13 Jul 2021

How is PCOS diagnosed

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By Kirra Morrill of Sunshine Coast Natural Health 

PCOS (Polycystic Ovary Syndrome) is notoriously difficult to diagnose, and the criteria has changed- why is an ultrasound just not enough anymore?

PCOS is a multi-factorial condition and often presents completely differently between women- the symptoms are hard to put inside a neat little box. Facial hair? Irregular periods? No periods? Weight gain? Weight loss?

It can get confusing, even for professionals.

And so is the diagnosis of PCOS. Time and time again I have women coming into the clinic saying they have been tested for PCOS. But with a little questioning, I soon realise that all they have had is an ultrasound for the presence of cysts.⁣

Now this may be one cyst, or it may be multiple. But majority of the time, they are being diagnosed with PCOS.

Nowadays this isn’t enough to diagnose PCOS; and you can even have PCOS without any cysts at all (likewise you can have cysts and no PCOS).⁣

An article by Jean Hailes puts this into perspective, clearly and concisely;

Criteria for a diagnosis of PCOS
1. Irregular periods or no periods
2. Higher levels of androgens are present in the blood (hyperandrogenism), shown by:

  • a blood test, OR
  • symptoms such as:
    • excess facial or body hair growth
    • scalp hair loss
    • acne.

3. Polycystic ovaries are visible on an ultrasound, meaning:

  • more than 20 follicles (partly developed eggs) are visible on one or both ovaries or
  • the size of one or both ovaries is increased (more than 10ml).

And just at the bottom of that criteria, they add; you do not need to have an ultrasound if you have criteria 1 and 2.⁣

This is something that I’m finding with my clients, is being missed.
The combination of symptomatic picture, blood tests for; testosterone, DHEA, insulin, LH/ FSH (to name a few) AND possibly and ultrasounds, is what is required to diagnose PCOS efficiently. and thoroughly.
So where to from here?⁣
⁣There are three scenarios here;

If you DON’T fit the mould:

  • You have been diagnosed with PCOS via ultrasound, but don’t fit the symptomatic picture and think something else may be going on
  • Find a GP or natural health professional who SPECIALISES in these conditions, and go from there.

If you haven’t yet been diagnosed but want to find out:

  • You have the symptoms, and may have done an ultrasound but havn’t been diagnosed with PCOS, and you suspect it may be
  • Again, find a health professional who SPECIALISES in these conditions, and go from there. You want to know how to treat your PCOS or symptoms naturally - without or alongside medication. 
  • Get in touch with a Naturopath who loves everything about treating Women’s Hormones. 

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