PCOS is the most common endocrine disorder, affecting 8–13% of women who are of reproductive age. It’s a hormonal and metabolic condition that can cause problems with ovulation, higher-than-normal levels of androgens (male-type hormones), and changes in how the body handles insulin. There are different types of PCOS, and it is common to have a combination of each type. PCOS affects every woman differently, but the more we are educated about how it is identified, the more clarity we can gain into supporting every woman as a unique individual.
What Is PCOS?
PCOS is an endocrine disorder that can cause an imbalance in hormones for women of reproductive age. Some symptoms include inconsistent periods, acne, and increase of hair growth, but it’s important to know that symptoms can look different for everyone. For some women, it can also be harder for the body to manage blood sugar, leading to excess androgen production.
Types of PCOS:
There are generally four types of PCOS. Most women may identify with a few symptoms in each category, not just one type.
Insulin-Resistant PCOS :
- Cause: High insulin overstimulates the ovaries → excess androgens (male-type hormones such as testosterone)
- Signs: Sugar cravings, belly weight gain, fatigue after carbs, dark skin patches
- Focus: Blood sugar balance with low-glycemic foods, strength training,
Inflammation-Based PCOS:
- Cause: Chronic low-grade inflammation disrupts ovulation
- Signs: Fatigue, headaches, eczema/psoriasis, food sensitivities, gut issues
- Focus: Anti-inflammatory diet, gut healing, stress reduction, lowering toxin load
Post-Pill PCOS:
- Cause: Ovaries “rebound” after stopping hormonal birth control, communication between ovaries and brain has been interrupted while on the pill
- Signs: Irregular or absent cycles, acne, hair shedding
- Focus: Gentle hormone recalibration with whole-food nutrition, cycle tracking, stress care (usually resolves in 3–12 months)
Adrenal PCOS:
- Cause: Excess stress hormones (DHEA-S) from the adrenal glands
- Signs: Anxiety, poor sleep, acne, high stress response
- Focus: Nervous system regulation, adaptogens, restorative movement, quality sleep
Signs of PCOS:
Each woman can present differently, but signs can include:
- Irregular or absent cycles
- Acne
- Weight gain or difficulty losing weight (especially lower belly)
- Excess hair growth (face/body)
- Thinning scalp hair
- Skin tags
- Pelvic pain
- Fertility challenges
- Insulin resistance
- Emotional & mood struggles
Diagnosis (Rotterdam Criteria – need 2 of 3)
Healthcare professionals, including Pelvic Floor Physical Therapists use the Rotterdam criteria for diagnosing PCOS. You need at least two of three listed criteria for a formal diagnosis.
- Excess androgen production – signs like too much face/body hair, acne, thin hair, or high androgen in blood tests.
- Ovulatory dysfunction – cycles lasting >35 days or <21 days apart
- Polycystic ovaries – ovaries with many small follicles or cysts
You do not need to present with cystic ovaries to have PCOS. Diagnosis should be a full body approach.
Life with PCOS and Next Steps
There is no “cure,” but there are many ways to manage your PCOS. Changes in how you live, like your diet, physical activity, decreasing stress, and improved sleep can help a lot. It is important to work with trusted specialists along your journey to support you and listen to you every step of the way.
Dr. Natalia’s Story
I’ve never had “normal” cycles. As a teen, my periods were irregular, my acne was severe, and birth control was prescribed as a quick fix. For 15 years, it gave me predictable periods and clear skin—but it never addressed the root cause of my imbalances. In June 2024, with my wedding on the horizon and dreams of a future family, I chose to come off birth control. A year passed without a cycle. My acne returned, mood swings flared, and the stress of wedding planning didn’t help. But with the guidance of a compassionate gynecologist, dermatologist, talk therapist, and somatic breathwork coach, I began a journey of healing from the inside out. My cycles haven’t fully returned yet—but I’m leaning into nourishment, gentle movement, nervous system care, and trust in my body’s natural rhythm.
I want all women to know that PCOS is not your fault. It’s your body asking for balance, nourishment, rest, and compassionate care. With the right support, you can come home to your body’s natural rhythm.
References
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Almhmoud H. et al. “Polycystic ovary syndrome and its multidimensional impacts on women’s mental health: A narrative review.” Medicine (Baltimore), 103(25), 2024. journals.lww.comjournals.lww.com
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World Health Organization (WHO). Polycystic ovary syndrome – Fact Sheet, 7 Feb 2025. who.intwho.int
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Mayo Clinic Staff. “Polycystic ovary syndrome (PCOS) – Symptoms & Causes.” Mayo Clinic, updated Sept 8, 2022. mayoclinic.orgmayoclinic.org
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Cleveland Clinic. Polycystic Ovary Syndrome (PCOS) – Symptoms, Causes, Diagnosis. Cleveland Clinic Health Library, updated 2023. my.clevelandclinic.orgmy.clevelandclinic.org
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Andonian N., MD, & Golden K.E., MD. “The 7 Most Effective PCOS Natural Treatments.” GoodRx Health, July 11, 2023. goodrx.comgoodrx.com
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Briden L. “4 Types of PCOS (a Flowchart)” – Lara Briden’s Blog, April 2025. larabriden.comlarabriden.com
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Pollie (PCOS care). “The Main Types of PCOS.” Pollie Blog, 2023. pollie.copollie.co
