The 4 Types of PCOS — and How to Know Which One You Have

By: Dr. Alyssa McPeak

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions affecting women today. It’s often linked with irregular cycles, difficulty ovulating, acne, excess hair growth, and fertility struggles. But here’s the thing: not all PCOS is the same and it can be reversed.

There are four main types of PCOS, and understanding your type is the first step to getting the right support for your body and hormones — especially if you’re trying to conceive.

How to Figure Out Your PCOS Type

PCOS is diagnosed based on symptoms, lab testing, and your personal health history. There’s no single test that defines your type, but looking at patterns can give you important clues:

• Blood work (fasting glucose, insulin, androgens, cortisol, inflammatory markers, thyroid labs).

• Lifestyle factors (stress, birth control history, food sensitivities, gut health).

• Symptom tracking (cycle length, pain, acne, cravings, fatigue).

Working with a functional medicine provider can help you get the right labs and uncover your unique root causes.

The 4 Types of PCOS (and How to Support Them)

1. Insulin-Resistant PCOS

• Clues: Irregular or absent cycles, weight gain (especially belly fat), sugar cravings, fatigue after meals.

• Root cause: High insulin disrupts ovulation and increases androgen hormones.

• Support Tips:

  • Balance blood sugar: eat protein + vegetables + healthy fat at each meal.

  • Exercise with strength training and walking after meals.

  • Limit refined carbs and sugary foods.

  • Consider supplements like inositol or chromium (work with your provider).

2. Adrenal PCOS

• Clues: Cycles that worsen under stress, anxiety, “wired but tired” feeling, high DHEA-S levels with normal testosterone.

• Root cause: Stress hormones (cortisol, DHEA) from the adrenal glands.

• Support Tips:

  • Prioritize rest and recovery (7–9 hours sleep, relaxation routines).

  • Gentle exercise like yoga, pilates, or walking instead of overtraining.

  • Use adaptogens (ashwagandha, rhodiola, holy basil) under guidance.

  • Practice breathwork, journaling, or nervous system regulation.

3. Inflammatory PCOS

• Clues: Chronic fatigue, joint pain, digestive issues, skin rashes or acne, cycles affected by inflammation.

• Root cause: Chronic inflammation disrupts ovulation and egg quality.

• Support Tips:

  • Follow an anti-inflammatory diet (lots of vegetables, omega-3s, grass-fed protein).

  • Reduce exposure to toxins (plastics, harsh chemicals, synthetic fragrance, processed foods).

  • Heal the gut: identify and eliminate food sensitivities, support with probiotics and digestive enzymes.

  • Prioritize recovery: sauna, red light, gentle movement to lower inflammation.

4. Post-Pill PCOS

• Clues: Cycles disappeared or became irregular after stopping birth control, acne flares, temporary hormone imbalance.

• Root cause: A rebound effect when synthetic hormones are removed.

• Support Tips:

  • Give your body 3–6 months to rebalance naturally.

  • Support liver detox pathways (leafy greens, cruciferous veggies, milk thistle, dandelion root, hydration).

  • Ensure adequate nutrients (B vitamins, zinc, magnesium, vitamin D).

  • Track your cycles and watch for signs of ovulation.

Why Knowing Your Type Matters

PCOS isn’t a one-size-fits-all diagnosis. What helps one woman may not work for another — in fact, it could make symptoms worse. For example: cutting carbs can help insulin-resistant PCOS, but in adrenal PCOS it may increase stress hormone production.

By identifying your PCOS type, you can choose the right nutrition, lifestyle, and supplements that address your root cause — and improve your chances of ovulating regularly, balancing hormones, and getting pregnant naturally.

✨ At Find Your Fertility, I help women uncover their unique hormone patterns, understand their PCOS type, and create personalized fertility resourses. You don’t have to guess your way through PCOS — with the right support, your body can find balance again.