The 4 ‘Types’ of PCOS: Finding Your Driver

Topic: PCOS education

You have PCOS. But why? Functional medicine categorizes PCOS into 4 types based on what is driving the hormone imbalance. Treatment is different for each.

1. Insulin-Resistant PCOS (Classic)

• Driver: High insulin causes ovaries to make testosterone.
• Signs: Weight gain around the middle, sugar cravings, fatigue, dark patches on skin (Acanthosis Nigricans).
• Prevalence: 70% of cases.
• The Fix: Low carb diet, Inositol, Strength training, Metformin.

2. Post-Pill PCOS

• Driver: Coming off the birth control pill causes a temporary surge in androgens as the ovaries “wake up.”
• Signs: You had normal periods before the pill, but now (after stopping) you have acne and no period.
• The Fix: Patience. Zinc. Peony & Licorice. Usually resolves in 6-12 months.

3. Inflammatory PCOS

• Driver: Chronic inflammation disrupts ovulation receptors.
• Signs: Joint pain, headaches, skin rashes (eczema), severe fatigue, “unexplained” issues. Often not overweight.
• The Fix: Fix the gut. Remove allergens (gluten/dairy). Omega-3s.

4. Adrenal PCOS

• Driver: Stress. High DHEAS (adrenal androgen) but normal Testosterone/Insulin.
• Signs: “Wired but tired.” Anxiety. Insomnia.
• The Fix: Stress reduction. Sleep. Magnesium. Avoid HIIT.

Identifying your type is the first step to stopping the guesswork.