13 Polycystic Ovary Syndrome (PCOS) Symptoms You Absolutely Need to Know

Polycystic ovary syndrome (PCOS) affects over 5 million women across the nation. The name, however, can be misleading, as many women who have PCOS don’t have ovarian cysts. Because of this, many women experiencing PCOS go undiagnosed until serious symptoms appear.

What is PCOS?

When one experiences symptoms of PCOS, tell-tale signs may begin shortly after puberty or during later teen years and early adulthood. Those with PCOS generally have irregular or missed periods as result of not ovulating.

While doctors haven’t been able to pinpoint the exact cause of PCOS, there are several factors that can contribute to the development of the disease, including:

  • Genes
  • Inflammation
  • Insulin Resistance
  • Environmental Factors

The body’s resistance to insulin tends to be the greatest factor in a person developing PCOS. This condition can be hereditary and is often found in families with a history of type II diabetes.

Treatment

In order to be properly treated for PCOS, it all depends on the cause of the illness and the symptoms presented. While each person’s experience with PCOS is unique, some common treatment options include:

  • Hormonal Birth Control
  • Anti-androgen Medicines
  • Metformin

While various medicines help control the symptoms of PCOS, there are steps you can take to organically relieve the effects. For instance, since excessive weight raises your insulin levels, it’s important to maintain a healthy weight to control your symptoms.

What are the Symptoms of PCOS?

However, there are treatment options for individual symptoms as well. Continue reading to get informed on the many symptoms of PCOS and how to combat them!

13. Irregular Periods

The first symptom of PCOS for many women is an irregular period. Often, women with PCOS will have cycles that are longer than normal and vary from light to heavy bleeding.

What is a Normal Cycle?

The average menstrual cycle lasts 28 days. However, a menstrual cycle lasting 21-35 days is still considered normal from a medical perspective. If a woman has cycles of irregular intervals or the frequency of those cycles falls outside this normal range, PCOS could be the cause.

Why Does PCOS Cause an Irregular Cycle?

Women with PCOS produce more androgens or male hormones, like testosterone. Androgens affect the estrogen and progesterone the body produces, both of which are essential to a health reproductive cycle.
When these hormones vary or are produced in abnormal amounts, it throws off the menstrual cycle and can even prevent the body from doing what is necessary for healthy reproduction.

Other causes of menstrual cycle irregularities may include:

  • Pregnancy or Breastfeeding
  • Eating Disorders, Extreme Weight Loss, or Excessive Exercising
  • Premature Ovarian Failure
  • Pelvic Inflammatory Disease
  • Uterine Fibroids

Treatment

Often, metformin and weight loss are the go-to treatments for irregular cycles. However, in women who do not wish to conceive, hormonal birth control is very effective in regulating cycles as well.

The following sign of PCOS also presents in those with diabetes…

12. Insulin Resistance

Insulin resistance is one of the more serious underlying symptoms of PCOS. Unfortunately, many people go through life with the condition without realizing they have it.

What is Insulin Resistance?

When your body becomes insulin resistant, your cells are less receptive to the hormone insulin, which is crucial for regulating blood sugar levels. In order to keep your glucose (blood sugar) at a healthy level, your body produces more of this hormone. Unfortunately, this excess insulin affects the balance of other hormones in your body; that’s why this resistance is a significant factor in the hormone imbalances that characterize PCOS.

How Does Diabetes Fit In Here?

In addition, your pancreas beings to work overtime to keep your glucose levels down. Eventually, this becomes more difficult and the pancreas can’t keep up with demand. This exhaustion is why many people with insulin resistance develop type II diabetes.

Treatment

When you experience insulin resistance, it may feel as if it’s something you’re stuck with forever. Fortunately, insulin resistance can be prevented, delayed, or even reversed.

Non-medicinal Treatments

Some of the treatments for insulin resistance include:

  • Physical Exercise
  • Weight Loss
  • Low-carbohydrate Diet
  • Mediterranean Diet

Medicinal Treatments

While these self-care treatments can help reverse insulin resistance, medicine such as metformin can help as well. Metformin works by making your cells more receptive to insulin.

This receptivity means your pancreas needs to produce less insulin to maintain healthy glucose levels. Not only can these treatments improve insulin resistance, but they also prevent type II diabetes and its complications and risks.

The following sign of PCOS? It’s incredibly alarming and requires medical attention…

11. Ovarian Cysts

The name polycystic ovary syndrome was derived from this specific symptom, which not all women with PCOS possess. The word polycystic simply means, “many cysts.”

Ovarian Cysts and PCOS

Ovarian cysts are normal in all women of reproductive age. Every month, when an egg is maturing before being released, it forms a cyst on the ovary. Once the egg matures, it is released from the cyst and enters the Fallopian tubes.

However, in women with PCOS, the egg may not fully mature or enough hormones may not be produced for its release. This process can result in many cysts that should go away on their own over time.

Treatment

Ovarian cysts are normal and typically go away on their own. However, if your ovaries are swelling or a cyst is enlarged, your doctor may take a wait-and-see approach.

Some of the treatment options for ovarian cysts include:

  • Monitoring for Changes or Improvement
  • Common Medications (Estradiol, Progesterone)
  • Laparoscopic Surgery

If you develop painful or enlarged cysts, hormonal contraception is a great option to prevent them from forming. Weight loss and metformin can also improve the ovulation cycle for most women. Rarely, more serious cysts may form and your doctor may perform laparoscopic surgery to determine the next steps in treatment.

The next symptom of PCOS might be one of the most emotionally devastating of them all…

10. Infertility

Women with PCOS often discover that they have the condition after having difficulty getting pregnant (infertility). Infertility is identified by a couple attempting to conceive for 12 months without pregnancy.

It’s important to note that just because someone has PCOS and/or experiences difficulty getting pregnant does not mean that they won’t ever conceive.

Infertility Causes

During a normal menstrual cycle, new eggs begin to develop in preparation for release with only one reaching maturity. Upon maturity, FSHs, or follicle-stimulating hormones, signal the release of a healthy ovum (egg).

In people who have PCOS, the egg may not mature or it may not be released due to hormonal imbalances. This process results in an inability to get pregnant. In addition, irregular cycles can make it difficult to predict ovulation, further complicating the issue.

Treatment

There are a number of treatments for infertility for PCOS. Some of these options include:

  • Timed Intercourse
  • Medications (Estrogen Modulator, Anti-diabetic Medication, Hormone, Sex Hormone Suppression)
  • Medical Procedures (Artificial Insemination, Assisted Reproductive Technology, Ovulation Induction, IVF)
  • Counseling Psychology

With PCOS affecting hormones so significantly, it isn’t surprising that the following symptom often develops in those who have this condition…

9. Weight Gain or Difficulty Losing Weight

Women with PCOS often gain weight and struggle to take it off and keep it off. This struggle can occur even in very athletic individuals with a healthy diet.

The Weight Struggle

PCOS and insulin resistance go hand-in-hand. In addition to cells being resistant to insulin, insulin resistance can affect how the body processes sugar and carbohydrates.

Normally, sugars are converted into energy, which we burn off. However, with insulin resistance, those sugars build up in the bloodstream and your body uses more insulin to combat it.

When this happens, androgens kick in and wreak havoc on your system. Since androgens are male hormones, a woman will gain weight, usually around her middle as that’s where androgens tend to cause weight gain.

Treatment

Although weight gain can be an unpleasant experience, there are ways to combat this symptom, including:

  • Diet
  • Exercise
  • Metformin

Diet, exercise, and metformin play an important role in weight loss with PCOS. Cutting back on processed sugars, increasing the intensity of workouts with high-intensity training exercises, and weight lifting are beneficial to all women. But with PCOS, they are essential for weight loss.

Unfortunately, PCOS makes it easier to shed hair than a few pounds…

8. Thinning Hair and Hair Loss

Thinning hair and hair loss are possible symptoms of PCOS. Not only are these symptoms signs of underlying hormone imbalance, but they can also be very damaging psychologically, affecting one’s self-esteem.

What Causes Hair Loss?

Women with PCOS often produce more androgen hormones. Androgen hormones are responsible for a number of male-related attributes in PCOS patients.

In this case, the androgen hormones can produce a male-pattern baldness effect. Often people don’t notice their hair falling out until there is already damage to the hair follicle. The good news is that there are some things you can do to treat the problem.

Treatment

In order to prevent hair loss, the first thing you need to do is get your hormones under control. That means getting down to a healthier weight, taking metformin, and possibly taking a hormonal contraceptive. If you fail to do so, the problem will continue and may worsen.

Next, there are several medications that you can try. Spironolactone is approved for the treatment of androgenetic alopecia (female hair loss due to male hormones). Other treatments include finasteride and dutasteride, which are approved for male hair loss and sometimes prescribed to women.

Unfortunately, the following common sign of PCOS can also damage someone’s self-esteem…

7. Acne

One of the most common signs of PCOS is acne. If a woman is past the age of 25 and has cystic or hormonal acne occurring on the lower third of her face, there is a possibility that PCOS is the cause.

Hormonal Acne

With hormonal irregularities, it is not uncommon for women to develop cystic acne, which are hard bumps under the skin. These knots are painful and often occur on the jaw, chin, and around the mouth.

Androgens—resulting from the hormone imbalance in PCOS patients—are often the cause of hormonal acne. Fortunately, there are many options that will prevent and treat this type of acne.

Treatment

Hormonal contraceptives are often the first step in treating hormonal acne and are often prescribed by dermatologists. These medications not only treat acne symptoms, but they also regulate other hormones, addressing the underlying cause of the condition. It’s a two-for-one treatment!

If hormonal contraceptives aren’t an option, you may be prescribed spironolactone. Spironolactone is a diuretic that is effective in treating hormonal acne.

However, making a trip to the doctor’s office might be challenging if the next sign of PCOS develops…

6. Fatigue

One of the most commonly reported symptoms among women with PCOS is fatigue. This common side effect may be the result of many factors related to PCOS.

Causes of Fatigue in PCOS

There are a number of reasons why fatigue is so common in PCOS patients. Some of these reasons include:

  • Insulin Resistance
  • Thyroid Problems
  • Low Vitamin B12 or Vitamin D Levels
  • Anemia
  • Side Effects of Medication

In patients taking metformin, it is important to note that this medication can interfere with B12 absorption, meaning that patients could develop a B12 deficiency. The primary symptom of B12 deficiency is—you guessed it—fatigue.

Treatment

Metformin can help you manage insulin resistance along with diet and exercise. However, if metformin is causing a B12 deficiency, you may need to take a supplement or B12 injections to increase your B12 levels. If your thyroid is causing the fatigue, there are many medications available to treat an under-active thyroid that can improve this symptom.

PCOS can affect different people in different ways. Some might lose their hair while others have the complete opposite problem…

5. Unwanted Hair

Another common symptom of PCOS is unwanted body hair, typically in a male-growth pattern. Unwanted hair growth, while not harmful physically, can damage a women’s self-esteem and body image, affecting mental health.

Unwanted Hair Growth

This symptom is often accompanied by hair loss and acne because, like those symptoms, it is caused by androgens. Male hormones tend to cause problems that have male characteristics and excessive hair growth, or hirsutism, is one of them.

Treatment

Since the underlying cause of unwanted hair growth is androgens, addressing insulin resistance usually improves this symptom. Metformin, weight loss, and a healthy diet can improve hirsutism, but if those options don’t help, hormonal contraceptives can resolve the issue. Speak with your doctor about your options.

Unfortunately, PCOS can take a toll on someone’s mental health as well as their physical health…

4. Anxiety and Depression

Anxiety and depression are common symptoms of PCOS with over a quarter of all women with PCOS reporting it. Although the connection is not fully understood, these conditions are treatable.

Theories

People with insulin resistance are more likely to be depressed. This is a well-accepted statistic, but it isn’t well understood. However, several of its symptoms can cause a negative body image and stress.

In addition, hormone imbalances could potentially affect serotonin levels, a major factor in depression. Over time, stress and negative thoughts can cause depression and anxiety and interfere with a person’s daily life.

Treatment

Not only are many of the symptoms of PCOS treatable, but so too are depression and anxiety. If someone is struggling with depression, she should speak to her doctor or a therapist. Both can provide care for depression or anxiety and give the patient the tools she needs to overcome them.

The following symptom of PCOS? It’s a real pain…

3. Pelvic Pain

Pelvic pain is relatively uncommon in women with PCOS; however, it can be a sign of an ovarian cyst or a complication from an ovarian cyst.

Cause of Pelvic Pain

When you develop multiple cysts or have an enlarged cyst, the ovaries may swell and become inflamed. Typically, ovarian cysts are asymptomatic and resolve on their own. However, if the pain is intense or accompanied by bleeding, seek emergency medical attention.

Although not serious by itself, a cyst can rupture and cause severe pain. Also, if the pain is severe, you need to rule out other potential causes, such as appendicitis.

Treatment

If you continue to produce large cysts, your doctor may prescribe oral contraceptives to prevent ovulation, which causes cysts. If a cyst continues to grow in size, it may be removed or biopsied via laparoscopy and tested to determine its cause. Once again, this is very rarely needed.

If all of these symptoms sound exhausting, that’s because they are… which can lead to the following classic PCOS symptom…

2. Headaches

Headaches are more common in women with hormonal extremes and changes, meaning that women with PCOS and insulin resistance tend to have more headaches as a result. Fortunately, headaches are treatable and hormone fluctuations can be improved in women with PCOS.

Hormones and Headaches

Estrogen is a known cause of headaches in women. When estrogen drops before ovulation and is at its lowest before menstruation, women are much more likely to have headaches. For migraine sufferers, this hormone fluctuation exacerbates the issue and can cause more frequent migraines.

In women with PCOS, estrogen tends to dominate the cycle and weaken progesterone levels; this balance is important for avoiding headaches, among other unwanted side effects. This process means that when hormone changes happen, the drop of estrogen can be severe and cause headaches more frequently.

Treatment

Hormonal contraception is often used to control these hormone fluctuations in women who have frequent headaches or migraines. However, birth control methods that don’t deliver a consistent level of the hormone without a break are less effective.

If you have periods on birth control, estrogen levels can drop and cause headaches and migraines during your period. IUDs and Depo-Provera injections are contraceptives that prevent menstrual cycles while still keeping your hormone levels steady throughout the month.

The most exhausting symptom of them all?

PCOS is no fun, and the following might just be the most tiring symptom of them all…

1. Sleep Problems

Sleep problems are more common in women with PCOS, particularly sleep apnea. With sleep apnea, a person stops breathing while they sleep.

Theories

There are several theories for why women with PCOS have sleep apnea and other problems sleeping, including:

  • Obesity
  • Diabetes
  • Stress and Anxiety
  • Depression

Obesity and diabetes significantly increase your chances of developing sleep apnea. Since these are common conditions related to PCOS, they could also explain why more women have sleep apnea. However, sleep apnea is just one of many sleeping issues women with PCOS have.

Treatment

If you have sleep apnea, your doctor will likely prescribe a CPAP machine to regulate your breathing while you sleep. This machine greatly reduces sleep apnea and improves the quality and amount of sleep you receive.

If stress is the culprit, try meditating before bed or taking a warm bath. Do whatever relaxes you and listen to music or white noise to help distract you from intrusive thoughts.

What’s Next?

What’s most important for someone who suspects they have PCOS to know?…

PCOS and Its Symptoms are Treatable

PCOS doesn’t have to be a scary diagnosis. Often all it takes is metformin, a healthy diet, and exercise to drastically improve your symptoms. Your doctor can advise you on which diet is healthiest for you and even give you exercises that are proven to help people with insulin resistance lose weight more efficiently.

Manage Your Symptoms

If you take metformin and maintain a healthy diet and exercise regimen, you may need additional help to manage specific symptoms of PCOS. Discuss with your doctor any concerns or symptoms that you struggle with.

Hormonal contraceptives, prescription medications, and over-the-counter drugs and supplements may improve your symptoms. If what you try doesn’t work, try something else. Be patient. You will eventually find the combination that works best for you.

Your Doctor Is Your Best Resource

Regular blood tests and following up with your doctor regularly will help you maintain your health and prevent many of the side effects caused by PCOS. Don’t be afraid to ask questions to better understand your health and treatment.

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