What are the Four Types of PCOS and Common Symptoms to Look For?

Many women with PCOS are unaware that they have it, nor do they know much about it. Sometimes the symptoms are clear; however, that’s not always the case, leaving many women with undiagnosed PCOS. If you are struggling to determine whether you have PCOS, we want you to know that you’re not alone, Mama. FIT4MOM has joined forces with Dr. Danelle Desroche, a licensed naturopathic doctor specializing in PCOS, to help spread awareness and empower women to educate themselves to help with early PCOS diagnosis and ensure they are making decisions that are best for them and their lifestyle.


What is PCOS?

Polycystic Ovary Syndrome (PCOS) affects 1 in 10 women, making it the most common endocrine disorder in women of reproductive age. PCOS means that the ovaries have an abnormally large number of follicles on them and is a complicated hormonal condition that impacts metabolism, digestion, and reproductive health.

How do you know if you have PCOS?

To be diagnosed with PCOS, you must meet two of the following three criteria:

  1. Irregular or absent periods.

  2. High androgen hormones, including testosterone or DHEA-S.

  3. Polycystic ovaries seen on ultrasound.

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📸: @drdanielle.nd on Instagram

    What are the common symptoms of PCOS?

    Regardless of what type of PCOS you have, common symptoms include:

    • Irregular menstrual cycles

    • Weight gain

    • Hair loss

    • Acne

    • Facial hair growth

    • Fatigue

    • Insomnia

    • Infertility

    • Depression or anxiety

    How to Manage and Treat PCOS?

    Healing and managing PCOS can be complicated, and you must understand what type of PCOS you have in order to address the root cause. The four types of PCOS include: insulin-resistant, post-pill, inflammatory, and adrenal.

    Insulin-resistant PCOS

    Insulin-resistant PCOS accounts for 70% of all PCOS cases. Insulin is a hormone produced by the pancreas to help bring glucose (sugar) from the blood into cells to be used for energy. When insulin resistance is present, cells are unable to respond to insulin and blood sugar remains high.

    Signs of insulin resistance include weight gain, sugar cravings, skin tags, and afternoon fatigue. A fasting insulin level of 2 to 20 mIU/mL is considered normal, with less than 8mIU/mL being optimal.

    How to treat insulin resistance

    • Limit sugar, soda, and processed foods as these foods cause blood sugar levels to rapidly increase.

    • Prioritize strength training to increase muscle mass and improve insulin resistance.

    • Consider supplementing with magnesium, chromium, inositol, NAC, or berberine. Please speak with your doctor before starting any new supplement.

    Post-Pill PCOS

    While PCOS symptoms typically first present during puberty, symptoms related to post-pill PCOS will not appear until after coming off the birth control pill. Women with post-pill PCOS often have high luteinizing hormone (LH), the hormone responsible for triggering ovulation. Clinically, I typically see post-pill PCOS resolve 6-12 months after getting off birth control.

    How to treat post-pill PCOS

    • Eat more vegetables such as broccoli, cauliflower, kale, brussels sprouts, and mustard greens. These foods contain a compound called DIM, which helps break down excess estrogen in the body.

    • Limit alcohol consumption to support liver health. Our liver is responsible for breaking down hormones, including synthetic estrogen and progesterone found in the birth control pill.

    • Supplement with zinc, selenium, magnesium, and B vitamins as these are often depleted by the pill. Peony and vitex are herbs that may help regulate ovulation post-pill.


    📸: Alicia Petresc

    Inflammatory PCOS

    Inflammatory PCOS is most often related to poor gut health. Signs of inflammatory PCOS include digestive symptoms, joint pain, brain fog, fatigue, headache, and skin issues. CRP is a general marker of inflammation, with levels less than 10mg/L being considered normal, and less than 5mg/L being optimal.

    How to treat inflammatory PCOS

    • Identify and eliminate food intolerances. Common inflammatory foods include gluten, dairy, sugar, soy, corn, and peanuts.

    • Supplement with zinc, l-glutamine, magnesium and probiotics to support gut health.

    • Eat foods high in omega-3 fatty acids including fatty fish, avocado, nuts, seeds, and olives. You may also consider supplementing with fish oil or turmeric to reduce inflammation.

    Adrenal PCOS

    Adrenal PCOS is the least common, accounting for 10% of all PCOS. Unlike the other types of PCOS, adrenal PCOS is characterized by elevated DHEA-S but normal testosterone levels. Signs of adrenal PCOS include daytime fatigue and nighttime insomnia and are often due to high stress.

    How to treat adrenal PCOS

    • Get 7-8 hours of uninterrupted sleep each night.

    • Skip the cardio workouts. Instead, opt for strength training and low-impact movements like yoga or pilates.

    • Limit caffeine including coffee and soda.

    • Consider adaptogenic herbs like Rhodiola, ashwagandha, holy basil, and maca to help the body adapt to stress.

    Is it really PCOS?

    Hypothyroidism and hypothalamic amenorrhea are two conditions that may be mistaken for PCOS.

    Hypothyroidism, or low functioning thyroid, is similar to PCOS in that it involves hair loss, weight gain, fatigue, and irregular cycles. Some unique features of hypothyroidism that may not be seen with PCOS include dry skin, sensitivity to cold, and thinning of the eyebrows. These two conditions often present together, with 22.5% of women with PCOS having hypothyroidism compared to 8.75% of women without PCOS. If you are unsure of your thyroid status, ask your doctor to run a thyroid panel that will provide a comprehensive look at all your thyroid hormones.

    Hypothalamic amenorrhea (HA) is similar to PCOS in that they both involve irregular menstrual cycles and increased ovarian follicles. Where HA differs is that these menstrual changes occur due to under-eating or over-exercising. Additionally, those with HA typically have low luteinizing hormone (LH), while those with PCOS typically have high LH. Women with HA often require more carbohydrates in their diet versus women with PCOS who may benefit from less.

    To learn more about PCOS, visit Dr. Danielle Desroche on Instagram and be sure to watch our BUMP Day series on our @FIT4MOMHQ Instagram!

    About Dr. Danielle Desroche

    Dr. Danielle Desroche is a licensed naturopathic doctor specializing in PCOS, fertility, and thyroid health. Using natural therapies, she aims to address the root cause of symptoms while restoring balance in the body so it can function optimally. She owns a virtual telemedicine practice, which allows her to connect with and support women from across the country. She is passionate about educating and empowering her patients to understand their body and take control of their health. To learn more, visit www.drdanielledesroche.com or follow on Instagram @drdanielle.nd.