PCOS ultrasound: what a PCOS ovary looks like, and what causes PCOS
Medically reviewed by our consultant obstetrician & gynaecologist (MBBS, MS OBG). Last reviewed: 25 September 2026.
PCOS (polycystic ovary syndrome) is a common hormone condition in which ovulation becomes irregular. It usually comes from a mix of family tendency, insulin resistance and higher male-type hormones. On a PCOS ultrasound the ovary often shows many small follicles, but the scan alone does not make the diagnosis. PCOS cannot be cured, yet it can be controlled well.
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What PCOS is
PCOS is one of the most common hormone conditions in women of child-bearing age. In PCOS, the ovaries do not release an egg regularly every month. Because ovulation is irregular, periods often come late, come rarely, or stop for months at a time, and getting pregnant can take longer.
The name is a little misleading. The "cysts" in polycystic ovaries are not true cysts that need removing. They are small follicles, each holding an egg, that started to grow but did not go on to release it.
What causes PCOS?
There is no single cause. In most women it is a mix of several things working together:
- Family tendency. PCOS often runs in families. If your mother or sister has it, your own chance of having it is higher.
- Insulin resistance. Many women with PCOS need more insulin than usual to keep their blood sugar normal. High insulin pushes the ovaries to make more male-type hormones, which upsets ovulation.
- Higher male-type hormones. All women make small amounts of these hormones. In PCOS the levels are higher, which can cause acne, extra hair growth on the face or body, and thinning of the scalp hair.
- Weight and lifestyle. Extra weight, especially around the waist, makes insulin resistance worse and often makes the symptoms stronger. PCOS is not caused only by weight, though: slim women can have it too.
Signs that may point to PCOS
- Irregular, infrequent or absent periods
- Acne that carries on beyond the teenage years
- Extra hair on the face, chest or tummy
- Thinning hair on the scalp
- Weight gain that is hard to shift
- Difficulty getting pregnant
Not every woman with PCOS has all of these. Some have only irregular periods; others have regular periods but other signs.
How PCOS is diagnosed
A PCOS diagnosis is made when at least two of these three are present, after other causes have been ruled out:
- Ovulation that is irregular or absent, usually shown by irregular periods
- Signs of higher male-type hormones, either in the body (such as acne or extra hair) or in a blood test
- Polycystic-looking ovaries on an ultrasound scan
Blood tests also help rule out conditions that can look like PCOS, such as thyroid problems or a raised prolactin level, and they check your blood sugar.
Polycystic ovaries on ultrasound: what a PCOS ovary looks like
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In the second video, our doctor shows an ultrasound picture of a polycystic ovary. On the screen the ovary often looks slightly larger than usual, with many small, round, dark follicles arranged around its edge, sometimes described as a "string of pearls".
Two points matter here. First, the scan is only one part of the diagnosis: some women have ovaries that look polycystic on ultrasound but no hormone problem at all, and they do not have PCOS. Second, the scan itself is simple and quick. It is usually done early in the cycle, either over the tummy or, for a clearer picture, with a small internal probe.
Does PCOS affect fertility?
PCOS is one of the commonest reasons for difficulty getting pregnant, because an egg is not released every month. The encouraging part is that ovulation can usually be helped. Depending on your situation, treatment may start with lifestyle changes and medicines that help the ovaries release an egg, with ultrasound scans to follow the growing follicles. If that is not enough, IUI or IVF may be advised.
How easily pregnancy happens depends on your age, your husband's semen report and any other factors, so the doctor explains what is realistic for you after seeing both partners' tests. More answers about fertility and IVF.
Can PCOS be treated?
PCOS cannot be cured, but it can be controlled well. Treatment depends on what matters most to you right now:
- Regular periods: lifestyle changes and, where needed, medicines that regulate the cycle.
- Protecting the womb lining: if periods are very infrequent, treatment to bring on regular periods protects the lining of the womb.
- Acne or extra hair: treatments that reduce the effect of male-type hormones.
- Pregnancy: treatment to help ovulation, as described above.
- Long-term health: PCOS raises the chance of diabetes and cholesterol problems later in life, so regular checks of blood sugar and weight are worth keeping up.
Where weight is a factor, even a modest weight loss often makes periods more regular and helps treatment work. Read more about PCOS treatment in Goa.
When to see a doctor
See a gynaecologist if your periods are irregular or stop, if acne or extra hair bothers you, or if you have been trying for a baby without success. A consultation, a few blood tests and an ultrasound are usually enough to find out whether PCOS is the reason.
Consultations are held in Panjim, Margao, Mapusa and Vasco. For fertility questions, call Sheetal on +91 95459 20817 or +91 95185 02773. More answers about periods, PCOS and gynaecology.
Your questions
Read next: IVF centre in Goa · infertility specialist in Goa.
Is PCOS the same as having cysts on the ovaries?
No. The small "cysts" seen in PCOS are follicles that did not release an egg. They are not the kind of cyst that needs an operation; ovarian cysts are a different condition.
Can a slim woman have PCOS?
Yes. PCOS is more common with extra weight, but slim women can have it too. The diagnosis depends on your periods, hormone signs and the scan, not on your weight.
Does an ultrasound alone confirm PCOS?
No. Many women have ovaries that look polycystic but do not have PCOS. The doctor puts the scan together with your periods and hormone signs or blood tests before making the diagnosis.
Can I get pregnant if I have PCOS?
Many women with PCOS conceive, often with treatment that helps ovulation. The right plan depends on your age, your husband's semen report and your other tests.
Will PCOS go away on its own?
PCOS does not usually go away, but its symptoms can be controlled well with lifestyle changes and treatment, and they often improve when weight is brought down.
When in the cycle is the PCOS scan done?
It is usually done early in the cycle. The scan itself is simple, done either over the tummy or, for a clearer picture, with a small internal probe.
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This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.