Is it PCOS or just PCO?
So you’ve had an ultrasound that found the presence of multiple cysts. That means you have PCOS right? Wrong!
There is a big difference between PCOS and PCO. PCO is just that, polycystic ovaries, whereas PCOS is a complex metabolic condition characterized by hormonal imbalances.
The diagnosis of PCOS requires the presence of at least two of the following and should also include hormonal blood screening.
Polycystic ovaries (PCO)
Long cycles, anovulatory cycles or no cycle at all (amenorrhea)
Increased levels of male hormones in the blood (hyperandrogenism) which can lead to acne, excess hair growth or male pattern baldness
A note on long cycles: There are many other reasons why you may have long cycles, anovulatory cycles or no cycle at all and these should be ruled out before jumping straight to PCOS.
Now, more about PCO…
PCO is defined as the presence of multiple cysts, generally more than 12, on each ovary. Interestingly these ‘cysts’ are not actually cysts, they are follicles- fluid filled structures that contain an egg. PCO is a variant of normal ovaries and is not an issue in and of itself. Approximately 25% of women have PCO and it is often gone unnoticed until a routine ultrasound picks it up incidentally. In other words, nothing to be concerned about.
Usually, during a menstrual cycle, only 2-5 follicles develop in an ovary before one takes over and becomes the dominant follicle. At this stage the other follicles stop developing and the dominating follicle continues to grow. Once it reaches a certain size, the brain releases luteinizing hormone (LH) which triggers the follicle to be released from the ovary (ovulation). Sometimes, many more follicles are recruited at the start of a menstrual cycle and they all continue to develop. This is PCO.
So just to recap….
Multiple cysts (follicles) on ultrasound = PCO.
PCOS = A complex metabolic condition that involves more than just polycystic ovaries or an irregular cycle.
If you have been given a diagnosis of PCOS, based on ultrasound, or the characteristics of your menstrual cycle alone, you might want to revisit this with your healthcare provider and have some extra testing.
As always, we are here to answer any questions you may have and help you navigate the often confusing world of women’s health.
Sury x
