
I didn’t even need an ultrasound tbh: I’m 6’0”, built like a linebacker, had facial hair that was so bad that it needed professional removal since I was 10, and had debilitating periods from the time I started having them. I checked every single box that wasn’t ultrasound confirmation.
I got diagnosed by transvaginal ultrasounds. I had one when I was way younger and had a massive cyst so there was already a history when they went looking for PCOS specifically, but they wanted to check my thyroid and prolactin levels before the ultrasound to make sure there weren't any deadly issues first.