PCOS by Type: Treat the Root Cause
Lara Briden's root-cause framework for PCOS: identify which of four underlying types is driving your symptoms, then match the treatment approach to that type, alongside your own clinician.
Rule out other causes of androgen excess before accepting a PCOS diagnosis
Why ↓
PCOS is best defined as androgen excess once other causes (high-androgen birth control, congenital adrenal hyperplasia, high prolactin) are ruled out; ovarian cysts on ultrasound alone do not diagnose or rule out PCOS.
Test triglycerides, ALT or fasting insulin, not just blood glucose or HbA1c
Why ↓
A normal blood glucose or HbA1c cannot rule out insulin resistance; Briden's treatment approach for this type is quitting sugar, gentle intermittent fasting, and supplements including magnesium, lipoic acid, inositol and berberine.
Note whether symptoms started 3 to 6 months after stopping a drospirenone or cyproterone birth control pill
Why ↓
Coming off certain birth-control pills can cause a temporary androgen surge that qualifies for a PCOS diagnosis even though it usually resolves. Briden warns against using these herbs as a teenager, immediately after stopping the pill, or for more than about 10 months without reassessment.
Look for other signs of chronic immune activation alongside androgen excess
Why ↓
Chronic inflammation can stimulate the ovaries and adrenal glands to overproduce androgens; addressing the underlying inflammatory driver is Briden's stated approach for this type.
Check whether only DHEAS is elevated, with normal testosterone and androstenedione and regular cycles
Why ↓
This type is not driven by insulin resistance or inflammation, so the insulin- and inflammation-focused treatments above are less likely to help; it needs its own approach.
Treat this as education, not a diagnosis or a substitute for your own clinician
Why ↓
Briden is a naturopathic doctor, not an MD or endocrinologist; hormone-panel interpretation, ruling out other causes of androgen excess, and any medication decisions belong with your physician.
Treating every PCOS diagnosis the same way misses that the underlying driver differs by person; Briden's own clinical framework matches the treatment lever (insulin, hormonal, inflammatory or adrenal) to the actual mechanism, which she and colleagues have argued for in peer-reviewed work on PCOS heterogeneity.
4 Types of PCOS (a Flowchart) - Lara Briden
Inositol for Mood, Sleep, and PCOS (Polycystic Ovary Syndrome) - Lara Briden
Treatment for 4 Types of PCOS. Treat the Cause. - Lara Briden
Not medical advice. This page is for education only and is not a substitute for professional medical care. Consult a qualified clinician before changing your health routine.
Independent curation. YourProtocol is an independent platform. This protocol is based on the publicly available work of Lara Briden and is not created, reviewed, endorsed by, or affiliated with Lara Briden or Naturopathic Doctor (ND), Author · Period Repair Manual.
Is this for you
- Anyone diagnosed with PCOS wanting to understand which underlying type may fit their symptoms
- People whose PCOS treatment hasn't worked and want a root-cause framework to discuss with their clinician
- Not a substitute for diagnosis or care from an OB-GYN or endocrinologist
Cautions
- Lara Briden is a Doctor of Naturopathic Medicine (ND), not an MD or endocrinologist; a diagnosis and any hormone-level interpretation belongs with your physician or endocrinologist
- Herbs mentioned (vitex, licorice, peony) are pharmacologically active and can interact with hormonal birth control, fertility treatment and other medications; Briden herself warns against combining vitex with elevated LH, using these herbs as a teenager, or continuing them for more than about 10 months without reassessment
- Licorice can raise blood pressure; avoid it if you have hypertension, per Briden's own guidance
- Supplement doses (for example, myo-inositol 2g twice daily) are Briden's own stated clinical recommendation, not a universal prescription; confirm with your own doctor before starting, especially if pregnant, trying to conceive, or taking other medication
- PCOS itself must be diagnosed by ruling out other causes of androgen excess; this page is not a diagnostic tool
- Media note: only three verified Read sources are confirmed for this page as of publish; Listen/Watch/Clip sources are an open gap pending a further verification pass, not fabricated placeholders
- Educational only, not medical advice