Temel Bilgiler
What is PCOS and how is it diagnosed?
PCOS affects 8–13% of women of reproductive age. What it is, how it is diagnosed, what the new name PMOS means and what to look out for after a diagnosis.
Published · 7 min read
Maybe your periods are months late, maybe acne or unwanted hair is wearing you down, or maybe your doctor said "it could be PCOS" and you are left with a lot of questions. You are not alone. This article explains in plain language what PCOS is, how it is diagnosed and what is worth paying attention to afterwards.
In short: PCOS is a common condition that affects about 8–13% of women of reproductive age and involves hormones, metabolism and mental health [2]. In adults it is diagnosed when at least two of three criteria are present, after other causes of similar symptoms have been ruled out [1]. A diagnosis is not a label; it is a starting point for protecting your long-term health.
What exactly is PCOS?
Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions in women of reproductive age. According to the World Health Organization it affects 8–13% of women in this age group, and globally up to 70% of those affected may not yet have a diagnosis [2].
A "syndrome" is a condition defined not by a single test but by a group of signs and symptoms that tend to occur together. In PCOS these vary a lot from person to person. For some women irregular periods stand out, for others it is acne or hair growth, and for others it is difficulty getting pregnant. The exact cause is not yet fully understood; it tends to run in families, and the interplay between hormones and insulin seems to play a role.
The "cysts" in the name can be misleading
The small structures seen on ultrasound are not really cysts. They are many small follicles, the little sacs that hold eggs, which have not finished maturing. This appearance does not mean PCOS on its own, and not every woman with PCOS has it [1].
A new name: PMOS
PCOS affects much more than the ovaries: it can involve hormones, metabolism (especially insulin), skin, mental health and fertility. That is why, in May 2026, after an international process involving more than 50 patient and professional organisations, the condition was given a new name: PMOS (polyendocrine metabolic ovarian syndrome). The new name highlights that several hormone systems and metabolism are involved, and it moves away from the idea of "cysts", which are not actually increased in the condition. The diagnostic criteria did not change. Both names will be used during a three-year transition, with the new name fully adopted in the 2028 guideline update [3]. Whichever one you see on your report, it refers to the same condition.
How is it diagnosed?
Under the 2023 International PCOS Guideline, adults need at least two of the following three criteria, after other causes of similar symptoms have been ruled out [1]:
- Irregular periods or problems with ovulation: cycles that are very short, very long or unpredictable.
- Excess androgens: androgens are often called "male hormones", but women naturally have them too. An excess can show up in blood tests or as signs such as acne or unwanted hair growth.
- Polycystic ovaries on ultrasound or a high AMH level: AMH (anti-Müllerian hormone) is released by the small follicles in the ovaries. This criterion is used in adults only.
If irregular periods and excess androgens are both present, no ultrasound or AMH test is needed [1]. So not every woman needs an ultrasound to be diagnosed.
Diagnosis is different in adolescents
In adolescents, both irregular periods and excess androgens are required, and ultrasound and AMH are not used [1]. At this age it can be normal for the ovaries to have many follicles and for cycles not to have settled yet.
What counts as an "irregular" cycle?
The guideline uses these definitions, based on time since the first period [1]:
| Time since first period | Counts as irregular |
|---|---|
| Less than 1 year | Irregularity is considered normal |
| 1–3 years | Cycles shorter than 21 or longer than 45 days |
| More than 3 years | Cycles shorter than 21 or longer than 35 days, or fewer than 8 periods a year |
| More than 1 year | Any single cycle longer than 90 days |
Tracking your cycle regularly gives you concrete data to bring to your doctor.
Why other causes are ruled out
Symptoms that look like PCOS can come from other conditions. So before making a diagnosis, your doctor will usually check your thyroid hormones and prolactin (the milk hormone), and may order other tests if needed.
Another cause not to miss is functional hypothalamic amenorrhoea. In plain words: when the body does not get enough energy, is under heavy stress or is doing very intense exercise, the brain can suppress ovulation and periods can stop [4]. This needs a different approach from PCOS, so telling them apart matters.
Why a diagnosis matters
A diagnosis is more than a name for your symptoms. PCOS is linked with some health risks, and knowing about them lets simple, early steps make a difference.
- Blood sugar: the risk of impaired glucose tolerance (blood sugar coming down more slowly than normal) and type 2 diabetes is several times higher in PCOS, roughly 2–4 fold, and this is seen independent of weight [5]. Whatever your weight, the guideline names the 75 g oral glucose tolerance test (OGTT) as the most accurate check [1].
- Mental health: moderate to severe depressive symptoms are about 3 times and anxiety symptoms about 5 times more common [6]. The guideline recommends screening everyone with PCOS for depression and anxiety [1].
- Sleep apnoea: obstructive sleep apnoea, where breathing repeatedly stops during sleep, is more common independent of weight. Snoring, waking up unrefreshed and daytime sleepiness are signs to watch for [1].
- Lining of the womb: before menopause, the risk of endometrial cancer was found to be about 2–3 times higher, but the absolute risk is still low [7].
- Pregnancy: the risk of gestational diabetes, high blood pressure in pregnancy and preterm birth is higher, so it helps to talk to your doctor before trying to conceive [1].
None of this is meant to scare you. Risk is not destiny; the goal is to spot possible problems early through regular check-ups.
What you can do
- Track your cycle: note the start date of each period, how heavy it is and any symptoms around it. The LunaPCOS calendar makes this easier.
- List your symptoms: write down changes such as acne, hair growth, hair loss, sleep and mood, along with when they started.
- See a specialist: a gynaecologist or an endocrinologist is a good first step.
- Prepare questions: for example "Which tests will I have?", "How will we monitor my blood sugar?" or "When will my blood pressure be checked?"
- Agree on a check-up plan: the guideline recommends checking blood sugar every 1–3 years depending on risk, blood pressure every year and when planning pregnancy, and blood fats at diagnosis [1].
- Make room for your feelings: if your mood, body image or relationship with food is hard right now, tell your doctor. These are recognised and taken seriously in PCOS care [1].
Frequently asked questions
If I have PCOS, does that mean I cannot get pregnant?
PCOS can make getting pregnant harder by making ovulation irregular, but it does not make it impossible. There are treatments that support ovulation, and the guideline recommends letrozole as the first choice [1]. If you are planning a pregnancy, it is best to talk to your doctor early.
Can I have PCOS if I am slim?
Yes. PCOS occurs at every weight, and the higher risk of type 2 diabetes is also seen independent of weight [5]. Diagnosis is based on the criteria above, not on your weight.
Why do I read different numbers in different places?
How common PCOS appears depends on which diagnostic criteria are used. With the broader Rotterdam criteria, the numbers come out higher [8]. That is why it is normal to see a range rather than one exact figure.
Does PCOS go away?
There is no permanent cure for PCOS, but symptoms can be managed. The combined contraceptive pill is recommended as a first option for irregular periods and excess androgens, and lifestyle changes and other medicines can also help when needed [1]. You and your doctor can decide together which path suits you.
This article is for information only; talk to your doctor about diagnosis and treatment.
Sources
- Teede HJ et al. Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of PCOS. Fertil Steril. 2023; 120(4): 767-793. PubMed
- World Health Organization. Polycystic ovary syndrome – Fact sheet. 2023. WHO
- Endocrine Society. Polyendocrine Metabolic Ovarian Syndrome: new name to improve diagnosis and care. Press release, 12 May 2026. Endocrine Society
- Gordon CM et al. Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017; 102(5): 1413-1439. PubMed
- Kakoly NS et al. Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression. Hum Reprod Update. 2018; 24(4): 455-467. PubMed
- Cooney LG et al. High prevalence of moderate and severe depressive and anxiety symptoms in PCOS: a systematic review and meta-analysis. Hum Reprod. 2017; 32(5): 1075-1091. PubMed
- Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with PCOS: a systematic review and meta-analysis. Hum Reprod Update. 2014; 20(5): 748-758. PubMed
- Bozdag G et al. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016; 31(12): 2841-2855. PubMed
