The 4 Types of PCOS: What You Need to Know About the Condition and the Best Ways to Manage Each Kind

No two people with polycystic ovary syndrome (PCOS) experience the condition the same way. While certain symptoms can remain common across the board, there are actually four types of PCOS that present differently in everyone. And with no cure, living with this condition can be difficult. In light of the ever-evolving information available about life with PCOS, First turned to experts to share what you need to know about each type and easy PCOS treatment plans. Keep reading to learn more about PCOS and how you can alleviate your symptoms.

What are the 4 types of PCOS?

Four different phenotypes can classify PCOS. Gina Nick, NMD, PhD , a licensed naturopathic physician with a focus on hormone balance and women’s health says these are Type A: Classic PCOS, Type B: Non-polycystic PCOS, Type C: Ovulatory PCOS and Type D: Mild or Non-Hyperandrogenic PCOS.

Each variation is different and the “ NIH classified PCOS into four types based on androgens (high or normal levels), ovulation (or lack of), and the appearance (or not) of polycystic ovaries on an ultrasound,” explains Angela Grassi, MS, RDN, LDN , co-author of The PCOS Workbook: Your Guide to Complete Physical and Emotional Health and CEO of The PCOS Nutrition Center.

Surprisingly, there are only four types of PCOS even though each person presents differently, and the severity of their symptoms can vary as well. Grassi also points out that “post-pill," "insulin resistant,” "inflammatory" or "adrenal" aren’t the correct ways to identify this condition. “Many people have combinations of insulin resistance and inflammation, the adrenals normally produce androgens and there is no such thing as post-pill PCOS,” says Grassi.

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Types of PCOS: Type A or Classic

Classic PCOS is the most common. This group is identified by “high androgens, irregular or absent ovulation, and polycystic ovaries,” says Dr. Nick. People with this type may have an increased risk of metabolic issues such as insulin resistance and raised cholesterol.

A low-carb diet and regular exercise are key to managing insulin resistance – losing weight, managing your blood sugar levels and staying active can all help symptoms in the long term. “These lifestyle changes help to stabilize blood sugar and reduce androgen levels,” adds Dr. Nick.

Loriana Soma, MD , physician in obstetrics and gynecology at The Ohio State University Wexner Medical Center, also notes that managing symptoms depends on what they are in everyone. “If a patient has glucose intolerance, insulin resistance, or prediabetes then we discuss lifestyle/nutritional changes including a referral to a nutritionist to help with that or medical management with prescriptions,” she says.

Types of PCOS: Type B or Non-polycystic PCOS

This group also has high androgens and irregular periods. The difference, Grassi notes, is that they present without polycystic ovaries.

“If bleeding and irregular periods are a problem then we discuss treatment options for that including hormonal medications or birth control options like pills or IUDs,” says Dr. Soma.

Dr. Nick also recommends bioidentical hormone replacement therapy (BHRT) specifically for Type B. “BHRT can help stabilize hormone levels without the harsh effects of synthetic hormones. This approach can be particularly beneficial for managing symptoms like irregular ovulation and androgen excess.”

Types of PCOS: Type C or Ovulatory PCOS

Ovulatory PCOS presents itself with “high androgens and polycystic ovaries” and has regular ovulation, says Dr. Nick.

To manage symptoms here, Dr. Nick recommends getting a handle on your stress. “Since stress can exacerbate androgen production by the adrenal glands, managing stress through lifestyle changes and adaptogens like ashwagandha can be crucial,” says Dr. Nick.

Adding these into your routine helps stabilize cortisol levels and reduce the overall impact of stress on your hormones.

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Types of PCOS: Type D or Non-Hyperandrogenic PCOS

People in type D have the least common type of PCOS. Ovulation is regular, the ovaries are polycystic, and the difference is the androgen levels are normal whereas they’re high in every other type.

Dr. Nick says certain types of HRT can ease symptoms and incorporating anti-inflammatory foods into your diet can make a difference. “Since this type of PCOS is often linked with chronic inflammation, dietary interventions focusing on anti-inflammatory foods are vital and incorporating omega-3 supplements can also help reduce systemic inflammation.”

Regardless of the type of PCOS you have, it’s important to understand the root causes of your symptoms. From there you can find effective management plans and remedies to alleviate any discomfort.

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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan .