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PCO vs PCOS: Differences, Symptoms & Treatments Explained

Having Polycystic Ovaries (PCO) does not necessarily mean that you also have Polycystic Ovarian Syndrome (PCOS). There is a subtle but important difference between these two medical conditions.

You must understand the difference if you are trying to conceive with polycystic ovaries or polycystic ovarian syndrome. Both PCO and PCOS can have an impact on your fertility as well as your general reproductive health. In this article, we will understand the differences between Polycystic Ovarian Syndrome and PCO regarding both your chances of conceiving and overall health.

PCO vs PCOS: Differences, Symptoms & Treatments Explained
Polycystic ovaries or PCOS – What’s the difference?

What is PCO?

Having polycystic ovaries is not that uncommon. According to medical studies, as many as one in four women of reproductive age have PCO. Most women don’t even realise they have PCO until they discover it during a routine ultrasound. Some women might also have some mild symptoms, which we will discuss in upcoming sections. A polycystic ovary is considered a variation in ovaries.

Contrary to popular belief, PCO and Polycystic Ovarian Syndrome are not the same. Having polycystic ovaries is an important diagnostic criterion for Polycystic Ovarian Syndrome, but it is not the sole criterion. Many women with PCO lack other features and might not be diagnosed with PCOS.

The major difference between PCO and PCOS is how they impact the hormonal system. Women with PCO have a disturbance in their reproductive hormones even though they might not have PCOS. The hormone levels of women with PCO are generally between the normal values and values of women diagnosed with polycystic ovarian syndrome.


    • That said, most women with PCO might not have any outwardly detectable symptoms at all


A routine ultrasound exam is the easiest way to diagnose PCO. In most cases, women with PCO don’t have any symptoms, so they find out about their condition by accident. For some women, mild symptoms such as having irregular periods or light abdominal cramps might prompt them to visit the doctor’s office, where they might discover their condition. If you have PCO, your ultrasound might reveal multiple ovarian follicles.


How common is it to have PCOS and endometriosis?
Can you have PCO and not PCOS?

What is PCOS?

PCOS, or Polycystic Ovarian Syndrome, is a less common form of PCO. However, it is still one of the most commonly diagnosed reproductive medical conditions among women of reproductive age. The rate of PCOS diagnosis stands at 1 in 5 women visiting their OB/GYN with any period-related complaint. As said earlier, women diagnosed with Polycystic Ovarian Syndrome have polycystic ovaries, but women with polycystic ovaries aren’t necessarily diagnosed with PCOS.

PCOS is a metabolic condition characterised by abnormal levels of reproductive hormones in the body. Women with PCOS have an increased level of the male sex hormone testosterone and oestrogen. Women diagnosed with PCOS often resist Insulin, an important hormone in sugar metabolism.

Most women diagnosed with polycystic ovarian syndrome will have some symptoms. Some of them are listed below:

    • Having Polycystic Ovaries (PCO)
    • Pain in the abdomen
    • Irregular periods
        • Abnormal menstrual cycles shorter than 21 days or longer than 35 days are considered irregular.
        • Heavy bleeding during the menstrual phase of your periods
    • Having obesity or being overweight
    • Having excessive growth of facial and body hair
    • Female pattern baldness and even acne


Diagnosis of PCOS is made clinically, and two of the following three criteria must be met for a positive diagnosis:

    • Having Irregular Periods: Irregular periods that are longer or shorter than normal are among the hallmark symptoms of PCOS.
    • Having too many Androgens: An abnormal level of androgens in the body is also a clear telltale sign of Polycystic Ovarian Syndrome.
    • Having Polycystic Ovaries: All women diagnosed with Polycystic Ovarian Syndrome will have polycystic ovaries.

If you exhibit obvious symptoms, such as excess facial hair (Hirsutism) or irregular periods, your fertility expert can diagnose you with PCOS immediately. Sometimes, they might prescribe some lab tests to confirm the diagnosis.

Can you take an ovulation test if you have PCOS?
Can you take an ovulation test if you have PCOS?

How to treat PCO vs. PCOS?

Having polycystic ovaries is a variant of having normal ovaries and hence does not require medical intervention. If on the other have, you have been diagnosed with PCOS, your doctor might recommend some of the following treatment options:

    • Hormonal birth control pills: Birth control pills are used to treat Polycystic Ovarian Syndrome as they can lower the levels of androgens (male sex hormones) in the body. Hormonal birth control pills can help you control acne and normalise irregular periods.
    • Another medicine that is routinely prescribed to women with PCOS is Clomid. It helps in regularising periods and helps women with PCOS ovulate regularly. As a result, Clomid might also help women diagnosed with PCOS with their fertility issues.
    • Other medications, such as Spironolactone to control acne, are also prescribed. Most additional drugs prescribed for PCOS are not necessarily TGA-approved for PCOS treatment but as used as off-label treatments. Metformin, a medication used to treat diabetes also helps with insulin resistance in PCOS.
    • Many women with Polycystic Ovarian Syndrome are overweight or obese and have some degree of insulin resistance. Losing a healthy amount of body weight might help prevent the development of type II diabetes and other symptoms of PCOS. Consult with your doctor to determine a safe weight loss goal.
    • Myo-Inositol helps restore ovarian function and regulates your menstrual cycle to promote conception.

The Best PCOS Fertility Supplement available in Australia is Conceive Plus Women’s Ovulation & PCOS Support Fertility Supplements, combined with Folic Acid. Which has been shown in studies to help regulate your cycles.

Fertility PCO vs. PCOS

Let’s get one thing very clear, women with PCO can get pregnant. However, multiple follicles may affect the regularity of their menstrual cycle and occasionally interfere with the ovulation process. Hence, getting pregnant can be a bit difficult, but certainly not impossible.

On the other hand, women diagnosed with PCOS can find getting pregnant much more difficult because of the hormonal component involved. The good news is that it is still possible for women with polycystic ovarian syndrome to get pregnant with proper fertility treatments. There are many fertility treatment options for women having PCOS, and it is often a matter of which treatment option will work.

Clomid is one of the first-line treatment options for PCOS in women TTC. A normal woman below 35 has a 25% chance of getting pregnant every month. With Clomid, the chance for a woman with PCOS is about 15% every month. Hence, although the chance of getting pregnant is lower, what is important is that it still is 15%. Women who can ovulate on Clomid have a 50% chance of getting pregnant.

If a woman cannot get pregnant even on Clomid for a year, she is considered resistant to the medication. Your doctor might refer you to In-vitro fertilisation (IVF) to help you get pregnant in such cases. According to one study, Clomid resistance in women with PCOS was about 25% of the test subjects.

How do you know when your ovulating when you have PCOS?
How do you know when you are ovulating when you have PCOS?

Tracking ovulation PCO vs. PCOS

Irregular ovulation is one of the reasons that women with PCOS find it difficult to get pregnant. If predicting your ovulation is difficult, you might find it difficult to plan sexual intercourse to give yourself a chance of getting pregnant. Women with PCO can also have irregular cycles making them difficult to track their ovulation, but it is far less common in PCOS than PCOS.

Tracking your ovulation using ovulation prediction kits from Fertility2Family can help you determine your fertility window. Our ovulation test kits are available in both strip and ovulation mid-stream forms. We suggest buying the ovulation strip tests as they are cheaper, allowing you to test multiple times a day throughout your cycle without worrying about the cost.



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Evan Kurzyp

Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified Registered Nurse and has expertise in guiding & managing patients through their fertility journeys.

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