Did you know that not all PCOS presents the same way? This is because of the different phenotypes of PCOS, understanding the 4 subtypes can help explain why symptoms vary so widely.
Rotterdam Criteria (you need 2 of 3 for diagnosis):
▪️ Irregular or absent periods (long cycles/no ovulation)
▪️ Androgen excess (acne, hair growth, high testosterone)
▪️ Polycystic ovaries on ultrasound (PCOM)
Phenotype A or “classic PCOS” – All three of the Rotterdam criteria are present.
Phenotype B – Irregularity of cycles and excess androgens but normal ovaries are visualized on ultrasound.
Phenotype C – There is androgen excess and PCOM on ultrasound but cycles are regular.
Phenotype D – PCOM on ultrasound and irregular cycles are present but there are no signs of androgen excess.
This phenotype is debated…could it be something else like hypothalamic amenorrhea?
Regardless of phenotype, insulin resistance is almost always a player, even though it’s not typically part of the diagnosis.
You don’t need to fit neatly into a box. PCOS is a spectrum. Treatment should focus on your unique symptoms, goals, and lifestyle.
Ready to learn more about PCOS? Book in with Dr. Passy
Jules Passy, ND 
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