Each month, your period adapts and responds to your body as though it were moving through a checklist. When everything runs smoothly, it’s right on time — but things are hardly ever that easy. Unless you’re someone who diligently tracks their cycle, it’s easy to convince yourself that what should be regarded as a red flag is just you having an “off” month. In fact, a lot of women misread the signs of PCOS because they assume the painful symptoms they’re experiencing are “normal” and that they’ll eventually come to pass. Truth be told, though, anything out of the ordinary for your body is usually worth looking into.
For anyone who might be unfamiliar with the abbreviation, PCOS stands for Polycystic Ovary Syndrome. It’s a hormonal disorder, though the exact cause of PCOS is still unknown. On average, PCOS affects about 10 million people all over the world, according to the PCOS Awareness Association. Those who experience PCOS typically have high levels of androgen (male) hormones, are resistant to the effects of insulin (a hormone involved in regulating blood sugar), and/or an imbalance of progesterone (a steroid hormone that acts on the inner lining of the uterus).
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Similar to each woman’s menstrual cycle, there’s no one-size-fits-all diagnosis for PCOS. Common symptoms range from irregular periods to bouts of depression and even infertility, but because the disorder is extremely difficult to diagnose, it’s estimated that 75 percent of individuals who visit their doctor leave the office mistakenly undiagnosed, according to a 2018 study published in the International Journal of Environmental Research and Public Health.
According to Kate Davies, RN BSc(Hons), FP Cert, a fertility nurse consultant, advisor to the OvuSense Fertility Monitor, and founder of Your Fertility Journey, on average, it can take up to 13 years to receive a definitive diagnosis of PCOS. The reason, she tells DoctorOz.com, is partially because teens and women in their early 20s often use hormonal contraception that masks the symptoms of PCOS. As a result, they may only start to notice symptoms when they stop using said birth control and start trying to conceive.
Another reason someone with PCOS might not know of their condition is because either they a) don’t know the tell-tale signs to look out for or b) have overlooked these signs, chalked them up to be something else, and/or have just been putting up with them. This is unfortunate and problematic, as there is no known cure for PCOS. In other words, once diagnosed, it’s a condition you’ll need to manage for life.
There are also some additional health risks that come with a PCOS diagnosis. According to Davies, “Women with PCOS have a higher incidence of developing diabetes and gestational diabetes (diabetes during pregnancy) and also heart disease. Therefore, taking back control and getting the right advice and support can make a huge difference to a woman's health in the future. The best thing you can do for your health is to familiarize yourself with the most common symptoms and speak with your doctor as soon as you notice them. Here are seven of the most common signs of PCOS.
Irregular Periods and Infertility
Davies notes that the most common sign of PCOS is irregular, lengthy, and/or absent periods. “90 percent of women with irregular periods will have PCOS as this is the most common reason,” she says. “However this may also occur with other conditions including thyroid disorders such as Hashimoto’s or hypothalamic amenorrhoea,” which is why the symptoms can often be overlooked.
Per the U.S. Department of Health & Human Services’ Office of Women’s Health, acne on the face, chest, and back is also a commonly overlooked sign of PCOS. “Hard and painful lumps under the skin to more prominent white heads” may surface in response to elevated testosterone levels, but a general hormonal imbalance can also be a factor, Davies says.
According to a 2012 study published in the Journal of Reproduction & Infertility, 36 percent of women with PCOS suffer from high levels of stress and 15 percent from extremely high levels of stress. But despite symptoms of depression and stress being a common complaint among those with PCOS, they are often overlooked and, therefore, untreated, Davies says.
“It has also been documented that the longer it takes to receive a diagnosis of PCOS, the more likely women are to be depressed or anxious,” Davies explains. It is both a physical and mental strain that can take a toll on your sleep quality, appetite, self esteem and worth, as well as your social/professional relationships.
Excessive Body Hair Growth
Per the American Society of Reproductive Medicine’s booklet on the relationship between PCOS and hirsutism (aka the excessive growth of facial and body hair on women), PCOS can be one cause of hirsutism. Hair growth is a direct response of high androgen (male hormone) levels in women, and, conversely, can also cause thinning of hair on the scalp, Davies adds. However, because hair growth can be a reflection of genetics or ethnic predisposition, medications, and menopause, this sign can be overlooked as well.
Those with PCOS may also have a sleep disorder known as sleep apnea. However, because our society does not prioritize a good night’s rest, many people just assume it’s perfectly normal to function on less than is actually necessary, Davies explains.
“Our minds and bodies need to be well rested to allow it to repair, recuperate, and ready itself for the upcoming day,” she tells DoctorOz.com. “Eight hours of uninterrupted quality sleep helps you to adequately managing stress, strengthening the immune system, improving your mood, as well as balancing hormones that help in controlling your PCOS.”
Davies tells DoctorOz.com that nearly 70 percent of people with PCOS have what is referred to as “insulin resistance,” when the cells in the body resist the effects of insulin, which is to regulate blood sugar levels.
At this time, Davies adds, there is not enough scientific evidence to definitively say how insulin directly affects a woman’s ability to conceive. However, some research suggests that the insulin receptor cells in the womb lining of someone with PCOS could be impaired, therefore causing lower pregnancy implantation rates. This would also mean that insulin levels could have a direct correlation with pregnancy success during IVF. Again, more research needs to be done on the subject.
Obesity and PCOS are linked in some people. Additionally, they may each lead to the other. Some people develop PCOS after they have gained weight. In others, the hormone imbalance in people with PCOS may cause fat distribution in the body to be shifted.