Because of the hormone imbalance caused by PCOS, a variety of obvious symptoms can occur. Remember, though, that PCOS is a syndrome, meaning that it is a collection of signs (physical findings) and symptoms (patient complaints), so each person may have a different combination of features than another person. If you have two or more of the following symptoms, you should see your doctor for an accurate diagnosis and a treatment for PCOS that is right for you.
- Irregular or absent menstrual periods. Nine or fewer menstrual cycles per year may be a clue that a woman may have PCOS. Bleeding may be heavier than normal.
- Infertility. Women with polycystic ovary syndrome do not form eggs regularly so they may be unable to conceive.
- Excess or unwanted body or facial hair growth. PCOS may cause usually fine hairs on a woman's face to become heavier and darker. There may also be increased hair growth on a woman's arms, legs, and elsewhere on her body.
- Thinning hair on the scalp may be present.
- Weight problems. Many women with polycystic ovary syndrome gain weight easily and have difficulty losing extra pounds. Weight gain often is concentrated around the waist. Weight gain is of concern because it puts women at risk for the metabolic problems such as type II diabetes and heart disease. A woman with a waist measurement greater than 35 inches is likely considered to be overweight. Physicians measure waist circumference as a way to estimate a patient's abdominal fat - a predictor of risk factors for obesity-related medical conditions.
- Skin problems
- Acne is sometimes found on the face, chest, and back.
- Skin tags, about the size of small raisins, are sometimes found in the armpits or neck.
- Darkening and thickening of the skin may occur around the neck, groin, underarms, or skin folds. This condition is called 'acanthosis nigricans' and often a result of decreased sensitivity to insulin.
In addition to irregular periods and some of the symptoms described above, women with PCOS are at higher risk for a number of serious health conditions. These conditions may go unnoticed, but are potentially dangerous, and include the following:
- Diabetes, elevated insulin levels, or insulin resistance. Most women with PCOS have problems using their body's insulin, the hormone that carries sugar from the blood stream into our cells. About 30 percent of women with polycystic ovary syndrome will have some problem with processing blood sugar. This is a major risk factor for adult-onset diabetes, a disease characterized by too much sugar in the bloodstream.
- Heart and blood vessel diseases including high blood pressure - Women with PCOS often have elevated levels of the bad cholesterol (LDL), low levels of the good cholesterol (HDL), and high levels of other fats, including triglycerides. These factors are known to increase the risk of heart attack or stroke later in life.
- Cancer of the uterus. The lining of the uterus - called the endometrium - normally builds up and is shed with the menstrual period each month. Because of irregular menstrual cycles and lack of ovulation in women with PCOS, the lining of the uterus may not shed as often as is desirable. In this case, the endometrium may become extremely thick. If polycystic ovary syndrome goes untreated, and the lining of the uterus does not shed as it should, this may increase the risk of cancer over time.
- Sleep apnea. Characterized by brief interruptions of breath during sleep, sleep apnea is among the most common cause of all sleep disorders, but most people do not know they have it. These breathing irregularities cause snoring and irregular sleep that results in daytime drowsiness, putting people at risk for accidents. Untreated, the problem can be life threatening, putting individuals at increased risk for stroke, heart disease and heart attacks.
The more obvious signs of polycystic ovary syndrome described above are particularly troublesome for women from puberty through their reproductive years. As women approach menopause - the time of life when periods begin to taper off and eventually stop - they may notice that many of their PCOS symptoms diminish in severity. Some women may even begin to experience regular menstrual cycles for the first time. Unfortunately, the risk for diabetes and heart disease increases with age. This means that if you have had symptoms of polycystic ovary syndrome for most of your life, then you should be carefully evaluated for diabetes, insulin resistance, and heart disease, even if your overall symptoms are improving with age.