PCOS is a complex, multi-system disorder that affects different individuals differently; researchers have identified two distinct forms of PCOS based on core symptoms.[1],[2]
In this article we explore metabolic vs reproductive phenotypes of PCOS.
Roughly 40% of individuals with PCOS have core symptoms associated with the metabolic type of PCOS, i.e.:[3]
High body mass index (BMI), the ratio of your weight in kilogram divided by the square of your weight in meters, with higher than 25 or 30 being classified as overweight or obese respectively;[4]
High circulating glucose levels, the level of glucose (sugar) in your bloodstream, with levels greater than 125 milligrams per deciliter (mg/dL) classified as hyperglycemia;[5]
High insulin levels, the level of insulin (the natural hormone that turns food into energy)[6] in your bloodstream, with levels great than 25 milli international units per liter (mIU/L) in a fasting test classified as hyperinsulinemia;[7]
Androgen excess (AE) (or hyperandrogenism), higher than usual levels of androgens, a type of sex hormone naturally produced in the ovaries and in the adrenal gland located on the top of your kidneys;[8],[9]
Lower levels of sex hormone binding globulin (SHBG), a protein that helps control the amount of sex hormones that are actively working in your body;[10] and
Lower levels of luteinizing hormone (LH), a chemical messenger that plays an important role in regulating the menstrual cycle and supporting pregnancy.[11]
Roughly 20% of individuals with PCOS have core symptoms associated with the reproductive type of PCOS, i.e.:[12]
Higher levels of LH;
Higher levels of SHBG;
Relatively low BMI; and
Relatively low insulin levels.
In the research, the remaining individuals were found to not fit within the typical characteristics of either the metabolic or reproductive type.
Reviewed by Dr. Elisabet Stener-Victorin, principal investigator of the Reproductive Endocrinology and Metabolism research group at the Department of Physiology and Pharmacology at Karolinska Institutet, Stockholm, Sweden and Chief Scientific Officer of the AE-PCOS Society
Sources
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310679/
[2] https://www.researchgate.net/publication/365363631_Assessing_the_androgenic_and_metabolic_heterogeneity_in_Polycystic_ovary_syndrome_PCOS_using_cluster_analysis
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310679/
[4] https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
[5] https://my.clevelandclinic.org/health/diseases/9815-hyperglycemia-high-blood-sugar
[6] https://my.clevelandclinic.org/health/body/22601-insulin
[7] https://www.verywellhealth.com/hyperinsulinemia-is-associated-with-type-2-diabetes-1087717
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9541126/
[9] https://my.clevelandclinic.org/health/articles/22002-androgens
[10] https://medlineplus.gov/lab-tests/shbg-blood-test/
[11] https://my.clevelandclinic.org/health/body/22255-luteinizing-hormone
[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310679/
Symptoms