PCOS Diagnosis with Regular Periods

April 24, 2025 Imane Harmonie

Diagnosing PCOS with Regular Periods: Is It Possible?

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting many women. Traditionally, irregular periods are a hallmark symptom. However, it's possible to have PCOS even with regular menstrual cycles. This article explores how PCOS can be diagnosed in women who menstruate regularly, the underlying mechanisms, and management strategies.

Understanding PCOS and Its Symptoms

PCOS is characterized by a combination of symptoms:

Hyperandrogenism: Elevated levels of male hormones leading to acne, hirsutism, and alopecia.
Ovulatory Dysfunction: Irregular or absent ovulation, often resulting in irregular menstrual cycles.
Polycystic Ovaries: Enlarged ovaries containing numerous small follicles.

While irregular periods are common, some women with PCOS maintain regular cycles yet still experience other symptoms like acne or excessive hair growth.

Can You Have PCOS with Regular Periods?

Yes, it's possible. Studies indicate that many women with PCOS may have regular menstrual cycles but still exhibit other symptoms. For instance, a study found that 74% of hyperandrogenic women with regular menses had evidence supporting a PCOS diagnosis.

Regular periods do not necessarily equate to regular ovulation. Some women may experience anovulatory cycles—where no egg is released—despite having regular bleeding.

Diagnostic Criteria for PCOS

The Rotterdam criteria are widely used for diagnosing PCOS. A diagnosis requires two of the following three features:

Irregular or Absent Ovulation: This can occur even with regular periods if ovulation doesn't happen consistently.
Clinical or Biochemical Signs of Hyperandrogenism: Such as hirsutism or elevated androgen levels.
Polycystic Ovaries on Ultrasound: Presence of 12 or more follicles in each ovary or increased ovarian volume.

Therefore, even with regular periods, if a woman exhibits hyperandrogenism and polycystic ovaries, she may be diagnosed with PCOS.

Importance of Ovulation Testing

For women with regular periods but symptoms suggestive of PCOS, confirming ovulation is crucial. Measuring serum progesterone levels in the mid-luteal phase (around day 21 of a 28-day cycle) can indicate whether ovulation has occurred.
Management Strategies

Lifestyle Modifications

Diet: Emphasize low-glycemic foods to manage insulin levels.
Exercise: Regular physical activity improves insulin sensitivity.
Weight Management: Achieving a healthy weight can restore ovulation.

Medications and Supplements.

Oral Contraceptives: Regulate menstrual cycles and reduce androgen levels.
Anti-Androgens: Medications like spironolactone can reduce symptoms like hirsutism. Or supplement like "PCOS supplements for facial Hair " to reduce testosteron.
Insulin Sensitizers: Metformin improves insulin sensitivity and can aid in weight management. Or supplements like "wieghtloss management PCOS supplement" to increase insuline sensitivity and support weight loss.