Polycystic-ovaries: a clear sign of PCOS?

Written by: Mr Mahantesh Karoshi
Edited by: Lauren Dempsey

Despite its name, polycystic ovarian syndrome (PCOS) is actually a condition characterised by an excess production of the male sex hormone causing a hormone imbalance. As a result of this, multiple cysts can form on the ovaries, but someone can suffer from PCOS without getting cysts. Esteemed London-based women’s health expert and consultant gynaecologist, Mr Mahantesh Karoshi discusses this further.


Do normal ovaries have cysts? 

Ovaries contain hundreds of thousands of follicles, which are fluid-filled sacs inside the ovary. Each follicle has the potential to release a single egg and when it reaches a large enough size to release a mature egg, it becomes a dominant follicle. Ovulation occurs when the follicle bursts, releasing the matured egg for fertilisation. This follicle can be mistaken for a cyst, but in fact, it is a sign of a healthy and normal ovary.


What causes cysts in women with PCOS?

There is a complex biochemical situation that exists in ovaries with PCOS and as a result, the follicles don’t develop fully, meaning ovulation doesn’t occur. If a follicle doesn’t burst, a cyst can form from this follicle.  Women with PCOS often have a collection of cysts on their ovaries.


Does PCOS affect fertility?

Women with PCOS often have difficulties conceiving due to the lack of ovulation.


Can I have polycystic ovaries but not PCOS?

Women can have polycystic ovaries, that appear on an ultrasound scan, without having PCOS. PCOS is a complex syndrome that polycystic ovaries can be a symptom of. In women who haven’t experienced any symptoms of PCOS, polycystic ovaries have been found on ovaries. This means they have many small cysts, usually less than 1 centimetre in size, located just below the surface layer of the ovary. When looked at via ultrasound these cysts resemble a string of pearls in appearance. Ovaries can, as a result, be enlarged.


If you are interested in booking a consultation with Mr Mahantesh Karoshi, you can do so via his Top Doctors profile today.

By Mr Mahantesh Karoshi
Obstetrics & gynaecology

Mr Mahantesh Karoshi is a London-based women’s health expert and consultant gynaecologist, with a special interest in ovarian cysts, heavy menstrual bleeding, infertility, fibroids, and adenomyosis. He is currently one of the most highly-rated gynaecologists in London with a very good reputation amongst his patients and peers.

Mr Karoshi's work is recognised internationally, having volunteered in Ethiopia’s Gimbie Hospital, and later receiving the Bernhard Baron Travelling Fellowship from the Royal College of Obstetricians and Gynaecologists which led to his work in the University of Buenos Aires. Here he worked on the techniques needed to surgically manage morbidly adherent placental disorders - a serious condition that can occur in women with multiple caesarean sections.

He believes in an open doctor-patient relationship, being sure to include the patient and educating them so that they understand their condition better and they can be directly involved in their care and management at every stage. Aside from his clinical work, he is actively involved in research, which together with his experience, has given him the opportunity to publish the first stand-alone textbook on postpartum haemorrhage which was launched by HRH Princess Anne.

At the core of Mr Karoshi's practice is a high standard of professionalism where patients are involved in their treatment and where the latest techniques and advancements are used to provide an extremely high level of care.

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