If you’ve ever found yourself wondering ‘What the heck is PCOS?’ know that you are not alone. Despite affecting up to 13% of menstruators of reproductive age, this complex condition is incredibly misunderstood.
For starters, PCOS might sound like it’s a disease that exclusively impacts the ovaries (we get it, it’s all in the name), but it’s actually a little more complicated than that. Whilst it does impact the ovaries and their function, PCOS is actually a hormonal condition that affects the whole. entire. body.
This PCOS Awareness Month, we’re taking a deep dive into all things Polycystic Ovary Syndrome, including what this condition actually is, and the four different types of PCOS a person can be diagnosed with.
The four different types of PCOS are:
- Post-Pill PCOS
- Inflammatory PCOS
- Insulin-Resistant PCOS
- Adrenal PCOS
Post-Pill PCOS
Post-Pill PCOS is the phenomenon where menstruators who were not previously diagnosed with PCOS begin to experience PCOS symptoms after ceasing hormonal birth control.
Mind boggled? So were we when we first learned of this condition.
There are two different instances where Post-Pill PCOS can occur:
- As a temporary response to a hormonal imbalance.
- The individual unknowingly had PCOS prior to commencing hormonal birth control.
The first instance occurs when you make the choice to stop a hormonal contraceptive of any kind – not just The Pill (yep, we’re also talking about the Contraceptive Implant, Hormonal IUD, and vaginal ring). Once you stop hormonal birth control, it means that your body has to re-adjust and relearn how to function without the help of added hormones.
OK, so while it is important to remember that this response is temporary in nature, that doesn’t mean that what you’re going through isn’t a valid struggle. You know your body (and you know it better than anyone), so if something is concerning you, or you’re not feeling quite like yourself after coming off hormonal contraception, we always recommend reaching out to a trusted expert in female health.
The second instance of Post-Pill PCOS occurs when an individual who was unknowingly managing their PCOS symptoms with a form of hormonal contraception comes off their chosen method and their previously masked symptoms return with a vengeance.
Many young menstruators who were placed on hormonal contraceptives in early adolescence were promised that The Pill would answer their prayers for regular menstrual cycles and clear skin. We now know that not only are irregular periods and acne common symptoms of Polycystic Ovary Syndrome but, thanks to advancements in research in the PCOS space, there are also a plethora of ways to manage this condition naturally – if natural therapies are your vibe, of course.
What Are the Symptoms of Post-Pill PCOS?
As your body adjusts to a new life without The Pill, you might experience the following symptoms:
- Fluctuating hormone levels.
- Temporary hormone imbalances.
- Weight gain.
- Irritability.
- Restlessness.
- Mood swings.
- Stress.
As is common with PCOS cases, symptoms can be varied in nature and have different effects on each individual. If you’re not sure if what you’re experiencing could be post-pill PCOS, reflect on what your cycles were like prior to commencing The Pill. If your periods and cycles are looking a little different post-pill, we recommend speaking with your doctor – there’s a chance you could be experiencing post-pill PCOS.
Inflammatory PCOS
Ah, inflammation. You know, the swelling, warmth, redness, or pain that usually makes itself known moments after a cut or an injury of some kind?
Inflammation occurs when our body’s built-in bodyguards (aka our immune system) react to a foreign object in an attempt to protect us from anything it identifies to be a potential threat. When it works as it’s supposed to, our immune system is a wonderful thing. When it doesn’t work as it’s supposed to, our immune system flags something that isn’t harmful, like our internal organs, as a potential threat – which causes your immune system to attack your body’s own cells, tissues, and organs.
While moderate inflammation is expected and considered “normal” during ovulation, significantly higher levels of inflammatory cells and localised inflammation of the ovaries are used alongside other diagnostic methods (more on this below) to determine the presence of Inflammatory PCOS. Research has found that Inflammatory PCOS plays a role in both ovarian dysfunction and high levels of androgens. Ovarian dysfunction can result in difficulties conceiving and ovulating, whilst higher-than-normal levels of androgens can result in hair loss, excessive hair growth, weight gain, and acne.
Recent studies have proven the impact inflammation has on the entire body as a whole through highlighting the relationship between Inflammatory PCOS and a number of other conditions that PCOS can lead to, including insulin resistance, cardiovascular disease, type 2 diabetes, and obesity.
What Are the Symptoms of Inflammatory PCOS?
- Headaches.
- Tiredness and fatigue.
- Bowel issues (including IBS).
- Joint pain.
- Raised inflammation markers on blood tests.
- Weight gain.
- Hair loss.
You’re likely to have inflammatory PCOS if:
- You meet the criteria for PCOS
- You have the above signs and symptoms of inflammation
- You do not have insulin resistance and you’re not in a temporary post-pill phase
Insulin-Resistant PCOS
With over 70% of menstruators with PCOS being affected by insulin resistance, girl math says that if you have the condition, you’re more likely to have Insulin-Resistant PCOS than not.
If it’s been a while since you’ve brushed up on your insulin knowledge, don’t worry, we’ve got you. To put it simply, insulin is a hormone that the pancreas produces to help regulate blood glucose levels. Insulin resistance occurs when your body is unable to use the insulin effectively, which leads to higher than normal blood glucose levels. In true rebellious teenager fashion, the body retaliates by (you guessed it) creating even more insulin.
All this extra insulin causes the pancreas to work overtime, which places sufferers at an increased risk of developing Type 2 Diabetes.
Insulin resistance and PCOS are somewhat of a dynamic duo, with research finding that high insulin levels act as both a symptom and a driver of the condition. This means that whilst insulin resistance can be a result of PCOS, it can also be the cause of PCOS.
Just when you thought this condition couldn’t get any more complex, among other symptoms, studies have also shown that Insulin-Resistant PCOS also has the ability to impair ovulation and cause the ovaries to produce excessive testosterone. Individuals with Insulin-Resistant PCOS may experience struggles with maintaining a stable weight and carrying the majority of their weight around their midsection.
Insulin-Resistant PCOS is tested for via an oral glucose tolerance test. Yes it’s awful, and yes everyone hates it, but an oral glucose test is the most effective way to review how the body responds to glucose.
What Are the Symptoms of Insulin-Resistant PCOS?
- Changes in appetite.
- Cravings for sweet, carbohydrate-rich foods.
- Weight gain.
- Difficulty losing weight.
- Dark pigmentation in the folds of the skin around the neck, groin, and armpits.
Adrenal PCOS
Did you know that stress is more than a feeling? Nope, it’s not all in your head; stress has the ability to manifest itself physically and result in the display of physical symptoms.
For many individuals, stress can result in sweaty palms, panic attacks, difficulty breathing, and fatigue. For others, it results in Adrenal PCOS.
Meet your adrenal glands. They’re the guys responsible for pumping out stress hormones such as cortisol and adrenaline, and sex hormones, like testosterone and DHEA (aka dehydroepiandrosterone). When we’re stressed, whether that be emotionally or physically, our adrenal glands begin releasing more cortisol, which leads to a simultaneous increase in DHEA levels.
Adrenal PCOS occurs when a patient displays the common signs and symptoms of PCOS, but displays normal testosterone and insulin levels, and increased DHEA levels. Studies have shown that up to 30% of folks with PCOS have displayed higher than-average DHEA levels, which can result in irregular periods, acne, and hair growth. The best way to test for Adrenal PCOS is via blood test.
What Are the Symptoms of Adrenal PCOS?
Alongside irregular periods, acne, and unwanted hair growth, Adrenal PCOS can also lead to:
- Tiredness.
- Irritability.
- Anxiety.
- Brain fog.
- Difficulties focussing.
Why Determining What Type of PCOS You Have Matters
As we know by now, PCOS is a common yet complex condition. But being complex in nature doesn’t mean that it’s impossible to understand.
While PCOS is not curable, it is manageable. With that in mind, it is crucial that you work with a professional who is familiar with the condition, like our Hazel experts.
Because an individual can have one of the four types, a couple of them, or a mixture of all four, it is important that your healthcare provider determines what affects you so they can create a holistic care plan that adequately addresses all of your symptoms. And because PCOS looks different on everyone, your symptoms could be misdiagnosed as another condition altogether. If you’re tired of navigating these symptoms alone, speak to an expert in PCOS & women’s health to get the answers you need.
With the right care plan, you can live a life free from PCOS symptoms.
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