Polycystic Ovarian Syndrome (PCOS) is a common hormonal condition affecting around 10% of women. But while this condition is common, it’s often misunderstood and can feel confusing or complicated to understand and manage. We’re here to help you break down the important stuff, in a hopefully simple way!

A ‘Syndrome’ is defined as a group of signs and symptoms that occur together. However, many syndromes can present differently in different people and can have different drivers behind them. To really hone in and support your body's specific needs, it’s really important to find which type of PCOS you actually have. Yep, that’s right, there is more than one! It can sound a bit tricky but it doesn’t have to be. So, let’s break down the four types of PCOS.

What is PCOS?

It is classically known as a condition caused by high androgen levels (the group of hormones that includes testosterone), which can lead to symptoms like:

• Irregular periods,
• Acne typically on the chin, neck or jawline,
• Excessive hair growth on the face, back or stomach,
• Hair loss from the scalp,
• Weight gain,
• Fertility challenges.

However, each of the four types of PCOS is a little different.

The 4 Types of PCOS

Insulin Resistant PCOS

This is the most common type of PCOS, accounting for around 70% of all cases. When your liver, muscles and fat cells stop responding well to insulin, blood sugar levels increase and your pancreas is forced to pump out even more insulin. This is what we call insulin resistance. This increase in insulin levels causes the ovaries to release more and more androgens, which can delay or skip ovulation and result in the set of symptoms listed above. You may be dealing with insulin resistant PCOS if, along with the symptoms above, you struggle with low energy, frequent thirst and urination, a foggy mind, and weight gain around the middle.

Post-Pill PCOS

The good news about post-pill PCOS is that it is temporary. It’s called post-pill because it can set in after coming off hormonal birth control. As your ovaries wake up and start to do their thing again, they can throw a bit of a hormone party and create a ton of androgens, with symptoms peaking around 3-6 months post-pill. You may be dealing with post-pill PCOS if you first noticed symptoms within 6 months of coming off hormonal birth control.

Inflammatory PCOS

This type is driven by, you guessed it, inflammation. Chronic inflammation can stimulate the ovaries to make more androgens, and can also lead to some insulin resistance. Cue the symptoms listed above. You may be dealing with inflammatory PCOS if alongside the symptoms of high androgen levels listed above, you’re also experiencing other symptoms of chronic inflammation, which can include digestive problems, unexplained fatigue, stiff sore joints, headaches and skin conditions such as eczema and psoriasis.

Adrenal PCOS

This is the least common of the four types. Adrenal PCOS is caused by the body’s response to stress. Or, more specifically, the body not responding as it should to stress. Unlike the other types, the levels of only one androgen (DHEA-S) will be raised, and levels of other androgens should be normal. You may be dealing with adrenal PCOS if you have tested for, and ruled out, insulin-resistance, and if hormone testing (like the Eve Test Complete) shows that only your DHEAS is elevated and not your other androgens.

Just remember this

An important thing to remember is that PCOS should not be diagnosed by ultrasound alone! This is because small cysts on the ovaries are extremely common, but having cysts does not necessarily mean that you are dealing with insulin resistance or high androgen levels. It’s worth diving deeper with testing to look at all of the available clues our bodies give us so we can ensure we’re supporting our bodies in the right way.

For anyone experiencing PCOS symptoms or any hormonal concerns, we recommend the blood tests from your GP for a deep dive into your sex hormones including androgens, oestrogen, progesterone and hormone metabolites. The test can give you a clear picture of where your sex hormones levels are sitting, as well as useful lifestyle, nutrition and wellness tips to support your body’s specific needs to live your happiest hormone-balanced life.