The symptoms of PCOS are wide-ranging and manifest differently between different women, which makes it challenging to recognise. Likewise, a handful of these symptoms—like acne, weight gain (especially around the abdomen), and hirsutism (abnormal hair growth)—overlap with other health problems, which can make PCOS difficult to isolate without a diagnosis. 

Therefore, many women don’t learn about PCOS or even learn that they have the disorder until they encounter more serious symptoms like infertility. In fact, the CDC writes “It’s common for women to find out they have PCOS when they have trouble getting pregnant, but it often begins soon after the first menstrual period, as young as age 11 or 12.”

Other symptoms include infrequent or irregular periods, thinning hair or hair loss, skin darkening, and skin tags (excess skin), and many more. Links between PCOS and mental health disorders like depression, anxiety, and disordered eating are also under study.

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Despite the increasing prevalence of the disorder, the cause of PCOS remains unclear. Many even consider it to be among “the most perplexing disorders posing threat to women’s health.”

Nevertheless, the patterns observed thus far suggest some useful insights, including the following:

• Women with PCOS produce more androgens than women who do not. While all bodies make androgens (a sex hormone), the so-called “male hormone” is generated at higher rates in males, engendering traits associated with males (e.g. male-pattern baldness). Higher androgen levels are also related to acne, abnormal hair growth, and interference with ovulation cycles.
• Excess insulin blood levels as a result of insulin resistance are also typical in women with PCOS, particularly in those with a family history of diabetes. This, in turn, is linked to an increase in androgen production.
• Researchers suggest that PCOS is a hereditary disorder, with genetics playing a key role in the transmission and realisation of PCOS. Johns Hopkins Medicine explains “PCOS may also run in families. It’s common for sisters or a mother and daughter to have PCOS.”

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Following a physical exam—and often, a pelvic exam to inspect reproductive organs both internally and externally—PCOS diagnosis will likely include a pelvic ultrasound to examine ovaries for cysts and the thickness of the endometrium (the lining of the uterus), as well as blood tests to observe androgen levels. Another important step in the diagnosis process is eliminating the possibilities of other conditions commonly mistaken for PCOS, like thyroid disease.

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The symptoms of PCOS can be managed in isolation, with specific treatments and medications for different conditions:

• Hormonal birth control methods are often prescribed to regularise menstrual cycles, and in some cases, can also improve symptoms like acne and abnormal hair growth.
• There are also medications specifically designed to target acne, hair growth, irregular ovulation, and insulin resistance.
• Adopting a more active lifestyle and a change in diet can help manage the weight gain and high blood sugar often observed in women with PCOS.

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