Adrenal PCOS Symptoms: The Stress-Driven Hormonal Imbalance You Might Be Overlooking
When people talk about PCOS, they’re usually referring to the “classic” type—irregular periods, ovarian cysts, and high testosterone linked to insulin resistance. But what if your blood sugar is normal, you’re not insulin resistant, and you’re still dealing with PCOS symptoms?
Enter: Adrenal PCOS.
It’s real, it’s underdiagnosed, and it’s often totally driven by stress.
Let’s unpack what it is, how it’s different from other types of PCOS, and the signs that point to this sneaky hormonal imbalance.
What Is Adrenal PCOS?
Adrenal PCOS is a subtype where the adrenal glands (your stress glands) are the main source of elevated androgens (like DHEA-S). In this case, high stress = hormonal chaos.
Unlike other forms of PCOS, this type isn’t typically caused by insulin resistance or inflammation—it’s more about HPA-axis dysfunction (the communication between your brain and adrenal glands).
Adrenal PCOS Symptoms
If you suspect stress is a major player in your PCOS story, see if these sound familiar:
⚡ You’re wired but tired
Can’t sleep at night, but feel sluggish all day? Classic adrenal imbalance.
😩 You’re sensitive to stress
Little things make you anxious, overwhelmed, or emotional—and your body seems to “overreact” to everything.
🕒 You have irregular or missing periods
Even without insulin resistance, your cycle might be missing, delayed, or unpredictable.
💆♀️ You crave salt more than sugar
Craving salty chips or pickles like they’re air? That can be a sign of adrenal fatigue.
💥 You break out around your jawline or chin
Androgens (like DHEA-S and testosterone) can trigger acne in the lower face area.
🧬 Your labs show elevated DHEA-S
This is key. In Adrenal PCOS, your DHEA-S (dehydroepiandrosterone sulfate) is high, but testosterone and insulin may be totally normal. That’s how you know the androgens are coming from your adrenal glands, not your ovaries.
What about Cortisol
Cortisol is not often tested in the mainstream medical system but it can give valuable information about your stress patterns. Cortisol changes throughout the day, but for women with PCOS, it can spike at the wrong times (“wired and tired” feeling at night) and dip too low when it should be high, leading to daytime exhaustion. The best way to test cortisol is with saliva testing, collected four times throughout the day. For a convenient at home test, check out Rupa Health’s Diurnal Cortisol Test.
Why Do Adrenal PCOS Symptoms Happen?
Your adrenal glands release DHEA-S (and other hormones) when your body is under stress—whether that stress is emotional, physical, mental, or even environmental.
And in today’s world? Constant stress is kind of the norm. Think:
• Overworking
• Under-eating
• Too much high-intensity exercise
• Not enough sleep
• Emotional stress or trauma
• Chronic anxiety
When your body thinks it’s in danger all the time, it ramps up stress hormone production—and your cycles (and skin, mood, and energy) can pay the price.
Healing from Adrenal PCOS Symptoms
This type of PCOS needs a nervous system first approach. You can’t “out-supplement” stress, but these tips can really help:
🧘♀️ 1. Prioritize Calm
Daily nervous system regulation is essential. Try breathwork, yoga, meditation, journaling, or even just 10 minutes of quiet.
😴 2. Sleep is therapy
Aim for 7–9 hours of solid sleep. Your adrenals heal during rest, not during hustle.
🥑 3. Eat enough (and often)
Skipping meals or under-eating can signal “danger” to your body. Focus on balanced meals with protein, fat, and carbs—every 3–4 hours.
🚫 4. Ditch the HIIT (for now)
High-intensity workouts can actually worsen adrenal stress. Try walking, Pilates, or strength training instead.
🌿 Supplements That Can Help Adrenal PCOS Symptoms (With Your Doctor’s OK)
✨ Magnesium
Calms the nervous system and helps regulate cortisol. Bonus: also great for sleep and mood.
🌿 Ashwagandha
An adaptogenic herb that supports adrenal function and helps your body respond to stress more gracefully.
💊 Vitamin C + B5
Your adrenals burn through these when you’re stressed. Supplementing can support their recovery.
💆♀️ Phosphatidylserine or Rhodiola
May help blunt cortisol spikes and improve mood and focus under stress.
⚠️ Always talk to your doctor or integrative practitioner before starting any new supplements—especially if you’re on medication or have other health conditions.
Click here to access Dr. Whelan’s curated Adrenal PCOS protocol on Fullscript.
Final Thoughts
Adrenal PCOS is real, and it’s not “just in your head.” If you’re dealing with burnout, stress, and stubborn symptoms despite normal labs or a healthy lifestyle—it might be time to dig deeper.
Balancing your hormones isn’t just about what you eat or how you move. It’s also about how safe and supported your body feels.
About Dr. Whelan
Dr. Whelan is a highly regarded licensed naturopathic doctor (N.D.) and Creighton Model FertilityCare™ Medical Consultant. She personally struggled with adrenal PCOS symptoms for twenty years before learning how to reverse these symptoms.
She is renowned for her expertise in treating women’s reproductive hormone disorders. Her practice specializes in lifestyle medicine, nutritional counseling, botanical medicine, and bioidentical hormone replacement therapy.
Dr. Whelan’s main focus addresses hormone imbalances related to conditions such as PCOS, Hashimoto’s, heavy menstrual bleeding, PMS, perimenopause symptoms – (including insomnia, brain fog, fatigue, anxiety, depression, digestive issues), fertility issues, irregular menstrual cycles, and endometriosis.
She earned her Doctor of Naturopathic Medicine (ND) degree from the National University of Natural Medicine. She completed additional training as a Creighton Model FertilityCare™ Practitioner and NaPro Medical Consultant from the St Paul VI Institute in Omaha, NE.
Dr. Whelan is the owner of Dr. Jessica Ann Whelan, ND, PLLC and St Joseph FertilityCare™ Center, an affiliate of the FertilityCare Centers of America.