Which Type of PCOS do I have?
Written by
Arva Health Team
24-Feb-2024
Last time, we told you the PCOS story — what it is, what some common symptoms are, and of course, how you can treat it.
But wait - Haven’t caught up yet? Read Part 1 of our PCOS exposé here.
PCOS is a condition with various symptoms. Because our hormones are so intertwined with other bodily functions like skin, hair, weight gain, heart rate, etc., it presents in completely varied ways depending on the person.
That’s why getting an official PCOS diagnosis along with the type (yes, there are types. Scroll down for spoilers) is such an important part of understanding how to care for your body and needs.
So, we’re here to tell you that if you think your symptoms aren’t on the regular google search for PCOS, or just really vary in intensity, you’re not alone.
Read on!
How is PCOS diagnosed?
Generally, doctors use an industry-standard test called the ‘Rotterdam Criteria’ which is a multistep checklist. They test for:
Lack of regular ovulation
High levels of androgens (male-dominant hormones)
Levels of insulin in the body
Extra immature follicles in your ovaries.
But here’s the catch. Like most clinical studies, the Rotterdam criteria is centred around studies and samples of menstruators in the Western hemisphere.
Their biology is inherently different that ours due to their diet, lifestyle, gene pool, etc.
That’s why consulting doctors that understand that key difference (like our non-judgemental gynaecs) can help you get an accurate diagnosis.
According to some interesting research conducted by and for South Asian women, some symptoms which are normally considered ‘essential’ in a PCOS diagnosis may not be present in us, due to our demographic profile and genetics. That’s why some doctors have their own methods and interpretations — which honestly, just leads to more confusion for us.
How is Arva any different?
We’re glad you asked 😛
Our PCOS test is curated specifically for Indian women based on this study and the help of our awesome medical panel. We told you! We’re designed for you, and backed by science.
Here’s what we look at in our Fertility Test:
LH/FSH ratio
Thyroid
Various other biomarkers (such as prolactin, DHEA, free testosterone)
Physical traits/symptoms (Check out Part 1)
Why? Because we’re thorough and want to ensure nothing slips through the cracks. We check all these criteria to also understand what type of PCOS you have, because that affects our suggestions for treatment plans and specialists.
The test is, of course, the first step. We then recommend a chat with one of our non-judgemental doctors to understand your results better, which is followed by AFC, an ultrasound test to give you a confirmed diagnosis.
What are the types of PCOS?
Yes! As surprising as it is, there’s types of PCOS too.
It’s such a varied condition that figuring out what type you have can actually unlock the right treatment for you. So let’s go through it all briefly:
1. Insulin Resistant PCOS
Weight fluctuations, stubborn abdomen fat sugar cravings aren’t your fault. You and 70% of women worldwide can easily blame Insulin Resistant PCOS.
When you have higher insulin levels than normal (hyperinsulinemia), the cells in your body can become a bit “numb” to the effect of it. So the pancreas decides to really drive the message home by producing more and more until your cells understand.
But your cells still “ghost” the amount of insulin in the bloodstream, which keeps increasing. And all that extra insulin unleashes another contributor to the PCOS story, androgens.
To understand the insulin levels, we test the HbA1c levels with our fertility test.
2. Adrenal PCOS
Dealing with abnormal stress responses? You and 10% of women might have adrenal PCOS. With this type, typically you’ll show elevated levels of DHEA-S (another androgen) along with testosterone and androstenedione.
All that stress, or lack of good sleep, leads to the release of DHEA-S, which is formed in the adrenal glands.
DHEA-S unfortunately, isn’t a hormone that people test unless you go through a specialist. But we ensure it’s tested as part of the Fertility Test, so we can identify if it’s your stressful life that causing hormone fluctuations.
3. Inflammatory PCOS
When chronic inflammation causes the ovaries to produce excess androgens, it can cause issues with ovulation and other physical symptoms like headaches, joint pain, fatigue, eczema or IBS.
Inflammatory PCOS can be traced back to your gut health, diet and lifestyle that could cause inflammation in your body. You may have to follow an anti-inflammatory diet (avoid excess of sugary snacks, processed meat, cheese, milk, alcohol and food with preservatives), and involve exercise, meditation, and even treatments such as acupuncture to help reduce the inflammation.
4. Post-Pill PCOS
Oral contraceptive pills (we mean birth control) and some other types of medication can affect your natural hormone levels. So after you stop taking them, your ovaries throw a party and produce a lot of androgen.
This can cause typical PCOS symptoms like acne, irregular periods, hair growth, etc. But not to worry! This type of PCOS can heal on its own over time, or with the right nutrition, lifestyle and supplements can be dealt with quickly!
Arva’s take on types of PCOS
Identifying the right type of PCOS can help you uncover what treatments and changes you should actually be making to deal with it. Instead of taking advice from the neighbourhood auntyji.
That’s why we always emphasise the importance of testing your hormones via something as simple as a fertility test to identify the root cause of your reproductive issues.
Finally getting the hang of this PCOS thing? Don’t worry, we’ve only got one part left to go where we’ll discuss some treatments of PCOS and more. Stay tuned!
TL;DR:
PCOS presents in completely varied ways depending on the person and their symptoms.
Getting an official PCOS diagnosis along with the type is a vital part of understanding how to care for your body and needs.
Doctors will use an industry-standard test called the ‘Rotterdam Criteria’ to diagnose. But that criteria is centred around women in the Western hemisphere.
Our PCOS test is curated specifically for Indian women based on this study and the help of our awesome medical panel.
There are 4 main types of PCOS:
Insulin-Resistant
Adrenal
Inflammatory
Post-Pill
Knowing the type of PCOS or taking a fertility test to understand it better is the first step towards better, personalised treatment plans based on your type.
FAQs
1. What are the 4 types of PCOS?
PCOS, or Polycystic Ovary Syndrome, is categorized into four types based on clinical and hormonal characteristics: Insulin-resistant PCOS, Post-pill PCOS, Inflammatory PCOS, and adrenal PCOS.
Insulin-resistant PCOS is marked by elevated insulin levels, leading to irregular periods and difficulty in ovulation.
Post-pill PCOS occurs after discontinuing oral contraceptives, resulting in irregular menstrual cycles and androgen excess.
Inflammatory PCOS is associated with inflammation markers and insulin resistance, often presenting with acne and hirsutism.
Adrenal PCOS is characterised by irregular cycles despite normal androgen levels, often related to adrenal or thyroid dysfunction.
2. What is more serious PCOS or PCOD?
PCOS (Polycystic Ovary Syndrome) and PCOD (Polycystic Ovary Disease) are terms often used interchangeably, but PCOS is undeniably the more serious condition. PCOD is mainly the excessive production of immature eggs by the ovaries, and can be addressed with lifestyle changes, rarely requiring medication. However, PCOS encompasses a broader spectrum of symptoms such as insulin resistance, obesity, and increased risk of type 2 diabetes, compared to PCOD.
3. What is a rare type of PCOS?
A rare type of PCOS is Adrenal PCOS, which affects the adrenal glands and leads to excessive production of DHEA-S. It is due to abnormal stress response and affects about 10% of women. This also leads to increased levels of androgens, as DHEA-S is a type of androgen itself.
4. How do I know the type of PCOS I have?
Determining the type of PCOS requires a detailed evaluation by a healthcare professional, typically a gynecologist or endocrinologist specialising in reproductive health. Diagnostic criteria for PCOS include clinical symptoms such as irregular menstrual cycles, signs of androgen excess like acne and hirsutism, and hormonal imbalances detected through blood tests, including levels of testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and insulin.
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