People who suspect they have PCOS are being urged to get a proper diagnosis, as the condition is often confused with a similar-sounding but very different issue. According to a leading specialist, many are unaware of the key distinction betweenPolycystic Ovaries (PCO) and Polycystic Ovary Syndrome (PCOS).
As PCOS Awareness Month is marked this September, experts are highlighting the risks of this common confusion. While both conditions are related to the ovaries, they are not the same - and mistaking one for the other can have serious consequences.
The difference is crucial as whilst PCO is typically a harmless finding on an ultrasound, PCOS is a complex hormonal disorder. PCOS can impact fertility, mental health, and significantly increase the long-term risk of type 2 diabetes and cardiovascular disease.
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Experts say that identifying the difference early could be life-saving. “People often hear ‘polycystic ovaries’ and immediately assume that means they have ‘PCOS’. But the two are not the same thing at all,” explains Lead Consultant Gynaecologist and Obstetrician Mr Sachin Maitifrom Pall Mall Medical.
He continued: "Polycystic ovaries, or PCO, is just an ultrasound description. It means your ovaries are showing lots of small follicles, sometimes called cysts. Many women have this scan finding their whole lives and never experience a single symptom. On its own, it doesn’t mean anything is wrong.”
By contrast, PCOS is a hormonal disorder. To diagnose PCOS, doctors look at the 3 main features of PCOS which are:
- irregular periods – which means your ovaries do not regularly release eggs (ovulation)
- excess androgen – high levels of "male" hormones in your body, which may cause physical signs such as excess facial or body hair
- polycystic ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the eggs (but despite the name, you do not actually have cysts if you have PCOS)

If you have signs and symptoms of PCOS, they'll usually become apparent during your late teens or early 20s. They can include:
- irregular periods or no periods at all
- difficulty getting pregnant as a result of irregular ovulation or no ovulation
- excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
- weight gain
- thinning hair and hair loss from the head
- oily skin or acne
Mr Maiti added: “Some women notice persistent bad breath, oily scalp, stronger body odour, or subtle skin changes like tags or darker patches.
“Others report brain fog, fatigue, bloating, or tingling in their hands and feet. They aren’t the classic symptoms you read about, but they’re often part of the same hormonal puzzle.”
The Lead Consultant Gynaecologist and Obstetrician said that in short, “PCOS is about symptoms and hormone imbalances as much as what your ovaries look like. You can have PCO without PCOS, but you can’t really have PCOS without signs of hormone disruption.”
As the UK marks PCOS Awareness Month, Mr Maiti’s message is simple. “If you notice ongoing, unexplained symptoms, don’t dismiss them.
“The difference between PCO and PCOS isn’t just medical jargon, it’s the difference between a harmless scan result and a condition that needs careful, ongoing management."
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