What Are the Different Types of PCOS?

A lot of people have never heard of polycystic ovary syndrome (PCOS). But this condition deserves more awareness—according to the Office on Women’s Health (part of the U.S. Department of Health and Human Services), it affects 1 in 10 women of childbearing age. Essentially, PCOS describes an imbalance of reproductive hormones, as well as metabolism issues, that may affect a woman’s health and appearance. This hormonal imbalance means that the ovaries’ eggs may not develop properly or may not be released during ovulation, leading to missed or irregular periods, which can then lead to infertility or cysts in the ovaries.

The good news is that PCOS symptoms are treatable, but the bad news is that this condition can lead to other health problems. For example, the CDC reports that women with PCOS are often insulin-resistant, increasing the risk for type 2 diabetes, and can develop more serious diseases, especially if they are overweight. These potential health issues include gestational diabetes, heart disease, high blood pressure, high LDL (“bad”) cholesterol and low levels of “good” HDL cholesterol, sleep apnea, and stroke. In addition, PCOS can contribute to appearance-related changes like acne, thinning hair on the scalp, and excess hair growth on the face and body. It’s even been linked to depression and anxiety.

Even though PCOS is not curable in a single step, there are various approaches you can take to manage the symptoms—such as increasing physical activity or improving your diet—as well as certain medicines that can help with side effects. Click To Tweet

The Four Types of PCOS

Even people who have heard about PCOS might not be aware of its many manifestations. Did you know that there is more than one type? Let’s look at a few of the ways it can show up in the body.

1. Insulin resistance

In addition to having a metabolic syndrome, this is a common side effect of PCOS. Through medical testing, you might find that you have high blood sugar or high hemoglobin A1C, leading to an inability to process sugar correctly, just as you’d find with pre-diabetes or diabetes. This danger can be reduced by maintaining a healthy weight. One study, which urged all women with PCOS to be tested for insulin resistance, noted some key statistics: Insulin resistance affects about 65% to 70% of women with PCOS—and among obese women, that number rises to 70% to 80%, while only about 20% to 25% of lean women (with a body mass index of less than 25) experience this issue.

2. Post-pill syndrome.

This condition happens when women have been on birth control pills for a long time. When they get off birth control, they can experience symptoms of PCOS. Sometimes, this is a normal process; it simply takes some time for the body to recalibrate after being accustomed to this medication for so long, leading to missed periods (a phenomenon called amenorrhea) after ending their oral contraceptives. But for other women, ending the pill is the time when they discover they have had PCOS all along—the pill has simply been masking it. That’s what happened with me. After you get off the pill, you may discover that you can’t get pregnant, or you may experience acne or a lack of menstruation. These symptoms will be taken into account as you seek a proper diagnosis.

3. Inflammatory PCOS.

This type is fairly self-explanatory; it means you have higher levels of inflammation in your body. This can occur as a result of poor nutrition (like you’d experience through the standard American diet, or SAD) and/or a lack of exercise. To diagnose inflammatory PCOS, doctors can examine the level of C-reactive protein (also called CRP, a protein made by the liver). One study confirms that “circulating CRP is moderately elevated in PCOS women independent of obesity, which is indicative of low-grade chronic inflammation.” This can be determined through a CRP test, which is a blood test that shows if you have high levels of inflammation.

4. Adrenal PCOS.

This category of PCOS was a surprise to me—even I wasn’t previously aware of this one! It’s caused by an abnormal stress reaction, meaning you have elevated cortisol and DHEA sulfate levels. This stems from the adrenal glands and occurs when there are a lot of stressors in your life, or when you’re having a trauma reaction. Even over-exercising, combined with a lower tolerance for stress, can create this condition. We know more about this type now, since a 2016 study concluded that a subgroup of women with PCOS may produce excess adrenal hormones—a discovery that has potential repercussions as far as treatment strategies. For example, the study’s senior author noted that, while treatment for PCOS has traditionally involved modifying ovarian hormones, these findings “indicate that a subgroup of patients could conceivably benefit from modification of adrenal hormones as well.”

Ultimately, knowing what type of PCOS you have is really important. By determining the type, you can get better treatment for the condition. Even though PCOS is not curable in a single step, there are various approaches you can take to manage the symptoms—such as increasing physical activity or improving your diet—as well as certain medications that can help address side effects such as unwanted hair growth. As always, when it comes to your health, knowledge is power!

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