Do I Have PCOS? 9 Easy-to-Identify Signs

PCOS stands for polycystic ovary syndrome, a condition characterized by overproduction of male hormones, irregular menstrual periods, and cysts in the ovaries. PCOS can interfere with your reproductive and metabolic health and cause numerous symptoms. It is a leading cause of infertility.

While the causes of PCOS aren't fully understood, genetics are suspected to play a role, possibly in addition to certain health and lifestyle risk factors.

The symptoms of PCOS can overlap with other conditions. But nine common symptoms can lead you straight to PCOS as the true cause.

Hair Loss

Hair loss in PCOS is sometimes called female androgenic alopecia (FAGA) or female pattern hair loss. It happens because of the androgens (male hormones) associated with PCOS. Similar to male pattern baldness, FAGA causes thinning hair on top of the head and along the hairline. It doesn't result in baldness, as it does in men, because the follicle doesn't die. This means the hair may grow in again. Multiple conditions other than PCOS can cause FAGA, including:

• Menopause
• Hyperprolactinemia, a condition known for excess prolactin, the hormone that produces milk in a woman's breasts
• Adrenal hyperplasia, an adrenal gland disorder
• Ovarian and adrenal tumors (rarely)

Several other conditions can cause general thinning of the hair all over rather than in the distinctive pattern of FAGA. They include:

• Anemia
• Autoimmune disease
• Syphilis
• Thyroid disease

Some medications may cause non-patterned hair thinning as well. Ask your healthcare provider if your medication is on the list.

Fatigue

Fatigue is a possible symptom of PCOS, but it's also a symptom of many other illnesses and lifestyle factors. This reality makes it nearly impossible to diagnose any condition based on fatigue alone. It has to be looked at in the context of your life and any other symptoms you may be experiencing.

Lifestyle factors that can cause fatigue include:

• Inadequate sleep
• Long work hours
• Medication side effects
• Nutritional deficiency
• Stress
  

Chronic conditions involving extreme fatigue that can have a severe impact on your life and ability to function include:

• Anemia
• Autoimmune diseases
• Cancer
• Chronic infection
• Depression
• Diabetes
• Fibromyalgia
• Heart disease
• Myalgic encephalomyelitis (chronic fatigue syndrome)
• Sleep disorders, such as sleep apnea and insomnia
• Thyroid disease

To help you and your healthcare provider figure out what's causing fatigue, look for possible triggers. Do you get tired after eating certain foods? After a stressful event? After a small amount of exertion?

Try to describe the specifics of your fatigue. Is it a "kind of tired all the time but functioning" fatigue or does it keep you in bed for days at a time? Does it come and go? Is it accompanied by pain or depression symptoms? Every piece of information ought to help your provider fit the puzzle together.

Mood Swings

You probably already know that female hormones can cause mood swings, especially at certain times during the menstrual cycle. It may be hard to tell them apart from PCOS mood swings. However, PCOS often disrupts your cycle by preventing ovulation, so if you're missing periods and having mood swings, PCOS is a possibility.

It's theorized that mood swings are associated with PCOS because of abnormal brain chemistry and the potential disruption of the brain-gut connection, which refers to the chemical and physical links between the brain and the gastrointestinal tract. Beyond mood swings, PCOS is associated with an increased risk of diagnosis of depression, anxiety, bipolar disorder, and obsessive compulsive disorder. It is also linked to worse symptoms of depression, anxiety, OCD, and somatization, or when someone's emotional distress shows up in the form of physical symptoms.

Migraines

Little research has been done involving migraines and PCOS. But a 2019 study appeared to confirm the link. It found that migraines are "highly associated" with PCOS.

Many people without PCOS have migraines, though. Migraines could be an indicator of PCOS if you:

• Never had them until you started having other symptoms suggestive of PCOS
• Have had them before but have noticed a change in frequency and potential triggers
• Tend to have migraines at certain points in your menstrual cycle
• Have them when other potential PCOS symptoms are especially bad

Sweet Cravings

Craving sweets all the time is a common symptom of PCOS, likely due to insulin resistance. Women with PCOS tend to have high levels of insulin in their blood. All that insulin can interfere with the function of other appetite-regulating hormones, leading to increased hunger. Eating sugar and refined carbs, in particular, can lead to sugar-rush-and-crash cycles that trigger even more cravings.

PCOS cravings can lead to unhealthy behaviors. For example, people with PCOS are especially prone to binge-eating. If you're obese, you're more likely to have a lot of food cravings, which makes weight loss harder.

To gauge whether your cravings could be insulin-related, watch for symptoms of low blood sugar. They can surface a few hours after a binge, when high insulin levels can cause blood sugar levels to plummet. Symptoms include:

• Anger brought on by being hungry
• Dizziness
• Headaches
• Irritability

Weight Gain or Difficulty Losing Weight

Weight loss can be very slow when you have PCOS. It may also be easy to gain weight, especially around the belly. Once again, insulin resistance is likely to blame.

Another one of insulin's jobs is promoting fat storage. But some people with PCOS gain weight even when they eat a healthy diet, avoid binges, and get regular exercise. Other symptoms of insulin resistance include:

• Dark, dry patches of skin in the armpits, groin, or back of the neck
• Excessive thirst
• Frequent urination

Hirsutism

The high androgen levels of PCOS lead many people to develop coarse, dark hairs on the face and on body parts where men typically have body hair and women just have vellus hair ("peach fuzz"). This condition is called hirsutism.

While hirsutism is a sign of possible PCOS, it may also be due to several other conditions, such as:

• Adrenal tumor or cancer
• Congenital adrenal hyperplasia, an adrenal gland disorder
• Cushing's syndrome, an endocrine disorder
• Hyperthecosis, or a series of changes affecting an ovary
• Ovarian tumor or cancer
• Thyroid disease

Not everyone with PCOS has hirsutism. But between 75% and 80% of women with hirsutism have PCOS.

Acne

Testosterone—the primary male hormone—is a cause of acne, so the high levels associated with PCOS can lead to breakouts that you may have thought you left behind with puberty. Not all adult acne is due to PCOS, though. Common causes include:

• Family history
• Hormonal fluctuations (linked to periods, pregnancy, menopause)
• Medication side effects
• Reactions to skincare products
• Stress
  

Fertility Issues

PCOS is one of the most common causes of infertility in women. This may be the hardest part of the disease for women who want to have a baby, now or in the future. Specifically, PCOS can interfere with ovulation, leading to irregular or absent periods and difficulties getting pregnant.

Talk to your healthcare provider if you've been skipping periods or have them irregularly. Just keep in mind that other things can interfere with conception, including:

• Age-related infertility
• Endometriosis
• Low body weight
• Obesity
• Premature menopause
• Premature ovarian insufficiency
• Structural problems in the reproductive organs
• Thyroid disease

PCOS Diagnosis

If you suspect that you may have PCOS, pay attention to your symptoms and their triggers. Most importantly, see your healthcare provider. Because the symptoms listed here can be traced to other conditions, it can take a while for your healthcare provider to be certain of your diagnosis. You might need the following tests to confirm it:

• A pelvic examination
• Blood tests
• Ultrasound or other imaging tests

The diagnostic criteria for PCOS includes:

• Polycystic ovaries (12 or more small follicles in each ovary)
• Hyperandrogenism (elevated testosterone, or DHEA)
• Ovulatory dysfunction (less frequent or absent periods)

If you are diagnosed with PCOS, it may help to know that numerous treatment options can help you manage the symptoms. For example, even a 5% weight loss can relieve many PCOS symptoms—and make living with the condition more bearable, day to day.

Summary

Most medical conditions make their presence known by triggering warning signs. And polycystic ovary syndrome is no different. This hormone disorder can disrupt a woman's menstrual cycle and interfere with the ability to conceive a child. Since PCOS can also put you at higher risk for type 2 diabetes, you'll want to stay alert to nine PCOS warning signs: hair loss, fatigue, mood swings, migraines, sweet cravings, weight gain (or difficulty losing weight), abnormal hair growth on the face or body, acne, and fertility issues.

Of course, a warning sign is not a confirmation. And many of these symptoms can be attributed to something else. But if your periods are irregular and you have two or more of these symptoms, it's wise to make an appointment with your healthcare provider to be checked for PCOS.