Identifying Your Type of PCOS: A Guide to the Four Variants

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Understanding Polycystic Ovarian Syndrome (PCOS)

PCOS is an endocrine disorder that results in an imbalance of male and female hormones as well as issues with metabolism. It causes eggs not to develop properly, resulting in the characteristic cysts on the ovaries. PCOS also has other non-reproductive organ symptoms, such as male-pattern hair growth (hirsutism), and is associated with a higher risk of various conditions, especially type 2 diabetes. PCOS typically causes fertility problems, although this can be corrected with treatment.

The Four Types of PCOS

There are four distinct types of PCOS, referred to as PCOS phenotypes. Phenotype A is the most severe form, characterized by having all three associated issues: hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Phenotype B is not associated with the development of cysts on the ovaries but still has ovulatory dysfunction and hyperandrogenism. Phenotype C has both hyperandrogenism and polycystic ovaries, but ovulation occurs, resulting in reduced fertility issues compared to the other type. Finally, phenotype D is non-hyperandrogenic PCOS, meaning you have multiple cysts and issues with ovulation but do not have elevated levels of male hormones.

Diagnosis and Treatment of PCOS

Diagnosis of PCOS requires a detailed menstrual and medical history, physical examination, blood tests, and an ultrasound scan of the ovaries. Treatment focuses on reducing elevated androgen levels, which may include lifestyle changes, oral contraceptives, progestin tablets, Clomifene, Metformin, topical creams or laser treatment, and anti-androgen medications. Treatment might be adjusted for the different phenotypes, although oral contraceptives are often helpful. Insulin resistance is a key marker for the condition and can eventually lead to type 2 diabetes.

When to See Your Doctor

If you have symptoms of PCOS, such as irregular periods, painful cramping, acne, excessive facial hair, male pattern baldness, or enlargement of the clitoris, talk to your doctor. Many people with PCOS only find out they have it when they try to get pregnant and find themselves referred to a fertility specialist.

PCOS is a complex and poorly understood condition that combines both genetic and environmental factors. If you suspect you have PCOS, be ready to advocate for yourself, as this condition is often underdiagnosed, especially when not all of the key markers are present.