The 4 Types of PCOS Explained: A Comprehensive Guide and Personalized Management Plans
The 4 Types of PCOS—And How to Know Which One You Have
If you've been diagnosed with Polycystic Ovary Syndrome (PCOS), you're not alone. PCOS affects up to 10% of women of reproductive age—but what most people don’t realize is that PCOS isn’t one thing
There are four root causes or types of PCOS, and understanding which one is driving your symptoms is key to healing. Most women fall into one dominant category, but many experience a blend of two or more.
Let’s break them down—and talk about how to test for each one.
1. Insulin-Resistant PCOS
This is the most common type, driving around 70% of PCOS cases. Insulin resistance happens when the body stops responding to insulin effectively, leading to chronically elevated insulin—often followed by blood sugar crashes, cravings, and increased testosterone production.
You might notice:
Sugar or carb cravings
Belly weight gain
Skin tags or dark patches around your neck or armpits
Fatigue after eating or getting “hangry” easily
What helps:
Eating a high-protein breakfast within 30–60 minutes of waking
Strength training a few times per week
Walking after meals to support blood sugar
Using supplements like inositol, magnesium, and chromium when appropriate based on HTMA testing
Prioritizing sleep and reducing caffeine crashes
Helpful labs:
Fasting insulin
Fasting glucose
HbA1c
Glucose:insulin ratio
Total and free testosterone
DHEA-S
2. Inflammatory PCOS
This type of PCOS is rooted in chronic, low-grade inflammation that disrupts hormone balance and ovulation. The inflammation can stem from gut issues, mold exposure, poor drainage, food sensitivities, or autoimmune patterns.
You might notice:
Bloating or digestive issues
Brain fog or fatigue
Skin rashes, histamine sensitivity, or frequent headaches
Irregular cycles that come and go
What helps:
Identifying and addressing root inflammatory drivers like gut pathogens or mold
Reducing processed food, alcohol, or high-histamine triggers
Supporting mineral balance, especially magnesium and zinc
Working on gut health and drainage (think liver, bowels, and lymph—not just a detox tea)
Using tools like castor oil packs and nervous system regulation
Helpful labs:
hs-CRP
GI-MAP
HTMA (Hair Tissue Mineral Analysis)
Mold/mycotoxin testing (if suspected)
TPO/TG antibodies or ANA if there’s autoimmune history
3. Post-Pill PCOS
Some women develop PCOS-like symptoms after coming off hormonal birth control, especially after years of suppression. These symptoms are usually temporary but frustrating—and often dismissed.
You might notice:
Return of acne, oily skin, or hair loss
Irregular or missing periods
Mood swings, fatigue, or brain fog
Feeling totally disconnected from your cycle
What helps:
Supporting detoxification pathways so hormones clear properly
Replenishing nutrients depleted by the pill—especially B12, folate, magnesium, zinc, and vitamin C
Focusing on gut repair and bowel regularity
Using castor oil packs, mineral-rich foods, and lymphatic support
Prioritizing consistent meals and cycle tracking without obsession
Helpful labs:
Total and free testosterone
DHEA-S
SHBG (Sex Hormone Binding Globulin)
Liver enzymes
HTMA for mineral status
4. Adrenal PCOS
This type is driven by stress—mental, physical, emotional, or environmental. Instead of elevated testosterone from the ovaries, DHEA-S (produced by the adrenal glands) is often the main androgen involved. This is common in women who’ve been stuck in fight-or-flight for too long.
You might notice:
Waking up wired and tired
Anxiety or panic attacks
Poor sleep or waking between 2–4 a.m.
Irregular cycles or missing periods during stressful seasons
What helps:
Prioritizing nervous system regulation (think: slower mornings, walking, grounding, deep breathing)
Cutting out high-intensity workouts and replacing them with rest, yoga, or Pilates
Supporting minerals like sodium, potassium, magnesium, and vitamin C
Using adrenal cocktails and blood sugar balancing to avoid cortisol spikes
Getting 8–10 hours of sleep and setting boundaries around stimulation
Helpful labs:
DHEA-S
Cortisol (DUTCH test or salivary panel)
ACTH
HTMA to assess stress patterns and adrenal resilience
Ferritin and a full iron panel if fatigue is significant
So… Which PCOS Type Do You Have?
Here’s the truth: most conventional providers don’t dig deep enough. If your labs “look normal” but you feel anything but, that’s your body asking for more support.
That’s where our Vital Insights consult comes in.
Inside this one time consult with HTMA, we give you the foundational data you need to understand your hormones—and what’s driving them to be out of balance in the first place.
Each Vital Insights consult includes:
A 90-minute 1:1 consult
A personalized 30-day nutrition, lifestyle, and supplement plan
An HTMA (Hair Tissue Mineral Analysis) to assess your stress, adrenal, and mineral patterns
14 days of chat support with your dedicated Motherland practitioner
The education and clarity to know what your body needs next
If you’re ready to stop guessing and start healing from the root, this is your next step.