As a PCOS dietitian, I learn first-hand from clients how the condition can negatively affect their physical health, mental health and quality of life. Clients struggle to understand the condition, to manage symptoms, and to feel seen and heard. In this blog post, I’ll review the signs, symptoms, and diagnostic criteria of PCOS. Learn more about nutrition management for PCOS here.
Polycystic Ovary Syndrome (PCOS) is a complex hormone disorder affecting roughly 10 percent of people with ovaries in reproductive age. Symptoms can be vast and the exact causes of PCOS remains unclear. The health complications associated with PCOS can be overwhelming and may include any of the following: trouble conceiving, type 2 diabetes, high blood pressure, insulin resistance, elevated cholesterol and triglyceride levels, sleep apnea, non-alcoholic fatty liver disease, and increased risk for mood disorders and eating disorders.
The Endocrine Society Clinical Practice Guidelines recommend using the Rotterdam criteria for diagnosis in adults where 2 of the following 3 criteria are met:
As you can see, a person doesn’t even require “cysts” on the ovaries to be diagnosed with PCOS. The Rotterdam criteria further divides PCOS into 4 phenotypes:
Notice that body size and weight are not diagnostic indicators. This is important because people in all sized bodies can be diagnosed with PCOS.
In children and teens, there is potential to over-diagnose PCOS which can lead to unnecessary treatment and psychological struggle. The 2018 PCOS International Guidelines further state that ultrasound should not be used for the diagnosis of PCOS in those who are less than 8 years from menarche (their first period). This is due to the high incidence of multi-follicular ovaries in this life stage.
The Endocrine Society suggests that the diagnosis of PCOS in a teen be made based on the presence of:
Polycystic Ovary Syndrome can come with various signs and symptoms. The only symptoms of PCOS included in diagnosis are:
However, there are many other symptoms/side effects of PCOS that are not part of the diagnostic criteria. These may include:
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