3 Main Forms of Polycystic Ovarian Syndrome (PCOS)

Dr. Tashko discusses PCOS variants, including those with impaired ovulation, elevated androgens, or metabolic issues. Understanding these types aids tailored treatment strategies for affected individuals.

Introduction – PCOS Care in Montgomery County, Maryland

As a PCOS specialist based in Montgomery County, Maryland, my focus lies in offering personalized care for individuals grappling with polycystic ovarian syndrome. I employ a comprehensive, evidence-based approach to address my patients’ unique needs and conditions.

Conveniently located in Rockville, my practice offers virtual and in-person services, extending support to nearby areas such as Chevy Chase, Bethesda, North Bethesda, Potomac, North Potomac, Gaithersburg, Germantown, Frederick, Silver Spring, Northern Virginia, Howard County, Anne Arundel, and the Eastern Shore of Maryland, ensuring comprehensive care.

Polycystic ovary syndrome (PCOS) has different types, known as phenotypes, each impacting health and fertility uniquely. Understanding these variations is key for effective management.

Now, Let’s Explore the Top 3 PCOS phenotypes:

1. Hyperandrogenic (High Androgen Levels)

This type is characterized by high levels of male hormones (androgens) like testosterone. Women with this PCOS type often have symptoms of excess hair growth on the face and body (hirsutism), acne, and sometimes male-pattern baldness. They also commonly experience irregular periods and difficulty getting pregnant due to ovulation problems. Women are also more likely to develop insulin resistance and metabolic issues like diabetes and heart problems.

2. Hyperinsulinemic (Insulin Resistance)

In this PCOS type, insulin resistance plays a central role. Insulin resistance means that the body’s cells do not respond well to insulin, leading to high insulin concentrations in the blood. This can worsen androgen levels and cause symptoms like irregular periods, acne, and hair growth. Weight gain and obesity are also common due to insulin-related anomalies. Treatment focuses on improving insulin sensitivity through lifestyle changes and sometimes medication.

3. Normoandrogenic (Normal Androgen Levels, Impaired Ovulation)

This phenotype doesn’t show the typical signs of high androgens like excess hair growth or severe acne. However, women with this PCOS type still have irregular periods and problems with ovulation, which can make fertility difficult. Despite normal androgen levels, there is still a higher risk of metabolic issues like insulin resistance and obesity. Treatment aims to regulate menstrual cycles and manage metabolic health through lifestyle adjustments.


Recognizing the specific PCOS phenotype is crucial for personalized treatment. By understanding the unique hormonal and metabolic aspects of each phenotype, a PCOS specialist can create effective treatment plans to manage symptoms and improve overall health and fertility for those with polycystic ovarian syndrome.

Dr. Tashko