Polycystic ovary syndrome (PCOS) is a hormonal disorder among women, yet often goes undiagnosed by health care providers. Some women have few, if any, symptoms. Others have many — irregular or absent periods, excess facial or body hair growth, obesity, and infertility — but they may be mistaken as signs of other health conditions.
As many as 15 percent of women between 18 and 45 have PCOS, making it the most common hormonal disorder among women of childbearing age. Often misunderstood and misdiagnosed, PCOS can play havoc with your fertility. Here’s how to recognize the symptoms and take action to protect your reproductive health.
Symptoms of Polycystic Overy Syndrom
PCOS symptoms present in many different ways. Some women will have only some, or mild symptoms, whereas others will have a number of severe symptoms. Symptoms can also change at different stages of a woman’s life. Symptoms of PCOS may include:
- Irregular Menstrual Bleeding – Polycystic ovary syndrome triggers the creation of excess testosterone, upsetting the body’s hormonal balance and causing cysts to develop that prevent the ovaries from releasing eggs. In most cases, this interrupts menstruation. In other cases, the menses can become infrequent, irregular, or even prolonged. This symptom often goes unnoticed when it occurs in teenagers and young women because it is common for cycles to be irregular at a young age.
- Absent Menstruation – Amenorrhea is defined as the absence of menstrual periods; it can be primary — when a woman never had menstrual periods — or secondary when experienced by a woman who was previously menstruating. Most often, PCOS cause secondary amenorrhea, although in some cases this condition had been associated with primary amenorrhea as well. Absent menstruation for six months or more is a sign of increased severity because it indicates testosterone levels are so high that they inhibit menstruation completely. Doctors will recommend various tests to rule out other conditions that may cause amenorrhea.
- Excess Body and Facial Hair – Excessive growth of hair on the female body is medically known as hirsutism. This noticeable symptom is a result of sudden and significant testosterone spikes and is a common symptom of PCOS. It can have psychological consequences such as stress and depression, which can further affect the quality of life.
- Sudden Thinning and Loss of Hair – Most women attribute more-than-normal hair loss to a new shampoo or over-brushing. Women with PCOS often notice hair on their pillows in the morning and may note less volume when brushing or styling. Though this may seem a surprising symptom to follow excess hair growth in other parts of the body, too much testosterone in the female body can affect the scalp. This condition, androgenic alopecia or a male-pattern hair loss, is often seen in women with PCOS.
- Unexpected Acne – People often battle acne during their teenage years due to clogged pores and hormone fluctuations, and some women have breakouts before they get their periods. If acne is experienced long-term or becomes more severe, with cysts, it could be a sign of PCOS. Male hormones are responsible for making the skin oilier than usual and causing breakouts. Most women with PCOS will develop acne on the upper neck, jaw, and cheekbones.
- Weight Problems – Most women with PCOS have difficulty losing weight. Up to 80 percent of women with PCOS are overweight or obese, and obesity further aggravates the condition and increases the chance of developing diabetes. This is a direct result of hormone imbalances. Any unexpected weight issues that seem unaffected by diet or fitness should prompt a woman to see a doctor.
- Sudden Hypertension – PCOS often causes rises in blood pressure or hypertension. This is a secondary symptom, which means it is not caused by PCOS itself but by the development of insulin resistance and being overweight. If not discovered early, PCOS can cause heart problems and many other complications. Anyone with unexplained hypertension should speak to a medical practitioner.
- Skin Discoloration – Acanthosis nigricans is a skin abnormality that manifests as black discolorations in skin folds on the neck, forehead, breasts, thighs, and groin. Insulin resistance and spikes cause the skin to turn black or brown in these places. Some people with PCOS also develop skin tags. One study suggested 68% of people with these symptoms have PCOS.
- Increased Stress – The culmination of symptoms of any disorder can lead to stress. Women with PCOS may begin to feel isolated, afraid, or ashamed of their condition, which can lead to work or school absences and avoiding social activities. Some women find it beneficial to speak to a psychologist once they have received a diagnosis.
- Depression – Stress and isolation can lead to depression, but this isn’t the only possible cause of this secondary condition in women with PCOS. Depression can also be brought about by the hormonal imbalance itself, which can cause mood fluctuations as well as other general symptoms such as fatigue and insomnia.
How is PCOS diagnosed?
Your health care provider will ask about your medical history and your symptoms. You will also have a physical exam. This will likely include a pelvic exam. This exam checks the health of your reproductive organs, both inside and outside your body.
Some of the symptoms of PCOS are like those caused by other health problems. Because of this, you may also have tests such as:
- A pelvic exam. The doctor visually and manually inspects your reproductive organs for masses, growths or other abnormalities.
- Blood tests. Your blood may be analyzed to measure hormone levels. This testing can exclude possible causes of menstrual abnormalities or androgen excess that mimics PCOS. You might have additional blood testing to measure glucose tolerance and fasting cholesterol and triglyceride levels.
- An ultrasound. Your doctor checks the appearance of your ovaries and the thickness of the lining of your uterus. The transducer emits sound waves that are translated into images on a computer screen.
When should I seek medical care?
While your primary doctor or gynecologist may suspect that you have this disorder, it’s strongly recommended that you consult with an endocrinologist for further diagnostic testing and treatment. An endocrinologist specifically treats disorders of the hormonal system.
So, if your doctor is advising you to see a specialist, you’re already ahead of the game. Start a conversation with your local endocrinologist. Dr. Angela Richter, Endoencrinologist at The Medical Group of South Florida can provide accurate diagnosis and an individualized treatment plan to work towards restoring your hormonal balance. Please call us at 561-622-6111 or use digital scheduling on our website to book your appointment.