What is PCOS and How Does It Affect Your Fertility?

By: Dr. Alyssa McPeak

Polycystic Ovary Syndrome (PCOS) is one of the most common hormone disorders affecting women of reproductive age, and it’s also one of the leading causes of infertility. PCOS occurs when your body experiences imbalances in hormones—especially androgens (male hormones), insulin, and stress hormones—that disrupt normal ovulation. Without regular ovulation, getting pregnant becomes much more difficult.

But here’s the thing: PCOS isn’t one-size-fits-all. There are actually four different types of PCOS, and understanding which one you have is key to knowing how to support your body and improve your chances of conceiving.

The Four Types of PCOS

1. Insulin-Resistant PCOS

This is the most common type, often linked to blood sugar imbalances. When your body can’t process insulin efficiently, it increases androgen levels, disrupts ovulation, and contributes to weight gain, sugar cravings, and fatigue.

How to know if this might be you:

• Irregular periods

• Sugar or carb cravings

• Midsection weight gain

• Fatigue after meals

• Blood sugar or A1C issues

Ways to support insulin-resistant PCOS:

• Focus on a low-glycemic, whole-food diet rich in protein, vegetables, and healthy fats.

• Break your fast with protein and healthy fats.

• Add daily movement (even walking after meals helps balance blood sugar).

• Support with nutrients like magnesium, chromium, and inositol.

2. Adrenal PCOS

This type is driven by an overproduction of DHEA and cortisol (your stress hormones) rather than insulin resistance. Women with adrenal PCOS may not have insulin issues but still struggle with ovulation.

How to know if this might be you:

• Elevated DHEA-S and cortisol on labs

• Normal insulin and blood sugar levels

• History of high stress or trauma

• Fatigue, especially in the afternoon and upon waking

• Anxiety, sleep struggles, or feeling “wired but tired”

Ways to support adrenal PCOS:

• Prioritize stress management (breathwork, yoga, journaling).

• Avoid high-intensity workouts that spine cortisol

• Support adrenals with adaptogens (like ashwagandha, rhodiola, or holy basil).

• Make sleep and recovery a non-negotiable.

3. Inflammatory PCOS

Chronic inflammation can disrupt ovulation, trigger insulin resistance, and raise androgens. This type is often seen alongside digestive issues, autoimmune conditions, or chronic pain.

How to know if this might be you:

• Ongoing bloating, IBS, or gut imbalances

• Skin flare-ups (acne, eczema)

• Joint pain or body aches

• Blood markers showing high CRP, ESR, Sed-Rate or inflammation

• Sensitivity to certain foods (like gluten or dairy)

Ways to support inflammatory PCOS:

• Reduce inflammatory foods (processed sugar, refined oils, gluten, dairy).

• Load up on anti-inflammatory foods (wild fish, leafy greens, berries, turmeric, ginger).

• Heal your gut with probiotics, bone broth, and fiber.

• Support detox pathways with hydration and gentle movement.

4. Post-Pill PCOS

Some women experience PCOS-like symptoms after coming off hormonal birth control. This is usually temporary, but it can delay ovulation and make it feel like your body is “stuck.”

How to know if this might be you:

• You recently stopped birth control and haven’t resumed a regular cycle

• Labs show high androgens

• Acne or hair changes after stopping the pill

• Periods are missing, irregular, or very light

Ways to support post-pill PCOS:

• Be patient—your body is recalibrating.

• Support your liver with cruciferous vegetables (broccoli, kale, cauliflower) and herbs like milk thistle and dandelion.

• Ensure you’re getting enough zinc, magnesium, and methylated B vitamins (especially B6 and folate).

• Prioritize real food, hydration, and gentle detox practices.

Why Knowing Your Type Matters

If you’ve been told you have PCOS but not much else, you might feel confused or even hopeless about your fertility journey. The truth is—not all PCOS is the same, and not all support strategies work for every type. By understanding your type, you can take targeted steps that bring your cycle back into balance and improve your chances of getting pregnant naturally.

✨ At Find Your Fertility, my mission is to help you uncover what’s really going on with your hormones and give you a clear plan of action. If you’re struggling with irregular cycles, hormone chaos, or PCOS, you’re not alone—and you don’t have to guess your way through this.