If you’ve recently been told you might have Polycystic Ovarian Syndrome (PCOS), it’s completely understandable to feel concerned. You may have gone online and read about the risks of infertility, insulin resistance, or even diabetes later in life. For many young women, hearing “PCOS” can feel like a life-changing diagnosis. But the truth is, sometimes this label is applied too quickly—or even incorrectly.
Dr. Steven R. Goldstein, MD, a leading gynecologist in NYC, has seen this all too often. Young women, usually in their teens or early twenties, come into his office deeply worried after being told they have PCOS. But after a full evaluation, Dr. Goldstein finds that many of these patients do not actually meet the medical criteria for this diagnosis.
Let’s break down what’s really going on—and why you may not need to worry.
What Is PCOS?
Polycystic Ovarian Syndrome is a hormonal condition that affects how a woman's ovaries work. True PCOS is typically characterized by three key features:
1. Irregular or absent menstrual periods
2. High levels of androgens (male hormones such as testosterone), either in blood tests or seen as symptoms like facial hair growth (especially on the chin), severe acne, or hair thinning
3. Ovaries that appear “polycystic” on ultrasound, meaning they contain 12 or more small follicles
According to the Rotterdam Criteria, a widely accepted guideline, a woman must have at least two of these three characteristics to be diagnosed with PCOS.
What’s Actually Happening in Many Young Women
Dr. Goldstein points out that many young women who have been labeled with PCOS don’t actually meet these criteria. Here’s what he’s seeing:
- Their periods are a little irregular—but that’s
common and even expected during late adolescence and early adulthood. Your
menstrual cycle is governed by a complex interaction between your brain
(hypothalamus and pituitary gland) and your ovaries, and it often takes
time—sometimes until your mid-twenties—for this system to fully mature.
- An ultrasound may
show “multiple small follicles” in the ovaries. This can sound alarming if
you're told it looks “polycystic.” But here’s the key insight: this
appearance is completely normal in many healthy young women. In fact, with
today’s high-resolution ultrasound machines, up to 50% of women may show
more than 12 follicles per ovary—making this finding far less meaningful
than it used to be.
- These patients are usually not obese, do not have
elevated testosterone or DHEA-S levels, and do not have symptoms like
excess facial hair or acne. In short, they are healthy.
Dr.
Goldstein prefers to use the term “multicystic ovaries” to describe what
he sees in these cases. It simply refers to the presence of multiple follicles,
which is often a normal part of the menstrual cycle in younger women and not
a disease. It’s not the same thing as PCOS—and it doesn’t mean you’ll have
trouble with fertility or develop diabetes later in life.
The Importance of a Proper Diagnosis
Getting a PCOS diagnosis can have real implications—not just emotionally, but also in terms of how your health is managed. If you’re told you have PCOS when you actually don’t, you might be started on treatments you don’t need, or live in fear of problems that may never arise.
That’s why Dr. Goldstein gynecologist in NYC stresses the importance of taking a careful, individualized approach. Instead of rushing to label every irregular period or follicle-rich ovary as PCOS, it’s important to look at the whole picture—your symptoms, hormone levels, body composition, and overall health.
There’s Good News
If you’re a young woman with slightly irregular periods and an ultrasound that shows multiple follicles—but you don’t have elevated androgens or other symptoms—you’re most likely just going through a natural phase of reproductive development. According to Dr. Goldstein’s experience, the overwhelming majority of women in this situation go on to have normal menstrual cycles, normal fertility, and no increased risk of insulin resistance or diabetes.
When to Seek a Second Opinion
If you’ve been told you have PCOS and you’re unsure if the diagnosis is accurate, consider seeking a second opinion. A thoughtful, experienced gynecologist like Dr. Steven R. Goldstein can help you understand what’s truly going on in your body and whether any treatment is actually necessary.
You deserve clarity, reassurance, and care based on the latest medical understanding—not outdated criteria or hasty conclusions.
Ready to Feel Confident About Your Health?
Dr. Steven R. Goldstein, MD, is a top NYC Gyn with decades of experience helping women understand and manage their reproductive health. If you're unsure about a PCOS diagnosis or simply want to learn more about your body, Dr. Goldstein can provide the insight and support you need.
Schedule your consultation today and get the answers—and peace of mind—you deserve.
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