Diagnosing PCOS: The 3 Criteria

Polycystic Ovarian Syndrome (PCOS) is a common hormonal disorder that affects millions of women worldwide, yet it remains widely misunderstood. Early diagnosis and management are key to preventing complications and improving quality of life, but understanding the diagnostic criteria is the first step. Here, we’ll break down the three main criteria used to diagnose PCOS, based on the Rotterdam criteria—a widely accepted guideline in the medical community.
1. Irregular or Absent Menstrual Cycles
One of the hallmark signs of PCOS is irregular or absent menstrual cycles. Women with PCOS may experience cycles that are longer than 35 days, fewer than eight cycles in a year, or complete absence of menstruation (amenorrhea). These irregularities occur because PCOS affects the normal ovulation process, which can disrupt the hormonal balance needed to maintain a regular cycle. If your periods are irregular, it’s a sign to talk to your healthcare provider.
2. Excess Androgen Levels
Androgens are often thought of as “male hormones,” but they are also present in women at lower levels. In PCOS, androgen levels can become elevated, leading to symptoms like excess facial or body hair (hirsutism), severe acne, or thinning hair on the scalp. These physical symptoms can vary in severity but are a significant indicator of PCOS when combined with other criteria. Testing for elevated androgen levels through bloodwork can help confirm this aspect of the diagnosis.
3. Polycystic Ovaries on Ultrasound
The term “polycystic” refers to the appearance of multiple small follicles (often referred to as “cysts”) on the ovaries during an ultrasound exam. These follicles are immature eggs that haven’t developed properly due to disrupted ovulation. It’s important to note that not all women with PCOS will have visible polycystic ovaries, and having polycystic ovaries alone does not confirm a PCOS diagnosis. This criterion must be assessed in combination with the others.
Meeting the Diagnostic Criteria
To be diagnosed with PCOS, a woman must meet at least two of the three criteria outlined above. Because PCOS can present differently from person to person, it’s essential to work with a healthcare provider for an accurate diagnosis. Other conditions that can mimic PCOS symptoms, such as thyroid disorders or hyperprolactinemia, should also be ruled out during the diagnostic process.
Why Diagnosis Matters
PCOS is more than just a reproductive health issue. It’s a complex condition that can increase the risk of other health concerns, including type 2 diabetes, heart disease, and infertility. Early diagnosis allows for better management through lifestyle changes, medications, and other treatments tailored to individual needs.
If you suspect you may have PCOS or are experiencing symptoms like irregular cycles or unwanted hair growth, our team is here to help. Schedule a consultation with us to take the first step toward better understanding your health and finding the care you need.