Adaeze was 19 when her periods first became irregular. For seven years, relatives told her it was normal, stress, or 'her body settling.' A pelvic scan and hormonal panel at Mascot Healthcare finally gave her an answer.
Content creator, Yaba. Seven years of irregular periods before diagnosis.
Polycystic Ovary Syndrome (PCOS)Adaeze's periods first became irregular at 19, shortly after she started university. Her mother told her stress was the cause. Her aunt told her it happened to many women in the family. A GP she briefly attended at 21 told her to 'wait and see — many young women have irregular cycles.'
By 25 she had started researching herself. She recognised many of the symptoms of PCOS — the jawline acne, the irregular cycles, the chin hair she had been told was just 'strong genes' — and asked her GP for a scan. She was told a scan was unnecessary without specific symptoms prompting it.
At 26, she walked into Mascot Healthcare and asked directly: 'I want a pelvic scan and a hormonal blood test. I think I have PCOS.'
Each symptom individually was explained away. Together, they formed a clear clinical picture.
Cycles of 45–90 days with unpredictable onset — sometimes skipping 2–3 months.
Coarse terminal hair on chin and upper lip — required frequent threading.
Steady weight increase despite no change in diet — particularly around the waist.
Hormonal pattern — worse in the 2 weeks before periods when they came.
Persistent low energy; mood dips coinciding with long anovulatory cycles.
Over seven years Adaeze had been given three explanations for her irregular periods: stress, low body weight (at university), and later, high body weight (after graduation). No clinician had connected the acne, the hair, the weight pattern, and the cycles as a single syndrome.
She had tried combined oral contraceptives at 22 — prescribed to 'regulate' her periods — which artificially induced withdrawal bleeds without addressing the underlying hormonal pattern. When she stopped the pill at 24 to 'give her body a break,' the irregular cycles returned immediately.
The pelvic ultrasound scan at Mascot Healthcare showed bilaterally enlarged ovaries with a polycystic morphology — multiple small follicles arranged around the ovarian periphery ('string of pearls' appearance), and increased ovarian volume.
Hormonal panel: LH:FSH ratio elevated at 2.8:1, testosterone mildly elevated at 2.6 nmol/L, AMH significantly elevated at 8.4 ng/mL (consistent with PCOS). Fasting insulin and glucose were measured — insulin resistance pattern identified. Thyroid function was normal, ruling out hypothyroidism as a contributing factor.
Pelvic USS: bilateral polycystic ovarian morphology. Hormones: elevated LH:FSH ratio, mildly elevated testosterone, elevated AMH. Insulin resistance pattern on fasting glucose/insulin. Diagnosis: PCOS (Rotterdam criteria met — oligomenorrhoea, hyperandrogenism, polycystic ovarian morphology).
Medication to address insulin resistance. A supplement option was also discussed. Dietary advice: low glycaemic index diet, reduced refined carbohydrates. Exercise prescription: 150 minutes moderate activity per week. Referral to gynaecology for long-term management including fertility planning.
Review at 3 months with repeat hormonal panel and fasting glucose. Cycle tracking encouraged using a period app. Blood pressure and weight monitoring.
Adaeze's cycle length normalised to 32–35 days by month 3. Jawline acne improved significantly by month 4 with combined dietary changes and medication. She described the diagnosis as 'seven years of confusion finally making sense.'
PCOS affects approximately 10% of women of reproductive age. In Nigeria, it is significantly under-diagnosed — partly because irregular periods are culturally normalised, and partly because the cluster of symptoms (acne, hair, weight, cycles) is rarely assessed as a single entity in primary care.
The Rotterdam diagnostic criteria require just two of three features: oligomenorrhoea/anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on scan. A pelvic ultrasound and basic hormonal panel — available at Mascot Healthcare combined — can confirm or exclude the diagnosis definitively.
Irregular periods combined with jawline acne, excess body/facial hair, or weight gain around the abdomen should prompt a PCOS screen — not reassurance. A pelvic scan and hormonal panel provide an answer in one visit.
Book an appointment at Mascot Healthcare, Akoka — same-day slots often available, 4.9★ rated.