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Various Types of PCOS: Exploring the Differences

Updated: Feb 28

Woman with PCOS

Polycystic Ovary Syndrome (PCOS) is complex, often misunderstood, and affects many women, primarily those within the reproductive age range. When ovulation is irregular or lacking, this can lead to small cysts forming in the ovaries; these cysts tend to produce androgens, hormones that can further complicate the already complicated business of fertility.

It's important to emphasize here that PCOS is a syndrome, meaning that it appears differently in each individual. It's definitely not a condition with set-in-stone attributes. It shows itself in these various forms, each with its own set of traits and symptoms:

— "Classic PCOS": This is the most common type and is characterized by irregular periods, high levels of androgens in the body, and the presence of small cysts in the ovaries. Classic PCOS often leads to symptoms such as acne, excessive facial and body hair growth (hirsutism), and weight gain.

— "Non-Classic PCOS": Some individuals with PCOS may not exhibit the typical symptoms, making it a challenge to diagnose. Non-classic PCOS might involve irregular periods or anovulation (lack of ovulation) without the typical androgen-related symptoms. These cases usually require careful evaluation and monitoring.

— "Lean PCOS": Contrary to the stereotype of PCOS being associated with obesity, lean PCOS affects individuals with a normal body mass index (BMI). Despite their healthy weight, these individuals still experience irregular periods, anovulation, and elevated androgen levels, which can mess with fertility and hormonal balance.

— "Post-Pill PCOS": Some women develop PCOS-like symptoms after discontinuing birth control pills. These symptoms may include irregular periods and hormonal imbalances. It's essential to talk with a credible doctor (i.e., me!) to figure out if what you're experiencing is genuine PCOS, or if it's the temporary post-pill hormonal fluctuations.

— "Inflammatory PCOS": Research suggests that inflammation may sometimes play a role in the development of PCOS. Inflammatory PCOS is characterized by elevated markers of inflammation in the body, potentially contributing to insulin resistance and other metabolic issues seen in PCOS.

— "Hidden PCOS": In some cases, a woman may have PCOS but doesn't display any of the typical signs or symptoms. This type is often referred to as "hidden" or "silent" PCOS, and may only become evident when fertility issues arise or through imaging tests of the ovaries.

— "Polycystic Ovary Morphology (PCOM)": A small number of women may show polycystic ovaries on ultrasound but lack the other diagnostic criteria for PCOS, such as irregular periods or androgen excess. PCOM can also occur by itself, without PCOS, so it's important not to assume anything based on imaging alone.

Diagnosis and effective treatment of all of these types should be tailored to the specific person, and to the types of symptoms being experienced.

Managing PCOS often involves a broad approach, including lifestyle changes, dietary modifications, therapies, and fertility treatments. Monitoring by a doctor (yep, still me) is the best way to fit the treatment to your individual needs, while keeping in mind your overall health and well-being.

If you suspect you may have PCOS, or are struggling with its symptoms, come visit me at Heal EastWest for a proper evaluation, so we can get you on the right path for managing your specific type of PCOS.

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