Which PCOS type are you?


This article was written by my previous Nutrition Grad Student, Kimmie Singh. She is a fat woman of color who experiences PCOS. You can find out more information about her work now as a dietitian here.

People with PCOS share many similar experiences, yet there is quite a bit of variation among the PCOS experience.

Why do people with PCOS have different symptoms? 

Why is there body diversity among the PCOS community if we all have the same condition? 

Will the same medications help everyone? 

The questions are endless!

Research has demonstrated people with PCOS can be separated in four different categories depending on three basic PCOS symptoms:

  • inconsistent and/or lack of ovulation (oligo/anovulation),
  • increased male sex hormones (hyperandrogenism),
  • and the presence of cysts on ovaries (polycystic ovaries).

Yes, you read that correctly, having cysts on your ovaries is not a requirement to having PCOS. One study identified the following four types of PCOS, and these four types have built the foundation for understanding the general differences between people with PCOS:







Classic polycystic ovary PCOS                X                X              X
Classic non-polycystic ovary PCOS                X                X
Non-classic ovulatory PCOS                X              X
Non-classic mild PCOS                X              X

Since these types of PCOS were identified many researchers examined what other symptoms vary between the types.

Want to find a way to treat your PCOS without dieting?

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The classic polycystic ovary PCOS is the most prevalent type of PCOS, and, unfortunately, it is associated with the most negative health outcomes. People with this type of PCOS are more likely to experience more severe insulin resistance (more on that here). They are also at an increased risk of having unhealthy lipid panels.

All three types of PCOS that have hyperandrogenism are at an increased risk for developing cardiovascular disease.

There are also hormonal differences between the types. One study found that people with classic polycystic ovary PCOS have higher testosterone levels than the other types.

There have been some studies that compared the body sizes and shapes between the types of people with PCOS. Most studies find that people with the Classic polycystic ovary PCOS are most likely to have larger bodies and carry more weight around the midsection.

Although the research on body diversity and PCOS is super scarce, this is such a great indicator that people with PCOS should not be expected to have a particular body type. I have heard so many people suggest that if there are thin people with PCOS then all people with PCOS should and can be thin. This is false for any population- especially for people with PCOS.

Differentiating between types of PCOS gives me hope for the future of PCOS research. So many people with PCOS feel disappointed with the quality of healthcare of treatment options available.

I hope that by better understanding different PCOS experiences, future treatment options will be more individualized.

Want to better understand your PCOS? Take a deep dive into PCOS management without dieting. Julie’s course can show you how. Details here.



Aziz, M., Sidelmann, J. J., Faber, J., Wissing, M. M., Naver, K. V., Mikkelsen, A., . . .

Skouby, S. O. (2015). Polycystic ovary syndrome: cardiovascular risk factors according to specific phenotypes. Acta Obstetricia et Gynecologica Scandinavica, 94, 1082-1089. doi:10.1111/aogs.12706

Clark, N. M., Podolski, A. J., Brooks, E. D., Chizen, D. R., Pierson, R. A., Lehotay, D. C., &

Lujan, M. E. (2014). Prevalence of Polycystic Ovary Syndrome Phenotypes Using Updated Criteria for Polycystic Ovarian Morphology. Reproductive Sciences, 21(8), 1034-1043. doi:10.1177/1933719114522525

Hayek, S. E., Bitar, L., Hamdar, L. H., Mirza, F. G., & Daoud, G. (2016). Poly Cystic

Ovarian Syndrome: An Updated Overview. Frontiers in Physiology, 7. doi:10.3389/fphys.2016.00124

Jamil, A. S., Alalaf, S. K., Al-Tawil, N. G., & Al-Shawaf, T. (2015). A case–control

observational study of insulin resistance and metabolic syndrome among the

four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. Reproductive Health, 12(1). doi:10.1186/1742-4755-12-7

Jamil, A. S., Alalaf, S. K., Al-Tawil, N. G., & Al-Shawaf, T. (2015). Comparison of clinical

and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria. Archives of Gynecology and Obstetrics, 293(2), 447-456. doi:10.1007/s00404-015-3889-5

Pehlivanov, B., & Orbetzova, M. (2007). Characteristics of different phenotypes of

polycystic ovary syndrome in a Bulgarian population. Gynecological Endocrinology, 23(10), 604-609. doi:10.1080/09513590701536246

Sahmay, S., Atakul, N., Oncul, M., Tuten, A., Aydogan, B., & Seyisoglu, H. (2013).

Serum anti-mullerian hormone levels in the main phenotypes of polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 170(1), 157-161. doi:10.1016/j.ejogrb.2013.05.019

PCOS keeps me dieting and I keep failing.

Have you dieted for you whole life? Are you looking for a way to help manage your health or a health condition, are being told that dieting and weight loss are the answer, but don’t feel that’s the right path for you? Listen now for some new options for better health.

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Episode’s Key Points:

  • Dieting leads to bingeing!
  • Diets don’t work… but doctors still prescribe dieting to “help” with all kinds of health conditions. What gives?
  • Polycystic ovarian syndrome (PCOS): A super common endocrine disorder that often is “treated” with dieting. But there are other ways!
  • Dieting is the GREATEST predictor of weight gain and developing an eating disorder.
  • There seems to be some connection between eating disorders and PCOS… but there isn’t enough research out there to figure out why!
  • PCOS symptoms: Hormonal disregulation that affects ovulation, hunger/cravings, hair growth changes, central adiposity, high insulin levels, weight gain. Many of these symptoms impact body image in a negative way!
  • People in fat bodies can suffer from anorexia!!
  • Symptom changes/increases means intervention is needed… but it’s not the time to blame the individual! It’s time to manage the PCOS differently.
  • Be aware of the more uncommon side effects of PCOS (eating disorders, ADD, constipation etc).
  • PCOS is HIGHLY genetically influenced, and there are individuals with PCOS in smaller bodies… so what do doctors tell clients with PCOS to do when they are in a smaller body?? (This question applies to ALL medical intervention suggestions.)
  • Healthcare providers can be extremely fatphobic… advocate for yourself!!
  • If you have PCOS and your cravings are increasing, look into changing up your medication or increasing that amount of protein in your diet.
  • Keep an eye on which foods energize you and which foods drain you!
  • Try incorporating movement into your life, and make sure you have enough food fueling your body to support that movement.
  • Get enough sleep!! Sleep is SO important for an all-around health-promoting routine. Turn off your screens!

Show Notes:

Do you have a complicated relationship with food? I want to help! Send your Dear Food letter to LoveFoodPodcast@gmail.com. 

Click here to leave me a review in iTunes and subscribe. This type of kindness helps the show continue!

Thank you for listening to the Love, Food series.

The Love Food Podcast Episode 45


Do you have a health situation that makes intuitive eating difficult? Do you have doctors telling you that weight loss and cutting out certain food groups is required for your wellbeing? Do you just feel lost and want to help guide yourself toward food peace?? Listen now for some first steps on how to tackle it all.

Subscribe and leave a review here in just seconds.

Key Points:

  • Reflections on the 2016 Election, the President-elect Donald Trump, and the fat phobia that has come along with his campaign.
  • The difficulty in choosing not to diet, and dealing with the pressures from outside sources to continue down that path.
  • Using food as a coping mechanism and a numbing agent for uncomfortable feelings.
  • The vulnerability and fear of being thin.
  • Coping with health issues, such as PCOS, while also dealing with a disordered relationship with food and your body.
  • PCOS: weight gain, hormone destabilization, fatigue… what do we do??
  • Does intuitive eating really work for PCOS?? Or does “healing” PCOS require weight loss, as so many doctors suggest?
  • The million dollar question: can someone work on intuitive eating (rather than dieting) AND manage their health with PCOS? HELL YES!
  • Polycystic Ovarian Syndrome: a genetic and environmental syndrome that affects someone’s hormones, which leads to high insulin levels and insulin resistance. These high insulin levels lead to a high drive to eat, especially carbohydrates, which can lead to weight gain. Weight loss is often the primary treatment from most practitioners. This can make delving into intuitive eating difficult! Other sympotoms can include hair growth and male pattern baldness. These symptoms can have a huge negative impact on the body image of someone dealing with PCOS.
  • Self-care needs to be a priority for people with PCOS, especially getting enough sleep.
  • Those affected with PCOS can actually use the delicate balance of their bodies to delve deeply into intuitive eating! Take notice of energy levels and mood, rather than weight and even hunger cues (hunger cues can be super difficult to interpret with PCOS!).
  • Those with PCOS will probably need more protein than those without, especially at breakfast and before bed, to help with fatigue and appetite (but don’t cut out carboydrates or fats!).
  • Focus on healing your body and your soul… Sometimes, it’s not about the food!!
  • Sit with your vulnerability. (This is where therapy can come in handy! Therapists allow us the space to sit in that feeling.)
  • Put weight loss on the back burner and check in with your body… how does it feel today? What self-care did I do that worked for me today? This will help lead you to food peace and body peace.

Show Notes:

Do you have a complicated relationship with food? I want to help! Send your Dear Food letter to LoveFoodPodcast@gmail.com. 

Click here to leave me a review in iTunes and subscribe. This type of kindness helps the show continue!

Thank you for listening to the Love, Food series. Give me feedback via Twitter @EatingPermitRD.


This episode was sponsored by my friends at Green Mountain at Fox Run.
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The Love Food Podcast Episode 31: PCOS, cravings, and bingeing

Ep 031 Image

Have you been told to cut out sugar or carbs to treat PCOS or pre diabetes and it is just leaving you bingeing and hopeless?

Listen now for ideas to bring to your next doctor’s appointment.

Subscribe and leave a review here in just seconds.

Key Points:

  • Have PCOS and looking for more tools to work toward Food Peace? If you live near Greensboro NC you are in luck! Give us a call for details 336.273.2808 x 0.
  • Every diet leads to a binge and weight gain.
  • Dieting is the greatest predictor of weight gain and eating disorders.
  • Polycystic Ovarian Syndrome (PCOS) affects 1 in 10 women and has genetic connections. Stop blaming yourself!
  • PCOS affects ovulation, mood, hair, male pattern baldness, and central adiposity. This affects body image for many women.
  • High circulating insulin = growth hormone
  • Hard core restricting may help decrease weight in the beginning yet over time harms health, increases weight, promotes bingeing.
  • Increased cravings, more symptoms, weight gain = time to look into how PCOS managed rather than blame the person.
  • Doctors: How do you treat patients with PCOS in smaller bodies? What are their recommendations??
  • Which foods energize you? Which foods drain you??
  • Do you feel like you are carrying around a bag of rocks when you go to exercise?
  • How are you sleeping??
  • Let’s keep talking about PCOS!

Show Notes:

Do you have a complicated relationship with food? I want to help! Send your Dear Food letter to LoveFoodPodcast@gmail.com. 

Click here to leave me a review in iTunes and subscribe. This type of kindness helps the show continue!

Thank you for listening to the Love, Food series. Give me feedback via Twitter @EatingPermitRD.