In this article we cover the signs and symptoms of PCOS and the correct way to diagnose PCOS.
What is PCOS?
PCOS stands for polycystic ovarian syndrome.Â
PCOS is an endocrine-metabolic disorder that affects about 1 in 10 women worldwide. It is the most common hormone condition in women of reproductive age, and the leading driver of anovulatory (lack of ovulation) subfertility in women of reproductive age.Â
PCOS is not in fact just one disease, but a disorder with different underlying factors.Â
Typically it is defined as androgen excess (when all other causes of androgen excess have been ruled out) and is often accompanied by symptoms such as weight gain, fertility issues, acne, excess body and facial hair growth.Â
Our preferred term for PCOS is actually anovulatory androgen excess (AAE) because it correctly identifies that you need BOTH irregular, anovulatory cycles and androgen excess to have the condition.Â
Top 10 Symptoms of PCOS
Let’s look at the top 10 symptoms of PCOS.
- Irregular or Missing Periods: PCOS often results in missed or infrequent periods, making it challenging to track your cycle.
- Hirsutism or excess hair growth: many women with PCOS have unwanted hair growth on the face, back and chest.
- Head Hair Loss: hair loss, particularly male pattern baldness is common in women with PCOS.
- Weight Gain: Insulin resistance, a driver of about 70% of PCOS cases, makes weight loss difficult and leads to fat accumulation, particularly around the abdomen (sometimes referred to as PCOS belly). You may also experience more food cravings and more bloating.
- Skin Issues: Acne (particularly along the jawline), dark patches (acanthosis nigricans), and skin tags are all common.
- Mood Changes: PCOS can impact mental health, leading to symptoms like anxiety and depression.
- Fertility Challenges: Irregular or absent ovulation can make it harder to conceive.
- Sleep Disturbances: Sleep apnea and poor sleep quality are often linked to the metabolic aspects of PCOS as well as low progesterone.
- Fatigue: Chronic tiredness is a common symptom due to hormonal imbalances, insulin resistance and difficulty sleeping due to low progesterone levels.
- Heavy or Prolonged Bleeding: Some women experience heavier periods due to irregular ovulation, which causes excess uterine lining buildup.
These are the most common signs and symptoms of PCOS, although depending on what type of PCOS you have, signs and symptoms may differ. For example if you have insulin resistance PCOS you may be more likely to suffer from excess hunger and thirst, or if you suffer from adrenal PCOS you may have impacted and interrupted sleep patterns. Read about the 4 types of PCOS to find out which type you might have.
How is PCOS diagnosed?
The Rotterdam Criteria for diagnosing PCOS, requires at least two of the following:
- Irregular or absent periods.
- High levels of androgens, detected in hormone testing.
- Polycystic ovaries, as seen on an ultrasound.
At FUTURE WOMAN, we believe a correct PCOS diagnosis should involve irregular or absent periods AND high levels of androgens in a hormone test (with other criteria for high androgens having been ruled out). You cannot be diagnosed by ultrasound and symptoms alone because there are other reasons for polycystic ovaries on a scan besides PCOS, particularly in young women.
Other conditions can also mimic PCOS symptoms, such as thyroid disorders and hypothalamic amenorrhea. Â
I have these PCOS symptoms, what should I do next?
At FUTURE WOMAN, our Advanced Hormone Test offers a thorough analysis of your hormone health, which can help you to confirm you have PCOS and also, more importantly, the underlying drivers. All our tests come with a personalised plan with tailored supplement, diet and lifestyle recommendations.Â
Related article: The four types of PCOS.
References:
Deswal, R., Narwal, V., Dang, A., & Pundir, C. S. (2020). The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. Journal of human reproductive sciences, 13(4), 261–271. https://doi.org/10.4103/jhrs.JHRS_95_18
Garg, A., Patel, B., Abbara, A., & Dhillo, W. S. (2022). Treatments targeting neuroendocrine dysfunction in polycystic ovary syndrome (PCOS). Clinical endocrinology, 10.1111/cen.14704. Advance online publication. https://doi.org/10.1111/cen.14704
Khan, M. J., Ullah, A., & Basit, S. (2019). Genetic Basis of Polycystic Ovary Syndrome (PCOS): Current Perspectives. The application of clinical genetics, 12, 249–260. https://doi.org/10.2147/TACG.S200341
Nautiyal, H., Imam, S. S., Alshehri, S., Ghoneim, M. M., Afzal, M., Alzarea, S. I., Güven, E., Al-Abbasi, F. A., & Kazmi, I. (2022). Polycystic Ovarian Syndrome: A Complex Disease with a Genetics Approach. Biomedicines, 10(3), 540. https://doi.org/10.3390/biomedicines10030540
Rosenfield, R. L., & Ehrmann, D. A. (2016). The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited. Endocrine reviews, 37(5), 467–520. https://doi.org/10.1210/er.2015-1104
