Symptoms of 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 of PCOS of present themselves in assorted forms- some women have uncomfortable and sometimes, quite distressing symptoms, whilst others have quite mild symptoms. Not every woman with PCOS will have all the symptoms and very few women in a group have shown the same exact group of symptoms. Symptoms may be present right from puberty or 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:
The average period of one menstrual cycle (i.e., with one ovulation) is 28 days, but any period between the range of 21 to 35 days is usually considered to be normal menstrual cycle. Due to high and increased levels of androgens (male hormones) and insulin, the regular monthly menstrual cycle of ovulation is often disrupted in women with PCOS. Even though some women diagnosed with PCOS may still have regular menses (periods), most will experience some changes to their menstrual cycle. The periods may be irregular (menstrual cycles with length more than 35 days or counted as eight or lesser menstrual cycles in a year) or may stop altogether. As the length of menstrual cycle increases, ovulation (release of egg from ovaries into fallopian tube) may entirely stop or it only occurs rarely. Some may also experience lighter or heavier bleeding during their periods.
Hirsutism is an excessive hair growth on the face and body of the women, that commonly appears in a male-like pattern caused by the increase in the androgen levels, that stimulate the hair follicles. This abnormal hair growth hair due to hirsutism can be seen to be darker and thicker rather than the thin and pale hairs you commonly see on your face and arms. n this case, the hair characteristically grows in the areas where it is more typically for men, such as the upper lip, chin, sideburn area, chest, lower abdomen and thighs. Around 60 percent of women diagnosed with PCOS are observed to have hirsutism. Women with PCOS hailing from ethnic backgrounds with darker body hair color (e.g. Indian and Mediterranean populations) are often found to be severely affected by hirsutism due to the color of the hair that becomes visible.
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.
Due to high androgen levels, some women may experience thinning or loss of their scalp hair in a ‘male-like’ distribution pattern (disappearing frontal hair line and thinning of hair on the top upper scalp rather than the sides).
Not all women with PCOS will have fertility problems. High level of androgens (male hormones) and high insulin levels can impact 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 become 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.
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.
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.