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.

Knowing more about some of the most common symptoms of PCOS can help you know when to see a doctor and why it may be worth seeking a second opinion of you experience them but haven't yet received a diagnosis.

Frequent Symptoms

Many of the most common signs and symptoms of PCOS are caused by hormone imbalances. While signs and symptoms of PCOS vary in type and severity, the following are the most common ones experienced by women who have the condition.

Irregular, Absent, or Heavy Menstrual Cycles

Typically, women with PCOS will have higher levels of male hormones called androgens. This can cause symptoms directly, but it can also throw off the ratio of female sex hormones, like the ones that control your menstrual cycle.

As a result, 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 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 obvious cause can indicate PCOS.

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. It also makes losing weight difficult and increases one's risk of metabolic conditions. In fact, over half of women with PCOS are obese.

Having high insulin levels can also contribute to increased cravings and low blood sugar.

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 the androgen 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 associated with PCOS.

Excess Hair Growth

Hirsutism, a term for excess hair growth in women, is common with the condition. This is another effect 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 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.

Fertility Issues

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 so much so that the follicles are oftentimes mistaken for cysts.

Women with PCOS also have a higher chance of miscarriage.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA), 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% 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% of overweight women with PCOS develop metabolic syndrome (prediabetes); 10% develop type 2 diabetes.

When to See a Doctor

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 intuition that something isn’t right.

Most of the symptoms of PCOS are not severe enough on their own 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 in or 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 well.

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