Symptoms and signs that show you may have PCOS
The diagnosis of polycystic ovarian syndrome (PCOS) is ultimately made by an expert in the field, usually a Gynaecologist after due patient consultation, examination, and investigations such as blood tests and ultrasound scans of the abdomen and pelvic region.
However, there are certain symptoms and signs that you may experience that may suggest that you have PCOS and necessitate you to see a doctor for proper evaluation. These symptoms and signs are not to be evaluated in isolation and making the diagnosis usually requires the presence of at least two or more of them. Also, there are other health conditions that may give rise to signs and symptoms similar to those of PCOS and this is why it is important to see an expert to rule out these other causes before a diagnosis of PCOS is established.
Some of the symptoms of PCOS include:
Hirsutism refers to a male pattern, and excessive hair growth in a woman. This means that a woman with PCOS may have facial hair peculiar to men such as beards, hairy chest, hairy back, and also male-pattern distribution of the pubic hair. About 5 out of every 10 women with PCOS have hirsutism. Hirsutism is due to the high level of circulating male hormones (androgens) seen in women with PCOS.
Acne is a common finding in women with PCOS. It is also due to the excessive levels of circulating male hormones (androgens) in their body.
A certain percentage of women with PCOS also have alopecia (hair loss), which is also a result of the high level of circulating male hormones (androgens) in them.
This is usually in the form of reduced menstruation (oligomenorrhea) or absent menstruation (amenorrhoea). The normal menstrual cycle in the majority of women occurs once every month (28 days cycle length). But when a woman menstruates once every 3 months or more, it is referred to as oligomenorrhoea and when a woman does not menstruate at all, it is amenorrhoea.
PCOS is most commonly associated with secondary amenorrhoea whereby menstruation ceases in a woman who was once menstruating. However, primary amenorrhoea can be seen in adolescents with early-onset PCOS whereby an adolescent develops PCOS even before menstruation starts. In most cases of secondary amenorrhea, the menstrual cycle first transitions to oligomenorrhea and then progresses to complete cessation (amenorrhea).
Infertility in PCOS can either be primary infertility where a woman has never been pregnant before or secondary infertility where a woman who has been pregnant before now finds it difficult to get pregnant again. PCOS is the most common cause of anovulatory infertility. Problems with ovulation and elevated androgen levels occur in the majority of women with PCOS. Approximately 90-95% of anovulatory women seeking treatment for infertility have PCOS. Women may learn they have PCOS only after seeking infertility treatment.
What this means is that a woman with PCOS does not ovulate regularly. The menstrual cycle in a woman with PCOS is thus referred to as an anovulatory cycle. When there is no ovulation, there will be no release of the egg for the sperm to fertilize to form a baby. This is why women with PCOS commonly have infertility.
Obesity is a common finding in women with PCOS and between 40–80% of women with this condition are reported to be overweight or obese. In the United States, some studies report that the prevalence of overweight and obesity in women with PCOS is as high as 80%.
Obesity is a recognized feature of PCOS and obesity has also been shown to be associated with an increased risk of all the other symptoms highlighted above.
Insulin resistance is a common finding in PCOS that is independent of obesity. This defect is independent of but substantially worsened by obesity. This is also referred to as impaired glucose tolerance, which means that the individual has problems with the metabolism of glucose in the body as seen in persons who have diabetes. Obesity, insulin resistance, and excessive male hormone levels, all of which are commonly seen in women with PCOS, are also factors that increase the risk of cardiovascular disease and diabetes mellitus.
This simply means that there are multiple cysts in the ovary. This can either be an incidental finding when an ultrasound scan is done for another purpose or when a woman is being evaluated for any of the above symptoms. However, greater than 12 cysts measuring 2-9mm need to be present to diagnose PCOS.
The takeaway is that the above signs and symptoms of PCOS are not specific to PCOS and can be found in other conditions, therefore it is pertinent to visit your doctor for proper evaluation and management.