The symptoms of polycystic ovary syndrome (PCOS) usually present in the late teenage years or early adulthood. As the symptoms can range from mild to severe, not all women with the condition notice the symptoms enough to seek medical aid.
The symptoms usually begin shortly after menarche, the first menstrual period of the woman, although in some cases they may not become evident until later in the reproductive years. Substantial weight gain and obesity can worsen symptoms, which often prompts symptoms and diagnosis at an older age.
Irregular Menstrual Periods
Irregular or absent menstrual periods is the most common characteristic of PCOS. The irregularity of the periods depends on the severity of the condition.
Affected women may have menstrual cycles longer than 35 days or less than eight cycles per year. Additionally, failure to menstruate for more than three months or particularly long and heavy periods may be indicative of PCOS.
Some women also experience significant pelvic pain, which may present with periods or at other times of the cycle when the woman is not bleeding.
Irregular ovulation or failure to ovulate is a significant symptom associated with PCOS, which can lead to problems of fertility. In fact, PCOS is one of the most common causes of infertility among females and it is often diagnosed when women seek advice due to difficulty conceiving.
Hair and Skin
Excessive growth of hair on the face, chest, back or buttocks, known as hirsutism, is common in women who have PCOS.
This is caused by altered levels of androgen hormones in the body and can also have an effect on the skin, which may become oily with moderate to severe acne.Additionally, some affected women may notice hair loss or thinning of hair on their head, similar to male-pattern baldness.
Approximately half of all women affected by PCOS struggle to maintain a healthy weight and are obese. Additionally, gaining weight is associated with worsening of other PCOS symptoms.
Many women with PCOS report feeling excessively tired and have low energy throughout the day. However, this may be associated with poor sleep quality in these women, as women with PCOS are more likely to be affected by insomnia and other sleep disorders.
In addition to the immediate symptoms associated with PCOS, there are several complications that are more likely to present later in life. Women with PCOS are more likely than other women to develop:
- Type 2 diabetes
- Heart disease
- Sleep apnea
- Depression, anxiety, and other psychological disorders
- Endometrial cancer
However, the risk of these complications can be greatly reduced with the appropriate interventions. For example, a healthy diet and regular exercise are protective against diabetes and cardiovascular conditions. Additionally, using the contraceptive pill or an intrauterine system for women with absent or irregular periods can reduce the risk of endometrial cancer.
Reviewed by Susha Cheriyedath, MSc