Dr. Patti Yik breaks PCOS into four subtypes: insulin-resistant, inflammatory, adrenal, and post-pill. Each needs different treatment. Insulin-resistant PCOS responds to inositol and berberine; inflammatory PCOS to anti-inflammatory diet and omega-3s; adrenal PCOS to adaptogens and stress management. Spearmint tea and vitamin D help all types.
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If you have PCOS and you want to get pregnant, This video is for you. Not the standard lose weight and take metformin conversation, but a real specific discussion about what's actually driving your PCOS, why that matters for your fertility, and what a root cause naturopathic approach looks like in practice. Let's get into it. First, I want to reframe how we think about PCOS. It is not a single uniform condition. It's a diagnosis applied to a cluster of symptoms— irregular cycles, elevated androgens, polycystic ovaries on ultrasound— that can have several very different underlying causes. And the treatment that works brilliantly for one type of PCOS may do nothing for another. This is the most important thing I can tell you in this video, and it's the foundation of everything else. There are 4 distinct types of PCOS, each with a different driver, each requiring a different therapeutic approach. Type 1: insulin-resistant PCOS. This is the most common type. Elevated insulin drives the ovaries to produce excess androgens— testosterone and DHEA— which disrupt the hormonal environment needed for ovulation. This is the, the type most often addressed with metformin in conventional medicine, but there are powerful natural alternatives. Type 2, inflammatory PCOS. This is driven by chronic low-grade inflammation rather than insulin. Elevated inflammatory cytokines directly stimulate androgen production independently of insulin. Women with this type often have elevated inflammatory markers, food sensitivities, gut dysbiosis, and conditions like endometriosis alongside their PCOS diagnosis. Type 3, adrenal PCOS. In this subtype, the androgen excess comes not from the ovaries, but from the adrenal glands, driven by chronic stress, And HPA axis dysregulation. The key marker is elevated DHEAS, with normal or mildly elevated ovarian androgens. Standard PCOS workups frequently miss this distinction entirely, and the therapeutic approach is completely different. Type 4, post-pill PCOS. This describes the temporary hormonal disruption that follows Discontinuation of oral contraceptives, which can mimic the PCOS pattern. The pill suppresses HPG axis function during use, and when discontinued, the axis can take months to resume normal rhythm. Why did this matter so profoundly? Because a protocol optimized for insulin-resistant PCOS will not correct the inflammatory driver in inflammatory Adrenal support strategies are irrelevant if the androgen excess is ovarian. Understanding which type you have is the foundation of effective treatment. Once we've identified the type of PCOS through comprehensive functional testing, the intervention is matched to the findings. For insulin-resistant PCOS, inositol are among the most evidence-supported natural interventions available. Multiple randomized controlled trials show meaningful improvements in ovulation, hormone levels, and pregnancy rates. Berberine shows comparable effects to metformin in several studies, and diet focuses on blood sugar regulation, not caloric restriction. For inflammatory PCOS, an anti-inflammatory dietary protocol Gut microbiome restoration, omega-3 fatty acids at therapeutic doses, and targeted antioxidant support directly address the inflammatory driver. For adrenal PCOS, adaptogenic herbs, adrenal nutrient support, HPA axis regulation strategies, and the stress response work I covered in my previous video are the primary interventions. And across all types, vitamin D optimization is universally relevant. Low vitamin D worsens insulin resistance, elevates androgens, and impairs ovarian function regardless of subtype. Spearmint tea, just 2 cups daily, has documented androgen-lowering effects in clinical trials. If you've been managing PCOS symptoms for years, And nobody has ever told you which type you have, that conversation is overdue. Book a free 15-minute discovery call through the link in the description. I'd love to find out what's actually driving your PCOS and build a plan around it. Give this video a like if it was helpful and subscribe for weekly fertility health content. I'll see you in the next one.
