Which Type of PCOS do I have?
Written by
Arva Health Team
24-Feb-2024
Last time, we told you the PCOS story — what it is, what some common symptoms are, and of course, how you can treat it.
But wait - Haven’t caught up yet? Read Part 1 of our PCOS exposé here.
PCOS is a condition with various symptoms. Because our hormones are so intertwined with other bodily functions like skin, hair, weight gain, heart rate, etc., it presents in completely varied ways depending on the person.
That’s why getting an official PCOS diagnosis along with the type (yes, there are types. Scroll down for spoilers) is such an important part of understanding how to care for your body and needs.
So, we’re here to tell you that if you think your symptoms aren’t on the regular Google search for PCOS, or just really vary in intensity, you’re not alone.
Read on!
What tests are done to diagnose PCOS?
Generally, doctors use an industry-standard test called the ‘Rotterdam Criteria’ which is a multistep checklist. They test for:
Lack of regular ovulation
High levels of androgens (male-dominant hormones)
Levels of insulin in the body
Extra immature follicles in your ovaries.
But here’s the catch. Like most clinical studies, the Rotterdam criteria is centered around studies and samples of menstruators in the Western hemisphere.
Their biology is inherently different from ours due to their diet, lifestyle, gene pool, etc.
That’s why consulting doctors that understand that key difference (like our non-judgemental gynaecs) can help you get an accurate diagnosis.
According to some interesting research conducted by and for South Asian women, some symptoms that are normally considered ‘essential’ in a PCOS diagnosis may not be present in us, due to our demographic profile and genetics. That’s why some doctors have their own methods and interpretations — which honestly, just leads to more confusion for us.
How is Arva any different?
We’re glad you asked 😛
Our PCOS test is curated specifically for Indian women based on this study and the help of our awesome medical panel. We told you! We’re designed for you, and backed by science.
Here’s what we look at in our Fertility Test:
LH/FSH ratio
Thyroid
Various other biomarkers (such as prolactin, DHEA, free testosterone)
Physical traits/symptoms (Check out Part 1)
Why? Because we’re thorough and want to ensure nothing slips through the cracks. We check all these criteria to also understand what type of PCOS you have, because that affects our suggestions for treatment plans and specialists.
The test is, of course, the first step. We then recommend a chat with one of our non-judgemental doctors to understand your results better, which is followed by AFC, an ultrasound test to give you a confirmed diagnosis.
What are the types of PCOS?
Yes! As surprising as it is, there’s types of PCOS too.
It’s such a varied condition that figuring out what type you have can actually unlock the right treatment for you. So let’s go through it all briefly:
1. Insulin Resistant PCOS
Weight fluctuations, stubborn abdomen fat sugar cravings aren’t your fault. You and 70% of women worldwide can easily blame Insulin Resistant PCOS.
When you have higher insulin levels than normal (hyperinsulinemia), the cells in your body can become a bit “numb” to the effect of it. So the pancreas decides to really drive the message home by producing more and more until your cells understand.
But your cells still “ghost” the amount of insulin in the bloodstream, which keeps increasing. And all that extra insulin unleashes another contributor to the PCOS story, androgens.
To understand the insulin levels, we test the HbA1c levels with our fertility test.
Arva's Take: We recommend a low-glycemic diet, regular exercise (like 30 minutes of brisk walking daily), and supplements such as inositol or berberine. These steps can help manage your insulin levels and reduce symptoms.
2. Adrenal PCOS
Dealing with abnormal stress responses? You and 10% of women might have adrenal PCOS. With this type, typically you’ll show elevated levels of DHEA-S (another androgen) along with testosterone and androstenedione.
All that stress, or lack of good sleep, leads to the release of DHEA-S, which is formed in the adrenal glands.
DHEA-S unfortunately, isn’t a hormone that people test unless you go through a specialist. But we ensure it’s tested as part of the Fertility Test, so we can identify if it’s your stressful life that causing hormone fluctuations.
Arva's Take: Focus on stress-reduction techniques like yoga or meditation. We might suggest adaptogenic herbs like ashwagandha to help manage stress and balance your hormones.
3. Inflammatory PCOS
When chronic inflammation causes the ovaries to produce excess androgens, it can cause issues with ovulation and other physical symptoms like headaches, joint pain, fatigue, eczema or IBS.
Inflammatory PCOS can be traced back to your gut health, diet and lifestyle that could cause inflammation in your body. You may have to follow an anti-inflammatory diet (avoid excess of sugary snacks, processed meat, cheese, milk, alcohol and food with preservatives), and involve exercise, meditation, and even treatments such as acupuncture to help reduce the inflammation.
Arva's Take: An anti-inflammatory diet rich in omega-3s, turmeric supplements, and regular exercise can work wonders. Incorporate stress-relief practices like meditation to further reduce inflammation.
4. Post-Pill PCOS
Oral contraceptive pills (we mean birth control) and some other types of medication can affect your natural hormone levels. So after you stop taking them, your ovaries throw a party and produce a lot of androgen.
This can cause typical PCOS symptoms like acne, irregular periods, hair growth, etc. But not to worry! This type of PCOS can heal on its own over time, or with the right nutrition, lifestyle, and supplements can be dealt with quickly!
Arva's Take: For Post-Pill PCOS, we’ll guide you through a hormone-balancing plan, including vitex supplements and specific dietary changes to support your body’s natural hormone production. Patience and consistency are key.
Arva’s take on types of PCOS
Identifying the right type of PCOS can help you uncover what treatments and changes you should actually be making to deal with it. Instead of taking advice from the neighborhood auntyji.
That’s why we always emphasize the importance of testing your hormones via something as simple as a fertility test to identify the root cause of your reproductive issues.
PCOD vs PCOS: What's the Difference?
You might have heard both terms and wondered if they’re the same thing. Well, they’re related, but not identical twins!
PCOD (Polycystic Ovary Disease) is like the milder cousin of PCOS. It’s when your ovaries produce many immature or partially mature eggs, which can turn into cysts. You might experience irregular periods, some weight gain, and maybe some hair loss. But here’s the good news: PCOD is often manageable with lifestyle changes.
PCOS (Polycystic Ovary Syndrome) is the more serious sibling. It’s a metabolic disorder that affects your whole body. You’ll see higher levels of male hormones, multiple cysts on your ovaries, and it can lead to more severe symptoms like obesity, insulin resistance, and a higher risk of type 2 diabetes. PCOS needs more comprehensive management, often including medication and lifestyle changes.
Arva's Take: Whether you have PCOD or PCOS, lifestyle changes can make a big difference. We recommend starting with small, achievable goals like adding a 15-minute walk to your daily routine or incorporating more leafy greens into your diet. For PCOS, we might also suggest specific supplements or medications based on your symptoms.
Can PCOS cause infertility?
This is a question that keeps many of us up at night; can I get pregnant with pcos? In short, PCOS can affect your fertility, but it’s not a dead end!
PCOS is actually one of the most common causes of infertility in women. Why? Because it messes with your ovulation. If you’re not ovulating regularly (or at all), it’s harder to get pregnant.
But here’s the silver lining: PCOS-related infertility is often treatable. With the right approach, many women with PCOS go on to have healthy pregnancies and babies.
Arva's Take: If you’re concerned about fertility, don’t lose hope! We can help you track your ovulation using methods like basal body temperature charting or ovulation predictor kits. Supplements like CoQ10 and folic acid can improve egg quality.
In some cases, we might recommend ovulation-inducing medications. Remember, many women with PCOS successfully conceive with the right support.
Exercise for PCOS: Your New Best Friend
Ladies, it’s time to lace up those sneakers! Exercise isn’t just good for your overall health; it’s a superhero when it comes to managing PCOS.
Here’s why exercise is so awesome for PCOS:
It helps with weight management: Many women with PCOS struggle with weight. Regular exercise can help you maintain a healthy weight or lose excess pounds.
It improves insulin sensitivity: Remember insulin resistance? Exercise helps your body use insulin more effectively.
It reduces stress: Less stress means better hormone balance. Win-win!
It boosts your mood: PCOS can be tough on your mental health. Exercise releases those feel-good endorphins.
So, what kind of exercise should you do? Mix it up!
Cardio: Think brisk walking, jogging, cycling, or dancing. Aim for at least 150 minutes a week.
Strength training: Build muscle to boost your metabolism. Try bodyweight exercises or lift some weights.
Yoga: Great for stress relief and improving flexibility.
Arva's Take:
Start small and build up gradually. Try our ‘PCOS-friendly workout plan’:
10-minute morning yoga for stress relief
20-minute brisk walk or jog 3 times a week
15-minute strength training sessions twice a week (try bodyweight squats, lunges, and push-ups)
Remember, consistency is key. Find activities you enjoy, and it won’t feel like a chore!
Understanding Ovulation with PCOS
When you have PCOS, understanding your ovulation can feel like solving a complex puzzle. But don’t worry, we’re here to help you piece it together!
How to Calculate Ovulation Day?
Typically, ovulation occurs about 14 days before your period starts. But with PCOS, your cycles might be irregular, making this calculation tricky. Here are some methods to help:
Ovulation Predictor Kits (OPKs): These detect the surge in luteinizing hormone (LH) that occurs before ovulation.
Basal Body Temperature (BBT) Tracking: Your body temperature rises slightly after ovulation.
Cervical Mucus Changes: As you approach ovulation, your cervical mucus becomes clear and stretchy, like egg whites.
Signs of Ovulation
Even with PCOS, your body might give you some hints that ovulation is approaching:
Mild cramping on one side of your lower abdomen
Increased sex drive
Breast tenderness
Bloating
Slight spotting
What are the Symptoms of Ovulation?
The symptoms of ovulation can include:
A slight increase in basal body temperature
Changes in cervical mucus
Mild pelvic or abdominal pain
Light spotting
Increased libido
Breast tenderness or soreness
Which Time is Best for Pregnancy?
The best time for conception is during your fertile window, which is typically the 5 days before ovulation and the day of ovulation itself. If you’re able to pinpoint your ovulation day, the two days before ovulation are usually the most fertile.
How Many Eggs Are Released During Ovulation?
Usually, only one egg is released during each ovulation cycle. However, in rare cases, two eggs might be released, which could potentially lead to fraternal twins if both are fertilized.
Finally, getting the hang of this PCOS thing? Don’t worry, we’ve only got one part left to go where we’ll discuss some treatments for PCOS and more. Stay tuned!
TL;DR:
PCOS presents in completely varied ways depending on the person and their symptoms.
Getting an official PCOS diagnosis along with the type is a vital part of understanding how to care for your body and needs.
Doctors will use an industry-standard test called the ‘Rotterdam Criteria’ to diagnose. But that criteria is centered around women in the Western hemisphere.
Our PCOS test is curated specifically for Indian women based on this study and the help of our awesome medical panel.
There are 4 main types of PCOS: Insulin-Resistant, AdrenalIn,Inflammatory, and Post-Pill
Knowing the type of PCOS or taking a fertility test to understand it better is the first step towards better, personalized treatment plans based on your type.
PCOD and PCOS are related but different conditions, with PCOS being more severe.
PCOS can affect fertility, but it’s often treatable.
Exercise is crucial for managing PCOS symptoms and improving overall health.
Understanding ovulation with PCOS can be challenging but is important for those trying to conceive.
Sources
FAQs
1. What are the 4 types of PCOS?
PCOS, or Polycystic Ovary Syndrome, is categorized into four types based on clinical and hormonal characteristics: Insulin-resistant PCOS, Post-pill PCOS, Inflammatory PCOS, and adrenal PCOS.
Insulin-resistant PCOS is marked by elevated insulin levels, leading to irregular periods and difficulty in ovulation.
Post-pill PCOS occurs after discontinuing oral contraceptives, resulting in irregular menstrual cycles and androgen excess.
Inflammatory PCOS is associated with inflammation markers and insulin resistance, often presenting with acne and hirsutism.
Adrenal PCOS is characterised by irregular cycles despite normal androgen levels, often related to adrenal or thyroid dysfunction.
2. What is more serious PCOS or PCOD?
PCOS (Polycystic Ovary Syndrome) and PCOD (Polycystic Ovary Disease) are terms often used interchangeably, but PCOS is undeniably the more serious condition. PCOD is mainly the excessive production of immature eggs by the ovaries, and can be addressed with lifestyle changes, rarely requiring medication. However, PCOS encompasses a broader spectrum of symptoms such as insulin resistance, obesity, and increased risk of type 2 diabetes, compared to PCOD.
3. What is a rare type of PCOS?
A rare type of PCOS is Adrenal PCOS, which affects the adrenal glands and leads to excessive production of DHEA-S. It is due to abnormal stress response and affects about 10% of women. This also leads to increased levels of androgens, as DHEA-S is a type of androgen itself.
4. How do I know the type of PCOS I have?
Determining the type of PCOS requires a detailed evaluation by a healthcare professional, typically a gynecologist or endocrinologist specialising in reproductive health. Diagnostic criteria for PCOS include clinical symptoms such as irregular menstrual cycles, signs of androgen excess like acne and hirsutism, and hormonal imbalances detected through blood tests, including levels of testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and insulin.
5.Can PCOS be cured permanently?
While there’s no permanent cure for PCOS, it can be effectively managed with lifestyle changes, medication, and other treatments tailored to your specific type of PCOS.
Remember, every woman’s PCOS journey is unique. At Arva, we’re committed to helping you understand and manage your PCOS in a way that works best for you. Don’t hesitate to reach out if you have more questions!
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