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Polycystic Ovarian Disorder (PCOD) and Polycystic Ovary Syndrome (PCOS) are common hormonal disorders affecting women of reproductive age.
They are characterized by irregular menstrual cycles, excess androgen levels (male hormones), and multiple cysts in the ovaries. PCOS, in particular, is a metabolic condition that can lead to infertility, weight gain, and insulin resistance.
A Transvaginal Ultrasound (TVS) is one of the most effective imaging techniques used to diagnose PCOD/PCOS by evaluating ovarian size, cyst formation, and endometrial thickness.
What is PCOD/PCOS and How Does Ultrasound Help?
Understanding PCOD vs. PCOS
- PCOD (Polycystic Ovarian Disorder) refers to multiple small cysts in the ovaries, often caused by hormonal imbalances but without metabolic complications.
- PCOS (Polycystic Ovary Syndrome) is a more severe condition, affecting hormonal balance, metabolism, and fertility, often leading to long-term health risks such as diabetes, obesity, and heart disease.
Role of Ultrasound in Diagnosing PCOD/PCOS
A TVS scan is the gold standard for detecting polycystic ovaries. It helps:
- Assess ovarian size (PCOS ovaries are often enlarged).
- Identify the number and arrangement of follicles (tiny cysts).
- Evaluate endometrial thickness, which may indicate hormonal imbalances.
- Monitor ovulation, as PCOS can prevent egg release.
Ultrasound scans provide a comprehensive diagnosis of PCOS/PCOD.
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How Ultrasound Scan Detects Polycystic Ovaries
A polycystic ovary appears different from a normal ovary in several ways:
1. Enlarged Ovarian Volume
Normal ovaries are smaller than 10 cm³ in volume. In PCOS, ovaries are often greater than 10 cm³, indicating an excess of underdeveloped follicles.
2. Multiple Small Follicles (Cysts)
Healthy ovaries develop 1–2 dominant follicles per cycle for ovulation. PCOS ovaries contain 12 or more small follicles (2–9 mm in diameter), arranged in a “string of pearls” pattern.
These follicles fail to mature properly, leading to irregular periods and anovulation (lack of ovulation).
3. Thickened Endometrial Lining
The endometrial thickness is often abnormal in women with PCOS due to irregular shedding of the uterine lining. This increases the risk of heavy periods or long gaps between menstrual cycles.
4. Poor Blood Flow to the Ovaries
Doppler ultrasound may be used to assess reduced blood flow, which is common in PCOS patients.
By analyzing these structural and functional changes, ultrasound scans help confirm the diagnosis of PCOS/PCOD.
Why Early Diagnosis of PCOD/PCOS is Crucial
1. Preventing Long-Term Health Risks
PCOS is linked to insulin resistance, type 2 diabetes, high cholesterol, and cardiovascular disease. Early detection allows for lifestyle modifications and medical interventions to prevent complications.
2. Managing Fertility Issues
Women with PCOS often struggle with irregular ovulation, making conception difficult. Identifying the condition early allows doctors to recommend ovulation-inducing treatments and fertility assistance such as IUI or IVF.
3. Controlling Hormonal Imbalances
Symptoms like excess facial hair (hirsutism), acne, and weight gain can be managed better when PCOS is diagnosed early. Doctors can prescribe hormonal therapy or lifestyle changes to restore balance.
4. Reducing the Risk of Endometrial Cancer
PCOS can cause irregular shedding of the uterine lining, increasing the risk of endometrial hyperplasia or cancer. Regular monitoring via ultrasound ensures early detection of any abnormalities.
Early diagnosis through ultrasound scans, hormone tests, and lifestyle assessments ensures timely medical intervention, improving long-term health outcomes.
Read More: Why Is Ultrasound the Gold Standard in Fetal Medicine?
Key Ultrasound Features of Polycystic Ovaries
A Transvaginal scan provides detailed imaging to diagnose PCOS accurately. The key ultrasound features include:
- Ovarian Volume >10 cm³ (indicating enlarged ovaries).
- 12 or more small follicles (2–9 mm) arranged around the ovary.
- Thickened endometrial lining due to irregular cycles.
- Lack of a dominant follicle, leading to anovulation and menstrual irregularities.
- Reduced ovarian blood flow detected via Doppler ultrasound.
Doctors use these findings, along with blood tests, to confirm a PCOS/PCOD diagnosis.
Other Tests That Complement Ultrasound Diagnosis
While ultrasound is essential for diagnosing PCOS, additional tests help confirm hormonal imbalances and metabolic complications.
1. Blood Tests for Hormonal Imbalance
- LH (Luteinizing Hormone) & FSH (Follicle-Stimulating Hormone): PCOS often shows an elevated LH-to-FSH ratio (typically >2:1).
- Testosterone Levels: High levels contribute to acne, hair growth, and male-pattern baldness.
- Insulin & Glucose Tests: PCOS is often associated with insulin resistance and prediabetes.
2. Lipid Profile
- PCOS increases the risk of high cholesterol and heart disease.
3. Thyroid Function Tests
- Hypothyroidism can cause similar symptoms to PCOS, so checking TSH levels helps rule out thyroid disorders.
A combination of TVS scans, hormone tests, and metabolic assessments provides a comprehensive diagnosis of PCOS/PCOD.
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