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The four types of PCOS: phenotypes A to D
Editorially reviewed on October 29, 2026. [TODO: medical reviewer] How we review
Quick answer
The four official types come from the Rotterdam criteria: irregular cycles, high androgens, and polycystic ovaries (or a high AMH in adults). Type A has all three, B has cycles and androgens, C has androgens and ovaries with regular periods, and D has cycles and ovaries without high androgens. The internet's “adrenal”, “inflammatory” and “post-pill” PCOS are not official types.
Educational only. Not a diagnosis. Talk to a doctor about your results.
How it works
PCOS is diagnosed when you have at least two of three features, after your doctor rules out other causes such as thyroid problems or high prolactin. Which two (or three) you have gives your phenotype. Tick the features your doctor has found and the diagram highlights the matching type.
Why your type matters
Phenotypes with irregular cycles (A, B and D) tend to come with more metabolic problems. A study of 142 Filipino patients at a tertiary hospital found that phenotype A had a median BMI of 31.69 and a median HOMA-IR of 4.70, and that the oligo-anovulatory phenotypes showed greater metabolic dysfunction. That is why every type still needs a glucose check (75 g OGTT) and a lipid profile, whatever your weight.
Type C is a reminder that regular periods do not rule PCOS out. If you have acne or chin hair and your ultrasound or AMH suggests polycystic ovaries, ask your doctor about it.
What about “adrenal PCOS” and the other pop types?
Social media often sorts PCOS into “insulin-resistant”, “adrenal”, “inflammatory” and “post-pill” types, usually to sell a matching supplement. These are not part of the 2023 International Guideline. Insulin resistance is real and common across all types, which is one reason the new name includes the word metabolic. But your treatment is chosen by your goals (cycles, skin, hair, fertility, metabolic health), not by a pop type.
Next steps: check your symptoms, read how PCOS is diagnosed, or see what tests cost.
This guide is for information. Talk to a doctor before starting or changing any treatment.
Frequently asked questions
Does my type change my treatment?
Not directly. Treatment is chosen by your goals: the pill for cycles and hair, metformin and lifestyle support for metabolic health, letrozole for fertility. Your type mainly helps your doctor judge metabolic risk.
Can I have PCOS without high androgens?
Yes. That is phenotype D: irregular cycles plus polycystic ovaries or high AMH, without high androgens.
Is lean PCOS a separate type?
No. Lean PCOS describes body size, not a phenotype. People of every size can have any of the four types, and insulin resistance can happen at any weight.
Is PMOS the same as PCOS?
Yes. PMOS (polyendocrine metabolic ovarian syndrome) is the new name for PCOS, announced in The Lancet on 12 May 2026. It is the same condition with the same diagnosis and the same treatments. Both names will be used until the 2028 International Guideline update.
Sources
- Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Teede HJ et al., Fertility and Sterility (co-publication), 2023.
- Phenotypes of PCOS among Filipino women in a tertiary hospital. Bisquera et al., Journal of the ASEAN Federation of Endocrine Societies, 2023.
- Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. Teede HJ, Bahri Khomami M, Morman R, et al. The Lancet. DOI 10.1016/S0140-6736(26)00717-8, 12 May 2026.