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An OB/GYN and fertility expert shares how to suss out a diagnosis.
Advocating for your health can often lead to endless Google searching for answers. But what if your symptoms don’t match up with a specific condition? For instance, polycystic ovary syndrome (PCOS) is usually associated with irregular periods. If you’re experiencing regular periods, you could still have PCOS, says Dr. Jessica Ryniec, a double board-certified physician in Obstetrics and Gynecology and Reproductive Endocrinology and Infertility.
Can I have PCOS with a normal cycle?
Absolutely! You can have PCOS even if your monthly cycle seems perfectly “on time” between 21–35 days. PCOS is, at its core, a syndrome — meaning it can show up in diverse ways. As Dr. Ryniec explains, “PCOS is a syndrome with different manifestations, and yes, it is possible to have PCOS with regular cycles.”
In other words, irregular periods aren’t the only box to check. Some people with PCOS still ovulate monthly, but may experience other telltale signs like acne, unexpected weight changes, or excess hair growth. When it comes to PCOS, there’s no one-size-fits-all profile: you can have typical cycles while other aspects of the syndrome are at play.
What are the symptoms of PCOS with regular periods?
PCOS is surprisingly common: The Cleveland Clinic estimates that up to 15% of reproductive-aged women have PCOS, and most are diagnosed in their 20s and 30s while trying to get pregnant.
“Many people don’t even realize they have the condition until they have trouble getting pregnant or are gaining weight for unknown reasons,” according to The Cleveland Clinic. “It’s also possible to have mild PCOS, where the symptoms aren’t severe enough for you to notice.”
Dr. Ryniec says that in order to get a PCOS diagnosis, you need to meet two out of three clinical criteria. These include:
- Irregular cycles, which could be frequent, delayed, skipped, heavy, or prolonged.
- Clinical or biochemical signs of hyperandrogenism, or excess male hormones. These include symptoms of high androgens, such as acne or hirsutism, or elevated androgens on bloodwork.
- An ultrasound showing ovaries with polycystic morphology, which she says means they’re enlarged or have many small follicles.
“In order to diagnose PCOS, your doctor also has to rule out or exclude other conditions that may cause the symptoms,” Dr. Ryniec adds.
You may notice a few other challenges, signs, and symptoms in the leadup to a PCOS diagnosis, including insulin resistance, weight gain and difficulty to losing weight, depression and mood disturbances, hair loss, and infertility or difficulty getting pregnant.
What to do if you suspect you have PCOS
Unfortunately, there isn’t a clear “cure” to PCOS, but there are a lot of things you can do to manage your symptoms and treatment options to make you feel your best. Here’s the path you should follow, according to Dr. Ryniec:
- Get diagnosed by a medical provider. For starters, Dr. Ryniec says you need to establish a diagnosis and rule out other causes of your symptoms. That said, you also want to make sure you and your doctor are aligned. If it doesn’t feel like the right match, make the extra effort to find the best medical provider for you and your needs.
- Determine achievable results. “The next step is reviewing what your goals are and what symptoms are causing you the most distress so that you can make a personalized treatment plan with your doctor,” Dr. Ryniec says. “This may include education on PCOS management, lifestyle interventions, and/or medications.”
- Prepare to adapt or alter your plan. These initial steps are the beginning of working through your PCOS symptoms, and it’s not always a linear or clear path to healing. “Since PCOS is lifelong, goals and therefore treatment options may change over time,” Dr. Ryniec says.
Lifestyle tweaks for PCOS
Physical symptoms aside, PCOS can affect you emotionally, too, especially since it can cause mood swings, anxiety, and depression. There are quite a few lifestyle changes you can make to take care of yourself, such as:
- Adding more lean protein, healthy fats, and veggies into your meals. “These can help keep your blood sugar stable, which is really important for managing symptoms,” Kristyn Hodgdon, the co-founder and chief creative officer at Rescripted, previously shared.
- Taking a gentle approach to self-care. It can be frustrating to experience hair growth or loss, acne, or weight gain, but those physical symptoms shouldn’t affect your self-esteem. Try your best to indulge in self-care by gently treating your body and mind, without worrying about getting quick results.
- Addressing mental health concerns. There are plenty of mood-boosting activities you can try to get in the right headspace, like meditating or queuing up your favorite comfort podcast. If these habits aren’t enough, though, consider consulting with a professional.
PCOS affects people physically and emotionally, but with the proper medical and self-care, you can set yourself up for success — whatever that means for you. For example, while 70-80% of women with PCOS have fertility challenges, it’s still possible to get pregnant, especially if you pursue fertility treatments that can improve ovulation. So, think of your PCOS diagnosis as the end to constantly Googling your symptoms and the start of your new normal.
Blake Bakkila is a freelance writer and editor with eight years of experience covering topics including baby and parenting, food, health, pop culture, and interior design. Her work has appeared in the digital publications of Architectural Digest, Sunset, Delish, and more. She highlighted the best, most game-changing baby and parenting products as the former senior commerce editor at What to Expect and BabyCenter, and she’s also held editorial positions at Good Housekeeping, Health, Real Simple, and People. Blake holds a bachelor’s in journalism from Northwestern University’s Medill School of Journalism. When she’s not typing, you can usually find her watching anything on Bravo, entertaining her son Rhode, and conducting field research on the best ice cream in Southern California.