Polycystic ovary syndrome is one of the most common hormonal conditions affecting women of reproductive age, and one of the most frequently delayed in diagnosis. Many women are told for years that irregular periods are simply how their body works.
It is a syndrome rather than a single disease, which is why diagnosis rests on a combination of findings rather than one test.
How it is diagnosed
Diagnosis generally requires two of three features: irregular or absent ovulation, clinical or biochemical signs of excess androgens, and polycystic ovarian appearance on ultrasound. Other conditions that can look similar — thyroid disease, raised prolactin, and others — are excluded first.
That is why a proper assessment involves history, blood tests and a scan rather than any one of them alone. The name on an ultrasound report is not, by itself, a diagnosis.
The symptoms that bring people in
Presentation varies widely, which is part of why it gets missed.
- Irregular, infrequent or absent periods
- Difficulty conceiving
- Acne, or unwanted hair growth on the face and body
- Hair thinning at the scalp
- Weight gain, or difficulty losing weight
- Skin darkening in the folds of the neck or underarms
The metabolic side people are not told about
PCOS is not only a reproductive condition. Insulin resistance is central to it in many women, which is why it carries an increased long-term risk of type 2 diabetes, and why metabolic screening belongs in the assessment.
This is the part most worth acting on early, and it is the reason a gynaecologist may check glucose and lipids alongside hormones.
What treatment looks like
There is no single treatment because there is no single presentation. What is offered depends on what is troubling you and whether you are trying to conceive.
Approaches include cycle regulation, treatment directed at skin and hair symptoms, insulin-sensitising medication where appropriate, and ovulation support for those trying to conceive. Weight management, where there is excess weight, improves several of these at once — often more than any single medication does.
Common questions
Can you have PCOS with regular periods?
Yes. Diagnosis requires two of three features, so someone with regular cycles can still meet the criteria through androgen excess and ovarian appearance. It is assessed as a whole picture.
Does PCOS mean I cannot get pregnant?
No. Many women with PCOS conceive, some without assistance and some with ovulation support. It can make conception take longer, which is a reason to seek advice earlier rather than to assume the worst.
What tests are done for PCOS?
Typically hormone blood tests, thyroid function, prolactin and a pelvic ultrasound, along with metabolic screening such as glucose and lipids. The combination is what allows other causes to be excluded.
This article is general health information, not medical advice, and does not replace a consultation. Care at Smart Care Polyclinic is provided by DHA-licensed clinicians.