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Do you have PCOS?

I have seen a number of patients in recent months who have come in alerting me that they have been told by their doctor that they have polycystic ovarian syndrome (PCOS) and would like to receive treatment for it. I LOVE that these patients are coming to me as a naturopath to treat their hormones as PCOS is a very treatable condition!

However, in many cases, after reviewing their health history and looking at their labs, I am left questioning this diagnosis! I wanted to write this article so that you understand the risk factors for developing PCOS as well as, most importantly, the diagnostic criteria to confirm that PCOS is indeed the correct diagnosis in your particular case.

Risk Factors

First, let’s start with the risk factors for the development of PCOS. These are screening questions I ask my patients when they have some symptoms that indicate that PCOS may be contributing to their symptoms.

  • A family history of PCOS
  • A family history of diabetes
  • A family history of irregular periods
  • Long-term use of the medication Valproate which is used to treat seizures
  • Obesity at puberty


If you have one or more risk factors, your risk of developing PCOS increases. The following symptoms, if present, may warrant a deeper investigation into the diagnosis of PCOS.

  • Acne
  • Abnormal growth of hair on the face, nipples, abdomen, chest, and thighs (hirsutism)
  • Overweight or obesity
  • Thinning hair or bald spots
  • Dark patches of skin
  • Pelvic pain
  • Infertility
  • Anxiety or depression


Now that you are aware of the risk factors and the symptoms of PCOS, how is it officially diagnosed? This is the most important part of this entire article! The answer is surprisingly simple! There is something called the Rotterdam Criteria which was created in 2003. If two out of three of the criteria are present, the diagnosis of PCOS can be made. Easy peasy. Let’s examine the criteria:

Oligo- or anovulation. This is characterized by a lack of ovulation, irregular menstrual cycles or an absence of a menstrual cycle.
Clinical and/or chemical hyperandrogenism. Hyperandrogenism is a state where there is too many male hormones (androgens) in the body. For a PCOS diagnosis you can either have high levels of androgens in the blood or symptoms suggesting high androgen levels such as acne, abnormal body hair growth or thinning hair.
Polycystic ovaries.  Polycystic ovaries are present if there are 12 or more follicles present on a single ovary OR if there is an increase in size of at least one ovary.

It’s as simple as that! If you only have one of the criteria present, you need to work with an educated healthcare professional to figure out what could be going on besides polycystic ovarian syndrome.

Yours in health,

Dr. Nicole Hartman

About Dr. Nicole Hartman

Dr. Nicole Hartman is a naturopathic physician, a world traveler, a hiker, and a blogger. She focuses her practice in digestion, women's health and weight loss and takes an integrative, evidence-based approach to healthcare.