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Guide to Adrenal PCOS: What it is, Symptoms & Treatments

Adrenal Polycystic Ovary Syndrome, or adrenal PCOS, might not be as well-known, but it's just as significant as other forms of PCOS. What sets it apart is that it involves the adrenal glands producing too many androgens (male hormones), not the ovaries. This guide is here to explain what symptoms to look out for and how to treat adrenal PCOS, offering essential insights for anyone dealing with this condition.

Understanding Adrenal PCOS

Adrenal PCOS is a variant of the traditional Polycystic Ovary Syndrome that specifically involves an excess of androgens produced by the adrenal glands. Unlike the typical form of PCOS, adrenal PCOS doesn't always present with polycystic ovaries, making diagnosis a challenge. Understanding its unique characteristics is crucial for accurate diagnosis and effective management.

Here’s a breakdown of the differences between the more common form of PCOS & Adrenal PCOS:


  1. Ovarian Origin: In classic PCOS, the ovaries produce an excessive amount of androgens (male hormones), like testosterone.
  2. Symptoms: Common symptoms include irregular or absent menstrual periods, excessive hair growth (hirsutism), acne, and often polycystic ovaries seen in ultrasounds. Women with PCOS may also experience weight gain, especially around the abdomen, and may have difficulty conceiving.
  3. Insulin Resistance: A significant number of women with PCOS have insulin resistance, leading to higher insulin levels which can exacerbate the production of androgens by the ovaries and contribute to symptoms like weight gain and irregular periods.
  4. Treatment: Often includes lifestyle changes like diet and exercise to manage weight and improve insulin sensitivity, as well as medications to regulate menstrual cycles, reduce androgen levels, and help with ovulation.

Adrenal PCOS:

  1. Adrenal Origin: In adrenal PCOS, the adrenal glands, rather than the ovaries, are primarily responsible for the excess production of androgens. The most common androgen secreted in excess is DHEA-S (dehydroepiandrosterone sulfate).
  2. Symptoms: While symptoms can be similar to ovarian PCOS, including irregular periods and hirsutism, women with adrenal PCOS may not always have polycystic ovaries. They might also experience symptoms related to adrenal gland dysfunction, such as fatigue or low blood pressure.
  3. Stress Connection: The adrenal glands are involved in the body's stress response. Chronic stress can exacerbate adrenal PCOS by leading to increased secretion of adrenal androgens.
  4. Treatment: May include managing stress and adrenal function through lifestyle interventions and possibly medications to suppress excess androgen production. Addressing any underlying insulin resistance is also crucial.

While there's an overlap in symptoms and treatment approaches, the primary difference lies in the source of the androgens and the specific hormonal imbalances involved. It's also worth noting that these conditions exist on a spectrum, and individuals may exhibit characteristics of both, making diagnosis and treatment more complex. Understanding the type of PCOS is important for effective treatment, and a healthcare provider can provide a diagnosis and personalized treatment plan based on individual symptoms and hormone levels.

Woman dealing with adrenal pcos fatigue
Chronic stress can exacerbate adrenal PCOS by leading to increased secretion of adrenal androgens

Identifying Adrenal PCOS Symptoms

Recognizing the symptoms of adrenal PCOS is the first step toward getting appropriate care. Common symptoms include irregular or absent menstrual cycles, severe acne, and hirsutism. However, adrenal PCOS can also present with unique signs like fatigue and low blood pressure, stemming from adrenal insufficiency.

Common symptoms include:

  1. Irregular or Absent Menstrual Cycles: As with other forms of PCOS, those with adrenal PCOS often experience disruptions in their menstrual cycle.
  2. Hirsutism: Excess hair growth on the face and body due to increased androgens, particularly from the adrenal glands.
  3. Acne and Oily Skin: Elevated androgen levels can lead to more severe acne and oilier skin than typically seen in traditional PCOS.
  4. Fatigue and Low Energy: Since the adrenal glands are involved, individuals might experience more pronounced fatigue, possibly related to adrenal fatigue or insufficiency.
  5. Low Blood Pressure: Some with adrenal PCOS may experience lower blood pressure, which can be linked to adrenal gland issues.
  6. Weight Fluctuations: While weight gain is common in traditional PCOS, those with adrenal PCOS might not always experience significant weight changes but can still have difficulty losing weight.
  7. Anxiety or Depression: Hormonal imbalances, including those from the adrenal glands, can impact mental health, leading to increased anxiety or episodes of depression.

It's important to note that symptoms can vary widely from person to person, and not everyone with adrenal PCOS will experience all these symptoms.

The Hormonal Imbalance in Adrenal PCOS

The hallmark of adrenal PCOS is the abnormal production of adrenal androgens. Elevated levels of hormones like DHEA-S can indicate adrenal involvement, differentiating it from other types of PCOS. Understanding these hormonal imbalances is key to targeted treatment.

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Navigating Adrenal PCOS Treatment

Treating adrenal PCOS involves a combination of lifestyle modifications and medical interventions aimed at managing symptoms and addressing the root causes of the hormonal imbalance. Here are some common treatment options:

Lifestyle Changes:

  1. Stress Management: Techniques like yoga, meditation, and deep breathing can help manage stress, which is crucial since stress can stimulate the adrenal glands to produce more androgens.
  2. Regular Exercise: Moderate exercise can help regulate hormones, improve insulin sensitivity, and support weight management.

Balanced Diet: A diet low in refined sugars and high in whole foods can help manage blood sugar levels and reduce insulin resistance.


  1. Corticosteroids: Low-dose corticosteroids may help suppress the overproduction of androgens by the adrenal glands.
  2. Insulin-sensitizing agents: Medications like metformin can improve insulin resistance, a common issue in PCOS.
  3. Hormonal contraceptives: Birth control pills can help regulate menstrual cycles and reduce androgen levels, though they may not specifically target adrenal androgens.
  4. Anti-androgens: Medications such as spironolactone can help reduce excessive hair growth and acne.

Supplements and Herbs: Certain supplements and herbs might support adrenal health and hormone balance, such as magnesium, vitamin D, or adaptogenic herbs like ashwagandha. However, it's essential to discuss these with a healthcare provider before starting.

Regular Monitoring: Regular check-ups with a healthcare provider are vital for monitoring hormone levels, adjusting treatment plans, and addressing any new symptoms.

Alternative Therapies: Some may find relief with acupuncture, homeopathy, or other complementary therapies, though these should be used in conjunction with conventional treatment.

Psychological Support: Dealing with PCOS can be challenging, and therapy or support groups can help address the emotional and psychological aspects of living with this condition.

It's important to note that while these treatment options can be effective, the response to treatment can vary among individuals. A healthcare provider who understands PCOS can help devise a personalized treatment plan based on the most current medical evidence and the individual's specific needs and symptoms.

Stress management to help with adrenal pcos symptoms
Techniques like yoga, meditation, and deep breathing can help manage stress

Empowering Your Journey with Adrenal PCOS

Adrenal PCOS is a complex condition, but understanding its symptoms and available treatments is the first step toward effective management. By recognizing the unique aspects of adrenal PCOS and seeking appropriate care, individuals can take control of their health and improve their quality of life. Remember, you're not alone on this journey, and support is available to help you navigate the challenges of adrenal PCOS.

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