Diagnosis Of Polycystic Ovary Syndrome (PCOS) In Adults

According to Health.mil, polycystic ovary syndrome is a common health condition affecting one in 10 women. Unfortunately, while PCOS is prevalent in society, it's often misunderstood and undiagnosed. Without a proper diagnosis, many women will continue to suffer from the related unpleasant side effects. 

Many women don't even realize that they have PCOS until they're in their 20s or 30s and attempt to get pregnant. A few different factors contribute to a diagnosis of polycystic ovary syndrome in adults.

This guide will discuss the signs of PCOS in adults. If you believe that you might have PCOS, you should make an appointment with your healthcare provider as soon as possible. 

Signs of PCOS in Adults

As a woman ages, the common symptoms of PCOS often go undetected. The symptoms can range from physical signs to irregular periods to hair growth. PCOS symptoms also get mistaken for typical adolescent hormonal fluctuations, resulting in a late-in-life PCOS diagnosis.  

Irregular Periods

Many women with PCOS experience abnormal menstruation. Irregular periods include not having a period or skipping one. You might also experience a heavy flow during your cycle. 

Hair Growth

According to NHS, hirsutism is a medical condition where women grow dark, thick hair in various areas of their body. Some parts of their body where this hair growth might occur include:

  • Thighs
  • Buttocks
  • Neck
  • Face
  • Lower back
  • Tummy
  • Chest

Around 70% of women with PCOS experience abnormal hair growth. This is because some women might have higher amounts of male hormones. 

Acne

Some women with PCOS might get adult acne on the face, chest, and back. Their acne might arise during their teenage years and be difficult to get rid of and treat. Having excess androgen levels is a cause of acne. 

Obesity

According to Cleveland Clinic, around 80% of women who have PCOS are obese or overweight. They also have trouble getting rid of their excess weight. The weight gain typically occurs in the abdominal region of their bodies. 

Fertility Problems

As we mentioned earlier, many women don't realize they have PCOS until they're trying to conceive. During your period, your ovaries release an egg into your uterus.

Women who have PCOS ovulate infrequently or not at all. Irregular ovulation results in absent or abnormal periods. This sensation also makes it difficult to get pregnant. 

For additional information read What Are The 4 Types of PCOS?

Who Diagnoses PCOS in Adults?

An endocrinologist can give you a PCOS diagnosis. They're a healthcare provider that has special training in hormonal disorders. The endocrinologist will work in conjunction with the following doctors to address your symptoms:

  • Dermatologists
  • Reproductive specialists
  • Nutritionists 

By providing you with a proper diagnosis and treatment, your doctors can help prevent future complications. 

Criteria to Diagnose PCOS in Adults

There are some specific criteria to diagnose PCOS. You'll need to meet two of the PCOS diagnosis criteria for your doctor to move forward with other examinations. 

Irregular Ovulation

One of the PCOS diagnosis guidelines includes having irregular ovulation.  According to Very Well Health, there are a few ways your menstrual cycle gets affected by PCOS:

  • High androgen levels prevent ovulation 
  • Hormonal imbalances inhibit the follicle from getting released or maturing
  • The follicle stays inside your ovary

Some women with PCOS can still have regular periods, while others can skip their periods entirely. Irregular ovulation is a normal side effect of PCOS but one that needs to get treated. This is especially true if you're getting less than eight periods every year. 

Increased Androgen Levels

Having high levels of androgens is a common symptom of PCOS. Androgens are a vital hormone that helps with the following bodily functions:

  • Muscle growth and function 
  • Mental wellness
  • Bone strength
  • Public and body hair growth
  • Libido
  • Fat cell production 
  • Reproductive function

In women, androgen hormones get created in their ovaries and fat cells. Androgens are also produced in the adrenal glands. The adrenal glands are located by your kidneys. 

Cysts in the Ovaries

Ovarian cysts without the presence of other symptoms don't meet the PCOS diagnosis guidelines. An ovarian cyst is a fluid-filled sac located on or in the ovaries. They're very common, and many women get them at some point during their life. 

Not all women with PCOS get ovarian cysts. In some instances, a woman might not make enough hormones needed to ovulate. If a woman doesn't ovulate, her ovaries might develop small cysts. 

These ovarian cysts create more androgen hormones, causing her androgen levels to be high. 

PCOS Diagnosis Tests for Adults

During your initial appointments with your doctor, they'll ask you about the symptoms and signs you've noticed. They'll also ask you questions regarding your family's health history.

Your doctor will typically ask you if your grandmother, mother, or sister had problems getting pregnant or has PCOS. This information is helpful because PCOS can be genetic. 

Next, your doctor might check your BMI and blood pressure. They'll also evaluate your skin to look for acne or excessive hair growth. There are a few tests your doctor will perform to accurately diagnose you with PCOS. 

Hormonal Blood Tests

Hormonal blood tests are a common component in a PCOS diagnosis. A lab test can help measure your hormone levels in the following areas:

  • Luteinizing Hormone (LH): Affects ovulation 
  • Follicle-Stimulating Hormone (FSH): Factors in fertility 
  • Testosterone: Higher in women who have PCOS
  • Estrogen: High or normal levels if you have PCOS

Your doctor might order a human chorionic gonadotropin (hCG) test. This hormone test evaluates if you're pregnant. 

You might also undergo an anti-mullerian hormone (AMH) test. This test can evaluate the functionality of your ovaries. It can also estimate how far you are from menopause. 

Pelvic Exam

Your doctor's pelvic exam during your PCOS diagnosis is similar to your yearly exam. Your doctor will feel and look at the following areas of your body:

  • Uterus
  • Cervix
  • Vaina
  • Ovaries
  • Rectum
  • Fallopian tubes

Your doctor will look for anything abnormal or unusual. 

Ultrasound Exam 

An ultrasound creates an image of what your ovaries and uterus look like. There are two different ultrasounds you might experience: transvaginal and abdominal. 

Transvaginal Ultrasound

A transvaginal ultrasound is typically performed in your doctor's office. If they don't have the equipment necessary for the ultrasound, your doctor might refer you to another office. 

You can expect to be asked to drink up to six glasses of water before the ultrasound to fill your bladder. While needing to go to the bathroom during your ultrasound is uncomfortable, it helps the ultrasound technician get a better picture of your ovaries. 

You'll be asked to lay flat on your back on a bed or comfortable table. The ultrasound technician will place a lubricated ultrasound probe into your vagina. The image of your internal organs will get transmitted onto a screen. 

The technician will take pictures and measure your ovaries. They'll also make a note of any follicles that are present. 

A transvaginal ultrasound shouldn't hurt. Some women might experience discomfort while the technician moves the probe around or presses on their abdomen. 

Abdominal Ultrasound

Another term for an abdominal ultrasound is an external ultrasound. An external ultrasound is usually used to check on an unborn baby while a woman is pregnant. It can also look at other organs in your body, like your ovaries. 

The ultrasound technician will rub the lubricating gel onto your abdomen. They'll run a handheld probe across the areas of your body that they're examining. The gel helps the probe move easier and creates clearer images. 

The abdominal ultrasound looks for the same things as the transvaginal one. A transvaginal ultrasound is more invasive than an abdominal one but gives your doctor a clearer picture of any follicles present on your ovaries. 

Understanding the PCOS Diagnosis Guidelines

Many women confuse their PCOS symptoms with normal hormonal fluctuations. While this diagnosis can be scary and overwhelming, it's essential to know there are natural treatments For PCOS available. What your treatment plan includes depends upon whether or not you want to get pregnant. 

If you want to get pregnant, your doctor might recommend the following:

  • Medications that promote ovulation 
  • Changes in exercise and diet

In addition to the above treatment methods, your healthcare provider might recommend a few more tactics if you don't want to get pregnant. They include:

  • Diabetes medication 
  • Birth control 
  • Medications to treat your other symptoms, such as acne or hair growth

Learn More About Diagnosis of Polycystic Ovary Syndrome in Adults

Knowing the guidelines for a diagnosis of polycystic ovary syndrome in adults is essential. Even if you don't meet the criteria needed for a PCOS diagnosis, you should still speak to your doctor about any unpleasant symptoms you experience. 

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