Do I need an ultrasound to diagnose PCOS?

Ultrasound can be helpful in supporting a PCOS diagnosis, but it isn’t always required. PCOS is typically diagnosed using a combination of your symptoms, menstrual history, signs of higher androgens (like acne or excess hair growth), and lab work—so an ultrasound is just one possible piece of the picture.

When an ultrasound is done, PCOS findings usually mean a higher number of small follicles and/or increased ovarian volume, which is different from true ovarian cysts such as endometriomas (ovarian endometriosis). If you’re being evaluated for significant pelvic pain or concern for endometriosis alongside PCOS, our team can help determine what type of imaging is most appropriate and what it can—and can’t—reliably show.