I find it outstanding how many women DO NOT know their PCOS type. This is mainly because this is not spoken about during diagnosis. The type of PCOS you have and your symptoms should direct an individualised approach for treatment.
I try to stress that PCOS is a heterogenous disease. This means that not all women with PCOS have the same symptoms. Some may have elevated testosterone, while others may not.
Alike many women, I was JUST told my LH:FSH ratio. I was offered the potential treatment of metformin (insulin resistance medication), despite not being informed of my insulin levels.
I hope this blog helps you understand the different PCOS types and by these symptoms, your PCOS type.
1. Insulin resistant PCOS
Insulin resistance: When your liver, muscle and fat cells are weak in their response to insulin which causes the pancreas to overproduce insulin, referred to as "hyperinsulinemia". This extreme amount of insulin can disrupt the development of ovarian follicles which can prevent ovulation.
Insulin Resistant PCOS is the most common PCOS type, affecting 70% of women. The common symptoms of Insulin Resistant PCOS include:
The insulin resistant induced hyperinsulinemia response can drive ovarian testosterone production, seen by: excessive facial hair growth, male pattern hair loss and acne
Ovulatory dysfunction (see blog named: "What is insulin resistance and how does it disrupt ovulatory function in PCOS?")
Other symptoms of insulin resistance may include: weight gain/holding weight around stomach/abdomen, sugar cravings, increased thirst, fatigue and tingly sensations in hands/feet.
How it can be diagnosed: Insulin resistance is measured clinically by the "fasting insulin" test. This includes taking a sample of blood. This test is available under the NHS.
Treatment: You can naturally reduce insulin resistance by increasing insulin sensitivity. This can be done through exercise, diet modifications and supplementation. To learn more on how to naturally treat your Insulin Resistant PCOS, see blogs in the "Insulin Resistant PCOS" section (stay tuned).
Additionally, you can treat insulin resistance by medication which can lift PCOS symptoms. The efficacy of these treatments can be improved by lifestyle modifications. To learn more on how to medically treat your Insulin Resistant PCOS, see blogs in the "Insulin Resistant PCOS" section (stay tuned).
2. Adrenal PCOS
The adrenal glands are small glands on top of the kidneys. They produce hormones that regulate your metabolism and respond to stress.
The diagram below shows the position of the adrenal gland in the body.
In Adrenal PCOS, there is an increase in the production of androgens secreted by the adrenal glands. It affects around 10% of PCOS women.
The common symptoms of Adrenal PCOS includes:
DHEA-S (an androgen secreted from the adrenal glands) is elevated, seen by: excessive facial hair growth, male pattern hair loss and acne
No insulin resistance or inflammation
Other symptoms include: increased levels of stress and tiredness
How it can be diagnosed: Specific androgens elevated in Adrenal PCOS can be measured by blood tests. Unfortunately, DHEA-S is not often tested.
Treatment: You can naturally decrease androgen secretion from the adrenal glands by reducing stress, less-intense exercise and supplementing. To learn more on how to naturally treat your Adrenal PCOS, see blogs in the "Adrenal PCOS" section (stay tuned).
You can also medically treat high androgen levels. To learn more on how to treat your Adrenal PCOS by medication, see blogs in the "Insulin Resistant PCOS" section (stay tuned).
3. Inflammatory PCOS
Chronic inflammation of the ovaries and the production of pro-inflammatory cytokines causes excessive testosterone production.
If you want to further understand why this happens, I will soon be releasing a blog with the title: "How does inflammation cause hyperandrogenism?" (Stay tuned)
The common symptoms of Inflammatory PCOS include:
Excessive testosterone levels, seen by: excessive facial hair growth, male pattern hair loss and acne
Disrupted ovulation
Signs of inflammation: headaches, joint pain, fatigue, skin issues (eczema), bowel issues (irritable bowel syndrome), chronic bloating
IMPORTANT!
It is crucial to understand that glucose mediated low-grade chronic inflammation can cause insulin resistance, which may develop into Insulin-Resistant PCOS. Therefore, Inflammatory PCOS must rule out insulin resistance and have the symptoms described above.
How it can be diagnosed: It is often diagnosed by increased serum levels of the inflammatory biomarker C-reactive protein (CRP) by blood tests.
Treatment: Diet modifications to reduce glucose mediated low-grade inflammation are often good treatments for Inflammatory PCOS. To learn more how to treat your Inflammatory PCOS, see blogs in the "Inflammatory PCOS" section (stay tuned).
4. Post-pill PCOS
Post-pill PCOS occurs after people stop taking the oral contraceptive pill. After coming off of the pill, the ovaries are in a "confused" state and secretes a natural surge of testosterone which can cause typical PCOS symptoms.
The common symptoms of Post-Pill PCOS includes:
No insulin resistant or inflammatory cause of increased testosterone or disrupted ovulatory cycles
Commonly seen 3-6 months after stopping the pill
However, it also crucial to understand that contraceptive pills often "hide" PCOS symptoms, such as disrupted ovulation. Therefore, if you're diagnosed with PCOS before taking the pill, stopping contraception will cause the return of symptoms.
"How do I treat my PCOS based on my type?"
To treat your PCOS symptoms to better your lifestyle is so important! I have written many blogs specific to each PCOS type that I'll be slowly releasing. Stay tuned to find out more about your PCOS type.
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