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The 4 Types of PCOS

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, so you've probably heard of it before. But, did you know there are actually 4 presenting "types" of PCOS?

Before we get ahead of ourselves, let's explain exactly what PCOS is. To diagnose someone with PCOS they have to meet at least 2 of the following 3 criteria, also known as the Rotterdam Criteria:

  1. Polycystic ovaries - this one is pretty self-explanatory. When the ovaries are visualized on transvaginal ultrasound, there have to be multiple cysts on at least one ovary to fulfill this criteria. The cysts are actually what we call follicles, or maturing eggs.

  2. Ovulatory dysfunction - this simply means that the body is struggling to ovulate for some reason. Ovulatory dysfunction can look like irregular periods or even the absence of periods - meaning your ovaries haven't ovulated and therefore a period doesn't follow at the expected time.

  3. Hyperandrogenism - this means high androgen hormones, and an example of an androgen hormone is testosterone. High levels of testosterone are a marker of PCOS and can be diagnosed using symptoms or by directly measuring testosterone levels in the blood. Common symptoms of high androgens can include cystic acne, facial hair, or alopecia.

Since we know someone only needs to fit two of the above criteria to be diagnosed with PCOS, that means there are a few different presentations of PCOS so let's walk through them.

Frank PCOS

This is the most common presentation of PCOS with 66% of cases presenting as Frank PCOS. It occurs when someone meets all 3 of the above criteria.

Ovulatory PCOS

The next most common form of PCOS is when we have ovulation occurring so there is no ovulatory dysfunction, but there are still cysts on the ovaries and signs of hyperandrogensim. This type occurs in 13% of all PCOS cases.


This one might sound a bit redundant - non-polycystic ovary, polycystic ovarian syndrome. This means there are signs of hyperandrogenism as well as ovulatory dysfunction/irregular periods, but when we look at the ovaries they are normal and have no cysts.

Normo-androgenic PCOS

Just as it might sound, this type of PCOS has normal androgen levels. People with normoandrogenic PCOS have cystic ovaries and ovulatory dysfunction, but no androgenic symptoms or androgen hormones are normal upon testing.

If you have PCOS and you're wondering what type it might be, let's chat! Click here to book your Free 15-minute Discovery Call!

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