PCOS Diagnosis Why You May Not Know You Have PCOS Until Adulthood By Nicole Galan, RN Nicole Galan, RN Facebook LinkedIn Twitter Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." Learn about our editorial process Updated on December 03, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Danielle Weiss, MD Medically reviewed by Danielle Weiss, MD LinkedIn Dr. Danielle Weiss is the founder of the Center for Hormonal Health and Well-Being, a personalized, proactive, patient-centered medical practice with a unique focus on integrative endocrinology. She enjoys giving lectures and writing articles for both the lay public and medical audiences. Learn about our Medical Expert Board Print Polycystic ovarian syndrome, or PCOS, is an endocrine disorder that affects the hormonal system. Women with PCOS tend to have higher-than-normal levels of androgens (like testosterone) circulating in their body, leading to a wide range of symptoms. Many women aren’t aware that they have the syndrome until they are trying to get pregnant in their 20s or 30s. This can be confusing and many women wonder why this wasn’t found earlier in their life. Frederic Cirou / PhotoAlto / Getty Images 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. The one common feature is irregular or absent periods. 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 progesterone. Hormonal birth control prevents ovulation and keeps cycles regular by maintaining elevated blood levels of estrogen and progesterone. Hormones also keep the cervical mucus thick and tacky, stopping any sperm from reaching the fallopian tubes. 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. 1 Source Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. El hayek S, Bitar L, Hamdar LH, Mirza FG, Daoud G. Poly Cystic Ovarian Syndrome: An Updated Overview. Front Physiol. 2016;7:124. doi:10.3389/fphys.2016.00124 Additional Reading Escobar-morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018;14(5):270-284. doi:10.1038/nrendo.2018.24 Editorial Process Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit