The different types of PCOS and how to treat

It's very common to go online and browse treatment for polycystic ovary syndrome PCOS after getting the diagnosis and you will get several results; from using the pill, weight loss, glucose and insulin controlling meds, to restrictive diets and even a number of supplements. And this will definitely make you feel overwhelmed.

When I speak with women for the first time, I always make sure they have gone through a two step process before seeking treatment options. 

STEP 1: I talked about in depth in a previous article: PCOS: How to know if you really have it because countless number of women have been misdiagnosed. You don't want to start treatments you don't need or opt for one that wouldn't work thereby worsening your symptoms. The fact that a few cysts were seen on ultrasound is not enough to say you have PCOS. There are a few other criteria to consider. You can always go to the link in description to watch that video after seeing this. 

This article will be discussing Step 2: Knowing the type of PCOS you have.

There are about 4 different types of PCOS which require completely different treatment plans.

1. Insulin resistant PCOS

The first and most common is the Insulin resistant PCOS. Insulin is the hormone that converts the sugar in our blood to energy that can be used by our muscles for bodily functions.

When we eat a meal, say carbs for example, your blood sugar increases then insulin is secreted to activate your cells to take up this glucose thereby reducing the sugar in the blood. So this could be taken up by your muscles for your normal bodily functions or it is stored until when needed. In Insulin resistant PCOS, your cells do not respond to taking up insulin. The blood sugar remains high and because of this, the pancreas keeps putting out more and more insulin hoping to reduce the blood sugar. These high levels of insulin will then trigger the production of androgens like testosterone from your ovaries which will prevent ovulation.

It is this high levels of androgen hormones that cause the physical symptoms like acne, male pattern hair loss, weight gain around the abdomen, excess hair growth on face, neck and body. Insulin levels need to be checked to confirm this kind of PCOS. With this type of PCOS you need to be patient because treatment takes time and you have to be consistent.

  • Address your diet- reduce carbs, add protein and fats to your diet. Try your very best to quit sugar if you can.
  • Sleep well. Have a sleep schedule, it helps 
  • Reduce stress
  • Take supplements like Inositol, berberine, magnesium, Chromium and even NAC. It's a long list and you will need to speak to a professional before choosing supplements. 
  • Engage in exercises to improve insulin sensitivity. When you engage your muscles regularly, it will help in taking up some of those blood sugar lying around.

2. Post Pill PCOS

This type of PCOS happens when a woman goes off the birth control pill. The pill like you already know suppresses ovulation by shutting down the communication between the brain and ovaries. In some women after stopping the pill, ovulation will resume but for some others it takes a longer time.
In post-pill PCOS, you find that ovulation isn't happening in addition to the physical signs of PCOS. I guess you are also aware the pill is often prescribed for acne. This is because the hormones in the pill suppresses the production of androgen hormones. High levels of androgen cause acne and other physical symptoms of PCOS . So when a woman stops the pill, there is a sudden increase in the levels of androgens which is temporary though but causes the manifestation of the physical signs of PCOS and there may be polycystic ovaries on the ultrasound too but with this type of PCOS, there is no insulin resistance.
This type of PCOS often resolves within 6 to 12 months with the right nutrition to help resume ovulation again. If your cycle was normal before going on the pill, it shouldn't take too long.

  • A supplement like Zinc is helpful in reducing androgen levels
  • Herbal supplements like Vitex/Chasteberry works to kickstart brain-ovary communication to start ovulation 
  • Again sleep and stress management is very important

3. Adrenal PCOS

    In this type of PCOS, it is the androgen hormone produced by the adrenal glands, on top of the kidney that is high. In this case, DHEAS. The androgens produced by the ovaries like testosterone and androstenedione are normal. Because this type of PCOS happens in response to high levels of stress, the woman will also have high levels of the stress hormone, cortisol. To treat this:;

    • managing stress through certain relaxing activities can help
    • supplements like Rhodiola, Ashwagandha to cope with stress and nutrients like vitamin B5 and C to support the adrenal glands and nervous system
    • improving sleep works very well too

    4. Inflammatory PCOS

      Inflammation in the ovaries cause the production of testosterone. Here, in addition to meeting the criteria for a PCOS diagnosis, the woman will have signs of inflammation which could be : headaches, thyroid disease, fatigue, joint pain, skin conditions like eczema, hives, issues with digestion. To further confirm this type of PCOS, there is no insulin resistance or the woman isn’t in a post-pill phase.
      Inflammation could be caused by your diet, lifestyle,  stress, toxins in your system.  So, the progression looks something like this: inflammation-anovulation-high testosterone-PCOS. To improve this type of PCOS, you will need:
      • antioxidants like N-Acetyl Cysteine, anti-inflammatories  like zinc, turmeric,omega 3 fatty acids
      • address your gut health by balancing the bacteria and improve digestion.
      • Avoid dairy products and other foods that trigger inflammation
      • Manage stress
      Like insulin resistant PCOS, treating this type also takes time. You have to be patient and consistent.

      You see why proper testing is important. If not, you may just be undergoing treatments that won't work or even worsen your symptoms. If you want to talk about PCOS symptoms, testing, review your test results or supplements that can help, you can always book a consultation with me here.

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      About Stephanie Nyong

      Stephanie is an internationally certified women's holistic hormone health practitioner and a member of the International Practitioners of Holistic Medicine, UK. She is very passionate about teaching women to master their unique menstrual cycle patterns and use their hormones to the their advantage (either for natural conception or birth control and to monitor their reproductive health)   She is a serial author and also the founder of Women's Health Platforms Foundation,  an NGO clinic in Abuja, Nigeria that has provided over 5,000 women with low-cost preventive healthcare services. 

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