PCOS ≠ Ovarian Cysts

The word “polycystic” in polycystic ovary syndrome (PCOS) refers to small antral follicles and not large, epithelial-lined ovarian cysts that can be painful or can rupture. Yet many patients and physicians assume, understandably, that large ovarian cysts are characteristic of PCOS.

To determine whether patients with PCOS are, in fact, at increased risk for having ovarian cysts, researchers compared transvaginal ultrasound findings in 223 people with PCOS and 1012 without. Diagnoses of PCOS were established according to the Rotterdam criteria, which include irregular menstrual cycles, hyperandrogenism, and an excess of small antral follicles. All participants were asymptomatic and not using hormonal contraception.