PCOS symptoms usually begin at the onset of puberty, but can begin later, especially after major weight gain. Symptoms of PCOS are caused directly by hormonal problems including insulin resistance and elevated levels of androgens, often called “male hormones” and normally only found in small quantities in women. Some PCOS symptoms may be ignored or attributed to another condition, so women may go months or years before receiving a diagnosis. It is important to remember that not every woman with PCOS will experience all of the symptoms of PCOS. Some doctors diagnose different types of PCOS based on which symptoms women experience.
In a normal menstrual cycle, the ovaries produce around five follicles. Each follicle is a small fluid-filled sac containing a maturing egg. One of the defining characteristics of PCOS is abnormal menstrual cycles. In PCOS, many underdeveloped follicles develop and collect in the ovary, hence the term “polycystic ovaries.” Due to their small size, the follicles cannot produce the hormones required for ovulation. Therefore, the levels of hormones in the body become unbalanced.
Women with PCOS can experience a range of menstrual disorders, including:
Severe pelvic pain is a common symptom of PCOS. Pelvic pain in PCOS is typically associated with menstrual periods or ovulation, but can occur at other times in the menstrual cycle.
Some women with PCOS experience joint pain and migraines.
PCOS is sometimes diagnosed in women seeking treatment for infertility. PCOS is one of the most common causes of infertility, but it is also treatable. Approximately 60 percent of women with PCOS become pregnant without medical help. Women with PCOS who require fertility treatments have the same average number of children as women without PCOS. For some women with PCOS, weight loss can help improve fertility. Other women with PCOS may need medication or surgery before they can conceive.
Women with PCOS have an increased risk of first-trimester miscarriage. The risk for first-trimester miscarriage in women with PCOS is between 30 and 50 percent compared with 10 to 15 percent in women without PCOS. It is thought that elevated levels of luteinizing hormone (LH) may be involved. Researchers are studying the relationship of insulin and glucose with embryo development, based on the theory that insulin resistance may damage the embryo, making it less viable.
Some women with PCOS experience a lowered libido – decreased interest in sex.
Read more about infertility treatments.
Skin and hair symptoms
One of the most common and noticeable symptoms of PCOS is hirsutism, an excess of hair on the face or body caused by elevated levels of androgens. Up to 70 percent of women diagnosed with PCOS have hirsutism. More than 90 percent of women who have hirsutism and normal menstrual cycles are found to have polycystic ovaries.
Some women with PCOS experience male pattern baldness, another consequence of abnormal androgen levels. Learn about treatments for excess hair growth and hair loss.
Oily skin and acne, which can be severe, are experienced by 15 to 30 percent of women with PCOS. Other skin symptoms can include dandruff, skin tags (small, fleshy, painless flaps of skin), and acanthosis nigricans (patches of thickened, darkened skin).
Some women with PCOS develop hidradenitis suppurativa (HS), a painful, chronic skin condition in which lumps and tunnels form beneath the skin.
Approximately 50 percent of all women with PCOS struggle with weight gain and obesity that is hard to control. While it can be difficult, losing even 10 or 15 pounds can help regulate the menstrual cycle. Other benefits of weight loss for women with PCOS are better cholesterol and insulin levels and a reduction of acne and unwanted hair growth.
Living with PCOS and contending with acne, weight gain, hirsutism, and infertility can lead to mood changes, anxiety, and depression. Up to 57 percent of women with PCOS experience anxiety, and around 29 percent report depression. You may feel helpless or discouraged, but there are treatments for all of these symptoms that can help you live the healthiest lifestyle possible.
At what age do PCOS symptoms appear?
Most women start to show early symptoms in their teens. Some girls begin experiencing PCOS symptoms as young as age 11. Read more about PCOS diagnosis.