As a woman, dealing with acne, stray hairs, weight gain, and period problems seem like they’re par for the course and, in some people’s minds, health woes that women simply need to learn to deal with. But a condition called polycystic ovary syndrome, or PCOS, may really be behind these problems. And if a woman has PCOS, it’s important to get the right diagnosis for her current comfort, long-term health, and future plans for having a family. Unfortunately, the reality is that there are several hurdles that can make getting that diagnosis especially difficult.Polycystic ovary syndrome is a hormonal problem that affects 10 million women in the world. (1) Women with PCOS produce high levels of androgens, which are male sex hormones.
(Women naturally have low amounts of these.) (2) Nonetheless, rather than referring to the condition by its popular name — PCOS — experts now see it as reproductive metabolic syndrome, says David A. Ehrmann, MD, director of the University of Chicago Center for Polycystic ovary syndrome in Illinois. That’s because not everyone who has the condition has polycystic ovaries (or the development of cysts, or fluid-filled sacs, in the ovaries); more important are the reproductive and metabolic abnormalities that are the hallmarks of Polycystic ovary syndrome.The first step in understanding PCOS is learning about the common signs and symptoms. Below, take a look at some of the most common ones, so you know whether Polycystic ovary syndrome may be at the root of your health issues.
1. Irregular or Unpredictable Periods May Be a Sign of PCOS
You may notice you have irregular, unpredictable periods (called oligomenorrhea). This isn’t just being two or three days late here or there; it means that your cycle length is greater than 35 days. (3) A normal cycle can range between 22 and 35 days. “Patients have unpredictable cycles, and have about eight or fewer cycles per year,” says Dr. Ehrmann. This is due to a lack of progesterone in women with PCOS. (1) Periods may also be especially heavy or really light.
2. Difficulty Conceiving Is One of the Hallmark Symptoms of the Syndrome
Women with PCOS have trouble getting pregnant. In fact, PCOS is the most common cause of female infertility. (4) Fertility problems arise from a lack of ovulation. Even if a woman is getting her period (albeit very late), that’s not assurance that she’s ovulating. She can get her period without ovulating. That’s why a woman may not notice anything is wrong until she’s been trying to get pregnant for some time.
3. Excess Hair Growth in Unexpected Places on the Body (Hirsutism)
Because PCOS is a hormonal condition in part marked by high levels of androgens (male hormones), women experience excess hair growth in unwanted places. With PCOS, women see this most often on their face, arms, back, chest, thumbs, toes, and abdomen. (5) But this symptom can vary depending on your ethnicity, which may predispose you to having excess hair, says Loren Wissner Greene, MD, professor of endocrinology and ob-gyn at NYU Langone Health in New York City. This is one symptom to pay close attention to. In women with Polycystic ovary syndrome, hirsutism was strongly linked to metabolic problems, research has found. (6)
4. On the Flip Side, Hair Loss Could Also Signal You Have PCOS
While you may grow hair in places you don’t want, you may also lose hair that you’d otherwise want to keep. Because of those excess androgens, women may suffer from “male pattern” hair loss, which is thinning hair on the top of the head or hair recession, something that may be more severe in middle-aged women. (5)
5. Excess Androgens May Make Certain Skin Types More Prone to Acne
Unfortunately, elevated androgens come into play again, this time delivering skin problems like acne. That said, certain skin types may be more vulnerable to acne, notes Dr. Greene.
6. Women With PCOS May Be More Likely to Be Overweight or Obese
While half of women with Polycystic ovary syndrome experience weight gain or are obese, it can also affect women who are thin. (5) The view that all women with Polycystic ovary syndrome are overweight or obese is a misnomer that can stand in the way of receiving the right diagnosis, says Amy Medling, certified health coach, founder of Polycystic ovary syndrome Diva, and author of Healing PCOS: A 21-Day Plan for Reclaiming Your Health and Life with Polycystic Ovary Syndrome. “Some doctors are only looking for the stereotypical overweight woman, meaning there are lots of thin women who are missed,” she adds.
7. PCOS Is Linked With Mood Disorders, Such as Anxiety and Depression
About one-quarter of women with Polycystic ovary syndrome have mood-related disorders, says Medling. (7) These include anxiety, depression, poor body image, and even eating disorders. One 2016 meta-analysis on six studies that looked at women from four countries found that depression and anxiety was about three times more likely in those with PCOS compared to those without the condition. (8) A potential reason is the distress from Polycystic ovary syndrome-related body changes and decreased body image, the researchers note. Therefore, your doctor should screen you for psychological problems so he or she can be best prepared to help you.
8. Signs of Insulin Resistance, the Hallmark of Type 2 Diabetes, Are Associated With PCOS
Women with Polycystic ovary syndrome are not as responsive to the hormone insulin, which helps ferry glucose to our cells for energy, so they they are at risk for developing insulin resistance. (1) In fact, 65 to 70 percent of women with Polycystic ovary syndrome are insulin resistant. (9) (This is where the metabolic problems associated with Polycystic ovary syndrome arise.) According to Medling, due to insulin resistance, women may notice skin issues like skin tags or a darkening of the skin, called acanthosis nigricans, which appear as dark, velvety patches around the armpits, groin, and neck. (10) Insulin resistance is the hallmark of type 2 diabetes, though people can have insulin resistance without developing the disease.
9. Sleep Trouble and the Resulting Fatigue Are Symptoms of PCOS
Tiredness and low energy are extremely common symptoms in women with Polycystic ovary syndrome . (11) One reason: Women with Polycystic ovary syndrome are more likely to have sleep apnea, a condition marked by brief pauses in breathing, which can contribute to daytime sleepiness. (5) Issues with sleep and insomnia can also exacerbate mood problems.