What Is PCOS?

What is Polycystic Ovary Syndrome
If you’ve just been diagnosed with Polycystic Ovary Syndrome (also known as PCOS), you will probably have many questions, like… What is PCOS?

So let’s dive in!

… What Is PCOS?

PCOS stands for Polycystic Ovary Syndrome. It is a complex hormonal disorder, affecting more than just your ovaries.

Increased emergence of PCOS

PCOS is present in approximately 10% of Caucasian women and 15- 20% of African-American and Hispanic women, with rates in Australian indigenous women estimated at 21%.

PCOS has been on the rise in recent years. This is attributable to our lifestyles. Excessive intakes of unhealthy food and drink, the introduction of artificial hormones to our food and environment, loss of appropriate nutrition, the constant state of stress we live under, suboptimal gut function, increasing medications, lack of movement and increasing rates of overweight and obesity, are taking their toll on our health.


There are two main diagnostic criteria used for the diagnosis of PCOS, the Rotterdam Criteria and the NIH/NICHD.

The Rotterdam criteria define PCOS as being present with at least two of the following: infrequent menstruation, excessive ‘male’ hormones (hyperandrogenism) and/or Poly Cystic ovaries on ultrasound.

The NIH criteria define PCOS as the presence of hyperandrogenism and infrequent ovulation (oligo-ovulation).

Both of these definitions are after the exclusion of other disorders that could be responsible for the symptomatic picture.

What does a Poly Cystic Ovary look like?

The definition of a Poly Cystic Ovary is one in which there is “either 12 or more follicles measuring 2-9mm in diameter and/ or increased ovarian volume (>10cm3)”. The follicles appear in a typical peripheral pattern, also known as the ‘string of pearls’ appearance. This is most commonly determined by ultrasound abdominal, and/or trans-vaginal.

It’s very important to have your scans performed by an experienced ultrasonographer. It is more accurate to have trans-vaginal scans performed.

The transvaginal scan may not be performed if you are a virgin, or you refuse.

What is PCOS

What does a polycystic ovary look like in PCOS?

What is the difference between Poly Cystic Ovaries and Poly Cystic Ovary Syndrome?

The appearance of Poly Cystic Ovaries and Poly Cystic Ovary Syndrome are two separate entities. A woman with the appearance of Poly Cystic Ovaries (PCO) may or may not have PCOS. Approximately 19-33% of the general female population may show PCO appearance on an ultrasound.

Approximately 10% of the female population has PCOS. There is some thought that PCO may develop into PCOS given the ‘right’ conditions (i.e. weight gain, or an increase in insulin levels), however, until further research is conducted, these two entities should be considered distinct from one another.

Signs and Symptoms of PCOS

PCOS can present in a myriad of ways. The picture of an average woman with PCOS is of an overweight woman with irregular, potentially painful, periods, infertility, excessive facial and body hair and acne. However, there is much variation.

Symptoms may include:

  • Delay of normal menstruation (primary amenorrhea) Fewer than normal periods (oligomenorrhea)
  • Absent periods, after having previously experienced periods (secondary amenorrhea)
  • Menstrual cycles without ovulation (anovulatory cycles) Painful periods with abnormal flow
  • Excessive body and/or facial hair
  • Scalp hair loss
  • Acne
  • Poly Cystic Ovaries on ultrasound
  • Infertility
  • Overweight or obesity
  • Difficulty losing weight
  • Elevated insulin levels
  • Skin discolouration (acanthosis nigricans)
  • Skin tags
  • Fatigue
  • High blood pressure
  • Abnormal blood lipid levels
  • Cravings
  • Mood swings
  • Hot flushes
  • Sleep apnoea
  • Diabetes
  • Heart dis-ease.

It’s not just your ovaries

The name PCOS is somewhat misleading. It may lead you to believe this is an ovarian condition, but this is simply not the case. Your ovaries play an important role. However, PCOS is a ‘whole body’ endocrine condition, a systemic syndrome that affects the entire body.

What causes PCOS
Two of the main drivers of PCOS

  • Insulin resistance
  • Inflammation

Insulin Resistance

One of the issues now known to lead to and aggravate PCOS is insulin resistance. Your body produces insulin to allow your cells to ‘take in’ glucose. When a person’s body cannot respond properly to the insulin, it produces excessive amounts known as hyperinsulinemia.

As hyperinsulinemia continues, insulin resistance results.

The excess insulin causes the ovaries to swell and develop cysts, and stimulates secretion of excess amounts of androgen. These ‘male hormones’ affect regular ovulation, the menstrual cycle and cause the masculine characteristics associated with PCOS.

Implementing positive lifestyle changes will help you overcome insulin resistance.


Inflammation is an underlying cause of dis-ease that is rarely discussed, let alone appropriately addressed. This is no different in women with PCOS, regardless of age.

Women with PCOS have been found to have elevated markers for inflammation. Even before you begin to develop the telltale signs of PCOS, you may be suffering from chronic low-grade inflammation affecting every part of your body.

Where to start?

Your doctor will take some blood tests, order an ultrasound, and may perform some other investigations. Which tests will depend on your history, and the signs and symptoms you present with. What tests are often conducted?

  • An ultrasound to look at your ovaries
  • Blood tests to measure your hormones
  • A Glucose Tolerance Test with insulin levels to look at your blood sugar and insulin levels
  • Other tests depending on your aim, i.e. you may need tests to determine other causes of infertility, excessive hair growth and so on

Resources for women with PCOS

Free PCOS Resources

Download Your Free PCOS Fact Sheet – PCOS Fact Sheet

PCOS and Poor Sleep? 9 Proven Steps To Better Zzzz’s

Discover 9 proven ways to improve your sleep for a healthier body and brain and to conquer your PCOS.
Click for this important sleep article.

9 Tips To Reduce – Even Eliminate – PCOS Related Acne and Hirsutism

Approximately 60 – 80% of women with acne are suffering from PCOS, along with a similar percentage suffering from excessive hair growth. Discover 9 steps to help you conquer these embarrassing ailments.
Read this article now to improve your skin health.

Where Can I Find Out More Information?

Conquer Your PCOS Naturally

Conquer Your PCOS – The 12 Week Intensive

From PCOS to Pregnancy Program

The Successful PCOS Weight Loss Program

Polycystic Ovarian Syndrome Association of Australia 02 88509429

The National Depression Initiative 1300 22 4636

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* This article is an excerpt from my Amazon bestselling book, Conquer Your PCOS Naturally.