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Normal Scan? You Might Still Have PCOS
7 Sep
Summary
- Ultrasounds may appear normal even with PCOS diagnosis.
- PCOS 'cysts' are follicles, not always visible on scans.
- Diagnosis relies on symptoms, not just ultrasound findings.
Polycystic Ovary Syndrome (PCOS) diagnosis can be misleading, as ovaries may appear entirely normal on an ultrasound, according to gynaecologists. The common term "polycystic" suggests cysts are the defining feature, but this is inaccurate. Many women with irregular periods or signs of hormonal imbalance like excess facial hair might assume they don't have PCOS if their ultrasound report shows no cysts.
Experts clarify that the structures referred to as "cysts" in PCOS are actually small ovarian follicles. These are distinct from pathological cysts and do not need to be visible on an ultrasound for a PCOS diagnosis. PCOS is a syndrome with reproductive and hormonal aspects, including ovulation problems and excess androgens, rather than a condition solely identifiable by imaging.
Diagnosis typically involves assessing two out of three features: anovulation (lack of ovulation), hyperandrogenism (excess androgens), and polycystic ovarian morphology on ultrasound, after other causes are excluded. Crucially, a normal ultrasound does not preclude PCOS. Women experiencing irregular cycles and androgen excess symptoms should consult a doctor, even if their scans are clear, as current guidelines state ultrasounds are not always required for diagnosis.
Conversely, identifying multiple small follicles on an ultrasound does not automatically confirm PCOS. A diagnosis requires a comprehensive evaluation, integrating menstrual history, symptoms, physical examinations, hormone testing, and metabolic assessments. Relying solely on an ultrasound report can lead to misdiagnosis, either missing PCOS or incorrectly diagnosing it.
