Why You May Not Know You Have PCOS Until Adulthood

Many women don't become aware they have polycystic ovarian syndrome (PCOS) until they are trying to get pregnant in their 20s or 30s. As a result, the diagnosis may come as a surprise, and many women wonder why it wasn’t discovered earlier in life. Unfortunately, symptoms of PCOS are often ignored as something else or go undetected entirely, making diagnosis challenging.

This article discusses the factors that prevent early detection of PCOS.

Signs Often Go Undetected

The most common symptoms of PCOS include irregular or absent periods, acne, weight gain, and irregular hair growth on the face, chest, or body. In addition, many women with PCOS have many small cysts on their ovaries, causing a characteristic polycystic appearance on an ultrasound. This can look like a string of pearls surrounding the ovaries.

Diagnosing PCOS can be difficult since there isn't a specific test that can be performed. Each woman’s experience of PCOS is unique because no two women have the exact same symptoms.

Some women have physical signs of PCOS like hair growth, acne, and obesity, but they get regular periods. Other women are extremely lean but have irregular periods and ovaries that appear polycystic on an ultrasound.

Symptoms Mimic Those Experienced During Adolescence

The symptoms that are associated with PCOS are often mistaken for those that are experienced during adolescence. Most physicians would consider irregular periods, acne, and weight gain to be normal signs of adolescence and wouldn’t diagnose PCOS until later in life.

Most women, in fact, wouldn’t think that anything was abnormal if they were having problems with acne or irregular periods late into their teens because a majority of teens have experienced these issues at some point during their adolescent years.

Birth Control Conceals PCOS

Many young women start hormonal birth control in their late teens and early 20s, such as the pill, the NuvaRing, the patch, ​and the Depo Provera injection. While they differ in the way that the hormones are deposited into the body, all of these options release small amounts of hormones like estrogen and/or progesterone.

A combination of Myo-inositol (MI) and d-Chiro-inositol (DCI) types in a 40:1 ratio has been found to be most physiologic. Combination inositol therapy (MI and DCI) can improve all symptoms, signs, and laboratory anomalies of PCOS. MI can correct insulin resistance and improve the metabolic features of PCOS, while DCI can correct hyperandrogenism, improve menstrual regularity, and promote ovulation and fertility.

When the Condition Is Usually Diagnosed

Women with PCOS who are not on birth control tend to have irregular menstrual cycles, meaning that they are not ovulating regularly. This can lead to difficulty in becoming pregnant.

Since it’s not unusual to have irregular periods and acne in the months following stopping your hormonal birth control, the symptoms of PCOS may still not be apparent at this point. This is especially true because most doctors recommend waiting at least a few months before trying to get pregnant.

It’s not a coincidence that many women are diagnosed with PCOS a few months after they come off their hormonal birth control as they are trying to get pregnant. The absence of these hormones tends to make the symptoms more apparent, as women become more aware of their irregular menstrual cycles.

Fortunately, there are a number of treatments and lifestyle changes that can help women manage PCOS.