Table of ContentsView AllTable of ContentsTransvaginal UltrasoundDiagnosing PCOSPCOS UltrasoundWho Diagnoses PCOS?
Table of ContentsView All
View All
Table of Contents
Transvaginal Ultrasound
Diagnosing PCOS
PCOS Ultrasound
Who Diagnoses PCOS?
When atransvaginal ultrasoundis done for suspected PCOS, orpolycystic ovary syndrome, it’s to see whether there are an excessive number of small follicles on the ovaries—a hallmark of the condition. This imaging test involves placing a probe in the vagina to view these organs from the inside.
While ultrasound alone isn’t enough to confirm PCOS, results are an importantpart of the diagnostic puzzle. A healthcare provider will also take your medical history, a physical examination, andblood testfindings into account.
This article discusses transvaginal ultrasound for PCOS. It explains how this type of imaging is performed and what your healthcare provider is looking for.
Kateryna Kukota / Getty Images
How Is a Transvaginal Ultrasound Performed?
A transvaginal ultrasound can be performed in a healthcare provider’s office. Your healthcare provider will advise if you need to drink fluids ahead of the procedure, depending on the reason for your ultrasound.
A lubricated ultrasound probe is placed inside the vagina, which transmits an image of the internal organs onto a screen. An ultrasound technician then measures and takes pictures of your ovaries and shares them with your healthcare provider.
Does a Transvaginal Ultrasound Hurt?Some individuals may experience very mild discomfort while the technician pushes down during the ultrasound. This depends on the ease with which the sonographer can locate the internal reproductive organs.
Does a Transvaginal Ultrasound Hurt?
Some individuals may experience very mild discomfort while the technician pushes down during the ultrasound. This depends on the ease with which the sonographer can locate the internal reproductive organs.
What Do Ovaries Look Like?
Diagnosing Polycystic Ovary Syndrome (PCOS)
Since these hormones are involved in the regulation of bodily processes ranging from reproduction to metabolism, the condition can lead to a wide variety ofsigns and symptoms of PCOS.
Polycystic Ovary Syndrome (PCOS)
The first step when evaluating your symptoms, exam and laboratory findings is to exclude other disorders which might cause these findings.
These conditions (which may appear similar to PCOS but are different) include:
Differentiating PCOS from thyroid disease is made more difficultin that some forms of thyroid disease are more common in people with PCOS, and some of the tests used to diagnose thyroid disorders are inaccurate in people with PCOS.
PCOS Diagnostic Criteria
The Rotterdam Criteria, the commonly diagnostic criteria for PCOS, requires two of the following (with the exclusion of other causes):
It is possible to have cystic ovaries without symptoms of hyperandrogenism. It is also possible to be diagnosed with PCOS without having “classically cystic” ovaries.
Studies suggest that measuring anti-Mullerian hormone levels may be a useful substitute for transvaginal ultrasound in some cases for the diagnosis of PCOS.
What Is an Endocrinologist and What Do They Do?
Ultrasound for Diagnosing PCOS
A transvaginal ultrasound is used to examine internal structures in assessing for PCOS. The sonographer will examine your uterus, cervix, and uterus. The number of follicles on your ovary will be counted to yield what is known as anantral follicle count (AFC).
What Are Antral Follicles?
Antral follicles are resting follicles that are found in the ovary at the beginning of each menstrual cycle. They are approximately 2 to 9 mm in size, which is less than half an inch.
A high antral follicle count indicates a large number of eggs that remained in the ovary instead of being released. This may indicate PCOS.
Cysts vs. Follicles in PCOS
Both cysts and follicles are more common in people with PCOS than those without the condition. Many confuse cysts with follicles.
Despite its name, the ovaries in PCOS don’t produce an overabundance of cysts. It is actually an excessive number of follicles that is part of the diagnostic criteria.
A name change for PCOS has been proposed to clear up confusion and properly educate health professionals and consumers.
People with PCOS tend to produce follicles, which are small collections of fluid in the ovary and are the result, not the cause of, the imbalance of sex hormones. Each month, the ovary produces follicles that mature and are released into the fallopian tube.
Symptoms of Polycystic Ovary Syndrome
If you are uncertain about your diagnosis of PCOS (or lack of one), it can’t hurt to get a second opinion. Check out the American Society for Reproductive Medicine or theAndrogen Excess and PCOS Societyfor a local recommendation.
A Word From Verywell
The diagnosis of PCOS can be time-consuming and frustrating. Other conditions which can cause similar symptoms need to be ruled out first, and then symptoms such as menstrual abnormalities and evidence of androgen excess are evaluated.
Transvaginal ultrasound can provide important information about follicles (as opposed to cysts which has led to much confusion over the years.) The measurement of the anti-Mullerian hormone may provide a substitute for ultrasound in some circumstances.
Once a diagnosis is made, thetreatment options for PCOScan be reviewed in order to help you cope with the many annoying (and sometimes serious) consequences of the condition.
Types of Drugs Used to Treat PCOS
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Iowa Radiology/UnityPoint Health Des Moines.Transvaginal Ultrasound: Why It’s Recommended & What to Expect.Cedars Sinai.Transvaginal Ultrasound.Ye W, Xie T, Song Y, Zhou L.The role of androgen and its related signals in PCOS.J Cell Mol Med. 2021 Feb;25(4):1825-1837. doi: 10.1111/jcmm.16205.McCartney CR, Marshall JC.Clinical practice. Polycystic ovary syndrome.N Engl J Med. 2016;375(1):54–64. doi:10.1056/NEJMcp1514916Singla R, Gupta Y, Khemani M, Aggarwal S.Thyroid disorders and polycystic ovary syndrome: An emerging relationship.Indian J Endocrinol Metab. 2015;19(1):25–29. doi:10.4103/2230-8210.146860Butt MS, Saleem J, Aiman S, Zakar R, Sadique I, Fischer F.Serum anti-Müllerian hormone as a predictor of polycystic ovarian syndrome among women of reproductive age.BMC Womens Health. 2022 May 28;22(1):199. doi: 10.1186/s12905-022-01782-2Bachanek M, Abdalla N, Cendrowski K, Sawicki W.Value of ultrasonography in the diagnosis of polycystic ovary syndrome - literature review.J Ultrason. 2015;15(63):410–22. doi:10.15557/JoU.2015.0038Legro RS.Evaluation and treatment of polycystic ovary syndromeIn: Feingold KR, Anawalt B, Boyce A, et al., editors.Endotext. South Dartmouth (MA): MDText.com, Inc; 2012.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Iowa Radiology/UnityPoint Health Des Moines.Transvaginal Ultrasound: Why It’s Recommended & What to Expect.Cedars Sinai.Transvaginal Ultrasound.Ye W, Xie T, Song Y, Zhou L.The role of androgen and its related signals in PCOS.J Cell Mol Med. 2021 Feb;25(4):1825-1837. doi: 10.1111/jcmm.16205.McCartney CR, Marshall JC.Clinical practice. Polycystic ovary syndrome.N Engl J Med. 2016;375(1):54–64. doi:10.1056/NEJMcp1514916Singla R, Gupta Y, Khemani M, Aggarwal S.Thyroid disorders and polycystic ovary syndrome: An emerging relationship.Indian J Endocrinol Metab. 2015;19(1):25–29. doi:10.4103/2230-8210.146860Butt MS, Saleem J, Aiman S, Zakar R, Sadique I, Fischer F.Serum anti-Müllerian hormone as a predictor of polycystic ovarian syndrome among women of reproductive age.BMC Womens Health. 2022 May 28;22(1):199. doi: 10.1186/s12905-022-01782-2Bachanek M, Abdalla N, Cendrowski K, Sawicki W.Value of ultrasonography in the diagnosis of polycystic ovary syndrome - literature review.J Ultrason. 2015;15(63):410–22. doi:10.15557/JoU.2015.0038Legro RS.Evaluation and treatment of polycystic ovary syndromeIn: Feingold KR, Anawalt B, Boyce A, et al., editors.Endotext. South Dartmouth (MA): MDText.com, Inc; 2012.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Iowa Radiology/UnityPoint Health Des Moines.Transvaginal Ultrasound: Why It’s Recommended & What to Expect.Cedars Sinai.Transvaginal Ultrasound.Ye W, Xie T, Song Y, Zhou L.The role of androgen and its related signals in PCOS.J Cell Mol Med. 2021 Feb;25(4):1825-1837. doi: 10.1111/jcmm.16205.McCartney CR, Marshall JC.Clinical practice. Polycystic ovary syndrome.N Engl J Med. 2016;375(1):54–64. doi:10.1056/NEJMcp1514916Singla R, Gupta Y, Khemani M, Aggarwal S.Thyroid disorders and polycystic ovary syndrome: An emerging relationship.Indian J Endocrinol Metab. 2015;19(1):25–29. doi:10.4103/2230-8210.146860Butt MS, Saleem J, Aiman S, Zakar R, Sadique I, Fischer F.Serum anti-Müllerian hormone as a predictor of polycystic ovarian syndrome among women of reproductive age.BMC Womens Health. 2022 May 28;22(1):199. doi: 10.1186/s12905-022-01782-2Bachanek M, Abdalla N, Cendrowski K, Sawicki W.Value of ultrasonography in the diagnosis of polycystic ovary syndrome - literature review.J Ultrason. 2015;15(63):410–22. doi:10.15557/JoU.2015.0038Legro RS.Evaluation and treatment of polycystic ovary syndromeIn: Feingold KR, Anawalt B, Boyce A, et al., editors.Endotext. South Dartmouth (MA): MDText.com, Inc; 2012.
Iowa Radiology/UnityPoint Health Des Moines.Transvaginal Ultrasound: Why It’s Recommended & What to Expect.
Cedars Sinai.Transvaginal Ultrasound.
Ye W, Xie T, Song Y, Zhou L.The role of androgen and its related signals in PCOS.J Cell Mol Med. 2021 Feb;25(4):1825-1837. doi: 10.1111/jcmm.16205.
McCartney CR, Marshall JC.Clinical practice. Polycystic ovary syndrome.N Engl J Med. 2016;375(1):54–64. doi:10.1056/NEJMcp1514916
Singla R, Gupta Y, Khemani M, Aggarwal S.Thyroid disorders and polycystic ovary syndrome: An emerging relationship.Indian J Endocrinol Metab. 2015;19(1):25–29. doi:10.4103/2230-8210.146860
Butt MS, Saleem J, Aiman S, Zakar R, Sadique I, Fischer F.Serum anti-Müllerian hormone as a predictor of polycystic ovarian syndrome among women of reproductive age.BMC Womens Health. 2022 May 28;22(1):199. doi: 10.1186/s12905-022-01782-2
Bachanek M, Abdalla N, Cendrowski K, Sawicki W.Value of ultrasonography in the diagnosis of polycystic ovary syndrome - literature review.J Ultrason. 2015;15(63):410–22. doi:10.15557/JoU.2015.0038
Legro RS.Evaluation and treatment of polycystic ovary syndromeIn: Feingold KR, Anawalt B, Boyce A, et al., editors.Endotext. South Dartmouth (MA): MDText.com, Inc; 2012.
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