PCOS Signs and Symptoms

As an integrative physician, I’ve spent the last decade working with thousands of women. One of the more common things my patients come in about is polycystic ovarian syndrome (PCOS). 

You may have heard of PCOS before. It’s a hormonal disorder that can cause pain, heavy periods, and often infertility. About one in 10 women has PCOS. 

While there’s no cure for PCOS, there’s a lot you can do to manage its symptoms. First, though, you need to know whether you have PCOS or not. 

This article will cover the signs and symptoms of PCOS, and what to do if you think you may have it. 

What is PCOS?

Polycystic ovarian syndrome is a hormonal disorder that results from an imbalance in estrogen and progesterone, the two main female sex hormones, and elevated testosterone, the main male sex hormone.

During a normal cycle, your ovaries develop little fluid-filled sacs (called follicles) that house a growing egg. When ovulation starts, the follicles break open, releasing the mature egg that’s ready for fertilization. 

Ovulation is controlled by estrogen and progesterone. With PCOS, estrogen and progesterone levels are off, and high testosterone stops the egg from breaking the follicle and descending for ovulation.

As a result, PCOS stops ovulation, causing irregular (or nonexistent) periods and potential infertility issues. Multiple follicles can develop at the same time and cause enlarged ovaries, which can be very painful. 

What causes PCOS?

Researchers still aren’t sure what causes PCOS. However, a few different things seem to influence your chances of developing it. 

  • Genetics play a role in PCOS. You don’t directly inherit PCOS, but you’re more likely to get it if your mother or sisters have it[*]. So while genetics don’t directly cause PCOS, certain inherited gene mutations may increase your risk for developing it. 
  • Excess insulin also contributes to PCOS. Insulin regulates your blood sugar, and if your blood sugar is constantly high (from a high-sugar diet, for example), your insulin response will begin to desensitize. You’ll begin to release too much insulin, which can increase your testosterone production and trigger PCOS.
  • Inflammation can also contribute to PCOS. Chronic, low-grade inflammation can cause your ovaries to produce more testosterone, triggering PCOS. 
  • Obesity is also a risk factor for PCOS, and being overweight often makes PCOS symptoms worse. 

PCOS symptoms

There are a few telltale symptoms of PCOS:

  • Irregular or absent periods. PCOS interferes with ovulation, which can shift your cycle or stop it entirely. 
  • Weight gain. Imbalanced sex hormones affect your metabolism, causing sudden and stubborn weight gain. 
  • Facial hair. Increased testosterone and other male sex hormones can cause women with PCOS to develop facial hair. 
  • Hair loss. Higher male sex hormones can also cause you to lose hair from your head. 
  • Acne. Imbalanced sex hormones can cause inflammatory acne. Cystic acne is especially common in women with PCOS. 
  • Infertility. PCOS makes it difficult to conceive because your ovaries don’t release eggs for ovulation. 

Can you get pregnant with PCOS?

It depends. Some women can still conceive with PCOS, and your odds increase if you can successfully manage your PCOS symptoms. However, even after conception, the risk of miscarriage is higher in women with PCOS. 

If you have PCOS and want to conceive, I suggest you work closely with an integrative physician to improve your odds of fertility. There are several lifestyle changes you can make to relieve PCOS symptoms. 

What to do if you think you have PCOS

If you think you have PCOS, the first thing to do is get your hormones tested. If your hormones are out of balance, your doctor may order an ultrasound of your ovaries to look for cysts. 

While there’s no cure for PCOS, there are a lot of ways to manage symptoms:

  • Balance your hormones. Your doctor may prescribe low-dose, bioidentical hormones to restore balance to your system. You can also balance your hormones naturally with diet and lifestyle changes. 
  • Cut sugar. Sugar interferes with your sex hormone production and drives up insulin, which can make PCOS symptoms develop faster and become more severe. Cut sugar and refined carbs out of your diet to relieve PCOS symptoms. 

Most importantly, don’t give up hope! While PCOS can be painful and frustrating, the symptoms are very manageable. Work with an integrative physician or functional medicine doctor to fix the root causes of PCOS and relieve symptoms like pain, facial hair growth, hair loss, and weight gain. With the help of a good physician and a few diet and lifestyle changes, you may be surprised by how little PCOS affects your day-to-day life.