What are the different types of PMOS?

According to the 2020 study on Distinct Subtypes of PCOS with Novel Genetic Associations, PMOS can be grouped into Reproductive, Metabolic and Mixed subtypes.

PMOS is a complex, multi-system disorder that affects different individuals differently; researchers have identified distinct forms of PMOS based on core symptoms.[1][2]  In this article we explore metabolic versus reproductive phenotypes of PMOS.

Roughly 40% of individuals with PMOS have core symptoms associated with the metabolic type of PMOS, i.e.:[3]

• High body mass index (BMI), the ratio of your weight in kilograms divided by the square of your height in meters, with a value 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), are classified as hyperglycemia;[5]

• High insulin levels, defined as the level of insulin (the natural hormone that converts food into energy)[6] in your bloodstream, with levels greater 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 a vital role in regulating the menstrual cycle and supporting pregnancy.[11]

Roughly 20% of individuals with PMOS have core symptoms associated with the reproductive type of PMOS, 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 not to fit within the typical characteristics of either the metabolic or reproductive type.

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/