PCOS symptoms MRI what to expect

Overview

Polycystic ovary syndrome (PCOS) is a common hormonal condition that affects how the ovaries work. It can cause irregular periods, excess male hormones (androgens), and small cysts on the ovaries. An MRI (magnetic resonance imaging) is a special scan that uses magnetic fields to create detailed pictures of the inside of your body. Sometimes an MRI is used to look more closely at the ovaries or to check for other conditions that might explain your symptoms.

Yes, PCOS is very common. Around 1 in 10 women and people assigned female at birth of reproductive age have PCOS, though many do not know they have it until they seek help for symptoms or fertility concerns.

PCOS affects anyone with ovaries, including women, transgender men, and non-binary people. It usually starts during the teenage years or early twenties, and it continues through reproductive age and beyond, with symptoms changing over time.

Symptoms

Common symptoms

• Irregular periods — missed periods, infrequent periods, or very heavy periods
• Acne, especially on the face, chest, or upper back
• Excess facial or body hair (hirsutism)
• Thinning hair on the scalp or male-pattern baldness
• Weight gain, especially around the belly, or trouble losing weight
• Skin darkening, often in skin folds like the neck, armpits, or groin
• Oily skin or dandruff
• Difficulty getting pregnant

Symptoms in children

• PCOS usually starts after puberty. In adolescents, symptoms include irregular periods, acne, weight gain, and excess hair growth. It may be hard to tell PCOS from normal teenage changes, so a doctor’s assessment is important.

Symptoms in older adults

• As people with PCOS age, symptoms like excess hair and acne may lessen, but the risk of metabolic conditions such as type 2 diabetes, high blood pressure, and high cholesterol increases. Irregular periods continue until menopause, and PCOS is linked with higher risks of heart disease and uterine cancer later in life.

Causes

Main causes

• The exact cause of PCOS is unknown, but it involves a combination of genetics and environmental factors.
• Hormonal imbalance — higher levels of androgens (male-type hormones) and sometimes insulin are common.
• Insulin resistance — the body does not use insulin well, leading to higher insulin levels and increased androgen production.
• Inflammation — low-grade inflammation may play a role.

Risk factors

• Having a close family member with PCOS (mother, sister, aunt)
• Being overweight or having obesity
• Having a history of type 2 diabetes or gestational diabetes
• Being inactive or having an unhealthy diet
• Being of a certain ethnicity — PCOS is more common in South Asian and Middle Eastern populations

When to see a doctor

See a doctor urgently if:

• Severe pelvic pain, heavy bleeding, or fainting as listed under emergency symptoms.
• If you have PCOS and suddenly develop very heavy periods or severe pain, seek medical care right away.

Book a routine appointment if:

• If you have irregular periods, persistent acne, excess hair growth, weight gain with no known cause, or trouble getting pregnant, make an appointment with a doctor.
• If you are thinking about pregnancy and have PCOS, talk to your doctor early to discuss fertility options.

Diagnosis

To diagnose PCOS, a doctor will review your medical history, ask about symptoms, do a physical exam, and often order blood tests to check hormone levels, blood sugar, and cholesterol. An ultrasound of your pelvic area is the standard imaging test to look at your ovaries. An MRI may be used if ultrasound results are unclear, if your doctor suspects other conditions, or if a more detailed look at the ovaries or adrenal glands is needed.

Tests that may be done

• Blood tests — to measure hormones, blood sugar, insulin, and cholesterol levels.
• Pelvic ultrasound — a painless test that uses sound waves to create images of the ovaries and uterus.
• MRI (magnetic resonance imaging) — a scan that uses magnetic fields to produce detailed images, often used to confirm or rule out other structures.
• Glucose tolerance test — to check how your body processes sugar.

What to expect at your appointment

If your doctor recommends an MRI, here is what to expect. You will lie on a narrow table that slides into a large tube-shaped scanner. The scanner makes loud banging noises, so you will likely be given earplugs or headphones. You must stay very still during the scan, which usually takes 30 to 60 minutes. Sometimes contrast dye is given through an IV to make certain organs clearer. MRI is painless, but if you are claustrophobic, tell your doctor — they may give you a sedative or plan an open MRI. Afterward, you can return to normal activities immediately.

Treatment

There is no cure for PCOS, but treatment focuses on managing symptoms, improving fertility, and reducing long-term risks like diabetes and heart disease. Your treatment plan will be personal, based on your symptoms whether you want to get pregnant, and any other health conditions you have.

Self-care at home

• Eat a balanced diet rich in vegetables, fruits, whole grains, and lean proteins.
• Get regular physical activity, such as brisk walking, swimming, or cycling, most days of the week.
• Maintain a healthy weight — losing even 5% of your body weight can significantly improve symptoms and insulin resistance.
• Track your menstrual cycle and symptoms to share with your doctor.
• Find healthy ways to manage stress, such as mindfulness, yoga, or talking to someone you trust.

Medical treatments

Treatments may include hormonal medications to regulate periods and reduce androgen effects, medications to improve insulin sensitivity, and medications to induce ovulation for fertility. For people who are not trying to conceive, combined hormonal contraceptives are often used to manage cycles and reduce symptoms like acne and excess hair. For fertility, additional medical therapy can help stimulate the ovaries. All medication must be prescribed and monitored by a healthcare professional — never start or change any treatment without consulting your doctor.

When is surgery considered?

Surgery is rarely used for PCOS. In certain cases, a procedure called laparoscopic ovarian drilling may be offered if ovulation is not achieved with medication. This involves making tiny cuts in the ovary to lower androgen production and improve ovulation. It is not a first-line treatment and is only considered after other options are exhausted.

Living with this condition

Living with PCOS means managing a long-term condition. Keep up with regular medical checkups, take any prescribed medications as directed, and monitor your symptoms. It can help to keep a diary of periods, weight, mood, and any other changes so you and your doctor can adjust your plan as needed. Be patient — it may take time to find the best approach for you.

Lifestyle tips

• Aim for at least 150 minutes of moderate exercise each week.
• Eat regular meals and snacks that combine protein, fiber, and healthy fats.
• Limit sugary drinks and refined carbohydrates like white bread and sweets.
• Quit smoking and limit alcohol intake.
• Prioritize sleep — as much as you can, aim for 7 to 9 hours a night.

Diet and exercise

A balanced diet and regular exercise are cornerstones of PCOS management. Choose whole, unprocessed foods, and include plenty of vegetables, legumes, nuts, and seeds. Try to avoid foods that spike blood sugar, like white bread, sugary snacks, and sweetened beverages. Regular physical activity improves insulin sensitivity and helps with weight management. Even small changes, like a 20-minute walk after meals, can make a difference.

Mental health and emotional wellbeing

PCOS can affect how you feel about your body and may increase the risk of anxiety, depression, and low self-esteem. It is normal to feel frustrated or worried. Talk to your healthcare provider if you are struggling — they can offer support, including counseling or other mental health resources. You don’t have to manage PCOS alone.

Prevention

PCOS cannot be prevented because it has a strong genetic component. However, early diagnosis and active management can prevent or delay complications such as type 2 diabetes, high blood pressure, and heart disease. Adopting a healthy lifestyle as early as possible helps a lot.

Vaccines

There is no vaccine for PCOS. However, staying up to date with routine vaccines, such as the flu and COVID-19, is important for everyone with a chronic condition to reduce risks of infections.

Screening programmes

Regular screening is recommended for people with PCOS. This includes checking blood pressure, blood sugar (for type 2 diabetes), cholesterol levels, and sometimes sleep apnea screening. Talk to your doctor about how often you should have these checks. If you are trying to conceive, fertility screening and preconception care are also important.

Complications

If left untreated

• Type 2 diabetes or prediabetes due to insulin resistance
• High blood pressure and unhealthy cholesterol levels
• Sleep apnea and other sleep problems
• Infertility or trouble getting pregnant
• Depression and anxiety
• Long-term risk of endometrial cancer (cancer of the uterus lining) if periods are very infrequent

Long-term outlook

With the right care, most people with PCOS can manage their symptoms, achieve pregnancy if desired, and reduce their risk of long-term problems. PCOS is a lifelong condition, but it does not define you. By working closely with your healthcare team and making healthy lifestyle choices, you can lead a full and active life.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.