Polycystic Ovary Syndrome (PCOS) is commonly associated with missed periods. Irregularity in the menstrual cycle is, in fact, regarded as one of the primary signs. But this is not always the case.
Dr Neha Abhijit Pawar, consultant, gynaecology at Kokilaben Dhirubhai Ambani Hospital, Mumbai, told HT Lifestyle it is possible for PCOS to be present even when periods are regular. She explained that PCOS is much more complex, and sometimes it may not reflect in the cycle.
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Dr Pawar said, “PCOS is a complex hormonal and metabolic disorder in which the ovaries produce higher-than-normal levels of androgens (male hormones) and the body may show resistance to insulin. These internal imbalances can exist even if the menstrual cycle appears to be normal.”
How can you have PCOS despite regular periods?
Even if your periods are regular, it does not mean the reproductive system is fully healthy. Revealing how ovulation may be compromised, she explained, “Ovulation occurs, but the egg quality may be poor, or ovulation may be inconsistent. This means that while bleeding happens at expected intervals, the underlying hormonal dysfunction that defines PCOS is still present.”
So it is very important not to rule out PCOS just because your periods are regular, since, as per the gyneacologist, “regular periods do not necessarily guarantee normal ovulation.”
Beyond the hidden ovulation issues, there’s also another reason why periods can appear normal in PCOS. The gynaecologist explained, “While excess androgens disrupt follicle development, estrogen and progesterone may still maintain a bleeding cycle. This ‘masking effect’ can mislead women into believing everything is normal, while the ovaries continue to show polycystic changes and the body continues to face risks like insulin resistance, weight gain, or difficulty conceiving.”
Signs of PCOS other than irregular menstrual cycle
Other than menstrual irregularity, here are the symptoms Dr Pawar shared:
- Excess hair growth (hirsutism) on the face, chest, or stomach.
- Persistent acne or oily skin that does not improve with usual treatments.
- Thinning hair or male-pattern baldness on the scalp.
- Unexplained weight gain, particularly around the waist and abdomen.
- Darkened patches of skin (acanthosis nigricans), often around the neck, groin, or underarms.
- Difficulty getting pregnant, even when cycles are regular.
- Polycystic ovaries on ultrasound, with multiple small follicles seen in the ovaries.
Should you visit a doctor?
With periods appearing normal, the question arises whether one should visit a doctor. Dr Pawar advised that PCOS should not be ignored, as untreated PCOS can worsen health. She said, “If you notice any of these symptoms, it is wise not to ignore them just because your menstrual cycles seem fine. PCOS, if left undiagnosed, can increase the risk of type 2 diabetes, infertility, cardiovascular disease, and endometrial problems over time.”
She suggested that a gynaecologist or endocrinologist may guide with blood tests to check hormone levels, assess insulin sensitivity, and conduct an ultrasound if needed.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.