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I have ovarian cysts, does that mean I have PCOS?

September 9, 2020 • read

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I have ovarian cysts, does that mean I have PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects the female reproductive system. You’d think the name is pretty self-descriptive. You have to have multiple cysts on your ovaries to qualify for a PCOS diagnosis, right? 

Not quite. Having cysts on your ovaries is only one of three qualifying criteria doctors use to diagnose PCOS. The three most common are the Rotterdam criteria. 

The Rotterdam criteria are:

  • Having irregular periods.
  • Elevated androgen levels. 
  • Having one or more ovarian cysts. 

As you can see, if you have high androgen levels and irregular periods then doctors can you can be diagnosed with PCOS as long as other conditions have been ruled out. Having ovarian cysts is a symptom of PCOS, not a cause. 

So then, why call this condition polycystic ovarian syndrome? There’s a lot of controversy amongst both doctors and patients surrounding the name. Doctors argue that PCOS is a misnomer. Cysts aren’t required for a diagnosis, and the “cysts” found in PCOS are actually ovarian follicles, not true cysts. Patients want the condition to be renamed with a title that accurately describes their experience. Having a lifelong condition that is misleadingly named can lead to difficulty accepting a diagnosis and receiving proper support from family and friends.  

For now, polycystic ovary syndrome is the accepted name for a hormonal disorder that’s associated with having high androgen levels. Androgens are hormones that cause male characteristics. The female reproductive system naturally produces them in small amounts in. People with female reproductive anatomy usually have a dominating balance of estrogen to androgen. When androgen levels rise, it can throw off typical ovulation rhythms. Unpleasant physical symptoms can ensue from there. 

Can you have ovarian cysts and not have PCOS?

Yes, you can. In fact, ovarian cysts are incredibly common. Most people who ovulate will develop one minor ovarian cyst every month. The vast majority of  ovarian cysts are benign, cause no symptoms, and go away on their own. 

The most common type of ovarian cysts are functional cysts. They’re so named because they’re caused by the functioning of your reproductive system. There are two varieties of functional cysts. They are:

  • Follicular — the female reproductive system usually releases one egg each month, which grows in a tiny sac called a follicle. If the egg can’t release, the sac fills with fluid and forms a cyst. 
  • Luteum — if an egg releases, the sac it grew in can fill up with fluid afterwards and form a cyst. 

There are other types of cysts that don’t relate to PCOS, and are less common than functional cysts. Some examples are:

  • Dermoid cysts — cysts that are made of bits of embryonic tissue. 
  • Cystadenomas — water or mucous-filled cysts that grow on top of an ovary. 
  • Endometriomas — cysts made of endometrial tissue that have migrated outside the uterus. 

Most cysts will come and go without you ever realizing. If cysts become very large they may present symptoms. Some large cysts need to be removed by surgery. If you experience sudden pain, faintness, nausea, or weakness, seek immediate medical attention. It may be an emergency situation.

Can you have PCOS without cysts?

The answer to this question is a resounding yes. Plenty of people with PCOS don’t have ovarian cysts. PCOS is an endocrine disorder rather than a condition solely involving your ovaries. 

Doctors describe PCOS as being a “constellation” of symptoms. If only the symptoms of PCOS were as beautiful as a galaxy in the night sky. PCOS can cause stubborn acne, excessive body hair growth, unpredictable and intense periods, and even infertility. These symptoms come from a systemic hormone imbalance in your body. Read more about that here

Can ovarian cysts cause hormonal imbalance?

In general, no. When it comes to PCOS, ovarian cysts are a result of an underlying hormone imbalance, not a cause. 

There are different factors that can lead to cysts on your ovaries. Taking fertility drugs and getting pregnant change your hormone levels, which may result in cysts. Lifestyle factors can also influence the incidence of cysts. PCOS is linked to insulin resistance, which is when your body stops responding to insulin’s signals. Insulin is a hormone, so when it’s out of whack then there can be cascade effects that unbalances the rest of your hormones.  

Do polycystic ovaries go away?

Yes and no. PCOS is a lifelong condition. Through medication and lifestyle adjustments, many people with PCOS reduce their symptoms to the point they no longer interfere with everyday life. But, the underlying sensitivity will always be there. PCOS tends to emerge in puberty, around the time you first menstruate. There are also genetic factors to PCOS. 

Functional cysts present much less stress. They tend to go away on their own without medical intervention. Simply having ovarian cysts is usually not a cause for concern, unless they get so big that they start affecting the structures around them. 

Are ovarian cysts and PCOS the same?

Again, the answer to this question is both yes and no. The difference between polycystic ovaries and polycystic ovarian syndrome is to do with hormone levels. People with PCOS may have ovarian cysts. But, these cysts have a hormonal cause. If you have ovarian cysts, but your menstrual cycle and hormone balance are normal, then you don’t have PCOS. 

Your endocrine system makes up all your hormones and the glands they secrete from. Hormones drive your body’s key processes like growing in height, metabolising food, conception and pregnancy, and mental health. We tend to take our hormones for granted when they’re in balance. When our hormones are out of balance, our bodies can feel like they’re acting out of order. 

If you think you might have PCOS, it’s important to talk to a doctor. They’ll ask questions to get to the bottom of your concern. Via referral, wait lists to see an endocrinologist are usually several months. If you’d prefer not to wait that long, our endocrinologists are available within days.

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