Adrenal PCOS: Symptoms, causes and treatment

In a nutshell

Excess of androgens (male hormones) is a characteristic of polycystic ovaries syndrome (PCOS). In cases of adrenal PCOS, the adrenal glands produce excess androgens. Symptoms include irregular periods, acne, and excess facial hair. Treatment options include lifestyle changes, hormonal medication, and medications to tackle the symptoms of PCOS.

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Polycystic ovaries syndrome (PCOS) is a common endocrine condition affecting over one in 10 women of reproductive age. Though it may be diagnosed in adolescence, most women with PCOS are undiagnosed. PCOS can lead to difficulty conceiving, and many women don’t receive a diagnosis until they access fertility services for help getting pregnant.

PCOS is characterized by three things: irregular periods, fluid-filled follicles around the ovaries, and excess androgens (male hormones). For most women with PCOS, these hormones are produced by the ovaries, but in adrenal PCOS, it is the adrenal glands that produce too many androgens.

What is adrenal PCOS?

Adrenal PCOS is considered a subtype of PCOS. In most cases of PCOS, the ovaries produce excess androgens (so-called “male” hormones); however, in cases of adrenal PCOS, the excess androgens are made in the adrenal gland instead of the ovaries. The adrenal glands sit on top of the kidneys and produce hormones.

According to a 2022 article published in Diagnostics, around half of women with PCOS produce excess androgens from their adrenal glands. High levels of androgens can cause irregular periods, facial hair, and acne.

Adrenal PCOS is not an official medical diagnosis, but it is a way of better understanding your condition. If you have adrenal PCOS, this may impact the type of medications your doctor prescribes.

Adrenal PCOS symptoms

The symptoms of adrenal PCOS are the same as the symptoms of PCOS. Symptoms of adrenal PCOS include:

• Irregular periods
• Excess facial and body hair
• Acne
• Fatigue
• Thinning hair on the scalp
• Difficulty getting pregnant

If we dust off a 2004 study published in the Journal of Clinical Endocrinology and Metabolism, we can see that 82% of women presenting with symptoms of androgen excess received a PCOS diagnosis.

Causes of adrenal PCOS

Scientists don’t fully understand why PCOS or adrenal PCOS happen. However, there are several theories as to why some women develop adrenal PCOS, including:

• Genetics

PCOS often runs in families.

• Insulin resistance

Insulin resistance causes high blood sugar levels worsening symptoms associated with adrenal PCOS. Scientists don’t yet understand precisely how PCOS and insulin resistance are linked.

• Stress

Women with PCOS have higher levels of stress in the body. We’re not just talking about emotional stress; oxidative and metabolic stress are also relevant. Oxidative stress plays a crucial role in PCOS, with chronic stress leading to adrenal dysfunction, which is why exercise and healthy eating are two treatment options for managing this condition.

Adrenal fatigue PCOS

Adrenal fatigue is a controversial term used to describe symptoms such as fatigue and digestive issues, which are said to be due to adrenal fatigue. However, a 2016 research review published in BMC Endocrine Disorders found no evidence that adrenal fatigue exists.

However, fatigue is a particular problem for women suffering from adrenal PCOS. While this may not be directly related to your adrenal glands, it is still a genuine and debilitating symptom for women with PCOS. Healthy eating, regular exercise, and good sleep hygiene can help fight fatigue.

Adrenal PCOS treatment options

Adrenal PCOS is a chronic condition with no cure. However, you can manage the symptoms with lifestyle changes and medication. Adrenal PCOS treatment options include:

Stress management

Stress nudges the adrenal glands to produce androgens, which could further intensify your PCOS symptoms. Stress management can make a big difference to women with adrenal PCOS. While some stress is unavoidable, changing the way you react to stress could make all the difference. Yoga, mindfulness, and meditation help to reduce stress levels.

Psychological support can also help to reduce stress. Talk therapy and cognitive behavioral therapy (CBT) can help you to manage stress more effectively. Joining a support group for women with PCOS may also help to reduce the psychological symptoms of this disorder.

Exercise

Exercise is often recommended as a treatment option for women with PCOS. Exercise can help to regulate your hormones, reduce stress, and help you maintain a healthy weight.  A 2020 research review found that vigorous aerobic exercise and resistance training improved androgen levels and insulin resistance in women with PCOS.

Another 20202 study published in Frontiers in Physiology found that 120 minutes of vigorous exercise was necessary for favorable health outcomes for women with PCOS.

Adrenal PCOS diet

The food you eat can impact your symptoms. Many women with PCO suffer from insulin resistance, which can lead to blood sugar spikes. Eating a diet to avoid blood sugar spikes may reduce your symptoms and help you maintain a healthy weight. An adrenal PCOS diet is rich in fresh fruits and vegetables, whole grains, lean proteins, and healthy fats. Avoid junk, processed, and sugary foods.

Sleep

Sleep is crucial for health. Sleep problems are common among women with PCOS, especially obstructive sleep apnea, which can cause excessive night wakings and daytime fatigue. Not getting enough sleep can cause hormonal imbalances, insulin resistance, and low mood.

Practice good sleep hygiene by carving out enough time for sleep, avoiding screens in the hour before bed, and avoiding distractions in the bedroom.

Hormonal contraceptive

One of the significant symptoms of adrenal PCOS is hormonal imbalance. A hormonal contraceptive can stabilize your hormones and regulate your menstrual cycle. By stabilizing your hormones and reducing excess androgens, birth control can reduce acne and excess fair and body hair. Speak to your doctor to find out which hormonal birth control option is right for you.

Medication

If you suffer from insulin resistance, there are insulin sensitizers you can take to improve this condition. Reducing your insulin resistance could boost your energy levels, improve your mood, and make it easier to maintain a healthy weight.

A 2016 research study by the National Institutes of Health found that many women with PCOS had adrenal disorder and that medications that block androgens may help to alleviate symptoms. Speak to your doctor to find out which medication they advise.

Supplements

There are dietary supplements that can help manage PCOS symptoms. Speak to your doctor before starting any new supplements. You can try the following supplements to manage symptoms of PCOS:

• Vitamin D

Vitamin D deficiency is common among women with PCOS, and vitamin D supplementation can help to alleviate PCOS symptoms.

• Myo-inositol

A 2017 study published in Endocrine Connections found that Myo-inositol supplementation improved metabolic function and reduced androgen levels in women with PCOS. Ask your doctor for recommendations of supplements that may reduce your symptoms.

• Magnesium

A 2024 study published in Biological Trace Element Research found that magnesium supplementation reduced metabolic dysfunction by improving insulin resistance in women with PCOS.

Summary

PCOS is a sub-type of PCOS. In adrenal PCOS, excess androgens are produced by the adrenal gland, not the ovaries. Excess androgens cause symptoms, including facial hair, acne, and irregular periods. Adrenal

Treatment options for adrenal PCOS include lifestyle changes, such as healthy eating, regular exercise, and stress management. Your doctor may also prescribe medications, including hormonal birth control, anti-androgens, and medications to fight insulin resistance, which may help to alleviate symptoms.