What should you know?
PCOS is a hormonal and metabolic syndrome that may affect ovulation, menstrual cycles and androgen levels. Polycystic ovarian morphology on ultrasound alone is not enough to diagnose the syndrome.
Diagnosis combines cycle history, clinical or laboratory androgen excess and ovarian morphology while excluding thyroid and other endocrine disorders. Metabolic risk also deserves attention.
Common symptoms and signs
- Irregular, infrequent or absent periods
- Acne, excess facial/body hair or scalp hair thinning
- Difficulty conceiving because of irregular ovulation
- Weight gain or insulin-resistance features
Diagnosis and the role of ultrasound
Transvaginal ultrasound evaluates ovarian volume and follicle distribution as well as the endometrium and other structural causes. Ultrasound criteria are used cautiously in adolescents.
- Ovarian volume and follicle pattern
- Evidence of ovulation
- Endometrial thickness after long cycles
- Exclusion of fibroids, polyps or other lesions
Treatment and next steps
Management may include sustainable nutrition and exercise, cycle protection, metabolic screening and ovulation treatment when pregnancy is desired. The plan depends on the main goal.
When is urgent care needed?
- Very heavy or prolonged bleeding
- Sudden severe one-sided pelvic pain
- Positive pregnancy test with pain or bleeding