Causes of Polycystic Ovarian Syndrome (PCOS)

In my previous post, I explained that functional medicine doctors define Polycystic Ovarian Syndrome (PCOS) as a group of symptoms associated with anovulation and high androgen levels. Androgens (male sex hormones) play a significant role in diagnosing and managing Polycystic Ovarian Syndrome (PCOS). To find out whether or not you are androgen dominant, I recommend using the Dutch test (use code Evie100 to save $100). This at-home, dried urine test, will provide a complete hormone analysis to determine your hormone levels. Based off the results, you’ll be able to identify if you have high levels of androgens.

PCOS Symptoms.png

Androgen excess doesn’t happen out of the blue. There are reasons, or as Dr. Briden calls them, drivers, of androgen excess. The four drivers she identifies are:

  • insulin-resistant PCOS

  • post-pill PCOS

  • inflammatory PCOS

  • adrenal PCOS

This easy-to-read flow chart is from an article by Dr. Briden.

4-Types-of-PCOS lara briden.png

As you can see, there are different reasons you might be androgen dominant. The priority here is to find out if you even have insulin resistance, because this is at the top of the list.

Insulin Resistant PCOS

Insulin resistance can lead to PCOS because it can impair ovulation and cause your ovaries to make too much testosterone and not enough estrogen. Insulin resistance is caused by too much sugar, but note that you could still have normal blood sugar when you test it. You must also look at insulin levels. Other causes of insulin resistance are from smoking, hormonal birth control, lack of sleep, alcohol, gut dysbiosis, magnesium deficiency, and environmental toxins.

Post-Pill PCOS

This driver of PCOS is common for women who stop taking hormonal birth control. When coming off birth control, you might encounter symptoms that qualify you for a PCOS diagnosis. The good news is that this type of PCOS is typically temporary because it is caused by coming off of the pill and not a true hormonal imbalance that will last long. Once your body adapts to no longer having the synthetic hormones, your ovulation, insulin levels, and vitamins/minerals will begin to normalize once again. This in turn can get rid of post-pill PCOS.

pcos ovaries

Inflammatory PCOS

This type of PCOS is caused by inflammation and environmental toxins (as I’ve mentioned in previous posts). Your hormone receptors are disrupted with high levels of inflammation which signals your adrenal glands and ovaries to make more androgens. Inflammation can come from a variety of triggers such as certain foods, smoking, lifestyle/environmental toxins, and digestive issues.

Adrenal PCOS

This type of PCOS is diagnosed if you do not have any of the other “types” of PCOS but are still androgen dominant. Dr. Briden describes adrenal PCOS as happening when you’ve ruled out other causes of PCOS and have elevated DHEAS, but normal testosterone and androstenedione.

This might seem overwhelming, but it doesn’t have to be. Working with a functional practictioner can help you identify which cause of PCOS you have and how to address it. All of these are addressed with diet, lifestyle, and sometimes medication/supplementation. The first part of reversing your PCOS is knowing the cause!