Symptoms of Polycystic Ovary Syndrome

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The symptoms of polycystic ovary syndrome (PCOS) are a big part of what makes this chronic disease so confusing. Not only do they differ from woman to woman, but many symptoms, such as fatigue, weight gain, and irregular or painful periods mimic those of many other diseases. Some women with the condition may show no symptoms at all. Because of this, many women with PCOS are misdiagnosed or not diagnosed until symptoms become more severe or obvious to the right doctor. Here are some of the most common symptoms of PCOS.

Frequent Symptoms

Many of the most common signs and symptoms of PCOS are caused by a hormone imbalance. Typically, women with PCOS will have higher levels of male hormones called androgens. Testosterone, for example, is an androgen (yes, women have testosterone just like men have estrogen). This can cause male-like appearance changes such as acne and excess hair growth. Too high of androgen levels can also throw off the ratio of female sex hormones, like the ones that control your menstrual cycle.

Insulin is also a hormone that has been shown to be elevated in women with PCOS. Insulin can contribute to weight gain and difficulties losing weight, along with increased risk for metabolic conditions.

While signs and symptoms of PCOS vary in type and severity, the ones listed here are the most common ones experienced by women who have the condition:

Irregular, Absent, or Heavy Menstrual Cycles

Only a small percentage of women with PCOS will have a monthly period. The majority of women experience absent periods for several months or irregular ones that may come two or more times in one month, or occur every other month or so. Some women may have periods that last for weeks at a time or they may experience heavy menstrual flow accompanied by blood clots.

Weight Gain

Gradual or rapid weight gain (5 to 30 pounds in a few months) with no overt reason can indicate PCOS. This is especially true if most of the weight is in the abdominal or middle part of the body. Compared to women without PCOS, women with the condition tend to experience higher levels of insulin. Insulin is a growth hormone that promotes weight gain, especially in the central part of the body or abdominal region. Over half of women with PCOS are obese.

Having high insulin levels can also contribute to increased cravings and low blood sugar as well as make it difficult for the body to lose weight.

Acne and Skin Problems

Acne may be one of the earliest signs of PCOS in adolescence. Women with PCOS may experience acne on their face, back, or chest well into adult years. Acne production is usually caused by higher levels of testosterone.

Skin tags or dark patches (called acanthosis nigricans) that look dirty but never come off when you scrub them are signs of high insulin which is associated with PCOS.

Excess Hair Growth

Hirsutism, a term for excess hair growth in women, is common in PCOS women. Hirsutism is a result of higher androgen levels, such as testosterone. Typically, there is increased hair growth in the central part of the body (chest, face, back, lower abdomen, fingers, toes). Some women may experience little to no hair growth at all in these areas, while some women may have a full grown beard.

Hair Loss or Thinning

High levels of androgens can also cause thinning or male-pattern baldness in women. While it’s normal to lose some hair every day, it’s not normal to see a recessed hairline or part or bald patches.

Rare Symptoms

These less common symptoms may also be associated with PCOS:

Complications/Sub-Group Indications

PCOS has several complications that are frequently linked to the condition.

Infertility

PCOS is the main cause of ovulatory infertility. As a result, women with PCOS tend to face more difficulty conceiving or becoming pregnant. An imbalance of sex hormones can stop ovulation by preventing the maturation and/or release of follicles from the ovaries. The follicles are oftentimes mistaken for cysts. Women with PCOS also have a higher chance of miscarriage.

Obstructive Sleep Apnea

Obstructive sleep apnea, commonly characterized by snoring, is highly prevalent in women with PCOS. Sleep apnea may be caused by increased weight as well as increased levels of testosterone, which affects sleep receptors in the brain. Sleep apnea can contribute to insulin resistance and high blood pressure as well as fatigue. About 20 percent of women with PCOS develop sleep apnea.

Mood Disorders

Mood disorders such as anxiety, depression, and bipolar depression are higher in women with PCOS. It is unknown whether this is because of the hormone imbalance seen in PCOS or due to the difficulty of living with this often frustrating and complex condition.

Metabolic Syndrome

The hormonal effects of PCOS leave you more vulnerable to metabolic syndrome, which includes high blood pressure, high blood sugar, abnormal cholesterol levels, and excess body fat around your waist. This condition increases your risk of heart disease, stroke, and diabetes.

About 35 percent of overweight women with PCOS develop metabolic syndrome (prediabetes) and 10 percent develop Type 2 diabetes.

When to See a Doctor or Go to the Hospital

If you experience any or some of the symptoms listed above, you should talk to your doctor about them. If you aren’t satisfied with the care you’ve received and think you may have PCOS or a related condition, seek another opinion. Many women with PCOS get diagnosed only after trusting their gut intuition that something isn’t right.

Most of the symptoms of PCOS are not severe enough in themselves to prompt a visit to the emergency room or urgent care clinic. The "cysts" seen in PCOS are egg follicles and usually go away on their own in one to three months without symptoms. Rarely, they enlarge enough to cause pain, bleeding, or a twisted ovary. These symptoms may result in seeking emergency care.

A Word From Verywell

It’s important to get diagnosed with PCOS as soon as possible. While the above symptoms may or not mean you have it, it’s important to get it ruled out. Early detection and treatment of PCOS can make a big difference in protecting your short- and long-term health. With the right diagnosis and treatment, you can then take the proper steps to manage PCOS and live very well.

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