PCOS / Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) is a hormonal condition that affects how the ovaries function. It is characterized by a combination of irregular menstrual cycles, signs of elevated androgens (male hormones), and polycystic-appearing ovaries on imaging. PCOS is common and may cause symptoms such as acne, excess hair growth, weight changes, and difficulty with fertility. Not all individuals with PCOS have ovarian cysts, and not everyone with ovarian cysts has PCOS.
What is it?
PCOS is a hormonal imbalance that affects how the ovaries release eggs. Individuals with PCOS may have higher levels of androgens, which can disrupt the menstrual cycle and affect ovarian function. On ultrasound, the ovaries may appear enlarged with multiple small follicles, sometimes referred to as a “polycystic” appearance. However, imaging alone does not diagnose PCOS—symptoms and hormone levels must also be considered.
Ultrasound helps identify whether the ovaries have the characteristic appearance often seen with PCOS. Imaging may also rule out other causes of irregular periods or hormone-related symptoms, such as ovarian cysts unrelated to PCOS or structural abnormalities.
Important to Know
PCOS is a lifelong condition that can affect reproductive, hormonal, and metabolic health. Many individuals manage symptoms effectively with lifestyle adjustments and medical treatment. PCOS is also associated with insulin resistance, increased cardiovascular risk, and metabolic syndrome, so long-term health monitoring is important.
Red flag symptoms include sudden severe pelvic pain (which is not typical of PCOS and may suggest another condition), prolonged absence of periods, rapid unexplained weight gain, or symptoms of high blood sugar such as excessive thirst or fatigue. These signs should prompt medical evaluation.