4 types of PCOS and how to treat them:

This is the part 2 of the previous PCOS article, published in honor of PCOS awareness month. Before understanding the type of PCOS you might have, it’s essential to educate yourself on what PCOS is and determine whether you have it. So please check out part 1 of this article, PCOS: why should you get checked for it?

There are basically four types of PCOS. But how to dtermine which tyoe you might have and how to treat it? Read on to find out.

1. Insulin-resistance PCOS:

70% of the PCOS in women is due to insulin resistance. Women with this type of PCOS also have an increased risk of developing Type 2 Diabetes.

What is Insulin-resistance PCOS?

Digested food gets converted to sugar which, in turn, gets converted to energy for the body. Insulin, a hormone released by the pancreas, orders the body to convert this sugar into energy. When the body becomes insulin resistant, it stops obeying the signal from the insulin. So the sugar in the blood fails to convert to energy. As a result, the blood sugar level increases, and there is a drop in energy leading to constant fatigue. To counteract this, the pancreas produces more and more insulin. High insulin levels in the body instruct the ovaries to produce excess male hormones, resulting in PCOS.

How to know if you have Insulin-resistance PCOS?

Some of the symptoms of this type of PCOS are,

  1. Difficulty losing weight
  2. Increased blood sugar levels
  3. Skin tags
  4. High blood pressure
  5. Low energy
  6. Dark patches on the skin, especially around the neck
  7. Cravings for carbohydrates
  8. Frequent urination
  9. A feeling of constant Thirst

How to manage Insulin-resistance PCOS?

  1. Insufficient sleep and stress are significant causes of insulin resistance. So, aim for 8 hours of sleep and stress-relief exercises.
  2. Reduce your carbohydrate intake.
  3. Avoid refined carbohydrates like bread, cereals, pasta, white rice, and artificial sweeteners.
  4. Opt for High-intensity interval training which improves insulin sensitivity.
  5. Include good sources of fat like coconut, avocados, and olive oil.

2. Inflammatory PCOS:

What is inflammation?

Imagine that your body has a military regiment for defense called the immune system. When the immune system detects a threat, it opens fire. And if there are no enemies, your healthy body cells might die in friendly fire. Hence when your immune system starts attacking your healthy cells, inflammation happens. Swelling and joint pain are a few consequences of inflammation.

What causes inflammation?

The reasons are difficult to determine but might include obesity, stress, gut imbalances, unhealthy diet, or excess exercise.

How to know if you have Inflammatory PCOS?

A few symptoms are:

  1. Muscle and joint stiffness
  2. Brain fog
  3. Puffy face
  4. Asthma
  5. Eczema
  6. Irritable bowel syndrome (constipation, bloating, or gas)
  7. Allergies
  8. Headaches
  9. Fatigue
  10. Chronic infection

How to manage Inflammatory PCOS?

  1. Avoid inflammatory foods like processed food, fried items, junk food, refined flours, and check for individual food triggers tailor-made for you. Few such food triggers might be, Dairy, gluten, or sugar.
  2. Avoid over-exercising. Adhere to the rest days. If your workout regimen leaves you tired instead of refreshed, you know you have to reduce the intensity. Start small and build from there. Always remember one step at a time.
  3. Increasing your fiber intake reduces inflammation.
  4. Improve your gut health. Introduce gut-friendly bacteria to your body through diet.

3. Adrenal PCOS:

The adrenal glands located over your kidneys release a hormone called Cortisol whenever you are highly stressed. This hormone helps you decide whether to fight or flee. But whenever Cortisol is released, male sex hormones are also released to protect the brain from too much Cortisol. When the male hormones are released in excess, PCOS is the result. So tackling the root cause, i.e., lowering the Cortisol level by reducing stress, is the only way to manage Adrenal PCOS.

How to know if you have Adrenal PCOS?

  1. Weight gain around the belly
  2. Anxiety
  3. Depression
  4. Constant Fatigue
  5. Tired even after resting well.
  6. Craving for salt and sugar

The body can develop stress even due to unexpected factors like excess exercise, extremely low-calorie intake, insufficient sleep, extreme dieting, or even gut imbalances.

How to manage Adrenal PCOS?

The main culprit, the stress hormone, Cortisol needs to be lowered. For that, first, identify your stressor and eliminate it from your life. It might be an abusive relationship or even an unrewarding job. A few other suggestions are:

  1. Endurance and strength training might burn fat but also increase cortisol levels. So, prefer workouts that you enjoy. Yoga, Tai chi, walking, or swimming might be ideal for you.
  2. Aim for 8 hours of sleep
  3. Set a bedtime routine and stick to it. A regular bedtime will help regularize your Circadian rhythm (the inner body clock)
  4. Don’t do intense exercises close to bedtime.
  5. If fatigue keeps you from exercising, start small and build on it.
  6. Shut down all electronics at least one hour before sleep.

4. Pill-induced PCOS:

Birth-control pills severe the connection between the brain and the ovaries. Hence pregnancy is prevented because the woman never ovulates. After coming off birth control pills, it takes time to re-establish the connection between the brain and the ovaries. So the woman still doesn’t ovulate, i.e., the follicles don’t break to release the egg. These follicles remain as cysts in the ovaries and hence resulting in a Polycystic ovary.

How to know if you have Pill-induced PCOS?

If you didn’t have any symptoms like irregular menstruation, acne, abnormal hair growth, etc., before going on the pill, chances are you have Pill-induced PCOS.

How to manage Pill-induced PCOS?

The good news is that this type is reversible and temporary. So, some ways to reverse it are:

  1. Birth-control pills tend to rid the body of essential vitamins like B vitamins, folic acid, etc. So, with your doctor’s consultation, consider taking supplements.
  2. Also, examine your gut health and include probiotics in your diet.

5. Hidden-cause PCOS:

There is also a less-addressed type called the hidden cause. Research shows that 25% of women with PCOS have a thyroid condition. But a lot of times, these thyroid problems are overlooked in women with PCOS. Hypothyroidism or underactive thyroid also causes increased male hormones and cysts in the ovary. Hence Hypothyroidism is also a hidden cause of PCOS.

Symptoms of PCOS due to Hypothyroidism:

  1. Weight gain
  2. Fatigue
  3. Dry hair and skin
  4. Hair loss or thinning
  5. Cold hands and feet
  6. Slower reaction time

How to manage PCOS due to Hypothyroidism?

A few things you can do by yourself on top of medications from your doctor are:

  1. Increase your protein intake
  2. Limit the intake of Broccoli, Brussels sprouts, kale, cauliflower, cabbage, spinach, and strawberries. They Goitrogens that interfere with thyroid functions.
  3. Avoid inflammatory foods
  4. Consult with your doctor about supplements like Selenium
  5. Increase your Iodine intake
  6. Engage in low-intensity exercises like yoga and walking.

As you can see, pinpointing the type of PCOS you have is half the battle. Once identified, you can go ahead and start managing it. Good luck.


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