4 Types of PCOS (a Flowchart)

Types of PCOS.

Polycystic ovary syndrome (PCOS) is not one disease. Instead, it’s “a heterogeneous disorder with different underlying biological mechanisms.” In other words, it’s a set of symptoms (androgen excess and anovulatory cycles) caused or driven by several underlying factors. To successfully treat PCOS, you need to identify which factor (or factors) is driving the symptoms. In other words, you need to know your functional type of PCOS.

The four functional types of PCOS include insulin-resistant PCOS, post-pill PCOS (which is temporary), inflammatory PCOS, and the far less common adrenal PCOS.

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4 Causes of Androgen Excess in Women

If you suffer hair loss, facial hair (hirsutism), or acne, then you know all about androgen excess or high male hormones.

You may have been given the diagnosis of PCOS, but there are actually several different reasons for androgen excess in women, including androgen hypersensitivity, adrenal androgen excess, high prolactin, menopause, and hormonal birth control with a high androgen index.

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Ovulation Is the Main Event of the Menstrual Cycle

Anovulatory cycles and pill bleeds.A menstrual cycle is, by definition, an ovulatory cycle in which ovulation is the main event and progesterone is made. Any other kind of bleed is either an anovulatory bleed or a pill bleed—neither of which is a real menstrual cycle.

Furthermore, an ovulatory cycle is the only way to make progesterone, which is important for general health and not just for making a baby.  

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The Downside to Contraceptive Injections and Implants

woman with contraceptive implant

The progestins of contraceptive injections and implants can cause depression, weight gain, and irregular menstrual bleeding. 

Side effects occur because 1) progestins are not progesterone, and 2) progestins at that dose can suppress ovulation and cause anovulatory bleeding.  Keep reading to learn the difference between a real period, an anovulatory bleed, and a pill bleed.

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