What are the different types of PMOS?

According to the 2025 study on Data-Drive Subtypes of PCOS and Their Association with Clinical Outcomes, PMOS can be grouped into four subtypes: HA-PMOS, OB-PMOS, SHBG-PMOS and LH-PMOS.

PMOS is a complex, multi-system disorder that affects different individuals differently; researchers have identified four different types of PMOS based on clinical measures.[1]

In this article we explore four different subtypes or phenotypes of PMOS.

Under this classification system, there were found to be roughly equal proportions of each of the subtypes:[2]

• Hyperandrogenic (HA-PMOS, 25%): high dehydroepiandrosterone sulfate (DHEA-S) with mild metabolic disorders;

• With obesity (OB-PMOS, 26%): higher body mass index (BMI), fasting glucose and fasting insulin level as well as highest prevalence of type 2 diabetes (T2D), dyslipidemia and hypertension;

• High sex hormone-binding globulin (SHBG-PMOS, 26%): highest SHBG level and lowest BMI; and

• High luteinizing hormone and anti-Müllerian hormone (LH-PMOS, 23%): elevated levels of LH, follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH).

Not only were these subtypes shown to be distinct, they showed different reproductive and metabolic health trajectories and outcomes over the 6.5 year study period following the initial classification, for example:[3]

• HA-PMOS: highest risk for dyslipidemia and pregnancy loss during the second trimester;

• OB-PMOS: most severe metabolic health complications, lowest live birth rates and highest PMOS remission rate (with treatment);

• SHBG-PMOS: lowest incidence of diabetes and hypertension and favorable reproductive outcomes; and

• LH-PMOS: greatest risk of ovarian hyperstimulation (during fertility treatment) and lowest PMOS remission rate.

Want to learn more about how PMOS affects different individuals?  Check out the sections on Metabolic vs Reproductive PMOS and The 4 Cluster Model.

Sources

[1] https://www.nature.com/articles/s41591-025-03984-1

[2] https://www.nature.com/articles/s41591-025-03984-1

[3] https://www.nature.com/articles/s41591-025-03984-1