The 4 Types of PCOS (PMOS) and How to Manage Them Naturally

Quick answer: PCOS (now also called PMOS) is often grouped into four practical "types": insulin resistant, post-pill, adrenal and inflammatory. These aren't official medical diagnoses, but they're a useful way to think about what might be driving your symptoms. Whatever your type, the international PCOS guideline puts healthy eating you can stick to, regular movement, sleep and stress care first, ideally alongside your GP.

When I was diagnosed in 2017 I felt completely lost. Understanding what was driving my symptoms was the turning point, so in this guide I'll walk you through each type, the signs to look for, and the management strategies with the best evidence behind them. I'll also be honest about where the research is still thin.

First, a quick note on the "4 types"

The four types are a framework popularised by naturopaths and integrative practitioners. Doctors diagnose PCOS using the international guideline criteria (irregular cycles, signs of high androgens, and ovary findings or AMH levels), not by type. Many women also fit more than one type. So use this as a guide to start a conversation with your health professional, not as a self-diagnosis.

You might also have noticed PCOS has a new name. In May 2026 a global consensus published in The Lancet renamed it polyendocrine metabolic ovarian syndrome (PMOS), to better reflect that it affects hormones and metabolism, not just the ovaries. Both names will be used for a few years while the change rolls out.

1. Insulin resistant PCOS

What it is: Insulin resistance means your body needs more insulin to keep blood sugar steady. Higher insulin can push the ovaries to make more androgens (like testosterone). The international guideline describes insulin resistance as a key driver of PCOS, and it can affect women of any body size, not only those carrying extra weight.

Common signs:

  • Weight gain around the tummy that's hard to shift
  • Sugar cravings or energy crashes after meals
  • Dark, velvety patches of skin on the neck, armpits or groin (acanthosis nigricans)
  • Irregular or missing periods, acne, excess hair growth or scalp hair thinning

What helps:

  • Eating you can sustain: The 2023 guideline found no evidence that any one diet beats another for PCOS. What matters is a healthy pattern you can keep up. For many women that looks like plenty of vegetables, protein and healthy fats at each meal, wholegrain or high-fibre carbs, and fewer refined sugars and ultra-processed foods.
  • Move most days: The guideline recommends 150 to 300 minutes of moderate activity a week (or 75 to 150 minutes of vigorous activity), plus strength training on two days. No single type of exercise has been shown to be best, so pick what you enjoy.
  • Inositol: The guideline says inositol may be considered. It's low risk and may help some metabolic markers, but the benefit for periods, hair growth and weight is limited. Chat to your GP, as metformin is the better-studied option for some symptoms.
  • Herbal teas: Ceylon cinnamon has been studied for blood sugar support, though most research uses supplements rather than tea. Cysterhood and Chaihood include Ceylon cinnamon and are a lovely daily ritual to pair with the steps above.

2. Post-pill PCOS

What it is: Some women notice acne, hair shedding or irregular cycles after stopping the contraceptive pill. This can be the body readjusting, and for many it settles within a few months. It isn't a formal diagnosis, and the pill can also mask PCOS that was already there, so if symptoms last more than six months it's worth getting properly assessed.

Common signs:

  • New or worse acne after coming off the pill
  • More hair shedding than usual
  • Periods that are irregular or don't return
  • No PCOS signs before you started the pill

What helps:

  • Give it time and track your cycle: Use an app or diary so you and your GP can see what's happening month to month.
  • Nourishing whole foods: Leafy greens, berries, oily fish, nuts and seeds support your overall health while your cycle resets.
  • Sleep and stress care: Both affect your hormones, and they're free.
  • Spearmint tea: In a small randomised trial, women with PCOS who drank two cups of spearmint tea a day for 30 days had lower androgen levels and better quality of life scores than those on a placebo tea, though hair growth scores didn't change significantly in that short time. Cysterhood is spearmint-based.

3. Adrenal PCOS

What it is: Here the extra androgens come mainly from the adrenal glands (which also manage your stress response) rather than the ovaries. It usually shows up as raised DHEA-S on a blood test with normal testosterone. One study of women with high androgens found about a third of those with PCOS had raised DHEA-S.

Common signs:

  • Raised DHEA-S with normal testosterone
  • Symptoms that flare during stressful times
  • Acne and some excess hair growth
  • Feeling wired but tired

What helps:

  • Get tested properly: The guideline recommends testosterone as the first test, with DHEA-S as an extra if testosterone is normal. Ask your GP.
  • Stress care you'll actually do: Walking, yoga, breathwork, time outdoors, or simply saying no more often.
  • Protect your sleep: A consistent bedtime and morning light help keep your stress hormones in rhythm.
  • Adaptogens: In a 60-day randomised trial of stressed adults, ashwagandha root extract lowered cortisol and stress scores compared with placebo. Zenhood blends ashwagandha with calming herbs like tulsi and skullcap. Check with your GP first if you're pregnant, trying to conceive or on thyroid medication.

4. Inflammatory PCOS

What it is: Research shows many women with PCOS have higher levels of low-grade inflammation, which is linked to insulin resistance and androgen production. In this type, inflammation seems to be a big part of the picture.

Common signs:

  • Fatigue that doesn't lift
  • Headaches, aches or joint pain
  • Skin issues like eczema
  • Bloating or other gut troubles

What helps:

  • Plenty of colour and fibre: Vegetables, fruit, legumes, wholegrains, oily fish, nuts and seeds.
  • Less of the inflammatory stuff: Ultra-processed foods, fried foods, sugary drinks and too much alcohol.
  • Gut support: Fermented foods like yoghurt, kefir, sauerkraut and kimchi, if they agree with you.
  • Warming spices: Turmeric and ginger are well studied for inflammation in general. Chaihood is built around them.

What the evidence does and doesn't show

I want to be upfront with you. Lifestyle changes (food, movement, sleep, stress) have the strongest evidence for PCOS. Some individual herbs, like spearmint and cinnamon, have promising early studies, but they're small and short, and no herbal blend has been tested as a PCOS treatment. I think of herbal teas as a supportive daily ritual alongside proper care, never instead of it. Thousands of our customers tell us they love them, but please keep working with your GP or specialist, especially if you're trying to conceive.

Frequently asked questions

How do I know which type of PCOS I have?

Look at your symptoms and blood tests together. Ask your GP for testosterone, DHEA-S, fasting glucose and insulin markers, and inflammation markers if relevant. Many women have more than one type.

Can PCOS be cured naturally?

There's no cure for PCOS, but many women manage their symptoms really well with lifestyle changes, and some find their cycles become regular again. Medical treatment can be an important part of that too.

Is PMOS the same as PCOS?

Yes. PMOS (polyendocrine metabolic ovarian syndrome) is the new name for PCOS, agreed in 2026. The condition and its diagnosis are the same.

Does spearmint tea help PCOS?

Small studies suggest two cups a day may lower androgen levels, but bigger, longer trials are needed to know whether it reliably reduces hair growth or acne.

Sources

Written by Brigitte Warne. Brigitte has a degree in Public Health and Health Promotion, was diagnosed with PCOS in 2017, and co-hosts the PCOS Girls Podcast. This article is general information only and isn't a substitute for advice from your GP or specialist.

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