Adrenal PCOS: A Comprehensive Guide, Symptoms, Treatments

Explore our in-depth guide about adrenal PCOS, which encompasses symptoms of adrenal PCOS and treatment options. Gain practical insights for managing adrenal PCOS.

January 4, 2024
8 min

Adrenal PCOS is a variant of Polycystic Ovary Syndrome that's not as widely recognized but equally significant. It's characterized by an excess production of male hormones (androgens) from the adrenal glands instead of the ovaries. This guide will dive into the symptoms and treatments of adrenal PCOS, offering insights for those navigating this condition.

Understanding Adrenal PCOS different?

Adrenal PCOS is a subtype of the more commonly known Polycystic Ovary Syndrome, distinguished by its source of androgens. Unlike regular PCOS, where the ovaries produce too many male hormones, adrenal PCOS comes from the adrenal glands. This difference means that even though some symptoms are similar to those of regular PCOS, adrenal PCOS has its own set of unique issues and needs its own ways of being diagnosed and treated.

Here’s how classical PCOS and Adrenal PCOS compare:

Classical PCOS vs. Adrenal PCOS

Classical PCOS:

  • Ovarian Androgens: The ovaries produce excess androgens, leading to various symptoms.
  • Common Symptoms: These include irregular or absent periods, hirsutism, acne, and often, polycystic ovaries detectable via ultrasound.
  • Insulin Resistance: Many women with classical PCOS also struggle with insulin resistance, affecting weight and hormonal balance.
  • Treatment Approaches: Typically involves managing insulin sensitivity, hormonal regulation, and sometimes, ovulation induction.

Adrenal PCOS:

  • Adrenal Androgens: The adrenal glands are the primary source of excessive androgens.
  • Unique Symptoms: Besides the common PCOS symptoms, individuals might experience more fatigue or low blood pressure, linked to adrenal function.
  • Stress Impact: Chronic stress can worsen this type, as the adrenal glands are directly involved in the stress response.
  • Treatment Focus: Often includes stress management, lifestyle changes, and possibly medications to address the specific hormonal imbalances.

Spotting Adrenal PCOS Symptoms

Exploring the Signs of Adrenal PCOS

Identifying adrenal PCOS involves recognizing its symptoms, which can range from the typical PCOS signs like irregular periods and hirsutism to more specific issues related to adrenal function such as unusual fatigue or lower blood pressure. Understanding these can guide individuals towards seeking appropriate evaluation and care.

Common Symptoms:

  1. Menstrual Irregularities: Individuals often face disruptions in their menstrual cycle, similar to other forms of PCOS.
  2. Excessive Hair Growth: Increased androgens, particularly from the adrenal glands, lead to hirsutism or unwanted hair growth on the face and body.
  3. Acne and Oily Skin: Higher levels of androgens can result in more persistent acne and oilier skin than is typically seen with standard PCOS.
  4. Persistent Fatigue: Those with adrenal PCOS might experience pronounced tiredness, potentially linked to issues with adrenal gland function.
  5. Lower Blood Pressure: Some individuals may encounter lower than average blood pressure, a symptom that can be connected to the adrenal aspect of this condition.
  6. Challenges with Weight: Unlike traditional PCOS where significant weight gain is common, individuals with adrenal PCOS might not see substantial weight changes but could still struggle with weight management.
  7. Mood Fluctuations: Hormonal imbalances from the adrenal glands can affect mental health, potentially leading to increased anxiety or depression.
stress can exacerbate adrenal pcos
It is crucial to manage stress levels to avoid exacerbating symptoms

Hormonal Imbalance and Its Effects

The excess adrenal androgens like DHEA-S are central to adrenal PCOS. These hormones can lead to a variety of symptoms and need to be measured for an accurate diagnosis and targeted treatment approach.

Approaches to Managing Adrenal PCOS

Lifestyle Strategies for Symptom Management

Key lifestyle adjustments can significantly impact adrenal PCOS management. Stress reduction is particularly crucial given the adrenal glands' role in stress response. Regular exercise and a balanced diet also play vital roles in overall hormonal balance and symptom management.

Stress Management:

  • Techniques: Practices like yoga, meditation, and mindfulness can significantly reduce stress, which is crucial as stress directly influences adrenal gland hormone production.
  • Impact: Reducing stress can help decrease the production of adrenal androgens, alleviating some of the symptoms of adrenal PCOS.

Regular Exercise:

  • Types: A combination of cardiovascular, strength training, and flexibility exercises can help regulate hormones and improve insulin sensitivity.
  • Benefits: Regular physical activity not only helps in managing weight but also reduces insulin resistance, a common issue in PCOS, and improves overall well-being.

Balanced Diet:

  • Dietary Focus: Emphasizing a diet low in refined sugars and high in whole foods, fiber, lean proteins, and healthy fats can help manage blood sugar levels and reduce insulin resistance.
  • Considerations: Some may benefit from a lower-glycemic index diet, or in certain cases, dairy-free or gluten-free options, but it's essential to tailor dietary choices to individual needs and responses.

Medical and Alternative Treatment Options

Various medications, including corticosteroids and insulin-sensitizing agents, may be prescribed to target the specific hormonal imbalances of adrenal PCOS.


  • Purpose: Low-dose corticosteroids might be prescribed to suppress the overproduction of androgens by the adrenal glands.
  • Considerations: The use of steroids needs careful medical supervision due to potential side effects, particularly with long-term use.

Insulin-sensitizing agents:

  • Common Medications: Metformin is often used to improve insulin resistance. It can help lower insulin levels, which may reduce the production of androgens.
  • Benefits: Beyond improving insulin sensitivity, these medications can also aid in weight management and restore regular menstrual cycles.

Hormonal contraceptives:

  • Effects: Birth control pills can help regulate menstrual cycles and reduce androgen levels. While they may not specifically target adrenal androgens, they can provide symptomatic relief.
  • Options: Different formulations are available, and a healthcare provider can help determine the most suitable one.


  • Function: Medications like spironolactone can help reduce excessive hair growth and acne.
  • Usage: They're often used in conjunction with other treatments, like hormonal contraceptives, for a more comprehensive approach.

Additionally, complementary therapies and psychological support can be integral components of a comprehensive treatment plan.

Often, the most effective management strategy involves a combination of these lifestyle and medical treatments. Regular follow-ups with a healthcare provider are crucial to monitor progress, adjust treatments as necessary, and ensure that any side effects are promptly addressed.

Women experiencing adrenal pcos
Connecting with other PCOS women can help the journey feel less lonely

Regular Monitoring and Adjustments

Ongoing care with a healthcare provider knowledgeable about PCOS is crucial for monitoring hormonal levels, symptoms, and treatment efficacy. Regular check-ups ensure that the management plan remains effective and responsive to any changes.

Conclusion: Navigating Adrenal PCOS with Confidence

Adrenal PCOS, with its unique challenges and symptoms, requires a tailored approach to management. By understanding its distinct characteristics and exploring both traditional and innovative treatment options, individuals can effectively navigate this condition. Remember, effective management is possible, and with the right strategies and support, individuals can lead a healthy and balanced life.

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