” The Rotterdam criteria are commonly used to diagnose PCOS. According to the criteria, you need to have at least 2 of the 3 following symptoms:
- Irregular menstrual cycle
- Signs of hyperandrogenism (high testosterone) like acne, hair growth or hair loss
- Multiple follicles on your ovaries (seen on ultrasound)
Many doctors will do an ultrasound to check for multiple ovarian follicles as well as blood tests to check for high testosterone levels (amongst other hormone profiles).
Okay, so now that we know how PCOS is diagnosed, here are 8 reasons your PCOS diagnosis might be missed.
1. You are not overweight
There are many women who have lean PCOS. Their weight is normal (they may even be under weight). But, remember that although weight issues are often seen in women with PCOS, it’s not always the case and is not a diagnostic criteria for PCOS. Now, I have heard from women whose doctors did not pursue PCOS because they were not overweight.
2. You have a regular cycle
I have not always had a regular menstrual cycle. I’m very pleased to say that I do now. Does that mean that I don’t have PCOS anymore? Of course not. You only need 2 of the 3 criteria. So, you may well have a period regularly but struggle with high testosterone levels and ovarian follicles.
3. You did not have trouble getting pregnant
This is one that I have also come across frequently. A lot of women have gotten pregnant in spite of PCOS. Especially if you have a regular cycle.
A diagnosis of PCOS doesn’t always mean fertility difficulties, even though this is very common.
4. You don’t have a string of pearls.
I’m not talking about the pearls that you’d pay a small fortune to have. I’m talking about the string of pearls on your ovaries. You don’t need to have those ovarian follicles to have PCOS. 2 out of 3, remember?
5. Nobody else in your family has it
Although there is thought to be a strong genetic component to PCOS, it is not always seen in other female members of the family. For example, no other women in my family have PCOS, as far as I know.
6. You don’t have unwanted hair or acne
I know you’re starting to see a pattern here. Even if you don’t have hirsutism or acne, you could still have PCOS. If your cycle is irregular and you have the string of pearls, you could have PCOS.
7. You’ve been on birth control for years
A lot of us have been on the birth control pill for many many years. I was on it for at least 10 years before I was diagnosed with PCOS. The hormones from the pill often mask the symptoms of PCOS. It is only when you stop the pill that your symptoms come to light and you might start investigating the cause.
8. You’ve seen loads of doctors and none of them picked it up
Unfortunately this is another very common thing. It happened to me. PCOS is becoming more widely spoken about but there is still lack of awareness about PCOS. You may well have seen a number of doctors before you were diagnosed with PCOS.
So, there you have it. Your 8 reasons that your PCOS diagnosis may have been missed.”