What are the symptoms and signs of PCOS?

PCOS may present with different symptoms and signs at different stages of a woman’s life.
Common symptoms and signs of PCOS are:5,7,8,9
1. Menstrual irregularities or no periods at all, due to not ovulating
Approximately 85%–90% of women with very light or infrequent periods have PCOS
2. Unwanted hair growth on the upper lip, face, arms, back, chest, thumbs, toes or abdomen (hirsutism), due to an excess of androgens (male hormones)
70% of women with hirsutism have PCOS
3. Thinning hair on the head
Which may be more pronounced in middle age
4. Acne
Also due to an excess of androgens (male hormones)

5. Being overweight or obese
6. Insulin resistance
A complex condition where insulin is not taken up into cells. High insulin levels in the blood stream causes hormonal imbalances which can lead to excess androgens, no ovulation and infertility, and eventually also type 2 diabetes5
7. High blood pressure, high cholesterol
An intolerance to glucose or type 2 diabetes and being overweight are all components of the metabolic syndrome, which may be present in more mature women with PCOS and may place them at risk of coronary heart disease
8. Several cysts
Fluid-filled sacs on the ovaries which are seen with ultra-sound

What causes PCOS?

Why is it important to treat PCOS*?

The exact cause is unknown, but it is considered to be caused by hormonal imbalances. Genetics and environmental factors are believed to also be involved in the development of PCOS.4,7,10

Insulin resistance and the effect it has on androgens (male hormones) and female hormones in the body play a pivotal part in the general signs and symptoms of PCOS and also infertility.10

It is also believed that insulin resistance and being overweight increase harmful free radicals. This increase in harmful free radicals results in a condition known as oxidative stress, in which cells in the body are damaged. This affects embryo quality which in turn affects reproductive ability.4,5

PCOS not only affects your body physically and emotionally, but also has several health risks5,7

Apart from the obvious physical signs of PCOS such as hirsutism (excessive growth of terminal hair in women in a male-like pattern)acne and being overweightinsulin resistance and the other components of metabolic syndrome (high blood pressure, high cholesterol levels, glucose intolerance or type 2 diabetes) may lead to an increased risk of heart disease.5 Women with PCOS also have risk factors for endometrial cancer.5

* Speak to your healthcare professional about treatment options for PCOS

What are the effects of PCOS on reproductive health issues and pregnancy?

Due to the imbalances in hormonal levels caused by PCOS and oxidative stress, women with PCOS often do not ovulate.4,5,8 If a woman does not ovulate, conception cannot take place and she cannot fall pregnant. Oxidative stress can affect the quality of embryos.5

The nature of PCOS may also lead to complications during pregnancy, such as developing high blood pressure during pregnancy (pre-eclampsia) or developing diabetes during pregnancy (gestational diabetes).5

There is a possible two-fold increased risk of having a premature baby, and an increased risk of having a baby that weighs less for its gestational age than it should.5 Spontaneous abortion (miscarriage) tend to occur more frequently in patients with PCOS, with incidences ranging between 42 % and 73 %.8