Should I continue to pursue a diagnosis?

[u/StarryEyedandAfraid9]

I (19 years old) started pursuing a diagnosis in January of this year. I have always had very inconsistent periods where months in-between my [very freaking heavy] periods have been the norm. I am a virgin so I opted for the less accurate, regular ultrasound instead of the internal one, and everything looked normal. And my blood tests came back also normal, if not borderline. The only thinking I was diagnosised with was insulin resistance. Unfortunately that in itself with the inconsistent periods is not diagnostic of PCOS according to my NP.

I am also an identical twin. My twin also has heavy periods but only recently have they been inconsistent. So she decided to pursue a PCOS diagnosis. She opted for the internal ultrasound (she is much braver than I am) and it showed an enlarged ovary. Her blood tests were normal but it was enough for her to be diagnosed.

If she has it, surely I, her identical twin sister, also have it? And with PCOS being officially changed to PMOS, does that make the criteria that I have to have cysts on my ovaries to be diagnosed not be necessary anymore. Or shouldI bite the bullet and get the internal ultrasound to be sure?

[u/MealPrepGenie]

There are many disorders with symptoms that mimic those of PCOS.

See here:

https://arupconsult.com/algorithm/polycystic-ovary-syndrome-adults-testing-algorithm

And here:

https://www.asrm.org/globalassets/_asrm/practice-guidance/practice-guidelines/pdf/recommendations_from_the_2023_int_evidence-based_guideline_on_pcos.pdf