The four types of PCOS

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is best defined as high levels of androgens (male hormones) when all other causes of androgen excess have been ruled out. 

This may lead to unpleasant symptoms such as weight gain, irregular or absent periods, difficulty falling pregnant, oily skin and/or acne, hair loss or thinning hair on the head, and unwanted body hair growth.

Despite the name, you do not actually have cysts if you have PCOS. The ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs. Although it’s a condition that affects our hormones, PCOS has roots in metabolic health, inflammation, and adrenal function.

The four types of PCOS

1. Insulin resistance PCOS

This is the most common type of PCOS and is the result of high levels of insulin in the body, also known as metabolic syndrome or pre-diabetes.


Insulin resistance is what happens when the cells in your muscles, fat and liver stop responding well to insulin, which increases blood sugar levels and forces your pancreas to release even more insulin.

Higher levels of circulating insulin increase the production of androgens in women which interferes with ovulation and leads to symptoms of high androgens, resulting in PCOS symptoms noted above. 

How will I know if this is me?

In addition to signs of androgen excess, insulin-resistant PCOS may also cause fatigue, brain fog, frequent thirst and urination, and weight gain around the middle. Having a test to measure insulin levels is recommended.

2. Post-pill PCOS 

If symptoms of PCOS started a few months after coming off oral contraception, it may be a temporary state related to a surge of androgens that are produced as your ovaries kick back into gear.

Oral contraceptives contain an androgen-suppressing form of progestin. Even though it’s more of a temporary hormonal state, some women are given a PCOS diagnosis during this time.


How will I know if this is me?

You may be dealing with post-pill PCOS if you have ruled out insulin resistance, and started experiencing signs of higher androgens within 6 months of coming off hormonal contraceptives.

Fortunately, post-pill PCOS may heal within a few months to a year when supported with the right nutritional and lifestyle input. 

3. Inflammatory PCOS

This is where chronic inflammation in the body is the primary driver of elevated androgens.

High-level inflammation stemming from an overactive immune system can stimulate the ovaries to make too many androgen hormones, which can interfere with ovulation and lead to irregular periods.


How will I know if this is me?

If you have inflammatory PCOS you will not experience insulin resistance or be in the temporary post-pill phase. However, you may experience other signs related to high levels of inflammation, such as:

  • Persistent fatigue that isn’t remedied with sleep;
  • IBS-type bowel irregularities
  • Headaches
  • Joint pain
  • Skin conditions such as eczema, hives or psoriasis

4. Adrenal PCOS

The final type of PCOS is not driven by insulin resistance, hormonal contraceptive use, or inflammation, but rather the body’s response to stress.

With Adrenal PCOS you will either experience high levels of stress, or your body is reacting abnormally to stress. In either case, you will have high levels of DHEA (an androgen produced in the adrenal glands) and normal levels of other androgens produced in the ovaries (such as testosterone and androstenedione).

How will I know if this is me?

If you have ruled out insulin resistance, and testing shows only your DHEAS is elevated and not your other androgens, then you are most likely dealing with adrenal PCOS.

If you feel you may be affected by PCOS and would like some further guidance, please feel free to get in touch, I am here to support you as this can be an overwhelming journey.  Contact Me