Does Having Ovarian Cysts Mean That I Have PCOS?

ovarian cysts pcos
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Question: Does Having Ovarian Cysts Mean That I Have PCOS?

Answer:

Polycystic ovary syndrome , known as PCOS, is one of the most common endocrine disorders in women of childbearing age. PCOS is also one of the most complex disorders and is often overlooked by medical professionals. 

Cysts vs. Follicles

Both cysts and follicles are common in women with PCOS and those without the condition. Many confuse cysts with follicles.

Despite its name, women with PCOS don't typically produce cysts, but follicles that are used as part of the diagnostic criteria (see below). A name change for PCOS has been proposed to clear up confusion and properly educate health professionals and consumers. 

Women with PCOS tend to produce follicles, which are small collections of fluid in the ovary and are the result, not the cause of, the imbalance of sex hormones.Each month, a woman produces follicles that mature and get released from the ovaries in order to be fertilized. Because of the hormone imbalance, these follicles don't mature and don't get released by the ovaries, causing infertility. The follicles can be seen on an ultrasound and resemble a string of pearls.

Developing follicles are actually quite common in women and doesn’t mean that you have polycystic ovary syndrome. Cysts, on the other hand, develop if a follicle continues to grow larger and larger as the fluid inside of it builds up.

If the wall of the follicle weakens, a tiny hole can form as the fluid starts to leak into the pelvic cavity, and is called an ovarian cyst rupture. This fluid can be irritating and sometimes causes a great deal of pain, sending some women to the emergency room. The pain will likely subside after a few days.

Diagnosing PCOS

Characterized by high levels of androgens, (male hormones like testosterone), PCOS is an imbalance of sex hormones. The current diagnostic criteria for women with PCOS states that a woman has PCOS if she has 2 of the following 3 criteria (with exclusion of all other criteria):

1. Absent or irregular menstrual cycles (8 or fewer periods in 1 year)

2. High androgens shown on blood work or signs of high androgens on the body (acne, excessive hair growth, hair loss)

3. The presence of follicles, commonly referred to as cysts, on an ultrasound

Some criteria define PCOS as having 12 or more small follicles in each ovary. However, in the United States, physicians do not typically rely solely on that definition in order to make a diagnosis. There are many women who have cystic ovaries without symptoms of hyperandrogenism, and many women who have been diagnosed with PCOS who do not have classically "cystic" ovaries.

If you are uncertain about your diagnosis of PCOS (or lack of one), it can’t hurt to get a second opinion.

Endocrinologists and reproductive endocrinologists are medical specialists with additional training in evaluating and treating hormonal disorders. Check out the American Society for Reproductive Medicine, ASRM.org or the Androgen Excess and PCOS Society for a local recommendation.

Source:

Jensen, Jani R. and Ruben Alvero. "Polycystic Ovarian Syndrome." Reproductive Endocrinology and Infertility: The Requisites in Obstetrics and Gynecology. Ed. Mark Evans, MD. Philadelphia: Mosby, 2007. 65-75.

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