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PCOS Symptoms

In most cases, PCOS symptoms will start during puberty. Some women will have periods for a while before developing symptoms. Typically, the symptoms show up more severely in women with obesity.

Symptoms vary from person to person, though most will have at least two of these:

  • Irregular Periods
    • Most women with PCOS have menstrual cycles that are further than a month apart or do not have periods at all.
  • High Levels of Androgen
    • Women with PCOS often have high levels of androgen in their bodies. This hormone can cause excess facial and body hair as well as male-pattern baldness.
  • Polycystic Ovaries
    • Women with PCOS might have enlarged ovaries. Follicles containing immature eggs may develop around the edge of your ovaries, causing them to not function properly.

What is PCOS?

PCOS is a set of symptoms surrounding the androgen hormonal imbalance in women and girls. Small sacs of fluid develop along the outer edge of the ovaries. These sacs, or cysts, are filled with follicles also known as immature eggs.

While doctors don’t know exactly what causes PCOS, many factors play a role in the condition.

  • Insulin Resistance
    • The pancreas makes a hormone called insulin. It helps cells properly use your body’s main energy supply: sugar. If your cells become resistant to insulin, the level of sugar in your blood goes up. It can cause your body to make more insulin to bring down the levels of blood sugar. Too much insulin can cause your body to make the hormone androgen which can interfere with ovulation. A woman with insulin resistance might have dark velvety patches on the skin of her neck, armpits, groin, and breasts. A larger appetite and weight gain are also more common.
  • Low-Grade Inflammation
    • In response to infection and injury, white blood cells cause low-grade inflammation. If you have long-term inflammation, it can make polycystic ovaries produce androgens, causing heart and blood vessel problems.
  • Family History
    • Genetics might also be a factor in the cause of PCOS. A family history of the condition plays a role in whether or not you might develop it.
  • Excess Androgen
    • With PCOS, ovaries are more likely to produce higher levels of Androgen. Too much of this hormone causes ovulation problems. The eggs don’t develop properly or regularly and aren’t released from their follicles. It also causes excess hair and acne.

Complications that might occur with PCOS include:

  • Infertility
  • Gestational diabetes or preeclampsia
  • Miscarriage or premature birth
  • Nonalcoholic steatohepatitis: Fat growth in the liver causing severe inflammation
  • Metabolic syndrome: A grouping of conditions including high blood pressure, high blood sugar, and unhealthy cholesterol or triglyceride levels. These conditions heighten your risk of cardiovascular disease
  • Type 2 diabetes or prediabetes
  • Sleep apnea
  • Mood and eating disorders
  • Cancer of the uterine lining

PCOS Treatment

PCOS treatment is mostly managing the symptoms that concern you. The problems with fertility, hair growth, acne, and obesity can be treated with lifestyle changes and medication.

Lifestyle Changes

Lifestyle changes can help improve the effectiveness of treatments for PCOS. If needed, your doctor will help you devise a weight loss plan with diet changes and moderate exercise. Even a small reduction in your body weight has the potential to improve your condition. Losing weight can make your medication more effective and help with infertility.


Medications will help regulate your periods and other symptoms. They might recommend:

  • Birth Control
    • Birth control pills with estrogen and progestin can decrease the production of androgen and better regulate estrogen. Regulating hormones decrease the risk of endometrial cancer and help with irregular bleeding.
  • Progestin Therapy
    • To regulate your periods and protect against endometrial cancer, you can take progestin for 10 to 14 days every 1 to 2 months. The therapy doesn’t affect androgen or prevent pregnancy. If you are looking to prevent pregnancy, a progestin IUD or a mini pill is a good choice.
  • Clomiphene
    • A hormonal modulator that is used at a specific time of your menstrual cycle to promote ovulation.
  • Letrozole
    • A different type of hormonal modulator that can also promote ovulation.  It is also used as a treatment to reduce the risk of breast cancer recurrence.
  • Metformin
    • A medication for diabetes that improves insulin resistance, lowering insulin levels. This medication is sometimes used in conjunction with clomiphene or letrozole if ovulation induction is desired.
  • Gonadotropins
    • Injected hormone medications to help you ovulate.

Talk to your healthcare provider about these options to help you regulate the symptoms of your PCOS.

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