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The Four Types of PCOS You Need to Know About and How to get Diagnosed

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 1 in 10 women of reproductive age in the US. Despite what many lovely social media experts claim, there is no cure for PCOS, but you can manage the symptoms of PCOS. The best way to do this is actually understanding the type of PCOS you have. There are 4 types of PCOS: insulin-resistant, inflammatory, Adrenal, and pill-induced. Understanding the different types of PCOS and how to get properly diagnosed will help you better understand your unique journey.

This is a pretty long resource. Feel free to jump towards the section you’re most interested in:

How to Get Diagnosed With PCOS

In order to get diagnosed with PCOS, you need to meet two of the three criterias: irregular or missing periods, high androgen (male hormone) levels or symptoms, and/or cysts on your ovaries. For a lot of women, getting diagnosed with PCOS is probably the most frustrating part.

On average, it can take two years and three doctors to get diagnosed with PCOS. While this is slowly improving with more PCOS awareness, there still requires a ton of work towards improving women’s diagnosis and care in healthcare.

A general rule of thumb when trying to get a proper diagnosis for PCOS is to ask your doctor for a full hormone panel, a pelvic ultrasound to check for any existing cysts on your ovaries, and getting your blood sugars checked.

As we go through the different types of PCOS, we’ll also discuss what tests to ask your doctor for to help you better rule out which type of cyster you are.

Insulin Resistance PCOS

Insulin resistance is the most common type of PCOS! It actually occurs in about 70% of people with PCOS, including both lean and obese PCOS. So what causes insulin resistance PCOS? This type of PCOS is due to high amounts of insulin (and leptin) in the body which can inhibit ovulation (which is super important for a healthy flow, ladies). Once this happens, the ovaries then begin to produce higher amounts of testosterone than normal.

What Are Some Signs of Insulin Resistance with PCOS?

Women with insulin resistance PCOS will usually show signs of intense cravings, significant weight gain, cystic acne, darkening of the skin, ovarian cysts, moodiness, fatigue, and they’re probably hangry all the time!

How Can I Test For Insulin Resistance?

If you’re thinking you have insulin resistance PCOS, then your health practitioner should perform a glucose/insulin test to check and see if you have elevated insulin levels, and possibly high LH (luteinizing hormone) levels. You should also get your A1C (a blood test for type 2 diabetes and prediabetes) checked.

How Can I Fix Insulin Resistance?

You can’t permanently fix and cure insulin resistance PCOS, but you can make certain lifestyle changes and diet changes to better support and manage your symptoms caused by this type of PCOS. You 100% do not need to go on hormonal birth control to manage your PCOS symptoms. If that’s the only option your doctor is giving you, then nod and find another doc asap (preferably one who specializes in PCOS)!

Some ways you can support insulin resistance PCOS include:

  • Support your body with a diet that includes more quality protein, fiber, fat, and fewer carbohydrates and sugars to balance blood sugars

  • Include supplements such as magnesium and inositol to help symptoms subside

  • Implement gentle forms of exercise into your day that do not put extra stress on the body such as yoga, barre, and jogging!⁠

Pill-Induced PCOS

Have you ever felt like a whole different person when you got on birth control, so you decided to get off birth control, and your period goes MIA for what feels like forever? Pill-induced PCOS is a type of PCOS that happens as a result of coming off of hormonal birth control, which causes a surge in androgens for a short period of time.

The good news is this type of PCOS is temporary and may last up to 6 months (but EVERY woman is different)!

What Are Some Signs of Pill-Induced PCOS?

Women with pill-induced PCOS may experience irregular periods or completely missing periods, heavy bleeding, hair growth, acne, hair loss, weight gain, and headaches.

How Can I Test For Pill-Induced PCOS?

If you think you have pill-induced PCOS, then you have to rule out the possibility of insulin-induced PCOS. Then you must meet the criteria for a PCOS diagnosis.

How Can I Fix Pill-Induced PCOS?

Since pill-induced PCOS is the only type of PCOS that is temporary, the best way to fix it is to be patient and support your body’s needs during this time. Your healthcare provider may try to get you back on the pill during this time, but please consider the pros and cons of being on hormonal birth control before jumping back on it.

Some ways you can support pill-induced PCOS include:

  • Since pill-induced PCOS is temporary we need to stay calm and remember that the symptoms will not be here forever!⁠

  • Supplements such as zinc, peony & licorice, DIM, and vitex may be used to manage your symptoms!⁠

Inflammatory PCOS

Inflammatory PCOS is caused by exactly what it sounds like what would cause it: chronic inflammation. This inflammation can stimulate your ovaries, which causes them to produce an excessive amount of testosterone.

What Are Some Signs of Inflammatory PCOS?

If you’ve ever slept for 8 hours, and then woke up feeling like you need a nap, then you may have this type of PCOS my friend! Women with this type of PCOS may experience bloating, a weight plateau, chronic skin conditions like eczema, hair loss, IBS, SIBO, headaches, joint pain, moodiness, and chronic fatigue.

How Can I Test For Inflammation?

This type of PCOS is often difficult to diagnose (as if being diagnosed with PCOS wasn’t hard enough). You’ll need to be tested for insulin-resistance and pill-induced PCOS prior to being considered this type of PCOS. Your best bet is to discuss your symptoms and concerns with your healthcare provider.

How Can I Fix Inflammatory PCOS?

As you already know you can’t permanently fix and cure inflammation PCOS, but you can make certain lifestyle changes and diet changes to better support and manage your symptoms caused by this type of PCOS. You 100% do not need to go on hormonal birth control to manage your PCOS symptoms. In fact, if you have this type of PCOS, then the pill will just aggravate your symptoms even more. Why? The pill can cause more inflammation and deplete your body of essential vitamins and nutrients.

Some ways you can support inflammatory PCOS include:

  • Your PCOS is best treated by getting to the root cause of the inflammation. This could mean additional testing to find the root cause!⁠ More testing— I know I know!

  • Repairing underlying gut issues by running tests such as the GI MAP can give you an insight into your gut health

  • Supplements such as zinc, omega-3 fatty acids, or N-acetyl cysteine may help to alleviate inflammation symptoms

Adrenal PCOS

Adrenal PCOS is caused by an increase in DHEA ONLY and NOT an increase in androgens compared to inflammatory, pill-induced, and insulin-resistant PCOS.⁠

What Are Some Signs of Adrenal PCOS?

Women with adrenal PCOS may experience chronic fatigue, irritability, weight gain, anxiety, hair loss, and have trouble sleeping or getting a good night’s sleep.

How Can I Test For Adrenal PCOS?

If inflammatory PCOS was difficult to diagnose, then this type of PCOS takes the cake with being the most difficult since only about 10% of PCOS cases are adrenal based. All other PCOS types need to be ruled out first to be diagnosed with this type of PCOS. A lot of times adrenal PCOS is induced by chronic stress, so this goes to all my type A peeps out there: be like Elsa from Frozen and “let it go”!

How Can I Fix Adrenal PCOS?

You can’t permanently fix and cure adrenal PCOS, but you can make certain lifestyle changes and diet changes to better support and manage your symptoms caused by this type of PCOS. Adrenal PCOS will flare if you’re stressed, so definitely take up activities you love to calm yourself and your stress levels.

Some ways you can support Adrenal PCOS include:

  • Implementing a *consistent* (KEYWORD ladies) self-care routine that will help you to destress and decompress such as journaling your thoughts, taking a hot bath before bed, or meditating for 20 minutes

  • Supplements such as magnesium, GABA, L-theanine, adaptogen herbs, and vitamin D may be helpful to alleviate your symptoms

Are you still struggling with where to start on your PCOS journey? I know how you feel cyster because I have been in your shoes! Connect with me on social media to learn more or explore the different programs I offer to help you navigate your PCOS.

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