Polycystic Ovary Syndrome Symptoms You Should Know

Content medically reviewed by Jennifer VanHorn, APRN, CNP

Weight gain, irregular periods and hair growth on the face and chest wouldn't seem to have much in common. For some, however, these seemingly unrelated symptoms stem from one condition. Polycystic ovary syndrome (PCOS) symptoms can affect nearly every aspect of your health and quality of life, including fertility. Fortunately, a variety of treatments, including some to increase the chances of getting pregnant, are available to help control the symptoms of PCOS so you can thrive.

What Is PCOS?

With PCOS, the ovaries don't function as they should. Typically, every month, one of the ovaries will release an egg. If you have PCOS, however, this process may not occur. Sometimes, the ovaries don't work as expected. Reproductive hormones are not the only ones that play a role in PCOS symptoms; insulin also contributes. Insulin is a hormone that helps the body control blood sugar levels.

"Women with PCOS have insulin resistance," said Jennifer VanHorn, APRN, CNP, specializing in fertility, obstetrics and gynecology at Essentia Health. "This means their cells can't 'see' insulin and, therefore, don’t respond to the insulin in their blood. The brain incorrectly thinks there's a shortage of insulin and begins making even more. In turn, high levels of insulin cause the body to produce multiple hormones in excessive amounts, especially the male hormone testosterone."

Higher hormone levels lead to a wide range of PCOS symptoms. In addition, because the body is insulin resistant, blood sugar levels may climb too high. This increases the risk for Type 2 diabetes.

Insulin resistance may play a role in PCOS' development. Another potential cause is high levels of male hormones called androgens. Normally present in small amounts, androgen levels are higher in women with PCOS. As a result, women may develop physical characteristics typically seen in men, such as excess hair growth and male-pattern baldness.

8 Common PCOS Symptoms

PCOS can cause a variety of symptoms, but not every patient experiences all of them. Some common symptoms include: 

• Menstrual disorders. You may have periods more or less often than in the past, or they may stop altogether. When your periods occur, they may be heavier than usual. You may also have pelvic pain, which can be sharp or dull.
• Excess hair growth. Known as hirsutism, growth of facial or chest hair occurs due to high androgen levels. Most women with PCOS have excess hair growth.
• Increased acne. You may see acne appear on your face, back, and chest.
• Trouble getting pregnant. PCOS is the No. 1 cause of female infertility, according to the Office on Women’s Health. "Can I get pregnant?" is the most common question VanHorn hears from patients with PCOS. Every patient's situation is different. In general, though, pregnancy may be possible if you have PCOS, but it may take longer and require more medical assistance, according to VanHorn.
• Weight changes. PCOS can cause weight gain for many women and may make it harder to lose weight.
• Skin changes. You may notice your skin grow darker and thicker in certain areas, such as under your breasts or along neck lines. Small growths called skin tags may also form on your neck or underarms.
• Hair thinning. PCOS may cause hair loss, leading to areas of thinning or, in some cases, baldness.
• Ovarian cysts. These are fluid-filled growths that develop on the ovaries.

When to See a Physician About PCOS Symptoms

If you develop symptoms that seem like PCOS, see your provider. Many conditions can cause PCOS-like symptoms, and only your provider can determine whether you have this condition.

"It's especially important to see your physician if you've gone three or more months without a period, have had difficulty getting pregnant after six to 12 months of trying or have symptoms of diabetes, including skin darkening, increased thirst or hunger, or increased urination," VanHorn said. "Delaying a visit for these issues can lead to serious complications and difficulty in treatment."

To diagnose PCOS, your gynecologist or primary care provider will rule out other conditions that could cause your symptoms. They will perform a physical exam to look for excess hair growth and skin changes. You may also have a pelvic exam, which allows your provider to examine the ovaries. Your provider may recommend a pelvic ultrasound to look for ovarian cysts or a blood test to check your androgen levels.

If your provider diagnoses PCOS, the two of you can develop a plan to control the symptoms and reduce your risk for related health problems. These include high blood pressure, heart disease, diabetes and sleep apnea.

Management Matters

PCOS can affect the hormone that regulates appetite, making it harder for some women to feel full. This hormonal imbalance can lead to binge eating behaviors. While PCOS doesn't have a cure, there's still plenty of cause for hope. That's because you can take steps to limit how symptoms affect your life. Start by making healthy lifestyle changes. Working with a dietitian to come up with a personalized nutrition plan may be a good place to start.

"Diet and exercise are some of the best and most effective interventions for PCOS," VanHorn said. "For women with PCOS who are dealing with excess weight or obesity, even small weight loss can significantly improve their symptoms. Whether a patient is lean or overweight, exercise helps the body use insulin better. As a result, many women can manage PCOS symptoms with exercise."

If you're hoping to get pregnant and are overweight, losing weight may help. Your provider can also recommend other ways to improve fertility, such as medication to help the ovaries function correctly. Birth control medications can play a role in PCOS treatment if pregnancy isn't part of your plans.

"We sometimes use medications that help the body use insulin better, such as metformin," Van Horn said. “Hormonal medications can also be highly effective. They're the most commonly used medications for PCOS management because they reduce many of the excess hormones, improve the body's use of insulin and manage bleeding issues. We can also recommend medications to address excess body hair and acne."