What are 4 Types of PCOS? Causes, Symptoms and Treatment

PCOS is the leading cause of female infertility in India and worldwide. Read on to learn more about PCOS, types of PCOS, and possible treatment plans.

Polycystic ovary syndrome (PCOS) is a debilitating condition that affects millions of women around the world. In India, the prevalence of PCOS varies. Research claims that the percentage of women living with PCOS in India could be anywhere between 3.7-22.5%.

What is PCOS?

It’s a condition in which women don’t produce enough hormones necessary for ovulation. In the absence of ovulation, ovaries develop cysts (that’s where the condition gets its name from). These cysts, in turn, make androgens – the hormones responsible for giving a person ‘male’ characteristics. But what the increased androgen level does in a female is contribute to excess hair growth, acne, irregular periods, and infertility.

Now that you understand what PCOS is, let’s talk about the types of PCOS.

The Four Types of PCOS

Listed below are the 4 types of PCOS you should know about:

1. Insulin-resistant PCOS

Even though the exact cause of PCOS has not been identified yet, the condition has long been associated with insulin resistance. It means that if your cells have become insensitive to insulin – a characteristic of diabetes – it is likely what’s causing your PCOS.

Hence the name: insulin-resistant PCOS. It’s one of the most common types of PCOS. When cells become insulin-resistant, the pancreas is forced to produce more insulin. The fat-storage hormone then signals the ovaries to produce more testosterone.

Nearly 60% of women with PCOS in India have reported insulin resistance.

If you are still borderline, there are ways to restore your insulin sensitivity:

• Eliminate processed foods from your diet
• Limit carb-rich cuisines
• Avoid stressful situations
• Exercise more often

Of course, if you’re already suffering from PCOS and/or diabetes, it’s best to consult your doctor before making any changes to your diet plan and exercise routine.

It’s also important to know that reducing obesity and improving insulin sensitivity may help relieve PCOS symptoms, but it’s not a cure. Read more to find treatment options for PCOS and infertility (more on that later).

2. Pill-induced PCOS

The second type of PCOS we’re going to discuss is pill-induced PCOS.

Birth control pills are commonly used to prevent unwanted pregnancies. When women are on birth control, the pills work to suppress their ovulation. The effect lasts as long as they are taking the pill.

When they stop, the effect wears off too. However, in some women, this doesn’t happen. They don’t resume ovulating. This is known as pill-induced PCOS. However, in most women, it’s temporary.

Many studies indicate that oral contraceptives do not cause PCOS. Instead, it’s the body adjusting to hormonal changes after women discontinue contraception. It’s also called post-birth control syndrome and may last 4-6 months.

On the other hand, an observational study revealed that women who already have PCOS might experience aggravated symptoms due to oral contraceptives.

To understand what type of PCOS you may have, your best option is to consult a gynaecologist.

3. Adrenal PCOS

Women with adrenal PCOS typically don’t show high testosterone levels but have elevated DHEA-S (a type of androgen secreted by the adrenal gland). Less common of the 4 types of PCOS, it affects 5-10% of women worldwide.

The prevalence of adrenal PCOS in India is not known. What’s known is that DHEA is a biomarker of stress. It means that high levels of DHEA are associated with high-stress levels.

This is why adrenal PCOS is believed to be an abnormal stress response. If you don’t have insulin-resistant PCOS or pill-induced PCOS, you’d need to meet an endocrinologist or other specialist to get tested for adrenal PCOS.

It’s only after an accurate diagnosis can you begin the treatment plan. Meanwhile, try and avoid stress as much as possible to manage the condition.

4. Inflammatory PCOS

Many would argue that it isn’t necessarily a different type of PCOS but rather something experienced by most women with PCOS. Studies also reveal that chronic inflammation is observed in a majority of women living with PCOS.

The inflammation triggers the ovaries to produce excess testosterone. This leads to PCOS symptoms and problems with ovulation. Signs of inflammation include bowel issues, skin conditions like eczema, joint pain, and headaches, among others.

Your doctor will likely order a blood test to identify inflammatory markers such as high C reactive protein (or CRP).

To manage inflammatory PCOS, you may need anti-inflammatory medicines (as prescribed by your doctor), eliminate food triggers like dairy, and take steps to improve gut health.

Now that you understand the different types of PCOS, let’s talk about your treatment options.

Causes of PCOS

Research suggests that the exact cause of PCOS is unknown. However, there are a few contributing factors that can result in PCOS:

• Lowgrade inflammation
• Heredity
• Excess male hormones (androgen)
• Unhealthy lifestyle
• Insulin resistance

Symptoms of PCOS

Here are a few symptoms of PCOS:

• Irregular periods
• Heavy bleeding or missed periods
• Enlarged ovaries
• Increased levels of male hormones (androgens)
• Facial hair
• Infertility
• Irregular body weight
• Obesity

Treatment Options for PCOS

The treatment plan depends on the types of PCOS and whether or not you’re planning to become pregnant.

If you’re not, the treatment may comprise:

• Medications to block androgens
• Insulin-sensitising medicine
• Lifestyle changes such as a healthy diet and weight loss

If you’re planning a family, the treatment will likely involve:

• Medication to induce ovulation
• Surgery to remove androgen-producing tissues in the ovary (this method is now rarely used, thanks to the availability of newer medications)
• In vitro fertilisation (IVF)

IVF involves fertilising your egg in a lab by infusing it with your partner’s sperm, after which it’s implanted in your uterus. This treatment option is preferred when medication doesn’t induce ovulation.

Conclusion

Many women of childbearing age suffer from PCOS. The formation of ovarian cysts and high levels of androgens disrupt ovulation. It’s the reason why PCOS is a prominent cause of infertility in women in India and elsewhere.

The 4 types of PCOS discussed require a proper medical diagnosis, after which the treatment can begin.

To get suitable, cutting-edge treatment for PCOS and infertility, visit Birla Fertility & IVF or book an appointment with Dr Deepika Mishra.

FAQs

1. How do I know which type of PCOS I have?

The doctor will analyse your medical history, weight changes, and menstrual cycle. They will order tests to check insulin resistance to determine the type of PCOS.

2. Are there different kinds of PCOS?

The 4 types of PCOS are insulin-resistant, inflammatory, pill-induced, and adrenal PCOS.

3. What is the most common type of PCOS?

Insulin-resistant PCOS is the most prevalent of the different types of PCOS.

4. Which type of PCOS causes infertility?

Since all 4 types of PCOS prevent ovulation, they can all cause infertility.