Can you have PCOS without cysts on the ovaries?

Yes, the name is somewhat misleading. Under the Rotterdam criteria, a diagnosis requires only two of three features (irregular periods, high androgens, polycystic ovaries). You can be diagnosed with PCOS without polycystic-appearing ovaries on ultrasound.

Can women with PCOS get pregnant?

Yes, many women with PCOS conceive naturally or with medical assistance. Weight loss, ovulation-inducing medications like letrozole, and assisted reproductive technologies such as IVF can significantly improve fertility outcomes.

Does PCOS go away after menopause?

Hormonal symptoms like irregular periods and excess androgen levels may improve after menopause, but metabolic issues such as insulin resistance, type 2 diabetes risk, and cardiovascular risk persist and continue to require management.

EndocrineICD-10: E28.2Affects 6–12% of reproductive-age women in the US (about 5 million)

Polycystic Ovary Syndrome

Also known as: PCOS, Polycystic Ovarian Syndrome, Stein-Leventhal Syndrome

Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age, characterized by irregular menstrual periods, excess androgen (male hormone) levels, and polycystic ovaries on ultrasound. It is the leading cause of female infertility and is associated with insulin resistance, metabolic syndrome, type 2 diabetes, and cardiovascular risk. Early diagnosis and management can prevent long-term complications.

Symptoms

Irregular, infrequent, or absent menstrual periods

Excess hair growth on the face, chest, and back (hirsutism)

Acne and oily skin

Thinning hair or male-pattern baldness

Weight gain, especially around the abdomen

Darkened skin patches (acanthosis nigricans)

Difficulty getting pregnant (infertility)

Mood changes including anxiety and depression

Causes

Hormonal imbalance with elevated androgens
Insulin resistance and compensatory hyperinsulinemia
Genetic predisposition (multiple genes involved)
Low-grade chronic inflammation

Risk Factors

Family history of PCOS
Obesity or overweight
Insulin resistance or type 2 diabetes
Sedentary lifestyle
Family history of type 2 diabetes

Diagnosis

Rotterdam criteria (2 of 3: oligo/anovulation, hyperandrogenism, polycystic ovaries on ultrasound)
Blood tests for androgens (testosterone, DHEA-S), glucose, insulin, and lipids
Pelvic ultrasound showing multiple small follicles (≥12 per ovary or ovarian volume >10 mL)
Exclusion of other causes (thyroid disease, congenital adrenal hyperplasia, Cushing syndrome)

Treatment

Lifestyle modifications (weight loss of 5–10% significantly improves symptoms)
Combined oral contraceptive pills for cycle regulation and androgen reduction
Metformin for insulin resistance
Spironolactone for hirsutism and acne
Letrozole or clomiphene for ovulation induction (fertility treatment)
In vitro fertilization (IVF) for resistant infertility

Prevention

PCOS itself cannot be prevented, but complications can be reduced by:
Maintaining a healthy weight through diet and exercise
Monitoring and managing blood sugar and insulin levels
Regular screening for diabetes and cardiovascular risk factors

When to See a Doctor

Irregular or absent menstrual periods
Unwanted facial or body hair growth
Difficulty conceiving after 12 months of trying
Signs of insulin resistance or rapid weight gain

Frequently Asked Questions

Related Conditions

Obesity

Metabolic

Infertility

Reproductive

Menopause

Reproductive

Related from the Supplement Library

Myo-Inositol

Moderate

Compound · PCOS management and ovulatory function restoration

Berberine

Strong

Compound · Blood sugar regulation comparable to metformin (AMPK activation)

Vitamin D

Strong

Vitamin · Bone health and calcium absorption

Omega-3 (EPA/DHA)

Strong

Fatty Acid · Cardiovascular health (TG reduction, anti-arrhythmic)

Chromium

Moderate

Mineral · Blood sugar regulation and insulin sensitivity

These supplements have been studied in relation to Polycystic Ovary Syndrome. Always consult your healthcare provider before starting any supplement, especially if you take medications.

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