We’ve known clinically that PCOS doesn’t always present as, well, PCOS. There is a far broader collection of phenotypes for PCOS than has been adequately documented. Thus, I was pleased to see this recent paper looking at PCOS subtypes and genetic associations.
From the discussion: The key traits driving the subtypes were BMI, insulin, SHBG, glucose, LH, and FSH levels. The reproductive subtype was characterized by higher LH and SHBG levels with lower BMI and blood glucose and insulin levels. The metabolic subtype was characterized by higher BMI and glucose and insulin levels with relatively low SHBG and LH levels. The remaining 40% of cases had no distinguishable cluster-wide characteristics, and the mean trait values were between those of the reproductive and metabolic subtypes.