PCOS and Irregular Periods in Vasant Kunj

PCOS and Irregular Periods: What a Scan Can and Cannot Tell You

The short answer

A pelvic ultrasound that reports "polycystic ovaries" does not, on its own, mean you have PCOS. Many women have ovaries that look polycystic on a scan and do not have the condition at all.

PCOS is diagnosed on a combination of things, not a single scan. In adults, you need two of the following three: periods that are irregular or absent, signs of raised male-type hormones, and either polycystic ovaries on a scan or a raised AMH blood level. Other conditions that look similar have to be ruled out first.

In teenagers the rules are different, and a scan should not be used at all in the first eight years after periods begin, because multi-follicular ovaries are common and normal at that age.

PCOS is not only a fertility condition. It affects how your body handles insulin, which is why it matters even if you are not planning a pregnancy.

Gynaecology consultations at All Is Well Medical Centre, Vasant Kunj. Monday to Saturday, 10 AM to 7 PM. Appointments only — call 8800844793.

PCOD or PCOS — are they the same thing?

You will hear both in India, often in the same conversation. In practice people use them to mean the same condition, and PCOD is the more common word in everyday speech.

The medically correct term is PCOS — polycystic ovary syndrome. "Syndrome" is the important word: it is a cluster of findings that occur together, not a single abnormality on a scan. That distinction is the whole subject of this article.

What PCOS actually is

PCOS is a hormonal and metabolic condition. Three things tend to travel together.

Ovulation happens irregularly, or not at all. This is why periods become unpredictable, widely spaced, or stop. It is also the reason PCOS is a common cause of difficulty conceiving.

The body produces more male-type hormones than usual. All women produce these normally; in PCOS the level is higher. This is what drives acne that persists past the teenage years, unwanted hair growth on the face or body, and in some women thinning of the hair on the scalp.

The body responds less well to insulin. The pancreas compensates by producing more of it, and higher insulin levels push the ovaries to make still more male-type hormone. This is the engine of the condition, and it is why PCOS carries consequences well beyond the menstrual cycle.

It is common. International estimates put it at roughly one in ten women of reproductive age. Studies in India have reported a wide range of figures depending on the population studied and the criteria used, but no one disputes that a great many women have it, and that a large proportion of them have never been properly assessed.

A scan showing polycystic ovaries is not a diagnosis

This is the single most useful thing to understand, and it is the source of a great deal of unnecessary worry.

An ultrasound can show many small follicles arranged around the edge of the ovary. Radiologists report this as polycystic ovaries, or PCOM — polycystic ovarian morphology. It describes an appearance. It is not a diagnosis.

A substantial number of women with entirely normal cycles and no other features have ovaries that look like this on a scan. They do not have PCOS. They do not need treatment. They frequently arrive having been told they do, and having spent months worrying about it.

The reverse is also true. Some women meet the criteria for PCOS on their symptoms and blood tests while their ovaries look unremarkable on the scan.

So the scan is one input among several. On its own it settles nothing. If you have been handed a report saying polycystic ovaries and nothing else, what you have is a finding that needs interpreting, not an answer.

How PCOS is actually diagnosed

The current international guideline, updated in 2023, sets out what has to be present.

In adults, two of these three:

Ovulatory dysfunction — cycles that are irregular, widely spaced, or absent. In practice, cycles consistently shorter than 21 days or longer than 35 days, or fewer than about eight periods in a year.

Hyperandrogenism — either visible signs, such as persistent acne, unwanted hair growth in a male pattern, or scalp hair thinning; or raised male-type hormones on a blood test.

Polycystic ovaries on ultrasound, or a raised AMH level on a blood test. The 2023 guideline added AMH as an alternative to the scan in adults, which is genuinely useful — it means the diagnosis need not depend on a transvaginal ultrasound in a woman who would rather not have one.

And other causes must be excluded. Thyroid disease, a raised prolactin level and certain adrenal conditions can all produce irregular periods and similar features. These are simple blood tests, and skipping them is how people end up treated for the wrong thing for years.

If you are a teenager, the rules are different

This matters and is widely got wrong.

In the first years after periods begin, irregular cycles are common and usually normal. The hormonal system that controls the cycle takes time to mature. Acne is common at that age. And ovaries that look multi-follicular on a scan are so usual in adolescence that the finding means very little.

For that reason the guideline says that in adolescents both irregular ovulation and signs of raised male-type hormones must be present, and that ultrasound and AMH should not be used for diagnosis until about eight years after the first period.

A teenager scanned for irregular cycles two years after her periods started will very often be told she has polycystic ovaries. In most cases this is a normal finding for her age, reported without that context, and it causes real distress in a young person who did not need to hear it.

If your daughter has been given this label, it is worth having it reviewed properly rather than accepted.

What actually brings women in

Rarely a scan result. Usually one of these.

Periods that have become unpredictable, or have stopped for months at a time. Acne that has not settled with age, or that appeared in the twenties. Hair growth on the face, chin, chest or abdomen. Hair thinning at the crown. Difficulty conceiving after several months of trying. Weight that has climbed without an obvious change in eating or activity. Or simply that a sister or mother has PCOS and the pattern feels familiar.

Any of these is a reasonable reason to be seen. You do not need to have all of them, and you do not need to be trying to conceive.

Why it matters even if you are not planning a pregnancy

Most writing about PCOS in India treats it as a fertility problem. That framing fails the twenty-two-year-old with irregular periods who is not thinking about children at all, and it is medically incomplete.

Insulin and metabolic risk. PCOS raises the risk of type 2 diabetes and of raised cholesterol and triglycerides. South Asian women carry that risk at a lower body weight than European populations, which is why body weight alone is a poor guide here. Periodic blood sugar and lipid checks are part of proper care.

The lining of the uterus. If ovulation is not happening, the uterine lining is exposed to oestrogen without the progesterone that normally follows ovulation. Over years this can cause the lining to thicken abnormally. This is a manageable risk and a well-understood one, but it is a reason not to leave very infrequent periods unaddressed for years.

Sleep and mood. Sleep apnoea is more common in PCOS, and so are anxiety and low mood — both as a consequence of the hormonal picture and as a reasonable response to living with symptoms that affect appearance and fertility.

None of this is written to alarm you. It is written because these are the things that make PCOS worth diagnosing accurately rather than approximately.

What treatment looks like

There is no single treatment, and anyone who offers one has skipped a step. What is appropriate depends on what is troubling you and what stage of life you are at. A twenty-year-old wanting predictable periods, a thirty-year-old trying to conceive and a thirty-eight-year-old concerned about metabolic risk need three different plans.

Lifestyle changes come first, and they work through insulin. Regular activity improves how the body handles insulin independently of any weight change, which is worth knowing if the scales are not moving. Where weight loss is appropriate, a modest reduction — the order of five to ten percent — is often enough to restore ovulation in women whose cycles had stopped. Larger targets are not required.

A word about weight, because it is usually handled badly. PCOS makes weight harder to lose, so this is not a matter of effort. Plenty of women with PCOS are not overweight at all. If you have been told to lose weight and sent away, that was not a treatment plan.

Medication is used for specific purposes, and is chosen for the individual. Broadly, there are treatments that regulate the cycle and protect the uterine lining; treatments that improve how the body responds to insulin; treatments that address unwanted hair growth and acne; and, where pregnancy is the goal, treatments that encourage ovulation. Which of these is right, and whether medication is needed at all, is a conversation to have with a doctor who has seen your results — not something to decide from an article.

Follow-up is part of it. PCOS is a long-term condition, and what suits you at twenty-five may not suit you at thirty-five.

Lean PCOS

You do not have to be overweight to have PCOS. A meaningful proportion of women with the condition are of normal weight, and they are frequently missed for exactly that reason — the assumption is made that PCOS looks a particular way, and it does not.

If you have irregular cycles and signs of raised male-type hormones and you are slim, that combination still warrants proper assessment. Insulin resistance can be present at a normal body weight, particularly in South Asian women.

When to see a doctor

Book an appointment if any of these apply.

Your cycles are consistently shorter than 21 days or longer than 35 days. You have had fewer than eight periods in the past year. Your periods have stopped for three months or more and you are not pregnant. Acne or unwanted hair growth is troubling you. You have been trying to conceive for a year, or for six months if you are over 35. You have been handed a scan report mentioning polycystic ovaries and nobody has explained what it means for you.

Seek attention sooner for periods that are unusually heavy, bleeding between periods, or bleeding after intercourse. Those are separate symptoms that need assessing in their own right, whatever else is going on.

PCOS assessment at All Is Well Medical Centre

Both our gynaecologists are women. For many patients that matters, and it is worth stating plainly rather than leaving to be discovered.

Dr. Meghana Lal — MBBS, DNB (Obstetrics & Gynaecology), DGO. Obstetrician, gynaecologist and infertility specialist, 18 years in practice.

Dr. Neha Jain — MBBS, DGO. Infertility specialist and laparoscopic surgeon, 16 years in practice.

What an assessment involves. A proper history — your cycle pattern, when things changed, what is actually bothering you, family history, and anything you are already taking. An examination where appropriate. Blood tests chosen for your situation rather than a standard panel, including the tests that rule out the conditions PCOS is confused with.

Scans are arranged through our partner imaging centres. We book the appointment for you and the report comes back to your doctor here, so it is interpreted alongside everything else rather than handed to you on its own. Blood tests can be collected at home free of charge.

Consultation fee: ₹1,000 when you book directly with us. Fees for bookings made through third-party platforms are set on those platforms and may differ.

Appointments only. Not all our specialists sit at the clinic all day, so please call rather than arriving unannounced.

Monday to Saturday, 10 AM to 7 PM. Closed Sunday.

Call 8800844793 to book.

All Is Well Medical Centre, Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi 110070.

Frequently asked questions

Is PCOD the same as PCOS?

In everyday Indian usage, yes — people use both words for the same condition. The medically correct term is PCOS, polycystic ovary syndrome.

My scan says polycystic ovaries. Do I have PCOS?

Not necessarily. Polycystic-looking ovaries are a common finding in women with normal cycles and no other features. A diagnosis needs two of three criteria in adults, with other causes excluded. The scan alone does not settle it.

Can PCOS be cured?

It cannot be cured, but it can be managed well, and symptoms often improve considerably with the right approach. Many women find the condition becomes easier to live with over time.

Can I get pregnant with PCOS?

Most women with PCOS do conceive. It is a common cause of difficulty conceiving because ovulation is irregular, but that is often treatable. If you have been trying for a year — or six months if you are over 35 — it is worth being assessed rather than waiting longer.

Do I need an ultrasound to be diagnosed?

Not always. Since 2023, an AMH blood test is accepted as an alternative to the scan in adults. In adolescents, neither should be used for diagnosis until about eight years after periods begin.

Will losing weight fix it?

Weight loss helps some women considerably, particularly with restoring ovulation, and a modest reduction is usually enough. But PCOS also makes weight harder to lose, and a significant number of women with PCOS are not overweight at all. Weight loss is one tool, not the whole answer.

Is it hereditary?

It runs in families. If your mother or sister has PCOS your own likelihood is higher, which is a reason to get irregular cycles looked at rather than to assume nothing can be done.

This article is general health information, not a diagnosis or a prescription for any individual. PCOS overlaps with several other conditions and cannot be distinguished reliably without examination and tests. If any of this applies to you, please see a doctor.

Reviewed by Dr. Meghana Lal, MBBS, DNB (Obstetrics & Gynaecology), DGO — All Is Well Medical Centre, Vasant Kunj. Last reviewed: 5 September, 2026.

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Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi, Delhi 110070

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