Bilateral polycystic ovaries means that both ovaries (left and right) contain multiple small fluid-filled cysts. This is the hallmark finding of PCOS — Polycystic Ovary Syndrome, a common hormonal disorder affecting women of reproductive age. 'Bilateral' means both sides. The cysts are actually immature follicles that did not develop into eggs due to hormonal imbalance.
Bilateral polycystic ovaries = multiple cysts in both ovaries — key feature of PCOS.
PCOS = Polycystic Ovary Syndrome — common hormonal disorder in women of reproductive age.
Cysts are immature follicles, not true cysts; appear as 'string of pearls' on ultrasound.
PCOS affects 8–13% of women globally.
Symptoms: irregular periods, excess hair (hirsutism), acne, weight gain, subfertility.
Diagnosed using Rotterdam Criteria — 2 of 3 criteria must be present.
Treatment: lifestyle changes, metformin, OCP, clomiphene for fertility.
Term Breakdown: • Bilateral = both sides (both ovaries) • Polycystic = multiple cysts (poly = many; cystic = cysts) • Ovaries = female reproductive organs that produce eggs and hormones
What Are the Cysts? • The 'cysts' in PCOS are NOT true cysts — they are small, immature follicles (antral follicles) • Normally, one follicle grows and releases an egg (ovulation) • In PCOS, multiple follicles start growing but none fully mature — they appear as small cysts on ultrasound • On ultrasound, a PCOS ovary has 12+ follicles (2–9 mm in size) in each ovary — 'string of pearls' appearance
PCOS (Polycystic Ovary Syndrome): • One of the most common endocrine disorders in women of reproductive age • Affects 8–13% of women globally • Cause: hormonal imbalance — high LH, high androgens (testosterone), insulin resistance
Symptoms of PCOS: • Irregular periods (oligomenorrhoea) or absent periods • Excess hair on face, chest, back (hirsutism) — due to high androgens • Acne • Weight gain / difficulty losing weight • Thinning hair on scalp (male-pattern baldness) • Difficulty getting pregnant (subfertility) • Darkening of skin in body folds (acanthosis nigricans) — insulin resistance sign
Diagnosis (Rotterdam Criteria — 2 of 3 must be present):
Treatment: • Lifestyle changes: weight loss (even 5–10% improves symptoms) • Metformin (for insulin resistance) • Oral contraceptive pills (regulate periods and reduce androgen symptoms) • Clomiphene citrate or letrozole (for fertility/ovulation induction) • No permanent cure — managed with lifestyle and medication
Note: • Not every woman with bilateral polycystic ovaries on ultrasound has PCOS — she must also have symptoms • PCOD (Polycystic Ovarian Disease) = same as PCOS in common usage
Bilateral polycystic ovaries means both ovaries (left and right) contain multiple small cysts — actually immature follicles that failed to release eggs due to hormonal imbalance. It is the main ultrasound finding in PCOS (Polycystic Ovary Syndrome), which affects 8–13% of women of reproductive age. Symptoms include irregular periods, excess body hair, acne, and difficulty conceiving. It is managed with lifestyle changes, metformin, and hormonal therapy.
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