pCOS isn’t just about hormones; it’s metabolic

If you’ve been told you have PCOS, chances are you were given a label… but not a clear explanation.

Maybe you were told it’s a hormone imbalance. Maybe you were handed the pill or Metformin and told to come back when you want to get pregnant. Maybe you were told to lose weight, without being told how your body is actually working.

And if you’ve tried to do everything right but still feel stuck in your body, you’re not going mad.

Because PCOS isn’t just hormonal. At it’s core, it’s metabolic.

And once you start to understand that, everything starts to make more sense.

What PCOS actually is

PCOS (Polycystic Ovarian Syndrome) is often described as a reproductive condition. But this is where things get a little misleading.

Yes, it can affect your cycle.

Yes, it can impact ovulation.

Yes, it can show up as cysts on the ovaries.

But underneath all of that… there is usually something deeper driving it.

The 4 types of PCOS (and why knowing your type matters)

Before we go any further, it's important to know that not all PCOS is the same, and this is where so many women get stuck. Because while you may share the same diagnosis as someone else… the driver behind it can be completely different.

Broadly, PCOS can be grouped into four main types:

  1. Insulin-resistant PCOS

  2. Post-pill PCOS

  3. Inflammatory PCOS

  4. Adrenal PCOS

All PCOS sub-types tend to present with irregular or missing cycles, poor or no ovulation, trouble conceiving, anxiety, low mood. But here are the distinguishing features among each sub-type:

Insulin Resistant PCOS

This is the most common type and yet is often the most overlooked. It’s driven by underlying insulin resistance, which impacts how your body processes glucose and stores energy.

You might notice:

  • Weight gain or difficulty losing weight

  • Strong cravings (especially for carbs or sugar)

  • Energy crashes

  • Fat storage across your whole body (for most it is greatest around the abdomen)

  • Facial hair

  • Hair thinning

  • Skin tags

This is where supporting blood sugar becomes foundational to managing symptoms and preventing further metabolic decline.

Post-pill pCOS

This can show up after coming off the oral contraceptive pill. The pill suppresses ovulation, so when you come off it, your body can take time to re-establish its natural rhythm.

You might notice:

  • Irregular or missing cycles after stopping the pill

  • Acne (often new or worsened) around your jawline or back

  • Temporary hormone imbalances

In many cases, this type is very easily reversible with the right support.

Inflammatory PCOS

This type is driven by underlying inflammation in the body. This inflammation can disrupt ovulation and increase androgen levels.

You might notice:

  • Skin issues

  • Fatigue

  • Digestive symptoms

  • Joint pain

Here, the focus shifts to calming the system and addressing root drivers of inflammation.

Adrenal PCOS

This type is linked more closely to stress and the adrenal glands. Instead of insulin being the main driver, it’s often elevated stress hormones influencing androgen levels.

You might notice:

  • Feeling exhausted but also can't switch off

  • Sleep issues

  • Anxiety or overwhelm

  • Regular cycles, but high androgens on testing

  • Caffeine is your clutch

  • Cravings

  • Energy slumps

This is where nervous system support becomes essential.

Knowing your type changes Everything

When you understand your type (or combination of types), your approach becomes clearer. Because what works for one woman with PCOS… may not work for another.

And this is often why:

  • You’ve tried things that should work

  • You’ve followed advice that didn’t fit

  • You’ve felt like your body isn’t responding

It’s not that your body is difficult. It’s that your approach needs to match your physiology.

With love x

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