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There is a distinction to be made between polycystic ovaries and polycystic ovarian syndrome, also known as PCOS. There are women who have polycystic ovaries but who do not have PCOS, and there are women who have PCOS but who do not have polycystic ovaries. A polycystic ovary is simply an ovary lined with many small cysts. Often compared to a string of pearls, this form of cyst forms in the ovary when the tough protein coating protecting an egg simply does not dissolve at ovulation. In almost all cases, the cysts in polycystic ovaries stay non-cancerous, and they usually do not get very large, although they persist for years at a time.

Functional cysts, the kind of cysts that can get as large as 3 to 4 inches (7.5 to 10 cm) in diameter, usually drain themselves in just 3 or 4 weeks. The difference between polycystic ovaries and PCOS lies in how extensive their symptoms are. A diagnosis of polycystic ovaries simply requires an ultrasound exam finding multiple cysts.

For a woman to have polycystic ovarian syndrome, or PCOS, she must exhibit two of the following symptoms:

1. Polycystic ovaries.

2. Failure to ovulate on a regular basis, failure to ovulate at all, or unusual timing of or absence of menstrual periods, resulting in infertility.

3. Masculinizing features, such as unusual hair growth or acne, caused by excessive syndrome.

Some authorities add breast discharge to this list, still requiring just two symptoms our of four for a diagnosis of PCOS. While polycystic ovaries are not associated with imbalances of testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) found in PCOS, they may be associated with other endocrine disturbances. Many women who have polycystic ovaries but not PCOS suffer either hypothyroidism or Cushing's syndrome. Cushing's syndrome is a condition in which the body makes too many stress hormones. This can be due to a lesion in the pituitary gland in the brain, but more likely it is due to steroid medications or some stress on the liver that keeps it from recycling naturally occurring stress hormones. Over the long run, treating stress relieves polycystic ovaries in women who do not have PCOS.

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