Polycystic Ovary Syndrome (PCOS) is a complex, yet common, condition that affects hormone levels and can present a number of unpleasant symptoms.

Frustratingly, symptoms of PCOS aren’t always easy to spot and are regularly missed. In fact, one study which looked into PCOS diagnostic criteria found that nearly 70% of people with PCOS hadn’t been diagnosed, which is exceptionally concerning, as symptoms of PCOS have been linked to triggering depression, and complications of PCOS can include infertility and Type 2 diabetes.

So, what actually are the signs and symptoms of PCOS? And when should you see a doctor? We’ll explain…

What are the symptoms of PCOS?

Signs and symptoms of PCOS vary from person to person. So, whilst one individual could experience a number of PCOS symptoms, another might have only one or two subtle signs.

Often, symptoms of PCOS become apparent during late teenage and early 20s years, according to the NHS. Though, sometimes it’s not until a person tries to conceive (and experiences difficulties) that a PCOS diagnosis is made.

Symptoms of PCOS include:

• Irregular periods or no periods at all

• Hirsutism (excessive hair growth, often on the face, chest or back)

• Weight gain

• Thinning head hair or male pattern baldness

• Acne

• Difficulty conceiving

• Depression, anxiety or mood swings

• Dark patches of skin or skin tags on the neck, groin and under the breasts

What causes PCOS?

Annoyingly, the cause of PCOS remains unknown. However, it’s thought that genetics are likely to be a big influencing factor in whether or not you’re likely to have PCOS, and that lifestyle factors and environment could play a role too (though, it’s important to note that nobody “causes” PCOS).

Experts believe that an imbalance of hormones – raised levels of “male” hormones (like testosterone, for instance) – could have something to do with the cause of PCOS, and that along with genetics, insulin resistance and inflammation could be linked to excess production of those hormones (known as androgens).

According to research, insulin resistance is present in up to 70% of people with PCOS.

Insulin is a hormone that is produced by the pancreas to help transport glucose from food into the body’s cells where it can be used for energy. When you are insulin resistant, and your body can’t utilise insulin properly, it produces more insulin to compensate. This, in turn, could trigger a rise in testosterone levels, which can impede the development of follicles in the ovaries and affect ovulation.

The takeaway? If you have PCOS, the cause is effectively impossible to pin down, but know that it’s not through any fault of your own.

When to see a doctor if you have symptoms of PCOS

If you are experiencing any symptoms of PCOS, it’s best to get checked out by a doctor, particularly if your menstrual cycle is irregular, you’re struggling to get pregnant or you have symptoms of diabetes (which include excess thirst, extreme fatigue and unexplained weight loss).

Untreated PCOS can lead to more serious health conditions, such as type 2 diabetes, depression, sleep apnea, cardiovascular disease and infertility, so it’s always a good idea to raise any concerns you have with your GP.

How to get a PCOS diagnosis

After presenting your symptoms of PCOS to your GP, they will likely check your blood pressure and arrange tests to ascertain your hormone levels. Sometimes, they will refer you for an ultrasound scan to check for polycystic ovaries.

Often, a PCOS diagnosis can be made if other potential causes of your symptoms can be ruled out and you meet at least 2/3 of the following:

• You have irregular, infrequent or no periods (and are not pregnant)

• You have raised levels of “male” hormones

• A scan reveals you have polycystic ovaries (though, you don’t always need to have an ultrasound scan to get a PCOS diagnosis, and not everyone with PCOS has polycystic ovaries)