Polycystic Ovaries vs Polycystic Ovarian Syndrome


What is the Difference?

A common confusion among women, is understanding the difference between having polycystic ovaries (PCO) and having been diagnosed with a Polycystic Ovarian Syndrome (PCOS).

PCO refers to an ultrasound scan image of the ovaries that appear to be polycystic (ovaries containing high density of partially mature follicles).

PCOS is a metabolic condition that may or may not come with having polycystic ovaries.

PCOS Without PCO

PCO is more common than PCOS and a patient may be diagnosed with PCOS without PCO.

For example she may have PCOS with the following symptoms such as irregular periods or increased male hormone in a blood test or other associated symptoms such as extra hair growth or acne.

These symptoms may relate to other conditions such as thyroid or pituitary dysfunction. These may need to be excluded before a PCOS diagnosis can be made.

Similar Names But Different Risks & Treatments

The risks and medical treatments may be very different.




Who Does it Affect

Up to 33% of women of childbearing age having polycystic ovaries on ultrasound and no other symptoms.

12-18% of women of reproductive age, (70% remain undiagnosed)

Type of Disorder

Mainly ultrasound diagnosis without the metabolic derangement, could be variant of normal ovaries

A metabolic disorder with or without the polycystic appearance of the ovaries, associated with an unbalanced hormone levels released by the woman's ovaries


Dissimilar profile, but could be a dormant form of PCOS and may flare-up later depending on other contributing factors.

Developing associated short and long-term effects

Associated Risks

Dissimilar profile, but may on subsequent ultrasounds show normal ovaries

Diabetes, pregnancy complications (ie. gestational diabetes), cardiovascular disease, obesity and endometrial hyperplasia that can lead to endometrial cancer.

Early Symptoms

No symptoms and often discovered by chance through ultrasound

Evident early in life with Irregular anovulatory cycles, acne, hirsutism, weight gain, and long term diabetes and possible endometrial hyperplasia.

Genetic Nature

May show early but mostly discovered incidentally during health checks in older women

Can show symptoms (acne, excess hair growth etc.) in teen years, due to metabolic disturbance


Cysts may be caused by a variety of reasons

Linked to a hormonal disorder

Hormonal Balance Disturbance

Undisturbed, with typically normal hormonal balance and continued regular ovulation

Causing high insulin release, due to slow or reduced uptake of blood sugar at the peripheral cells, this increase production of androgens from the ovary disturbing ovulation.


Conception may not be difficult

Struggles with infertility and have problems falling pregnant

Miscarriage Rate



Your Next Step

If you are experiencing any symptoms of PCOS above are concerned about any gyneacological problem that may require further investigation.

Dr Alexander can offer advice on a possible diagnosis, further investigations and suitable treatment.

For patients suffering from Polycystic Ovarian Syndrome, we would advise that you see your general practitioner and possibly obtain a referral to see Dr Alexander at www.my-obgyn.com.au/contact