Polycystic ovary syndrome (PCOS) is a hormonal condition that causes enlarged ovaries and the presence of small growths. People with PCOS have higher levels of androgens—hormones that are usually responsible for male sex features.

These elevated hormone levels can cause a variety of symptoms, including irregular periods, increased body hair, skin changes, and weight gain. Some individuals may have only one symptom, several symptoms, or all of them. In certain cases, there may be no noticeable symptoms, which makes PCOS more difficult to diagnose.

It’s not always clear when someone has PCOS. Many people only discover the condition when they experience fertility issues, weight concerns, or skin problems. While PCOS often develops in the 20s or 30s, it can also appear during teenage years.

Antral Follicles On The Ovaries

The term “polycystic ovary syndrome” can be misleading. PCOS does not actually cause ovarian cysts. Instead, it leads to tiny growths called antral follicles. These follicles are small and often undetectable, but when they grow, they may range from 2 to 10 millimeters.

As you age, the natural number of antral follicles decreases. Having a higher count of these follicles may indicate PCOS. These growths cannot be detected by feeling or appearance and require an ultrasound for confirmation.

Menstrual Changes

One of the hallmark symptoms of PCOS is a change in menstrual cycles. This happens when the ovaries do not release eggs regularly. Without ovulation, the uterine lining can become thicker and shed irregularly, causing unpredictable changes in periods.

Menstrual changes may include:

  • Unpredictable cycles

  • More frequent periods

  • Missed periods (amenorrhea)

  • Very heavy or very light flow

Hair Changes

PCOS can affect hair growth patterns on the body, leading to either excess hair or hair loss.

Excess hair growth (hirsutism): Thick, coarse, dark hair may appear on areas such as the chest, face, stomach, or around the nipples. This affects about 70% of people with PCOS.

Hair loss: High androgen levels can also cause thinning hair or male-pattern baldness. While shedding hair is normal, bald patches, receding hairlines, or significant hair thinning can be signs of PCOS.

Weight Gain

Unexplained weight gain is another common sign. If you gain more than 10 pounds within a few months without changes in lifestyle, PCOS could be the reason. Nearly half of individuals with PCOS have obesity.

Difficulty losing weight despite healthy habits is also common. Keeping track of eating and exercise patterns and discussing them with a healthcare provider may help in managing weight.

Insulin Resistance

Many people with PCOS experience insulin resistance. Insulin is produced in the pancreas and allows cells in the muscles, fat, and liver to absorb glucose from the blood for energy. In insulin resistance, the cells do not respond properly, causing blood sugar to rise. This often contributes to obesity and increases the risk of diabetes.

Skin Changes

PCOS may also cause noticeable changes in the skin.

Acne: High androgen levels can trigger persistent, painful, or treatment-resistant acne. Breakouts often occur on the face, chest, or back and may appear later in life.

Acanthosis nigricans: This condition causes dark, thick patches or tags of skin. It is usually linked to insulin resistance and often appears in body folds such as the armpits, groin, neck, or under the breasts.

Infertility

PCOS is one of the leading causes of infertility. Around 60% of people with PCOS experience difficulties conceiving. The imbalance of sex hormones affects ovulation, making it irregular or absent. This prevents eggs from maturing properly, increasing the risk of miscarriage as well.

Symptoms In Adolescents

PCOS can also appear in teenagers, with 6% to 18% of adolescents showing symptoms. These include acne, irregular periods, ovarian cysts, and hirsutism.

However, diagnosing PCOS in teens is challenging because irregular cycles are often normal during the first years of menstruation. Research continues to explore how PCOS presents in younger individuals.

When To See A Healthcare Provider

If you notice symptoms of PCOS or suspect you may be at risk, it’s best to consult a healthcare provider early. They can begin the diagnostic process and rule out other conditions.

Early medical attention is important because PCOS increases the risk of complications such as endometrial cancer, diabetes, infertility, and obesity-related health problems.

A Quick Review

PCOS is a hormonal disorder marked by high androgen levels. Symptoms include menstrual irregularities, excess hair growth or hair loss, weight gain, insulin resistance, skin changes, and infertility. The condition commonly affects adults assigned female at birth but can also appear in adolescents.