Hi! Good afternoon. I am Dr Shareef answering your query. From the history of pain with PCOS, one could think of either a sudden hemorrage into the cyst, or a twisting of the ovarian pedicle giving rise to such acute pain. This could be diagnosed by a physical examination supported with an ultrasound report at the time of the acute pain. Till then you could go for some anti inflammatory drug along with a proton pump inhibitor. Further management would depend on the report of ultrasound. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef