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PCOs diagnosing criteria

Polycystic ovarian syndrome (PCOS) is an endocrine disorder that often goes missed. It takes an average of two years and three providers to finally receive. The good news is that having PCOS does not mean you can’t get pregnant. It is one of the most common causes of infertility in women and able to be treated.

Let’s begin by looking at the two main diagnosing criteria used to diagnose PCOS. The first one is Rotterdam criteria and you need to meet two of the three for the diagnosis

1. Excess androgens

2. No ovulation or irregular ovulation

3. Polycystic ovaries.

The Androgen Excess Society criteria are different and state you must meet all of the following

1. Excess Androgen

2. Ovarian dysfunction or polycystic ovaries.

What Are Signs of Androgen Excess?

It is thought that 20- 30 percent of women with PCOS have adrenal androgen (AA) excess. Signs of this include acne, unwanted hair growth, hair loss/thinning, oily skin, acne, irregular menstruation, and obesity.

Are there four types of PCOS?

The functional medicine approach discusses four types of PCOS. You can fit more than one of these types.

1. Insulin Resistant

Our body’s main source of energy is glucose (sugar) which we get from food. After we eat, it enters our bloodstream and the pancreas starts to process it. If you have insulin resistance, your cells don’t respond to the signal insulin is giving to stop. In turn, there is too much sugar in your bloodstream. Signs of this include:

A. Irregular periods

B. Excess weight

C. Acne

D. Hair changes


For this classification, it is important to know if your cycles were regular or irregular before starting oral birth control. You likely had PCOS before starting birth control if they were abnormal. If you had normal cycles, keep in mind they may return to normal after being off for a few months but I still would recommend a PCOS workup after six months of no period. 

3. Inflammatory 

This occurs when there is inflammation in the body which in turn causes the ovaries to produce too many androgen hormones. Signs of this include:

A. Fatigue
B. Skin issues
C. Food sensitives
D. Body aches
E. Headaches

4. Adrenal

This type of PCOS is thought to occur with elevated cortisol levels which is our stress hormone that is released from the adrenal glands. We know that when cortisol is elevated it is common to see elevation with DHEA levels which is an adrenal hormone. Signs of this include:

A. Elevated DHEA levels

B. Testosterone levels are often normal

C. Symptoms from the inflammatory list

Other reasons?

It is vital to have other factors ruled out such as hypothyroidism, prolcation levels, and deficiencies in nutrients like vitamin D and zinc. And don’t forget about the other category of lean PCOS. This will women will present with a lean body type but fit aspects of the above.

It is so important you work with someone who fully understands this disease because it is life long and learning how to best control yours means an individualized plan that fits your needs.

If you feel like you don’t quite fit any of the descriptions above but have irregularities in your menstrual cycle please seek a full workout.  There are a number of other things to investigate including other hormonal imbalances that weren’t mentioned in this blog. Find a healthcare provider who listens and trust your gut if something doesn’t feel right with a diagnosis or plan.

Also Read: Can You Improve Sperm Mobility and Mobility? 

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