Types of PCOS

PCOS is not divided into official types, but doctors describe patterns to guide care. The Rotterdam criteria diagnose PCOS when two of three features are present.

The three features

• Irregular or absent ovulation
• Signs of high androgens, on examination or blood tests
• Polycystic-appearing ovaries on ultrasound

Phenotypes (patterns)

• Type A (classic): all three features
• Type B: high androgens and irregular ovulation, with normal ovaries
• Type C (ovulatory): high androgens and polycystic ovaries, with regular cycles
• Type D (non-hyperandrogenic): irregular ovulation and polycystic ovaries, without high androgens

Practical groupings often used

• Insulin-resistant PCOS: weight gain, dark skin patches, cravings
• Lean PCOS: normal weight, but still insulin resistance or high androgens
• Inflammatory or stress-linked PCOS: a term used popularly, which is not a medical subtype
• Post-pill PCOS: a popular term for irregular periods after stopping contraceptives. It is not a distinct type and needs proper assessment.

Related conditions to rule out

Thyroid disease, high prolactin, non-classic congenital adrenal hyperplasia and rarely androgen-secreting tumours can look like PCOS.

Ayurvedic view

Ayurveda groups conditions of irregular periods by dosha and does not match these types exactly. This is an interpretive framework.

See a doctor if you suspect PCOS. A doctor will check other causes first.

When to get help

See a gynaecologist or endocrinologist if your periods are very irregular or absent, you have rapid hair growth or hair loss, you have been trying to conceive for 6 to 12 months, or you have symptoms of high blood sugar such as thirst and frequent urination.

Remember

The pattern shapes the plan. Not every woman with PCOS has cysts, and not every cyst means PCOS.