Bilateral polycystic ovaries is an imaging diagnosis made via an ultrasound scan which means that both of a woman’s ovaries (‘bilateral’) have a ‘polycystic’ appearance. This appearance is characterized by the presence of 12 or more small follicles (fluid-filled sacs) on each ovary and/or an increased ovarian volume. It is a key diagnostic feature, but it is not a disease in itself.
Understanding the Ultrasound Finding
During a normal menstrual cycle, several follicles begin to develop in the ovaries, but usually only one matures and releases an egg (ovulation). In a woman with polycystic ovaries, the ovaries produce a higher number of small follicles, but none of them mature properly to release an egg. These arrested follicles accumulate in the ovaries, giving them a characteristic ‘string of pearls’ look on an ultrasound.
When this finding is present in both ovaries, it is termed ‘bilateral polycystic ovaries’. It is important to understand that this is a description of how the ovaries look, not a complete diagnosis of a medical condition.
Bilateral Polycystic Ovaries vs. PCOS
This is the most crucial distinction to understand. Many women have polycystic ovaries on an ultrasound but are perfectly healthy. Having bilateral polycystic ovaries does not automatically mean you have PCOS (Polycystic Ovary Syndrome).
PCOS is a complex hormonal and metabolic syndrome. To be diagnosed with PCOS, a woman typically needs to meet at least two of the following three criteria (known as the Rotterdam criteria):
- Irregular or Absent Periods: Indicating irregular or no ovulation.
- Clinical or Biochemical Signs of High Androgens: This can mean physical symptoms like excess facial/body hair (hirsutism), acne, or blood tests showing high levels of male hormones.
- Polycystic Ovaries on Ultrasound: The presence of bilateral polycystic ovaries as described above.
Therefore, bilateral polycystic ovaries is just one potential component of a PCOS diagnosis. You can have the ultrasound finding without the syndrome, but it is a very common feature in women who do have the syndrome.
| Feature | Bilateral Polycystic Ovaries | Polycystic Ovary Syndrome (PCOS) |
|---|---|---|
| What is it? | An ultrasound finding; a description of how the ovaries look. | A complex endocrine and metabolic disorder; a medical diagnosis. |
| Symptoms | May have no symptoms at all. | Associated with a cluster of symptoms like irregular periods, acne, weight gain, and fertility problems. |
| Hormonal Imbalance | Not necessarily. | A key feature, including high androgen and insulin levels. |
| Diagnosis | Diagnosed by a pelvic ultrasound scan. | Diagnosed based on meeting at least 2 of the 3 Rotterdam criteria (clinical, biochemical, and imaging). |
| Implication | Can be a normal variant in some women. | A medical condition that requires long-term management to prevent complications. |
What to Do if You are Diagnosed with Bilateral Polycystic Ovaries
If your ultrasound report mentions bilateral polycystic ovaries, it is not a cause for immediate panic. Your doctor will correlate this finding with your symptoms and blood test results.
- If you have no symptoms: If your periods are regular and you have no signs of hormonal imbalance, your doctor may simply monitor the condition. Many women with this finding are healthy and fertile.
- If you have symptoms: If you also have irregular periods, acne, or other related symptoms, you may be diagnosed with bilateral PCOD or PCOS. In this case, your doctor will recommend a management plan.
The management for symptomatic PCOD/PCOS primarily revolves around lifestyle modifications, including a healthy diet, regular exercise, and weight management. This is a common health issue, and for more information, you can consult trusted sources like the World Health Organization.
Frequently Asked Questions (FAQs)
What does bilateral polycystic ovaries mean?
Bilateral polycystic ovaries is a finding on an ultrasound scan that shows both of your ovaries have multiple small follicles (cysts). It describes the appearance of the ovaries and is not, by itself, a disease. It is, however, a key feature of Polycystic Ovary Syndrome (PCOS).
Does having bilateral polycystic ovaries mean I have PCOS?
Not necessarily. Many healthy women with regular periods have polycystic-looking ovaries on an ultrasound. A diagnosis of PCOS requires you to have at least one other symptom, such as irregular periods or signs of high male hormones (like acne or excess hair growth).
Can I get pregnant if I have bilateral polycystic ovaries?
Yes. If you have this ultrasound finding but your menstrual cycles are regular, it suggests you are ovulating normally and your fertility is likely not affected. If your cycles are irregular (as in PCOS), you may have difficulty conceiving, but it is often treatable.
Is bilateral polycystic ovaries a permanent condition?
The appearance of the ovaries can change over time and with different hormonal states. However, if it is part of the underlying condition of PCOS, then it is a chronic condition that needs to be managed long-term, even if the symptoms improve.
What is the treatment for bilateral polycystic ovaries?
There is no treatment for the ultrasound finding itself if you are asymptomatic. If it is part of a PCOD/PCOS diagnosis, the treatment focuses on managing the symptoms through lifestyle changes (diet, exercise) and sometimes medication to regulate periods or manage hormonal imbalances.