Nkechi's periods had been irregular for two years. She'd been told repeatedly it was stress. A PCOS scan at Mascot Healthcare found polycystic ovaries on both sides — and suddenly, her irregular cycles, weight gain, and acne all made sense.
University student, Bariga. Presented with 2-year history of irregular periods (cycles ranging 35–90 days), weight gain of 8 kg over 18 months despite dietary control, mild facial hair increase, and acne worsening since age 22. Multiple pharmacy visits with reassurance "it's hormonal" and no investigation.
Pelvic Ultrasound (PCOS)Nkechi had gone to three pharmacies and one clinic with the same complaint: irregular periods. Each time she was told it was stress — she was a university student, after all. One pharmacist recommended evening primrose oil supplements. Another sold her a herbal "period regulator." Neither helped.
A friend who was studying medicine mentioned PCOS in passing — "have you been scanned?" Nkechi hadn't even known a scan was relevant. She assumed ultrasound was for pregnancy. Her friend explained that a pelvic scan could look at the ovaries for the characteristic multiple small follicles of PCOS.
At Mascot Healthcare, the sonographer performed a pelvic ultrasound. "Both ovaries are showing multiple small follicles arranged around the periphery — this is the appearance we call polycystic ovaries," the doctor explained, turning the screen toward Nkechi. The follicle count in the right ovary alone was 18.
Polycystic ovary syndrome (PCOS) is the most common hormonal condition in women of reproductive age in Nigeria — yet it is consistently under-diagnosed because it presents with symptoms (irregular periods, weight gain, acne) that are frequently attributed to lifestyle or stress without investigation.
Irregular, unpredictable periods — some months with no period at all — causing significant anxiety about fertility.
Progressive weight gain concentrated around the abdomen despite no dietary change — a feature of insulin resistance in PCOS.
New fine hair growth above the upper lip and on the chin — hyperandrogenism in PCOS.
Adult-onset cystic acne on the jaw and chin — driven by elevated androgens.
Nkechi was not yet trying to conceive, but was anxious about what her irregular cycles might mean for her future fertility.
Nkechi's biggest fear was infertility. She was 24 and not yet trying to conceive — but she wanted children eventually, and the word "polycystic" had always sounded alarming to her. She had read fragments of information online — some hopeful, some frightening.
The Mascot Healthcare doctor explained the distinction: PCOS affects ovulation and can make conception more difficult without treatment — but most women with PCOS conceive successfully, particularly when the condition is diagnosed and managed early. Early diagnosis at 24 gave Nkechi excellent options.
Right ovary: 18 follicles measuring 2–9 mm arranged peripherally around a bright stroma — follicle count exceeds the diagnostic threshold of ≥12 per ovary. Left ovary: 14 follicles — also diagnostic. Ovarian volume: right 12 mL, left 10 mL (normal < 10 mL — mildly enlarged bilaterally). Uterus: normal. No dominant follicle. Endometrial stripe: thin (5 mm) — consistent with anovulatory cycle.
Blood tests requested: LH:FSH ratio (elevated at 3.2:1), testosterone (mildly elevated), fasting insulin and glucose (fasting insulin elevated — insulin resistance confirmed), prolactin (normal — to exclude another cause of irregular cycles).
Diagnosis confirmed: PCOS (Rotterdam criteria met — oligomenorrhoea, ultrasound polycystic ovaries, biochemical hyperandrogenism). Management plan: lifestyle modification (low-GI diet, regular exercise for insulin resistance); medication to address insulin resistance; the combined contraceptive pill (for cycle regularity and skin benefit); dermatology referral for acne.
Bilateral polycystic ovaries (right: 18 follicles, 12 mL; left: 14 follicles, 10 mL). Thin endometrium. No dominant follicle. Consistent with anovulatory state.
Blood tests (LH:FSH, testosterone, insulin, prolactin); lifestyle modification; medication for insulin resistance; the contraceptive pill for cycle regulation; dermatology referral for acne; fertility referral when ready to conceive.
At 3 months on medication and the contraceptive pill: cycles regular (28–32 days). Acne improved significantly. Weight stable. At 6 months: 4 kg weight loss with low-GI diet + exercise.
Nkechi has regular cycles, improved acne, and stable weight at 6 months. She understands her condition and has a clear plan for when she is ready to start a family.
PCOS is the most common cause of irregular periods in women aged 18–35. It is not "just stress." It requires investigation — and a pelvic ultrasound scan is the central imaging test. Without a scan, the diagnosis cannot be confirmed.
PCOS diagnosed early means early management — of insulin resistance, cycle irregularity, and skin changes. Early management significantly improves long-term outcomes for fertility, metabolic health, and quality of life.
Irregular periods + weight gain + acne in a young woman = PCOS until proven otherwise. A 15-minute pelvic scan gives the diagnosis — stress does not.
Book online or via WhatsApp — same-day scan results, expert sonography, transparent pricing.