If you have irregular periods or struggle with fertility, your doctor may have told you that you have PCOS. PCOS is also known as a polycystic ovarian syndrome and describes a collection of symptoms that a woman may experience. It is important to note that PCOS is considered a syndrome, which means that it is made up of a group of symptoms. These symptoms can vary from person to person but often include:
Common Symptoms of PCOS
- Irregular cycles or missed periods
- Infertility
- High androgen hormones
- Excessive or abnormal hair growth on the upper lip, chin, arms, nipples etc.
- Acne
You will see that cystic ovaries were not on the symptom list. This is because, despite the name, having cystic ovaries can be a normal finding in women. Plus, women with PCOS do not always have polycystic ovaries. So, as you can see, the name “polycystic ovarian syndrome” is a bit outdated and misleading!
A less well-known aspect of PCOS is that there are different types. In general, there are four types of PCOS, each with different causes and varying symptoms. If you have been diagnosed with PCOS or exhibit symptoms of PCOS, such are irregular periods or infertility, it is important to determine what types of PCOS you have. Identifying what type of PCOS you have is essential to a proper treatment approach. So, what are the four types of PCOS? We will explain!

Classic (insulin-resistant) PCOS
Classic PCOS is seen in women who are typically diabetic or pre-diabetic and have insulin resistance. In this type of PCOS, women often struggle to lose weight and may have been told by their doctor that they have diabetes.
Insulin is a hormone that is released by the pancreas in response to blood high blood sugar from meals. When insulin is high, the body is under the impression that there is ample sugar to use for energy. Therefore it stops the burning of body fat for fuel. This is why weight loss is difficult when insulin is high.
Insulin resistance occurs when the body is less responsive to insulin, and the body must release more to get the same effect. Insulin resistance occurs for several reasons, including a prolonged high fat and sugar diet, exposure to glyphosate, a disrupted microbiome (<< this is an important and often overlooked cause!), and other reasons.
When insulin is high, it stimulates the production of higher androgen levels (which is testosterone), as well as impairs ovulation. This leads to irregular periods, infertility, high testosterone levels causing acne and hair growth, as well as difficulty losing weight. The treatment approach for Classic PCOS is centered around correcting insulin resistance. The process is different for each woman, but a naturopathic doctor who is experienced in treating PCOS can help you identify and resolve the underlying imbalances.

Adrenal PCOS
In Adrenal PCOS, high levels of stress (both mental-emotional and physical stress) can lead to an upregulation of cortisol and DHEA production to help the mind and body buffer the effects of elevated stress. When the body is under stress, it has two options for its resources: survive or reproduce. In all cases, the body will choose to survive! High levels of cortisol thus interrupt ovulation, and high DHEA converts to testosterone. Together, this creates the symptoms of PCOS, such as acne, missed/irregular periods, and infertility.
Adrenal PCOS can be managed by specific stress reduction techniques such as acupuncture adaptogenic herbs, which decrease excessive cortisol and DHEA production and support ovulation.

Post-Pill PCOS
PCOS can occur after taking oral contraceptives (birth control pills). Birth control pills shut down the ovulation process, which is how it prevents pregnancy. Many types of oral contraception can cause a temporary increase in testosterone production after they are discontinued. Birth control pills also lead to insulin resistance, which furthers the issue of PCOS, high testosterone, and ovulation issues. It is common for women to miss periods, develop acne, and thus have PCOS when stopping birth control pills. For some women, this process corrects itself naturally in a few months, and for other women, they need intervention to resume their periods. There are specific minerals, such as zinc, and other natural therapies that can help reduce testosterone and acne and support ovulation.

Inflammatory PCOS
Inflammatory PCOS occurs when there is a lot of inflammation in the body, which disrupts ovulation and stimulates DHEA and testosterone production. When elevated, these two hormones can lead to acne, abnormal hair growth, and head hair loss. The main concern with this type of PCOS is inflammatory stress. Therefore, the treatment is centered on identifying and addressing the source of the inflammation.
Common inflammation sources include a diet high in processed foods, dairy, animal products, sugar, soda etc. Another cause of inflammation is exposure to pesticides, chemicals, and environmental toxins like glyphosate (Round-Up). Therefore, the key treatment approach in inflammatory PCOS is to adopt an anti-inflammatory diet and include targetted inflammation-reducing herbs and supplements.
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