PCOS Without Cysts: The Hidden Type Doctors Often Miss

Is It PCOS If You Don’t Have Cysts?

You’ve gained weight, your cycles are irregular, and your hormones feel completely off—but your ultrasound came back clear. No cysts = no PCOS, right?

Wrong.

There’s a hidden type of PCOS that many doctors miss—especially when you don’t fit the “classic” image.
Welcome to the world of PCOS without cysts—and yes, it’s real.

What Is PCOS Without Cysts?

PCOS (Polycystic Ovary Syndrome) is a hormonal-metabolic condition, not just a “cyst” issue.

You don’t need to have visible ovarian cysts to meet the diagnostic criteria. In fact, the “Rotterdam Criteria” says you only need 2 of 3 of the following:

1. Irregular or absent ovulation
2. Signs of high androgens (like acne, hair growth, hair thinning)
3. Polycystic ovaries on ultrasound

So yes—you can have normal-looking ovaries and still have PCOS.

Common PCOS Without Cysts Symptoms

Even if your scan is clear, you might experience:

Hormonal Symptoms:

• Irregular or absent periods
• Adult acne (especially jawline)
• Hair thinning (top of scalp)
• Unwanted facial/body hair (chin, chest, belly)
• PMS, mood swings, anxiety

Metabolic Symptoms:

• Trouble losing weight
• Cravings for carbs and sugar
• Fatigue after meals
• Insulin resistance or prediabetes
• Dark skin patches (neck, underarms – acanthosis nigricans)

Emotional & Gut Clues:

• Anxiety or depression
• IBS-like symptoms
• Bloating or constipation

❗Why Is It Missed So Often?

Because many doctors still look for cysts on the ovaries as the main diagnostic tool. But cysts can come and go—and hormone dysfunction is the real root issue.

Plus, many women with “lean PCOS” (normal BMI) get dismissed even when they have all the symptoms.

What’s Really Causing It?

The root driver of PCOS without cysts is usually insulin resistance and stress.

Insulin resistance raises testosterone. Stress raises cortisol, which disrupts ovulation. Together, they:

• Block your cycle
• Create hormone chaos
• Affect mood, weight, and fertility

How to Treat PCOS Without Cysts Naturally

1. Balance Insulin & Blood Sugar

Even slim women can have hidden insulin resistance.

🔹 Eat protein at every meal
🔹 Cut out refined carbs + sugar
🔹 Walk after meals
🔹 Supplements: Berberine, Inositol, Chromium

2. Support Hormone Detox

Detox excess estrogen and balance androgens (testosterone).

🔹 Use:

• EstroFactors
• Calcium-D-Glucarate
• Milk Thistle + Sulforaphane
• Add flax, chia, leafy greens daily

3. Manage Stress & Cortisol

High cortisol can mimic or worsen PCOS.

🔹 Try:

• Ashwagandha, Magnesium Glycinate, Rhodiola
• Breathwork, sunlight, sleep hygiene
• No caffeine on an empty stomach

4. Track Your Cycle

Even if irregular, track signs like:

• Cervical mucus
• Ovulation strips
• BBT (basal body temperature)

This helps you understand your hormone pattern—even if your period is MIA.

🩺 Ask Dr Olz: PCOS Without Cysts Protocol

Here’s what we recommend in our South African protocol:

Step 1: Full Blood Work Panel

• LH/FSH ratio
• Free and Total Testosterone
• DHEA-S
• Insulin + Fasting Glucose
• Progesterone (Day 21)
• Cortisol + Thyroid levels

Step 2: Personalized Natural Protocol

• Anti-inflammatory nutrition plan
• Insulin-balancing supplements
• Hormone detox bundle
• Gut and liver reset

Step 3: Virtual Consultation
📩 Submit your bloods
💻 Book your consult
🛒 Get a personalized PCOS bundle (shipping across South Africa)

💬 Final Word: You’re Not Imagining It

You don’t need cysts to have PCOS. If you feel dismissed or overlooked, know this: Your symptoms are real. Your hormones matter. And you deserve answers.

At Ask Dr Olz, we help South African women uncover hidden hormone imbalances and reclaim control—naturally and with confidence.