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
Ultrasound findings must be interpreted together with symptoms, examination and, when needed, laboratory or other imaging results. An image alone should not be used for self-diagnosis or self-treatment.
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.
Management is individual and depends on age, symptoms, imaging findings, other health conditions and pregnancy plans. Medication or a procedure should be selected with the appropriate clinician.
When is urgent care needed?
- Very heavy or prolonged bleeding
- Sudden severe one-sided pelvic pain
- Positive pregnancy test with pain or bleeding
Related reading
- Late period and menstrual cycle disorders
- Follicle monitoring — when is it ordered and how is it performed?
- Endometrial thickness — normal changes by age and menstrual cycle
When should you consult radiologist Lana Ezieshvili?
Radiologist Lana Ezieshvili performs targeted ultrasound examinations, describes findings using standard imaging criteria and explains the report in clear language.
If you have symptoms, a referral or need follow-up imaging, use the form below to book a visit with Lana Ezieshvili. Timely, appropriately selected imaging can reduce uncertainty and help determine the right next step.
This article is for education and does not replace medical advice. Seek urgent care for severe or rapidly worsening symptoms.