Question for Betty.

Can someone have PCOS (polycystic ovary syndrome) if their periods occur normally?  There is conflicting information online and in medical booklets.

Betty's Answer.

You have a very controversial question as diagnostic criteria varies between different organizations. Specific diagnosis criteria for Polycystic ovary syndrome (PCOS) varies when not all the classic features are evident. Classic PCOS includes irregular menstrual periods, hirsutism, obesity, and classic ovarian changes. 

The National Institutes of Health (1990 PCOS Conference) proposes that a woman must have all of the following to be diagnosed with PCOS:

1. Irregular menstrual periods caused by anovulation or irregular ovulation.

2. Evidence of elevated androgen levels.  This can be based up sign (excess hair growth, acne, or male pattern balding) or blood tests (high androgen levels).

3.  No other cause of elevated androgen levels or irregular periods, such as congenital adrenal hyperplasia, androgen-secreting tumors, or hyperprolactinemia.

Blood tests usually recommended are: pregnancy, prolactin level, TSH (thyroid stimulating hormone), and FSH (follicle stimulating hormone).

If PCOS is confirmed, blood tests for glucose, cholesterol, testosterone, and DHEA-S may be recommended.

The Androgen Excess Society proposes that the definition should include those with polycystic ovaries, hyperandrogenism and apparently normal ovulation (and menses).   Some women have normal cycles which become irregular if the woman becomes overweight. Women with PCOS usually have fewer than six to eight menstrual periods per year. If ovulation does not occur, the lining of the uterus does not uniformly shed and regrow as in a normal menstrual cycle.  It can become thicker and shed irregularly, which can cause heavy and/or prolonged bleeding. 

If you think you may have PCOS and/or need further information please contact your health care provider or make an appointment with the SHCC for information.