Polycystic Ovary Syndrome Symptoms
Part of the problem when it comes to diagnosing PCOS is that many of the most common symptoms of the disorder do not seem to be related to one another, at least initially. In addition to menstrual problems, women with PCOS may suffer from acne, excessive hair growth, loss of hair, infertility, and weight gain. Of course, every woman is different; while one woman with PCOS may experience all of these symptoms, another may experience just acne and irregular periods. Getting a better understanding of just what the symptoms of PCOS may be will help you recognize whether you yourself suffer from it. Also check out our overview of PCOS.
PCOS often comes to light during puberty due to period problems, which affects around 75% of those with the disease. Infrequent, irregular or absent periods are all common variations, many finding their periods particularly heavy when they do arrive. The period disturbance is a sign that there is a problem with regular monthly ovulation. So just why do your periods go out of whack when you suffer from PCOS? The main culprit is hormonal imbalance.
In women without polycystic ovarian syndrome, the ovaries begin to develop 20 eggs every month. These eggs mature in little sacs known as cysts. Over the course of the month, one egg will become dominant and draw most of the hormones being produced, eventually being released by the ovary to be fertilized or shed with your period. Women with PCOS, though, fail to produce the correct balance of estrogen necessary to help one egg become dominant. As a result, the 20 eggs develop but remain as cysts, which in turn results in the production of androgens, or male hormones, and little to no production of progesterone.
Because of the build up of androgens and lack of progesterone, women with PCOS may have irregular periods, fail to ovulate (anovulation), or fail to have a period (amenorrhea) entirely. When a period does occur, many women with PCOS note that their bleeding can be quite heavy. Those women dealing with irregular or heavy periods due to PCOS can use the birth control pill to help regulate their menstrual cycle.
Many teenagers use the contraceptive pill to control their periods as irregularity or heaviness is a common complaint at this time, even in the absence of PCOS. This often leads to a delay in the diagnosis of PCOS, many not presenting until the birth control pill is stopped and finding periods cease or become irregular.
Given that period disruption with PCOS is due to irregular or absent ovulation, it is not surprising that it is a common cause of infertility. It is not usually 100% absolute, and some women with PCOS will ovulate normally, some will ovulate less frequently (leading to a delay to pregnancy) and some will not ovulate at all, meaning that for some infertility treatment, likely fertility drugs such as Clomid, will definitely be necessary.
Women who have already been diagnosed with PCOS may not be too surprised by their fertility problems. However, a number of women may not even realize that they have PCOS until they start trying to conceive. While 75% of women with PCOS do have menstrual problems, 25% do not. In these women, perhaps they have always had regular periods but never realized that they were not ovulating. Others may have had the occasional irregular period, but felt that it was nothing to be too concerned about, assuming a skipped period was due to stress or some other factor. Regardless of the reason, some women will only learn of their PCOS condition when they are investigated for infertility problems.
Changes in Hair Growth
It is not unusual for women with polycystic ovary syndrome to complain of excess hair growth on their face and body or to experience the exact opposite problem: a loss of hair. In either instance, the reason for the change in hair growth is, yet again, too much androgen hormones.
Androgens are a group of hormones, such as testosterone, found at high levels in men but present in women at much lower levels. PCOS sufferers, though, often have higher than normal levels of androgens. These excess hormones can cause a disorder known as hirsutism. Women with hirsutism typically have thicker and darker hair growing on their face and body. The areas most commonly affected are the mustache and beard, though the extra hair growth may also be noticed on the chest, back, stomach, arms, legs, and pubic region. While not all women with PCOS will have hirsutism, a whopping 95% of those women with hirsutism will have PCOS.
Thinning of the hair can also occur in women with PCOS and some may experience male-pattern baldness. This type of hair loss is known as "androgenic alopecia." Although alopecia is a disorder that results in complete hair loss, the type of alopecia that affects PCOS sufferers is caused by an increase in androgen levels and may be controlled through the use medications to even out hormone levels.
High androgen levels are also the reason why various skin conditions can develop in women with PCOS. Perhaps the most common are acne, which usually develops on the face, particularly along the jaw line, and on the chest and back, and oily skin. The hormone dihydrotestosterone, or DHT, is thought to be responsible, as it tends to stimulate the oil glands, resulting in a greater production of oil, which can clog the pores and cause acne.
Other skin problems noted by PCOS sufferers are skin tags and darkening of the skin. Skin tags are often located around the armpit area, along the bra line or on the neck. These thick lumps of skin can be removed quite easily, though, by a dermatologist. If you notice the skin around your neck, underarms, groin or skin folds getting darker and thicker, you may have Acanthosis Nigricans. This darkening is a symptom of insulin resistance, which is thought to be one of the main causes of PCOS nowadays.
This is a double-edged sword for women with PCOS, around 40% of sufferers being overweight. Obesity itself will initiate the symptoms described above in some women who would not have otherwise suffered had they remained of normal weight. It will worsen the symptoms for those who do have PCOS and, unfortunately, the hormone changes associated with PCOS make weight loss more difficult. But is this excess weight gain due to androgens or insulin resistance?
It is somewhat difficult to say just what causes the obesity. High androgen levels can make it difficult to lose weight as can insulin resistance. And while insulin resistance contributes to obesity by promoting fat storage, obesity itself contributes to insulin resistance, which in turn exacerbates PCOS symptoms.
Also find out how vitamin D can affect PCOS.
If you recognize two or more of these symptoms in yourself, make an appointment with your health care provider to investigate whether you may have PCOS. While a cure for PCOS has yet to be found, effective treatment for these symptoms is available.
Also check out are articles on the mental effect of PCOS, especially the effect of PCOS on teen girls.