Diagnosing PCOS with Transvaginal Ultrasound (TVS Scan)
Diagnosing Polycystic Ovary Syndrome (PCOS) can be challenging. Symptoms like irregular periods, excessive hair growth, and weight gain are common and can overlap with other conditions. Accurate diagnosis often requires a detailed examination, and that’s where a Transvaginal Ultrasound (TVS) can come into play.
PCOS presents a range of symptoms, making it a complex condition to diagnose. These symptoms can vary widely between individuals and often overlap with other hormonal or metabolic disorders. For many, the path to diagnosis involves a series of tests and consultations with healthcare providers to rule out other conditions.
What is Polycystic Ovary Syndrome (PCOS)?
Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting individuals with ovaries. It impacts up to 10% of women of reproductive age. It’s a condition characterised by an imbalance in hormones, which can lead to the formation of multiple small cysts on the ovaries. It disrupts normal ovarian function and can affect menstrual cycles, fertility, and overall health.
PCOS typically presents the following symptoms:
- Irregular Periods: Infrequent, irregular, or absent menstrual cycles.
- Ovulatory Dysfunction: Difficulty with ovulation, which can affect fertility.
- Excess Androgens: Symptoms such as acne, excessive hair growth (hirsutism), and male-pattern baldness.
- Polycystic Ovaries: The presence of multiple small cysts on the ovaries, visible on an ultrasound.
- Weight Gain: Many individuals with PCOS experience difficulty maintaining a healthy weight.
- Dark Skin Patches: Areas of darkened skin, often in the neck, armpits, or groin, known as acanthosis nigricans.
PCOS symptoms can range widely from person to person, manifesting through irregular menstrual cycles or severe acne and weight gain. This variability means that individuals might experience only a few symptoms, making it harder to identify a consistent pattern.
Diagnosis typically relies on meeting at least two out of three criteria: irregular periods, elevated androgens, and polycystic ovaries on ultrasound. This multi-criteria approach can complicate diagnosis if not all criteria are present. Conditions like hypothyroidism, endometriosis, and adrenal hyperplasia can present with similar symptoms, leading to misdiagnosis or delays in identifying PCOS.
Women with PCOS can face various forms of stigma and challenges when advocating for themselves, both in medical settings and broader social contexts. Healthcare providers may sometimes downplay or dismiss symptoms, attributing them to other causes or attributing them to weight alone, without a thorough evaluation.
How Does a TVS Scan Work?
TVS stands for Transvaginal Ultrasound. It is a type of pelvic ultrasound that uses a small, wand-like device (transducer) inserted into the vagina to get a close-up view of the pelvic organs. It might sound scary, but many healthcare professionals do their best to help you feel comfortable and less anxious.
During a TVS, a small, lubricated probe is gently inserted into the vagina. The probe emits sound waves that bounce off internal structures, creating detailed images on a monitor.
This close-up view allows for a detailed examination of the ovaries, uterus, and other pelvic organs. Transvaginal ultrasound scans are particularly useful for visualising the ovaries and identifying cysts or abnormalities.
Other Uses
- Diagnosis of Conditions: It helps diagnose and monitor conditions like PCOS, fibroids, endometriosis, ovarian cysts, and uterine abnormalities.
- Pregnancy Monitoring: It can be used to assess early pregnancy, monitor foetal development, and check for complications.
- Guided Procedures: TVS can assist in certain medical procedures, such as biopsies or injections.
PCOS Ultrasound vs. Normal Ultrasound
What would PCOS look like in an ultrasound?
Here’s what you wound normally see on a TVS scan of a uterus, next to a TVS scan of a patient with PCOS —
A common feature in PCOS is the presence of multiple small cysts on the ovaries. TVS can reveal changes in the size and appearance of the ovaries, which may be indicative of PCOS.
In a normal ovary, the size is relatively small, with a few follicles of varying sizes scattered randomly throughout the stroma. In contrast, a typical polycystic ovary shows an increase in both length and width, as well as the overall ovarian area. The number of follicles, mostly ranging from 2 to 5 mm in diameter, exceeds 12. These follicles are predominantly located around the periphery of the ovary. The central area of the ovary is filled with increased and hyperechoic stroma.
Other diagnostic methods will follow up on the results. This includes blood tests and other clinical evaluations to provide the whole picture of the patient’s condition.
Treatment for PCOS
While there is no cure for PCOS, there are various treatments and management strategies available that can help alleviate symptoms, manage associated conditions, and improve quality of life. Other medications can be prescribed to address different symptoms, though these medications are not made with PCOS patients in mind.
With lifestyle changes, the goal is to strengthen your body so that symptoms may be less prevalent and would not affect your health as greatly.
Healthy Eating: Adopting a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats can help manage weight and improve insulin sensitivity. Reducing intake of processed foods and sugars can also be helpful.
Regular Exercise: Physical activity helps with weight management, improves insulin sensitivity, and can alleviate some PCOS symptoms. Aiming for at least 150 minutes of moderate exercise per week is recommended.
Birth Control Pills: Oral contraceptives can regulate menstrual cycles, reduce male hormones, and improve acne and hirsutism (excessive hair growth). For women who cannot use oestrogen-based birth control, progestin-only pills or other hormonal methods can help regulate periods.
A Women’s Health Clinic in Alam Damai Cheras
Visit Klinik Azurose for Gynaecological Services
If you suspect you have PCOS or need a detailed evaluation, our clinic offers expert gynaecological services, including comprehensive TVS scans. Our experienced healthcare professionals are dedicated to providing accurate diagnoses and effective treatment plans tailored to your needs.
Don’t let PCOS symptoms go unchecked. Schedule an appointment with us today to start your journey toward better health and well-being.