How do I know if I have PCOS?

If you suspect that you may have PCOS it is important that you see a health professional such as your general practitioner. You may be referred to a specialist such as an endocrinologist or gynaecologist for more detailed assessments. An early diagnosis can not only help women manage the side effects of PCOS but also reduces the potential long-term health risks that are seen in women with PCOS.

Symptoms may present in many different ways - some women have uncomfortable and sometimes, quite distressing symptoms, whilst others have quite mild symptoms. Not everyone with PCOS will have all the symptoms and very few women will have the same set of symptoms. Symptoms may be present from puberty but might also begin later in life. Symptoms can also change and become more mild or severe or disappear and reappear.

Symptoms can include:

• Periods that are irregular, infrequent or heavy
• Excess facial or body hair
• Acne on both the face and the body
• Hair loss
• Difficulty in becoming pregnant

Other symptoms can include:

• Depression, low self esteem, mood changes, anxiety
• Sleep apnoea

Symptoms of PCOS

Period problems

The average menstrual cycle is 28 days long with one ovulation, but anywhere between 21 and 35 days is considered normal. Due to high levels of androgens (male hormones) and insulin, the monthly cycle of ovulation and menstruation is often disrupted in women with PCOS. Although some women with PCOS will still have regular periods, most will experience some changes to their cycle. The periods may be irregular (cycles defined as eight or less menstrual cycles per year or menstrual cycles longer than 35 days) or may stop altogether. As menstrual cycles lengthen, ovulation may stop entirely or only occur occasionally. Some women with PCOS may also experience heavier or lighter bleeding during their menstrual cycle.

Excess hair (hirsutism)

Hirsutism is an excess of hair on the face and body due to the high levels of androgens stimulating the hair follicles. This excess hair is thicker, darker hairs rather than the pale thin hairs you commonly see on your face and arms. The hair typically grows in areas where it is more usual for men to grow hair such as the sideburn area, chin, upper lip, around nipples, lower abdomen, chest and thighs. Up to 60 per cent of women with PCOS have hirsutism. Women with PCOS from ethnic groups prone to darker body hair (e.g. Sri Lankan, Indian and Mediterranean populations) often find that they are more severely affected by hirsutism.

Acne

In women with PCOS, an increase in male hormones or androgens may increase the size of the oil production glands on the skin which can lead to increased acne. Acne is common in adolescence, but young women with PCOS tend to have more severe acne.

Hair loss (alopecia)

Due to high androgen levels, some women may experience hair loss or thinning of scalp hair in a ‘male-like' pattern (receding frontal hair line and thinning on the top of the scalp rather than the sides).

Reduced fertility or infertility

Not all women with PCOS will have fertility problems. High levels of androgens (male hormones) and high insulin levels can affect the menstrual cycle and prevent ovulation (the release of a mature egg from the ovary). Ovulation can stop completely or it can occur irregularly. This can make it more difficult for women with PCOS to conceive naturally, and some women may also have a greater risk of miscarriage. However, this does not mean that all women with PCOS are infertile. Many women with PCOS have children naturally without any extra medical infertility treatment. Other women with PCOS can fall pregnant and have children with medical assistance. As being overweight exacerbates infertility in PCOS, one of the most important approaches to improve fertility is to prevent weight gain, exercise regularly and lose weight if overweight.

Other symptoms

Psychological effects

Self-esteem and a sense of one's body image may be affected by the symptoms of excess hair, acne, hair loss, obesity and fertility problems. Other psychological reactions may occur relating to issues of femaleness, sexuality and femininity and can contribute to mood changes and social isolation and can lead to depression. Being diagnosed with a medical condition can also be challenging and distressing and affect quality of life. If you are suffering from the emotional effects of PCOS, it is important to seek advice from your GP, counsellor or a psychologist.

It is very important to address these issues as psychological problems can make it very difficult to motivate yourself to change to a healthy lifestyle and look after yourself better.

Sleep apnoea

Women with PCOS, particularly when they are overweight or insulin resistant, can be at an increased risk of developing sleep-disordered breathing or sleep apnoea. Sleep apnoea occurs when the upper airway is obstructed during sleep - This can be due to pressure from excessive fatty tissue in the neck partially blocking the airway. This can lead to sleep loss, fatigue, tiredness and reduced quality of daily life.

Diagnosis & Management

If you suspect you may have PCOS, you will need to visit your GP or one of our Women's Health GPs and undertake the appropriate investigations to confirm this diagnosis. If you do not have a GP, or wish to see one of our Women's Health GPs to diagnose your PCOS, you can contact our Medical Centre on 03 9562 7555 to make an appointment.

After Diagnosis

If you have received a diagnosis of PCOS, the Jean Hailes Foundation can assist you with management through the PCOS Service. Click here for more information on the PCOS Service.

Further resources

Fact sheets

 PCOS and Emotional Health 105.50 Kb

 PCOS and Physical Health 99.14 Kb

 PCOS Management 115.24 Kb

Content updated 25 August 2011