Can one woman have more than one type of PCOS at the same time?

Yes. Some women may start with insulin-resistant PCOS and later also develop adrenal issues due to stress. A doctor can help identify overlapping factors.

Does PCOS mean I can never get pregnant?

Not at all. Many women with PCOS conceive naturally, and fertility treatments are available if needed. Identifying the type of PCOS helps improve fertility chances.

Are all women with PCOS overweight?

No. Many Indian women with PCOS are slim but still show symptoms, especially in adrenal or inflammatory PCOS.

Not All PCOS is the Same: 4 Main Types Explained

Studies suggest that PCOS affects at least 1 in 5 women of reproductive age in India. PCOS not only affect a woman’s reproductive organs, but it is also a hormonal disorder that has a far-reaching impact on a woman’s metabolism, fertility, mood, and long-term health conditions.
However, it is important to note that no two female bodies react the same way to the various symptoms of PCOS. While some struggle with insulin resistance, some struggle with obesity, some battle with symptoms triggered after birth-control pill use, and some can even struggle with PCOS despite being fit and healthy. These differences exist because PCOS has different root causes, and understanding that is the first step in choosing the right treatment plan.

Let’s discuss the four main types of PCOS -

1. Insulin-Resistant PCOS

Urban Indians follow a diet rich in refined carbs and lead sedentary lives, leading to Insulin-Resistant PCOS being the most common type in India. When a person with ovaries is diagnosed with insulin resistance, their body stops responding to insulin, the hormone that controls blood sugar. High insulin levels in the body can then trigger the ovaries to produce excess male hormones (androgens), which disrupts ovulation. Some key symptoms include -

Unexplained weight gain (especially around the belly)
Constant sugar cravings
Fatigue after meals
Dark patches on the skin (acanthosis nigricans)
Irregular cycles or missed periods

The biggest key to managing this type of PCOS is through lifestyle changes and minimal medication support. Switching to whole grains, adding more pulses, vegetables, and fibre in the diet. Cutting down on refined sugar and refined flour products is beneficial. Swapping evening carb-rich cookies with healthy options like roasted chana, nuts, or sprouts. Exercising for at least 30 minutes every day, which can include brisk walking, strength training, or yoga. Your gynaecologist may prescribe metformin to help improve insulin sensitivity.

2. Post-Pill PCOS

For women on the birth-control pills, PCOS-like symptoms develop once they stop consuming these pills, which are often prescribed in India to “regulate” periods. These pills suppress the natural hormone production, which, when stopped, usually leads to a temporary PCOS-like picture as the female body takes time to restart ovulation naturally. Some key symptoms include:

Cycles remain irregular for months after quitting the pill
Acne flare-ups
Excess hair growth
Symptoms start only after stopping contraceptives

If you have this type of PCOS, patience is key to managing it. Your body can take up to a year to improve and restart periods naturally. Focusing on a balanced nutritional diet that includes good fats like avocados and protein sources like paneer, tofu, and chicken helps rebuild hormones. Your doctors may also recommend supplements like vitamin B complex, magnesium, or inositol to help you manage the symptoms. Including flax seeds, sesame seeds, and coconut water in your diet is beneficial for your hormones.

3. Adrenal PCOS

This type of PCOS occurs due to extreme and chronic stress, something which is common in every Indian woman’s life due to work, family, and societal pressures. In the Adrenal PCOS, the stress glands (also known as the adrenal glands) produce excess male hormones. However, unlike insulin-resistant PCOS, blood sugar levels remain normal. Some key symptoms include -

High DHEA-S levels in blood tests, while other androgens may be normal
Anxiety, poor sleep, or mood swings
Normal weight but still showing PCOS symptoms
Irregular cycles, often worsened by stress

Stress management through yoga, pranayama, meditation, or simple daily walks is key to managing this type of PCOS. At least 7-8 hours of quality sleep, limiting the consumption of caffeine and processed foods, mindfulness, and spending quality family time are some key ways to manage this type of PCOS. Your medical professional may also prescribe mild anti-androgens to support your journey.

4. Inflammatory PCOS

This type of PCOS is often rooted in chronic low-grade inflammation. It can worsen by exposure to pollution, processed foods, and sedentary lifestyle habits. Inflammation interferes with ovulation and hormonal balance, leading to increased testosterone production by the ovaries. Some key signs include -

Regular cycles, but difficulty conceiving
Acne, skin flare-ups, or unexplained fatigue
Digestive issues like bloating or IBS
High levels of inflammatory markers (CRP) in blood tests

An anti-inflammatory diet rich in fresh fruits, vegetables, turmeric, ginger, and omega-3-rich foods like walnuts and fish is the key to managing this type of PCOS. Cutting down on triggers like highly processed snacks, fried foods, and excessive dairy can also help. Exercises such as swimming, yoga, or walking are highly beneficial too. Incorporating traditional Indian spices such as turmeric, garlic, and jeera, which are natural anti-inflammatory agents, is a good way to manage inflammatory PCOS.

Quick Summary

Types of PCOS	Main Cause	Common Signs	Solutions
Insulin-Resistant	High insulin resistance	Weight gain, dark patches, fatigue	Switch to millets, Metformin, and daily exercise
Post-Pill	Hormone imbalance post-pill	Irregular cycles, acne	Balanced diet, inositol, flax seeds
Adrenal	Stress-related	Anxiety, mood swings, normal weight	Yoga, meditation, and good sleep
Inflammatory	Chronic inflammation	Acne, fatigue, and digestive issues	Turmeric, anti-inflammatory foods, and low-impact exercise

PCOS does not have a one-size-fits-all approach. Knowing the type of PCOS you are affected with can save you from the trial-and-error of remedies, diets, and pills. Consulting a doctor and asking for detailed tests is the first step to managing your PCOS. Combining medical treatments with practical lifestyle changes, incorporating healthy foods into your diet, and practising yoga, mindfulness, and meditation can go a long way toward helping you stay in control of your health. Treating the root cause of your PCOS enables you to see the results last longer, too.

Whether you’re trying to conceive or navigating IVF, you’re not alone. Join our supportive communities to connect, share, and find strength with others on the same journey.

FAQs About Not All PCOS is the Same: The 4 Main Types Explained Simply

Can one woman have more than one type of PCOS at the same time?
Yes. Some women may start with insulin-resistant PCOS and later also develop adrenal issues due to stress. A doctor can help identify overlapping factors.
Does PCOS mean I can never get pregnant?
Not at all. Many women with PCOS conceive naturally, and fertility treatments are available if needed. Identifying the type of PCOS helps improve fertility chances.
Are all women with PCOS overweight?
No. Many Indian women with PCOS are slim but still show symptoms, especially in adrenal or inflammatory PCOS.