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The second most common type of PCOS is caused by high levels of stress hormones, or adrenal PCOS.
In the last section, we learned that excess insulin causes your ovaries to produce higher amounts of testosterone.
This is the most common root cause of PCOS and accounts for at least 80% of PCOS cases.
In adrenal PCOS, the problem isn’t in your ovaries but in your adrenal glands.
High levels of stress triggers your brain to secrete adrenocorticotropic hormone (ACTH).
The ACTH triggers your adrenal glands to secrete cortisol, adrenaline, and another hormone called dehydroepiandrosterone sulfate (DHEAS) to help us respond to stress or danger.
When stress continues for a long time, both cortisol and DHEAS levels continue to rise, leading to Adrenal PCOS.
DHEAS is a member of the androgen family, like testosterone, and causes very similar symptoms like acne, hair loss, and hair growth.
Research shows that at least 20-30% of women with PCOS have adrenal androgen excess.54
While the research in this area is still in its infancy, several studies suggest there may be a genetic link between women with adrenal androgen excess,54 meaning certain Cysters are more likely to develop this form of PCOS.
"Adrenal PCOS is essentially an abnormal response to stress."
You might experience a similar amount of stress to your friend or partner, but find that while they can carry on relatively unscathed, your PCOS symptoms flare up like they’re
going out of fashion.
When I mention “stress” I have likely conjured up an image in your mind of the overworked business woman with an overflowing inbox and looming deadlines.
Or maybe an exhausted mother stuck in traffic with screaming children in the backseat.
The reality is there are many “stressors” that can trigger this increased production of cortisol and DHEAS.
Psychological stress like that described in the scenarios above is very real in our modern world and absolutely contributes to stress hormone production.
However, other areas you may not have considered that could be contributing to your PCOS symptoms include: poor sleep, chronic infections, loneliness, restrictive dieting, over-exercising, autoimmune disease, and over-consumption of stimulants like caffeine.
Even if you don’t feel “stressed out,” you may be hypersensitive to a regular level of stress hormones.
In the opening chapter of this book, we looked at an interesting study that showed that stress experienced during puberty can contribute to the development of PCOS later in life.
Dealing with higher levels of stress in this critical development window likely “hardwires” your brain to be overly sensitive to the effects of stress later in life.
This might be relevant to you if you had a significant loss or traumatic event occur during adolescence, or engaged in extreme dieting or exercise at this time.
Adrenal PCOS was the missing link that tied all of my symptoms together after years of struggling.
Five years into my PCOS journey, I was following an insulin-resistant way of eating and was noticing massive changes to my sugar cravings, moods, and energy.
My skin was starting to clear, but my cycles were still arriving every 60-70 days.
I was frustrated because I had been working so hard on my health whilst also juggling two jobs, university study, and
trying to keep up some semblance of a social life.
I visited my doctor for more advice and she suggested we test my testosterone levels.
A week later, she called me to tell me my levels were completely normal and she didn’t know why my cycles were still so irregular.
I knew there were other androgens that could be contributing to my symptoms, so I took a urine test to measure my DHEAS and cortisol.
To my surprise, my DHEAS levels came back through the roof! My cortisol levels were also well out of range.
These tests showed I had been much more stressed out than I realized.
This was a huge wakeup call to the impact of stress on my PCOS symptoms.
I was getting up at 5am every morning to do a HIIT workout because I knew this improved insulin, then heading off to work followed by night classes at university and weekends packed full of social engagements.
I was strictly following a low carb style of eating and I was pushing myself to do more and be more perfect in every area of my life.
It wasn’t until I pulled back on my own expectations of myself that my symptoms finally resolved.
I switched some of my workouts to slow walks or swims at the beach.
I added a ten minute morning meditation to start the day with lowered stress hormones.
I started saying “No” to events and engagements that didn’t light me up and adopted an 80/20 approach to my way of eating (more on this in chapter 22).
After three months of taking this more relaxed approach, my cycles shortened to 32 days and my skin completely cleared.
I had finally found the missing piece to heal my PCOS at the core.
Even though the HIIT workouts and strict way of eating were helping my insulin, following them 100% was contributing to more stress hormones and therefore more DHEAS.
I had to find a balance that kept both my cortisol and insulin in check at the same time.
At the end of this chapter, we’ll look at how to manage multiple root causes at the same time.
Take the quiz below to rate the likelihood of high stress hormones being a root cause of your PCOS.
Each time you answer yes, give yourself one point.
If you said yes to six or more of the points above, there’s a high chance stress hormones are a driving force behind your PCOS.
If you aren’t sure or would like to confirm this with testing, see below for the best tests to confirm this.
One of the most common PCOS types is a combination of Insulin Resistance PCOS and Adrenal (type 1 + 2).
This is because high stress hormones increase insulin resistance. Insulin resistance puts stress on your body, worsening adrenal PCOS.
As you can see, both conditions contribute to each other.
While this might feel overwhelming at first, it is actually a positive situation because it means that no matter which root cause you start tackling first, the other will respond positively as well.
If you relate strongly to both types, I suggest starting with the Insulin Resistance Core Treatment Protocol in the next section of the book.
Once you feel confident with this, you can move onto the Adrenal Core Treatment Protocol and slowly build in some of these aspects to your existing habits.
If you would prefer to start by treating your Adrenal PCOS and then move onto Insulin Resistance because you feel stress is a bigger issue for you right now, that’s completely fine as well.
Both protocols will work in either order, and you will find several overlaps between them.
"Exercise Should Make you feel more energized soon afterward."
