Table of Contents
What is PCOS?
PCOS full form is Polycystic Ovary Syndrome. It is a hormonal condition seen in women of reproductive age. It develops when the ovaries produce higher-than-normal levels of androgens, hormones usually present in small amounts. When hormones go out of balance, ovulation may not occur as it should, causing irregular periods, cysts, or even broader metabolic concerns. However, these can be managed with the right care.
Women diagnosed with PCOS often face irregular or completely missed menstrual cycles. In some cases, the bleeding may last for many days, all linked to disrupted ovulation. A hallmark of this condition is the presence of numerous tiny fluid-filled sacs, or cysts, along the edges of the ovaries. The cysts contain immature eggs that fail to mature or release, causing continued hormonal imbalance and fertility difficulties.
Nobody knows exactly what causes PCOS, but factors like genes, how your body handles insulin, and hormone imbalances can play a part. Spotting it early helps a lot. If left untreated, it can lead to serious issues like diabetes or infertility. Fortunately, with treatment and lifestyle changes, PCOS symptoms can be kept under control.
How Is PCOS Diagnosed?
There is no single test that can diagnose PCOS. Doctors usually consider a woman’s symptoms, medical history, physical examination and selected blood tests or ultrasound findings. Current guidelines generally diagnose PCOS when at least two of three features are present, after other possible causes have been ruled out: signs of increased androgen levels, irregular or absent ovulation, and polycystic ovaries on ultrasound. In adults, an AMH test may also be considered as an alternative to ultrasound in certain diagnostic situations.
A doctor may assess PCOS symptoms and other health factors through:
- Menstrual history: Irregular, infrequent or absent periods can suggest problems with ovulation.
- Physical examination: The doctor may check for signs such as excess facial or body hair, acne, hair thinning and changes in weight or blood pressure.
- Hormone tests: Blood tests may be used to assess androgen levels and help rule out other hormonal conditions.
- Blood sugar and metabolic assessment: Screening may be recommended because PCOS is associated with insulin resistance and an increased risk of metabolic problems.
- Pelvic ultrasound: In adults, ultrasound may help identify polycystic ovarian morphology when it is needed for diagnosis.
- AMH testing: In adults, AMH can be used as an alternative to ultrasound as part of the diagnostic process, but it should not be used as a stand-alone test for PCOS.
Not every woman with PCOS will have all the typical signs. For example, some women may have irregular periods and higher androgen levels without having polycystic-looking ovaries on an ultrasound. This is why a medical assessment is important rather than relying on symptoms alone.
Types of PCOS
People often search for the different types of PCOS or the “4 types of PCOS.” However, current clinical guidelines do not classify PCOS into four official subtypes called insulin-resistant, pill-induced, inflammatory and hidden PCOS. PCOS is diagnosed based on its clinical features, such as androgen excess, ovulatory dysfunction and polycystic ovarian morphology, after other causes have been excluded.
1. Insulin-resistant PCOS
This is the most common type of PCOS. This type of PCOS is caused by smoking, sugar, pollution, and trans fat. In this, high levels of insulin prevent ovulation and trigger the ovaries to create testosterone.
If you have been told by your doctor that you are a diabetic on borderline and your glucose tolerance test was not normal. If you have increased levels of insulin and you are overweight, then you might be one having insulin resistance PCOD.
TIP- QUIT SUGAR! just shun the sugar, it should be your first step. A little amount of sugar is healthy but by taking it in large quantities you are contributing to insulin resistance. To prevent insulin resistance PCOS you can take inositol. A period of almost six to nine months is needed to improve from this type of PCOS as it is a slow process.
2. Pill-induced PCOS
This type is the second most common PCOS. It gets developed due to the birth control pills which suppress ovulation. For most women, these effects do not last long and they resume ovulating after the effect of the pill is over. But some women do not resume ovulating for months and years even after the effects of pills get over. During that time women should consult the doctor.
If you experience regular and normal periods before starting with the pills then this might be a sign of Pill-induced PCOS. Or if your levels of LH are increased in the blood test then this could be a sign too.
3. Inflammatory PCOS
In PCOS due to inflammation, ovulation is prevented, hormones get imbalanced and androgens are produced. Inflammation is caused due to stress, toxins of the environment, and inflammatory dietary like gluten.
If you have symptoms such as headaches, infections, or skin allergies and your blood tests show that you are deficient in vitamin D, your blood count is not normal, increased levels of thyroid then you might be one having inflammatory PCOS.
TIP- DON’T TAKE STRESS! Stop consuming inflammatory foods like dairy products, sugar, or wheat. Start taking supplements of magnesium as it has anti-inflammatory effects. The process of improvement takes about nine months as it is a slow process.
4. Hidden PCOS
This is a simpler form of PCOS, once the cause is addressed then it takes about three to four months to get resolved. Causes of Hidden PCOS: Thyroid disease, deficiency of iodine (ovaries need iodine), vegetarian diet ( it makes you zinc deficient and the ovaries need zinc) and artificial sweeteners.
If you are already done with numerous natural treatments for PCOS and nothing seems like working then consult the doctor and gather more information about it
Symptoms Of PCOS
Usually, the symptoms of PCOS are developed during the time of the first period of a woman and if it develops later, then the below-listed symptoms will tell you when to see a doctor.
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Periods With Abnormalities
Irregular, prolonged or infrequent menstrual cycles are one of the most common symptoms of PCOS. If you have less than 9 periods in a year, very heavy periods or a cycle of more than 35 days, then it is the time to see a doctor.
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Polycystic Ovaries
This situation the ovaries might get enlarged and as a result, the ovaries fail to function appropriately.
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Increment In Androgen
Increased levels of androgens (male hormones) result in physical appearances like excess body and facial hair and severe acne.
Other symptoms are high levels of stress, high blood pressure, sleep disorders, infertility, skin allergies, acne, dandruff, pelvic pain, depression, and low libido.
Causes Of PCOS
The apt cause of PCOS is not known but the factors affecting the causes might be:
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Heredity
According to some researches heredity could be one of the reasons behind PCOS as there are some genes which might link to PCOS.
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Surplus Insulin
Insulin is a hormone which is produced by the pancreas. It is the primary energy supplier of the body. When the body becomes resistant to the actions of insulin, the levels of blood sugar rises rapidly and due to which more insulin is might be produced by the body. Excess insulin can increase the production of androgen which can cause difficulties on ovulation.
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Inflammation Of Low Grade
This situation is related to the blood cells. Studies show that all those women who have PCOS develop a type of low-grade inflammation which lead to the production of androgens.
Risks
Women who have mothers or sisters having PCOS have a higher risk of developing it than others who do not have this situation. Other health risks and complications related to PCOS are: miscarriage or premature delivery, infertility, endometrial cancer (cancer in the lining of the uterus), type 2 diabetes, depression, eating disorders, anxiety, abnormal bleeding from the uterus, high blood pressure, abnormalities in cholesterol levels (this increases the risks of cardiovascular diseases), high blood sugar, steatohepatitis, and heart attacks.
Treatment of PCOS
There is no apt cure for PCOS but the treatments are for factors that reflect the symptoms of Polycystic ovary syndrome. There are many treatment options which include:
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Medications Of Diabetes
The medicines recommended for diabetes will help to manage it as increased levels of sugar can cause PCOS.
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Fertility Medications
In infertility treatments, some medications are required which includes the usage of Clomid and injectable medicines such as FSH (follicle stimulating hormone) and LH (luteinizing hormone). And, in some cases, letrozole is also recommended by the doctors.
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Treatment For Infertility
Infertility treatments like IUI (intrauterine insemination) or IVF (in-vitro fertilization), in these treatments some medications are given like spironolactone or eflornithine due to which excessive growth of hair is controlled.
** Women using spironolactone must use birth control due to the high risk of birth defects and breastfeeding is not recommended while the intake of this medicine.
Surgical Methods FOR PCOS
Surgery is not a routine treatment for PCOS itself. Most women are managed with lifestyle measures and medicines based on their symptoms, metabolic health and fertility goals. When infertility is caused by anovulation and medicines have not been successful, ovarian surgery may be considered in selected cases. The decision depends on individual circumstances and should be made with a fertility specialist.
1. Laparoscopic Ovarian Surgery
Laparoscopic ovarian surgery, commonly called laparoscopic ovarian drilling, may be considered for some women with PCOS-related anovulatory infertility when first-line ovulation-induction treatment has not worked. The procedure involves making small punctures in the ovary using surgical energy.
It is not suitable for every woman with PCOS and does not treat all of the condition’s symptoms. Because surgery has potential risks, doctors generally consider other fertility treatments first. The 2023 international guideline places ovarian surgery primarily as a second-line option for selected women with anovulatory infertility.
2. Ovarian Cyst Aspiration
Cyst aspiration involves draining fluid from a specific ovarian cyst. It is not a standard treatment for PCOS because the small follicles seen in polycystic ovaries are not the same as problematic ovarian cysts that require drainage.
If an ovarian cyst is found during an ultrasound, its size, appearance and symptoms are considered before deciding whether any treatment is needed. Management should therefore be based on the specific cyst rather than assuming that aspiration will treat PCOS.
3. Oophorectomy
Oophorectomy means surgical removal of one or both ovaries. It is not a routine treatment for PCOS and should not be presented as a method of treating hormonal imbalance or improving fertility.
Removal of an ovary may be considered for specific medical conditions, such as certain ovarian tumours or other serious ovarian problems. Removing both ovaries causes loss of ovarian function and has major implications for fertility and hormones. Therefore, it is not an appropriate general treatment for PCOS.
Women with PCOS should discuss persistent symptoms, fertility concerns or an ovarian mass with a qualified gynaecologist or fertility specialist to determine whether surgery is actually required.
So, ladies, this was all about PCOS Polycystic ovary syndrome and its types. Now you will be able to configure in which PCOS type are you! gather the information about your type, consult the doctor and do all the possible measures.
Understanding the different types of PCOS is important for timely diagnosis and treatment. You should also know that PCOS has been renamed PMOS, although the condition itself and its management remain unchanged. Read our detailed guide to understand the reason behind this terminology update.
Conclusion
Since there are several types of PCOS and each shows up differently in every woman, treatment isn’t one-size-fits-all. Doctors usually start with lifestyle and medicine, but if that doesn’t work, surgeries like laparoscopic ovarian drilling can help. Through these surgeries, doctors can help restore hormone health, restart ovulation, and improve fertility outcomes, particularly for women with anovulatory PCOS.
PCOS may be lifelong, but it doesn’t have to control your life. Early diagnosis and personalised care open the door to better health and fertility.
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Common Questions Asked
Which type of PCOS causes infertility?
PCOS-related ovulation problems can contribute to infertility. There is no single “infertile type” of PCOS. Irregular or absent ovulation may make conception more difficult without treatment.
Can a woman with PCOS get pregnant naturally?
Yes, many women with PCOS can become pregnant naturally, particularly when ovulation occurs. Others may need medicines or fertility treatment if irregular ovulation makes conception difficult.
How to lose weight with PCOS?
Sustainable healthy eating, regular physical activity, adequate sleep and personalised medical support can help manage weight with PCOS. Weight goals should be individualised rather than based on restrictive diets.
Is PCOD and PCOS the same?
PCOD and PCOS are often used interchangeably in everyday conversations in India. However, PCOS is the established medical term used in international clinical guidelines for the condition.
What is the difference between PCOD and PCOS?
PCOS stands for polycystic ovary syndrome and is the recognised medical term. PCOD is commonly used in India, but it does not represent a separate condition.
Can PCOS make PMS symptoms worse?
PCOS can cause irregular cycles and hormonal changes that may overlap with symptoms such as bloating, mood changes or breast tenderness. However, PCOS does not necessarily worsen PMS.
Can PCOS be cured or managed?
There is currently no permanent cure for PCOS, but its symptoms and associated health risks can be managed. Treatment may include lifestyle measures, medicines and fertility care.