The 4 Types of PCOS: How to Eat, Move & Live According to Your Root Cause
Polycystic Ovary Syndrome (PCOS) isn't one size fits all. While the symptoms-irregular cycles, acne, weight gain, and fertility issues can look similar on the surface, the root causes can be very different. That’s why some women thrive on one plan, while others feel worse.
Understanding which type of PCOS you have can be the key to managing symptoms, balancing your hormones, and feeling like yourself again.
Let’s dive into the 4 most recognized types of PCOS, how to identify them, and the lifestyle strategies that work best for each based on current science and clinical insights.
1. Insulin-Resistant PCOS
(The most common type)
What is it?
This type is driven by high insulin levels, often due to insulin resistance. Insulin is a hormone that helps regulate blood sugar, but when your cells stop responding to it, your body produces more and that excess insulin can trigger more androgen production from the ovaries.
Clues You Might Have It:
Sugar cravings or energy crashes after meals
Dark patches of skin (especially around the neck or armpits)
Weight gain, especially around the belly
Lab results showing high fasting insulin or glucose
Family history of diabetes or metabolic issues
Best Diet Approach:
Focus on low glycemic index (GI) foods: think oats, lentils, quinoa, non-starchy vegetables
Limit refined carbs and sugars- watch out for sneaky ones in sauces and drinks
Add healthy fats (avocados, olive oil, nuts) and lean protein to every meal to balance blood sugar
Try intermittent fasting (under guidance)- some studies suggest time-restricted eating may improve insulin sensitivity in women with PCOS
Lifestyle Tips:
Prioritize strength training + moderate cardio for insulin sensitivity
Get 7-9 hours of quality sleep (lack of sleep worsens insulin resistance)
Consider inositol supplements (especially myo-inositol + d-chiro combo) to support insulin regulation
2. Post-Pill PCOS
(Triggered after coming off hormonal birth control)
What is it?
Some women develop PCOS-like symptoms after stopping the pill, especially if they were on it long-term. The synthetic hormones suppress ovulation, and after withdrawal, the body can temporarily overproduce androgens like testosterone.
Clues You Might Have It:
Irregular periods that didn’t return months after stopping the pill
Acne flare-ups
Mild hair loss
You didn’t have PCOS symptoms before using birth control
Symptoms started 3–6 months after quitting the pill
Best Diet Approach:
Support your liver: include cruciferous vegetables (broccoli, kale, cabbage), lots of water, and fiber
Eat enough protein and healthy fats to support hormone synthesis
Avoid overly restrictive diets-your body needs nourishment to regulate naturally
Lifestyle Tips:
Focus on gentle movement (e.g., walking, yoga, Pilates) to avoid stressing the system further
Try seed cycling to support the natural rise and fall of estrogen and progesterone
Be patient-this type often resolves in 6–12 months with the right support
Consider zinc or DIM (diindolylmethane) supplements to support androgen clearance—but check with a professional first
3. Inflammatory PCOS
(Driven by chronic low-grade inflammation)
What is it?
Chronic inflammation can disrupt ovulation and trigger excess androgen production. Inflammatory PCOS is often linked with digestive issues, fatigue, and skin flare-ups.
Clues You Might Have It:
Regular cycles but signs of high androgens (acne, hair growth)
Joint pain, fatigue, or brain fog
Digestive issues (bloating, IBS, food intolerances)
Elevated inflammatory markers (like CRP or white blood cell count)
Skin issues like eczema or psoriasis
Best Diet Approach:
Focus on anti-inflammatory foods: leafy greens, berries, oily fish (like salmon), turmeric, ginger
Reduce intake of processed foods, vegetable oils (like sunflower or corn oil), and excessive dairy
Consider an elimination diet to identify triggers (gluten, dairy, etc.)
Add omega-3s, either through diet or supplementation
Lifestyle Tips:
Prioritize stress reduction: chronic stress worsens inflammation
Explore gut health-consider probiotics, fermented foods, and prebiotic fiber
Try meditation, breathwork, or journaling to calm the nervous system
Limit alcohol, which can spike inflammation levels
4. Adrenal PCOS
(Driven by chronic stress and high cortisol levels)
What is it?
This type is linked to abnormal adrenal function, specifically elevated DHEA-S (an androgen made by the adrenal glands). It's often stress-related, not driven by insulin or ovarian issues.
Clues You Might Have It:
Normal LH, FSH, insulin-but elevated DHEA-S
You feel “wired but tired,” anxious, or overstimulated
Stress triggers irregular cycles or acne
You’re lean but have clear PCOS symptoms
Blood sugar is stable, but cycles and energy are all over the place
Best Diet Approach:
Balance blood sugar with regular meals and snacks (don’t skip meals!)
Limit caffeine and alcohol-both spike cortisol
Focus on magnesium-rich foods (spinach, pumpkin seeds, dark chocolate)
Avoid overtraining or extreme dieting-it makes adrenal stress worse
Lifestyle Tips:
Restorative movement only: walking, stretching, breath-based yoga
Prioritize deep sleep and consistent routines
Use adaptogens (ashwagandha, rhodiola, holy basil) cautiously and with support
Focus on nervous system regulation: think nature, quiet mornings, or even cold plunges (if tolerated)
Find Your Type, Then Work With It
PCOS isn’t just a hormonal condition-it’s a metabolic and lifestyle puzzle. That’s why knowing your type is so powerful. Once you know the root cause, you can target your diet, supplements, and lifestyle changes in a way that works with your body.
Action step: If you’re unsure which type you have, consider hormone testing (like AMH, LH, FSH, testosterone, insulin, and DHEA-S) through your doctor or an at-home fertility test like Athena’s.
Need Help Getting Started?
We’ve designed our fertility tests to give you insights into your hormonal health so you can stop guessing and start acting with clarity. Whether you're just curious or actively managing PCOS, you're not alone.
