Which PCOS type are you?

Women with PCOS share many similar experiences, yet there is quite a bit of variation among the PCOS experience.

Why do women with PCOS have different symptoms? 

Why is there body diversity among the PCOS community if we all have the same condition? 

Will the same medications help everyone? 

The questions are endless!

Research has demonstrated women with PCOS can be separated in four different categories depending on three basic PCOS symptoms:

  • inconsistent and/or lack of ovulation (oligo/anovulation),
  • increased male sex hormones (hyperandrogenism),
  • and the presence of cysts on ovaries (polycystic ovaries).

Yes, you read that correctly, having cysts on your ovaries is not a requirement to having PCOS. One study identified the following four types of PCOS, and these four types have built the foundation for understanding the general differences between women with PCOS:

Oligo/

anovulation

Hyper-

androgenism

Polycystic

ovaries

Classic polycystic ovary PCOS                X                X              X
Classic non-polycystic ovary PCOS                X                X
Non-classic ovulatory PCOS                X              X
Non-classic mild PCOS                X              X

Since these types of PCOS were identified many researchers examined what other symptoms vary between the types.

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The classic polycystic ovary PCOS is the most prevalent type of PCOS, and, unfortunately, it is associated with the most negative health outcomes. People with this type of PCOS are more likely to experience more severe insulin resistance (more on that here). They are also at an increased risk of having unhealthy lipid panels.

All three types of PCOS that have hyperandrogenism are at an increased risk for developing cardiovascular disease.

There are also hormonal differences between the types. One study found that women with classic polycystic ovary PCOS have higher testosterone levels than the other types.

There have been some studies that compared the body sizes and shapes between the types of women with PCOS. Most studies find that women with the Classic polycystic ovary PCOS are most likely to have larger bodies and carry more weight around the midsection.

Although the research on body diversity and PCOS is super scarce, this is such a great indicator that women with PCOS should not be expected to have a particular body type. I have heard so many people suggest that if there are thin women with PCOS then all women with PCOS should and can be thin. This is false for any population- especially for women with PCOS.

Differentiating between types of PCOS gives me hope for the future of PCOS research. So many people with PCOS feel disappointed with the quality of healthcare of treatment options available.

I hope that by better understanding different PCOS experiences, future treatment options will be more individualized.

Let’s continue this conversation in the Facebook PCOS Support Group. Click here to join! Which type are you? Did that keep you from getting accurately diagnosed?

References

Aziz, M., Sidelmann, J. J., Faber, J., Wissing, M. M., Naver, K. V., Mikkelsen, A., . . .

Skouby, S. O. (2015). Polycystic ovary syndrome: cardiovascular risk factors according to specific phenotypes. Acta Obstetricia et Gynecologica Scandinavica, 94, 1082-1089. doi:10.1111/aogs.12706

Clark, N. M., Podolski, A. J., Brooks, E. D., Chizen, D. R., Pierson, R. A., Lehotay, D. C., &

Lujan, M. E. (2014). Prevalence of Polycystic Ovary Syndrome Phenotypes Using Updated Criteria for Polycystic Ovarian Morphology. Reproductive Sciences, 21(8), 1034-1043. doi:10.1177/1933719114522525

Hayek, S. E., Bitar, L., Hamdar, L. H., Mirza, F. G., & Daoud, G. (2016). Poly Cystic

Ovarian Syndrome: An Updated Overview. Frontiers in Physiology, 7. doi:10.3389/fphys.2016.00124

Jamil, A. S., Alalaf, S. K., Al-Tawil, N. G., & Al-Shawaf, T. (2015). A case–control

observational study of insulin resistance and metabolic syndrome among the

four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. Reproductive Health, 12(1). doi:10.1186/1742-4755-12-7

Jamil, A. S., Alalaf, S. K., Al-Tawil, N. G., & Al-Shawaf, T. (2015). Comparison of clinical

and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria. Archives of Gynecology and Obstetrics, 293(2), 447-456. doi:10.1007/s00404-015-3889-5

Pehlivanov, B., & Orbetzova, M. (2007). Characteristics of different phenotypes of

polycystic ovary syndrome in a Bulgarian population. Gynecological Endocrinology, 23(10), 604-609. doi:10.1080/09513590701536246

Sahmay, S., Atakul, N., Oncul, M., Tuten, A., Aydogan, B., & Seyisoglu, H. (2013).

Serum anti-mullerian hormone levels in the main phenotypes of polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 170(1), 157-161. doi:10.1016/j.ejogrb.2013.05.019