation can stimulate the ovaries to make too many androgen hormones, which can interfere with ovulation and lead to irregular periods. Inflammation is caused by stress, intestinal permeability (‘leaky gut’), environmental toxins (including endocrine-disrupting chemicals), and inflammatory foods. However it is important to recognise there could be other causes of inflammation that should be considered in your treatment, including:

• Bowel problems like IBS or SIBO
• Autoimmune disease like Hashimoto’s thyroid disease
• Endometriosis
• Skin conditions like psoriasis, eczema, or hives
• Cardiovascular diseases like high blood pressure 
• Lung diseases like asthma
• Mental illnesses like depression

Using an omega-3 supplement and ensuring your vitamin D is at an optimal level can be beneficial in reducing inflammation and addressing inflammatory PCOS. Taking a holistic approach to reducing inflammation can be beneficial for inflammatory PCOS. 

Adrenal PCOS

This is driven by the body’s response to stress. It’s a genetic and abnormal response causing elevated DHEAs (Dehydroepiandrosterone) but normal levels of testosterone and androstenedione. This tends to be identified when the other types have been ruled out. 

Treatments for adrenal PCOS include magnesium, zinc, and vitamin B5 and adaptogenic herbs to support the nervous system. 

Looking for personalised nutrition advice to manage PCOS? Book a consultation with Court!

If you’re interested in taking any supplements, please discuss this with your practitioner to ensure you’re taking the correct dose and form for you. This article is not intended to be medical advice and is purely for education purposes.