PCOS Symptoms

What are the First Signs of PCOS?

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. PCOS symptoms may begin shortly after puberty, but can also develop during the later teen years and early adulthood. 

Because symptoms may be attributed to other causes or go unnoticed, PCOS may go undiagnosed for some time. Usually, a diagnosis of PCOS can be made when you experience two of these three signs:

Irregular periods. People with PCOS typically have irregular or missed periods as a result of not ovulating. Infrequent periods are a common sign of PCOS. For example, you might have fewer than nine periods a year with more than 35 days between periods. Other women suffer from abnormally heavy periods.

Polycystic ovaries. Although some people may develop cysts on their ovaries, many people do not. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.

Excess androgen. Elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

Other symptoms include:

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  • Weight gain. About half of people with PCOS will have weight gain and obesity that is difficult to manage.

  • Fatigue. Many people with PCOS report increased fatigue and low energy. Related issues such as poor sleep may contribute to the feeling of fatigue.

  • Unwanted hair growth (also known as hirsutism). Areas affected by excess hair growth may include the face, arms, back, chest, thumbs, toes, and abdomen. Hirsutism related to PCOS is due to hormonal changes in androgens.

  • Thinning hair on the head. Hair loss related to PCOS may increase in middle age. 

  • Infertility. PCOS is a leading cause of female infertility. However, not every woman with PCOS is the same. Although some people may need the assistance of fertility treatments, others are able to conceive naturally. 

  • Acne. Hormonal changes related to androgens can lead to acne problems. Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back. 

  • Darkening of skin. You may see thick, dark, velvety patches of skin under your arms or breasts, or on the back of your neck.

  • Mood changes. Having PCOS can increase the likelihood of mood swings, depression, and anxiety.

  • Pelvic pain. Pelvic pain may occur with periods, along with heavy bleeding. It may also occur when a woman isn’t bleeding.

  • Headaches. Hormonal changes prompt headaches.

  • Sleep problems. People with PCOS often report problems such as insomnia or poor sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea. With sleep apnea, a person will stop breathing for short periods of time during sleep. This means that even when you do sleep, you do not feel well-rested after you wake up. You could also have trouble falling asleep.

  • Depression. Both hormonal changes and symptoms like unwanted hair growth can negatively affect your emotions. Many with PCOS end up experiencing depression and anxiety.

PCOS can disrupt a woman’s menstrual cycles and make it harder to get pregnant. Lifestyle interventions are the first treatments doctors recommend for PCOS, and they often work well. Weight loss can treat PCOS symptoms and improve the odds of getting pregnant. 

Medicines are an option if lifestyle changes don’t work. Birth control pills can restore more normal menstrual cycles. Metformin is often used to treat type 2 diabetes and may help some women with PCOS symptoms. Metformin improves insulin's ability to lower your blood sugar and can lower both insulin and androgen levels. 

After a few months of use, metformin may help restart ovulation, but it usually has little effect on acne and extra hair on the face or body. Both birth control pills and metformin are used by many to try to relieve PCOS symptoms.

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