Polycystic ovary syndrome, commonly known as PCOS, is a common hormonal and metabolic condition that can affect menstrual periods, ovulation, fertility, skin, hair, and long-term health.
PCOS can affect people differently. Some may mainly experience irregular periods, while others may notice acne, excessive facial or body hair, hair thinning, difficulty becoming pregnant, or metabolic changes. Therefore, symptoms should not be ignored simply because they seem unrelated.
Importantly, having PCOS does not mean that a person will experience every symptom. With proper medical evaluation and an individualised treatment plan, many symptoms and long-term health risks can be managed.
What Is PCOS?
PCOS is a hormonal condition associated with abnormal hormone signalling and, in many cases, higher-than-normal levels or effects of androgens. These hormonal changes can interfere with normal ovulation and menstrual cycles.
As a result, a person with PCOS may have irregular or absent periods and may experience symptoms such as acne, excess facial or body hair, or difficulty becoming pregnant.
Despite its name, not everyone with PCOS has ovarian cysts, and having ovarian cysts alone does not necessarily mean that a person has PCOS. Therefore, PCOS should be diagnosed through a proper medical evaluation rather than an ultrasound alone.
How Common Is PCOS?
PCOS is one of the most common hormonal disorders affecting people during their reproductive years.
The World Health Organization estimates that PCOS affects approximately 10% to 13% of reproductive-aged women globally. However, many people remain undiagnosed, partly because symptoms can vary considerably from person to person.
What Are the Common Symptoms of PCOS?
PCOS symptoms can vary in type and severity.
Common symptoms may include:
- Irregular periods
- Infrequent periods
- Absent periods
- Heavy or prolonged periods in some people
- Difficulty becoming pregnant
- Excess facial or body hair
- Acne or oily skin
- Hair thinning or female-pattern hair loss
- Weight gain, particularly around the abdomen
- Difficulty managing weight
- Dark, thickened patches of skin in some people
Some people may have only a few symptoms. Therefore, the absence of one symptom does not rule out PCOS.
Can PCOS Cause Irregular Periods?
Yes. Irregular periods are one of the common features of PCOS.
Hormonal changes associated with PCOS can interfere with normal ovulation. Consequently, periods may occur infrequently, unpredictably, or may be absent for long periods.
However, irregular periods can also occur due to pregnancy, thyroid disorders, stress, significant weight changes, excessive exercise, and other health conditions. Therefore, persistent menstrual irregularities should be medically evaluated rather than assumed to be caused by PCOS.
Can PCOS Cause Excess Facial or Body Hair?
Yes. Some people with PCOS develop excessive or coarse hair growth, known as hirsutism.
This may occur because of increased androgen activity. Hair growth may become more noticeable on the:
- Face
- Chin
- Upper lip
- Chest
- Abdomen
- Back
- Upper thighs
The amount and pattern of hair growth can vary significantly between individuals. Medical treatments and cosmetic hair-removal methods may help manage this symptom.
Can PCOS Cause Acne and Oily Skin?
Yes. Hormonal changes associated with PCOS can contribute to acne and increased oil production in the skin.
Acne may occur on the:
- Face
- Jawline
- Chest
- Back
Persistent acne can have several causes. Therefore, ongoing or severe acne, especially when combined with irregular periods or excess hair growth, may warrant medical evaluation.
Can PCOS Cause Hair Loss?
Yes. Some people with PCOS may experience thinning of the hair on the scalp or female-pattern hair loss.
This can be related to androgen activity. However, hair loss has many possible causes, including nutritional deficiencies, thyroid disorders, stress, certain medicines, and other medical conditions.
Therefore, persistent or noticeable hair loss should be properly assessed.
Can PCOS Make It Difficult to Get Pregnant?
PCOS can make pregnancy more difficult for some people because ovulation may not occur regularly.
When ovulation is irregular, predicting fertile days can become difficult. However, having PCOS does not mean that pregnancy is impossible.
Treatment may include lifestyle support, medicines to help stimulate ovulation, and fertility treatments when appropriate. The most suitable approach depends on the person’s symptoms, age, overall health, and pregnancy goals.
What Causes PCOS?
The exact cause of PCOS is not fully understood.
Researchers believe that several factors may work together. These may include:
- Hormonal imbalances
- Increased androgen activity
- Insulin resistance
- Genetic or family factors
- Metabolic factors
PCOS can run in families, and a family history of PCOS or type 2 diabetes may increase the likelihood of developing the condition. However, having a family history does not guarantee that someone will develop PCOS.
What Is the Role of Insulin Resistance in PCOS?
Insulin is a hormone that helps the body regulate blood sugar.
In insulin resistance, the body’s cells do not respond normally to insulin. As a result, the body may produce more insulin to compensate.
Higher insulin levels can influence hormone activity and may contribute to increased androgen levels and problems with ovulation in some people with PCOS.
PCOS is also associated with a higher risk of insulin resistance and type 2 diabetes. Therefore, doctors may recommend metabolic screening as part of ongoing care.
