04/17/2026
You DON’T need cysts on your ovaries to have PCOS…
Per The Rotterdam Criteria, you need 2 out of 3 to be diagnosed with PCOS:
1. Irregular or absent ovulation
– Irregular periods
– Long cycles or missed periods
2.Signs of high androgens (male hormones)
– Acne
– Excess facial or body hair
– Thinning hair on the scalp
– Or elevated androgen levels on blood work
3.Polycystic ovarian morphology on ultrasound
– Multiple small follicles (not true cysts)
– This finding may be present or absent
"Important to know:
• You do not need ovarian cysts to have PCOS
• Blood work and symptoms matter more than ultrasound alone
• Other conditions (thyroid, prolactin, adrenal disorders) should be ruled out
Bottom line:
PCOS is a clinical diagnosis, based on patterns — not a single scan or lab result.