Which type of PCOS do you have?

Which type of Polycystic Ovarian Syndrome do I have?

There are four different types of PCOS according to the Rotterdam Criteria.

Do you know which one you have?

Lets work it out:

HOP – Hyperandrogenism, Oligomenorrhoea and Polycystic ovaries.

HOP stands for Hyperandrogenism, Oligomenorrhoea and Polycystic ovaries.

If you you have this type you will have:

  • High testosterone on a blood test (and possibly some of the correlated symptoms of hyperandrogenism like acne and changes in hair growth).
  • Infrequent (less than 8) menstrual cycles per year. This is also called oligomenorrhoea.
  • Polycystic ovaries- discovered through ultrasound.

OH – Oligomenorrhoea and Hyperandorgensism

OH stands for Oligomenorrhoea and Hyperandrogensism

If you have this type you will have:

  • High Testosterone
  • Oligomenorrhea

HP – Hyperandrogenism and Polycystic ovaries


HP stands for Hyperandrogenism and Polycystic ovaries

If you have this type you will have:

  • High testosterone
  • Polycystic ovaries

OP – Oligomenorrhoea and Polycystic ovaries

OP stands for Oligomenorrhoea and Polycystic ovaries

If you have this type you will have:

  • Oligomenorrhoea
  • Polycystic ovaries

This diagnostic criteria doesn’t take into account that many women with PCOS will also experience a change in blood sugar regulation, insulin resistance and blood lipids (cholesterol).

As this is a major driver, and symptom, for a large percentage of women living with PCOS.

This information means that without addressing diet, in particular refined carbohydrate and alcohol intake, we’re not treating a major aspect of PCOS.



3 out the 4 types of PCOS are marked by high testosterone.

These can be categorised as androgenic type.

If a women is diagnosed with an androgenic type of PCOS, it puts her at an increased risk of:

  • High levels of inflammation
  • High fasting blood glucose levels
  • Increased incidence of insulin resistance
  • Increased incidence of non-alcoholic fatty liver disease; independant of obesity and insulin resistance
  • Increased likelihood of pelvic pain, dyspareunia (painful urination), urinary urgency and nocturia (needing to go to the toilet in the middle of the night)


Can we address high testosterone and its associated risk factors?

Lowering testosterone levels in women can be tricky, in terms of pharmaceutical medications, there aren’t really many options other than using the oral contraceptive pill, or hormone replacement therapy.

This technically doesn’t address the testosterone, it simply increases levels of oestrogen and progesterone. For many women, this isn’t enough to address their symptoms.

Also, coming off the pill can actually increase testosterone ratios, exacerbating the initial issue of high testosterone.

It’s no wonder that most women diagnosed with PCOS are dissatisfied with pharmaceutical intervention.

In a 2001 study, as many as 99% of women being treated for PCOS were dissatisfied with the OCP and fertility drugs, and many reach out to try natural and complimentary or alternative medicines.


Can Herbal Medicine Help?

There are several herbal medicines that can help to reduce testosterone from the body, and support many of the other processes that might need some nourishing in someone with PCOS.

In conjunction with changes to diet and lifestyle, and even nutritional medicines, herbal medicines can help to:

  • Reduce testosterone
  • Increase and regulate menstrual cycles and ovulation
  • Reduce occurrence of polycystic ovaries
  • Balance out blood sugar regulation issues and decrease insulin resistance

Some herbal medicines that are particularly helpful in PCOS:



Gymnema sylvestre in sack bag, isolated on white

In Ayurvedic medicine Gymnema is known as the ‘sugar destroyer’ and it does precisely that.

It helps our body to become more sensitive to the effects of glucose in the blood by improving insulin resistance.

Gymnema can also affect the way we taste sugar. One drop on the tongue has an anaesthetising effect on the sweet tastebuds, this can be used to our benefit to reduce the addictive nature of high sugar foods.

In PCOS management, this helps to improve the sensitivity of the ovaries to energy sources.

If your PCOS is also accompanied by blood sugar dysregulation, weight gain or even just sugar cravings, this one is for you!




Dry Liquorice Herb

Liquorice is a favourite amongst herbalist because it has so many uses.

For PCOS it is excellent at reducing excess androgens (testosterone), so a perfect fit for the following types of PCOS: HOP, OH and HP.

It is also a beautiful adrenal tonic helping to sustain energy levels in people who are stressed.

However, because liquorice can affect different people in different ways it is one herb that is best prescribed by a naturopath.




Peony is a go-to herb for SO MANY women’s health issues, from heavy and painful periods, to PMS to PCOS.

It works to balance out hormones (including decreasing testosterone) but also helps to regulate cycles and reduce cramping and blood loss- so is for perfect for those individuals who suffer from both PCOS and endometriosis.

I love to use Peony for women who have recently come off the oral contraceptive pill.

Mainly because it is what probably should have been given to women who have been put on the pill for menstrual complaints like heavy periods, irregular cycles and PMS. The only drawback?

It’s not a contraceptive…so you will need to make other plans in that department.


And these three herbs are just scratching the surface of all the incredible herbs available to treat PCOS, and most other female hormone conditions!

The hardest part is often getting the diagnosis, so if you’ve been given the diagnosis, or even just suspect that you might have some level of PCOS going on, it is important to know that there are other options than the oral contraceptive pill.

And many of them can help bring you back into a regular, healthy cycle, for good! 🌸