Symptoms and causes of PCOS

Symptoms and causes of PCOS

Symptoms of PCOS include excess hair (hirsutism), loss of scalp hair, acne, weight gain, difficulties with fertility, increased anxiety and depression, and irregular or infrequent periods. There is also information about the possible causes of PCOS and other health problems related to PCOS.

Up to 21% of women in some groups, eg. Indigenous Australians have PCOS polycystic ovary (ovary) syndrome, which is a hormonal disorder. It affects 12-18% of women of reproductive age and up to 21% in some high-risk groups, such as indigenous women [1].

PCOS can be a complex condition to identify because there are several symptoms and it is not necessary to have all of them to be diagnosed with PCOS. Very few women have the same set of symptoms. The name “polycystic” suggests that you may have multiple “cysts” in your ovaries, but not all women who have PCOS have multiple “cysts” and not all women who have multiple “cysts” have PCOS. The term ‘cysts’ is a bit misleading. Cysts are not really cysts but partially formed follicles that each contain an egg.



What are the signs and symptoms of PCOS?

Many of the symptoms of PCOS are caused by high levels of androgens circulating in your body, causing a “hyperandrogenism”. Androgens are also called ‘male’ hormones, and the main one is testosterone. All women produce small amounts of androgens in body tissues, including the ovaries and adrenal glands. High levels of androgens can prevent ovulation and affect the menstrual cycle.

It is also believed that the hormone insulin is an important part of the development of PCOS. Insulin is needed in the body to control blood sugar, and it is believed that “insulin resistance” is a key part of the development of PCOS. Insulin resistance means that some parts of the body are “resistant” to insulin, which means that more insulin than normal is needed to keep blood sugar in the normal range. This means that insulin levels are often high or that the body does not respond normally to insulin. This in turn can affect the function of the ovaries, including the production of hormones and ovules.

 PCOS symptoms may include:

Periods and fertility Hair and skin Mental and emotional health Sleep

There are no periods or periods that are:




Immature ovarian eggs that do not ovulate.

Multiple cysts in the ovaries.

Difficulty getting pregnant

Excessive facial and / or body hair (hirsutism)

Acne on the face and / or body.

Hair loss of the scalp (alopecia)

Patches of darkened skin (acanthosis nigricans)

Humor changes



Sleep apnea (a sleep disorder in which abnormal pauses of breathing occur during sleep)

The symptoms of PCOS come in many different ways. Some women will only have some or mild symptoms, while others will have severe symptoms.


Although some women with PCOS have regular periods, high levels of androgens and also the hormone insulin can interrupt the monthly cycle of ovulation (when the eggs are released) and menstruation.

If you have PCOS, your periods may be ‘irregular’ or stop altogether. In some girls, PCOS is a cause of periods not starting. The average menstrual cycle is 28 days with an ovulation, but anywhere between 21 and 35 days is considered “normal”. An ‘irregular’ period cycle is defined as:

Eight or less menstrual cycles per year.

Menstrual cycles greater than 35 days.

As menstrual cycles lengthen, ovulation can stop completely or only occasionally. Some women with PCOS also experience more intense or milder bleeding during their cycle.

Excess hair (hirsutism)

Hirsutism is the excess of hair on the face and body due to the high levels of androgens that stimulate the hair follicles. This excess of hair is thicker and darker. Hair usually grows in areas where it is more common for men to do so, such as the sideburns, chin, upper lip, around the nipples, lower abdomen, chest and thighs.

Up to 60% of women with PCOS have hirsutism [2]. Women with PCOS of ethnic groups with a tendency to have darker body hair (for example, the populations of Sri Lanka, India and the Mediterranean) are often more affected by hirsutism.

Hair loss (alopecia)

For some women with PCOS, the high level of androgens causes the loss or thinning of the hair on the scalp in a “male” pattern: a line of frontal hair in retreat and getting thinner on the top of the scalp.


If you have PCOS, the higher level of androgens can increase the size of the oil-producing glands in the skin, which can cause an increase in acne. Acne is common in adolescence, but young women with PCOS also tend to have more severe acne.

Reduced fertility

High androgen levels and high insulin levels can affect the menstrual cycle and prevent ovulation (the release of a mature ovum from the ovary). Ovulation can stop completely, or it can happen irregularly. This may make it harder for women with PCOS to conceive naturally, and some women may also have a disease.

Risk of miscarriage. However, this does not mean that all women with PCOS are sterile.

Many women with PCOS have children without the need for medical treatment for infertility. Others may require medical assistance. But in general, women with PCOS have the same number of children as women without PCOS (Joham, Human Reprod, 2014).

As overweight can increase fertility problems, it is important to exercise regularly to maintain a healthy weight and / or prevent weight gain. For those who are overweight, even 5-10% weight loss will improve fertility.

Psychological effects

Depression and anxiety are common symptoms [3] of PCOS. Approximately 29% of women with PCOS have depression compared to 7% of women in the general population and even more women with PCOS will have anxiety: 57% compared to 18% of women in the general population [ Four. Five].

There may be some link with hormones and PCOS, but more research is needed in this area before we can understand why and how hormones affect mental well-being in PCOS.

Addressing hirsutism, severe acne, weight changes and fertility problems can affect your body image, your self-esteem, your sexuality and your femininity. This can increase depression and anxiety levels. Problems with fertility can have an impact on your mood, especially if fertility has been a concern for a long time.

In addition to all this, a late diagnosis of PCOS and problems with weight control can make you feel discouraged and helpless. This creates a negative cycle, making it harder to take charge of your health and live the healthiest lifestyle you can.

What causes the SOP?

Although the cause of PCOS is unknown, it seems that there are connections to family history, insulin resistance and lifestyle or environment.

Family history

Immediate female relatives (ie, daughters or sisters) of women with PCOS have up to a 50% chance of having PCOS. Type 2 diabetes is also common in the families of people with PCOS. So far, it has not been found that a single gene causes PCOS, so the link is likely to be complex and involve multiple genes.

Insulin resistance and lifestyle

One of the functions of insulin is to prevent blood glucose levels from rising after eating. If you are resistant to insulin, your body does not use the available insulin effectively to help keep your glucose levels stable.

Because insulin does not work effectively, the body produces more insulin. These high levels can increase the production of androgens such as testosterone, in the ovaries. This contributes to excessive hair growth and acne, and can contribute to symptoms such as irregular periods, ovulation problems, excessive hair growth and acne.

Insulin resistance is present in up to 80% of women with PCOS. It may contribute to an increased risk of developing type 2 diabetes and cardiovascular disease.

Insulin resistance is caused in part by lifestyle factors, including overweight, due to diet or physical inactivity. While women without PCOS who are overweight may have this form of insulin resistance, women with PCOS are more likely to have a particular form of insulin resistance caused by separate genetic factors of insulin resistance associated with insulin resistance. overweight. That means that thin women with PCOS may also have insulin resistance.

This means that women with PCOS may have:

Insulin resistance as a result of genetic factors.

Insulin resistance as a result of overweight (related to diet and inactivity)

A combination of these two factors.


Being above a healthy weight worsens insulin resistance and PCOS symptoms. Some women with PCOS report that when they have a healthy weight, they do gather symptoms such as menstrual irregularity or excessive hair growth. These symptoms only appear once they gain weight. A healthy lifestyle with nutritious foods and physical activity can help treat PCOS and prevent it.

Health problems linked to PCOS.

Women with PCOS seem to have an increased risk of developing the following health problems during their lives:

Insulin resistance (if they do not already have it).

Type 2 diabetes

Cholesterol and abnormalities in the blood fat.

Cardiovascular diseases (heart disease, heart attacks and strokes)

Endometrial carcinoma (cancer)

For more information on these problems, see our website about PCOS complications.

Sleep apnea

Women with PCOS, especially when they are overweight or are insulin resistant, may be at an increased risk of developing respiratory disorders or sleep apnea. Sleep apnea occurs when the upper airway is obstructed during sleep. The excess of fatty tissue in the neck can partially block the airways, which leads to loss of sleep, fatigue, fatigue and reduces the quality of life.

If you suspect that you may have PCOS, it is important that you see a doctor. You can be referred to a specialist such as an endocrinologist (hormone specialist) or a gynecologist to get more detailed evaluations. An early diagnosis can help control the symptoms of PCOS and reduce the potential long-term health risks posed and PCOS.

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