PCOS: What Is It? Types, Grades, and How Is It Diagnosed?

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May 7, 2026

Last updated: 07/05/2026

PCOS is a hormonal disorder that affects ovarian function, menstrual cycle regularity, and ovulation. PCOS does not always mean the presence of dangerous cysts. It usually refers to a hormonal imbalance that may cause delayed periods, excess hair growth, acne, or difficulty getting pregnant. Medically, it is known as polycystic ovary syndrome or PCOS.

The World Health Organization explains that this condition is one of the most common hormonal disorders. It affects around 10% to 13% of women of reproductive age worldwide, while a large percentage remains undiagnosed.

Why Does PCOS Happen?

PCOS happens when the balance of hormones that control ovulation is disrupted. In a normal cycle, the ovary releases a mature egg almost every month. When PCOS occurs, the egg may not mature properly, or it may not be released regularly.

This condition is often linked to three main factors:

Hormonal imbalance, especially increased effects of male hormones.
Weak or irregular ovulation.
Insulin resistance, a condition in which the body does not respond to insulin efficiently.

Mayo Clinic notes that this condition is linked to the effects of androgens and the way the body uses insulin, not only to the presence of small follicles on the ovary.

Is It Dangerous?

PCOS is usually not dangerous if it is diagnosed and monitored. However, the Saudi Ministry of Health states that women with polycystic ovary syndrome are more likely to develop certain health problems, especially with weight gain, such as diabetes, high blood pressure, and cholesterol disorders.

Does PCOS Prevent Pregnancy?

PCOS does not mean pregnancy is impossible. However, it may delay pregnancy because of irregular ovulation.

If ovulation is irregular, the chances of pregnancy become less predictable. However, pregnancy chances can improve in many cases after proper diagnosis, ovulation regulation, or treatment of the underlying cause.

NHS states that PCOS symptoms can be treated, and that most women with polycystic ovary syndrome can get pregnant with appropriate treatment.

What PCOS Symptoms Should You Watch For?

PCOS symptoms vary from one woman to another. Some women have clear symptoms, while others only discover the condition after delayed pregnancy or menstrual irregularity.

The Saudi Ministry of Health states that symptoms of polycystic ovary syndrome include irregular periods, excess facial and body hair, acne, obesity, and difficulty getting pregnant.

What Are the Types of PCOS?

Polycystic ovary syndrome can appear in more than one pattern. This is why the condition does not look the same in all women.

The types can be simplified as follows:

Type	How It Appears	Practical Note
Complete PCOS	Irregular periods + signs of increased androgens + polycystic appearance on ultrasound	The most traditional form
Hormonal PCOS	Irregular periods + excess hair growth or acne	Ultrasound may not be needed to confirm it
PCOS with Almost Regular Periods	Hormonal signs with unstable ovulation	It may be discovered late
Mild PCOS	Mild or occasional symptoms	Needs follow-up, not neglect

These patterns do not mean that each type is a separate disease. They are ways to understand how PCOS can differ from one woman to another.

How Is PCOS Diagnosed?

PCOS is diagnosed through medical history, clinical examination, hormone tests, and sometimes ultrasound.

Doctors often rely on an important rule:

The presence of two out of three signs after excluding other causes.

The three signs are:

Irregular menstrual cycle or weak ovulation.
Signs of high male hormones or elevated levels in blood tests.
A polycystic ovarian appearance on ultrasound.

The earlier the diagnosis, the easier the condition is to control. If you notice a persistent change in your cycle or hormonal symptoms, start with a simple medical evaluation instead of waiting.

What Tests Are Needed to Diagnose PCOS?

The doctor may request certain tests depending on the case.

The most common tests include:

Male hormone tests.
LH and FSH tests.
Prolactin test.
Thyroid function test.
Blood sugar or insulin resistance tests.
Lipid profile.
Ultrasound of the ovaries and uterus.
Blood pressure, weight, and waist circumference measurement.

Diagnosis may require hormone tests and ultrasound, along with diabetes or high cholesterol tests when needed.

What Conditions Can Look Like PCOS?

Not every irregular period means PCOS. There are other conditions that may cause similar symptoms.

These conditions include:

Thyroid disorders.
High prolactin levels.
Adrenal gland disorders.
Some medications.
Severe stress or rapid weight loss.
Other hormonal disorders.

Therefore, this condition cannot be diagnosed based on symptoms alone. A correct diagnosis requires excluding similar causes.

When Should You See a Doctor?

We recommend seeing a doctor if any of the following signs appear:

Absence of periods for more than 3 months.
Fewer than 8 periods per year.
Noticeable increase in facial or chin hair.
Severe or persistent acne.
Difficulty getting pregnant.
Unexplained weight gain.
Clear darkening of the skin around the neck or underarms.
Heavy or unusual bleeding.

Seeing a doctor does not mean the condition is dangerous. It helps identify the cause and determine the right plan.

How Should You Prepare for the Diagnosis Appointment?

Before visiting the doctor, prepare this information:

Date of your last menstrual period.
Number of periods during the past 12 months.
Cycle length and number of bleeding days.
Presence of acne or excess hair growth.
Weight changes during the past year.
Family history of the disease or diabetes.
Any medications or supplements you use.
Whether you currently want to get pregnant.

This information helps the doctor assess the condition quickly and accurately.

Do not start any medication to regulate the cycle, treat insulin resistance, or manage hormones without a prescription. Registered medications and

alternatives can be checked through Saudi Food and Drug Authority services, but choosing the treatment remains a medical decision.

Frequently Asked Questions

What Is PCOS?

PCOS is a hormonal disorder that affects ovarian function, ovulation, and menstrual cycle regularity. It may be linked to increased androgen effects or insulin resistance, and it does not always mean the presence of dangerous ovarian cysts.

Is PCOS a Chronic Disease?

Yes, PCOS is often a long-term condition. The World Health Organization explains that it is a chronic metabolic condition that may continue beyond the reproductive years. However, it can be controlled with medical follow-up, lifestyle changes, and appropriate treatment.

What Is the Difference Between PCOS and Ovarian Cysts?

PCOS is a hormonal disorder that affects ovulation and the menstrual cycle. Ovarian cysts are fluid-filled sacs that may appear for different reasons. The World Health Organization also explains that visible cysts on ultrasound are not always required to diagnose PCOS.

Is PCOS Dangerous?

PCOS is usually not dangerous when diagnosed and monitored. However, neglecting it may increase the risk of insulin resistance, type 2 diabetes, high blood pressure, cholesterol disorders, and uterine lining problems when periods are absent for long periods.

Conclusion

PCOS is a common condition, but its symptoms, severity, and effect on the menstrual cycle and ovulation can vary from one woman to another.

Therefore, symptoms alone or ultrasound results alone are not enough to confirm the diagnosis.

Medical examination, hormone tests, and ruling out similar conditions help identify the cause accurately.

When menstrual irregularity repeats, pregnancy is delayed, or clear hormonal signs appear, seeing a doctor remains the most important step to choose the right follow-up plan.

Disclaimer: This article is for health education purposes only and is not a substitute for consulting a specialist doctor.

Reviewed by the editorial team at Magrabi Hospital with the support of specialized doctors