Polycystic Ovary Syndrome (PCOS) – Symptoms and Causes

What is PCOS?

PCOS (polycystic ovary syndrome) is a hormone disorder. It affects people during their childbearing years. When someone has PCOS, their body produces higher levels of androgens (male hormones) than normal.

This hormone imbalance often causes irregular or prolonged menstrual cycles. In PCOS, the ovaries develop numerous small, fluid-filled sacs called cysts. These cysts contain immature eggs that often fail to be released regularly, disrupting normal ovulation patterns.

Doctors don’t fully understand what causes PCOS. However, getting diagnosed early and making lifestyle changes can help manage symptoms and reduce risks.

Weight management is particularly important, as it can lower the chances of developing serious health problems like:

• Type 2 diabetes
• Heart disease
• High blood pressure

PCOS affects about 1 in 10 women of reproductive age, making it a common hormonal disorder.

Signs and Symptoms

People with PCOS often first notice symptoms around their first period. For others, symptoms may appear later, after having regular periods for some time.

PCOS symptoms can vary greatly between individuals. Doctors diagnose PCOS when at least two of these main signs are present:

• Irregular menstrual cycles – Having infrequent or unpredictable periods is common with PCOS. You might have:

  • Fewer than 9 periods per year
  • Periods that come more than 35 days apart
  • Unusually long periods
  • Difficulty becoming pregnant

• Elevated androgen levels – High levels of this hormone can cause:

  • Excess facial and body hair (hirsutism)
  • Severe acne
  • Hair thinning or male-pattern baldness

• Polycystic ovaries – Ovaries may be enlarged and contain many small follicles with immature eggs around the edges. This can affect normal ovarian function.

People with obesity often experience more severe PCOS symptoms due to the impact of weight on hormone levels.

When to Contact a Healthcare Provider

It’s important to schedule a medical appointment if you notice:

• Concerns about your menstrual cycle pattern
• Fertility challenges when trying to conceive
• Signs of high androgen levels include new hair growth on the face or body, persistent acne, and hair loss resembling male-pattern baldness.

Early diagnosis allows for better management of symptoms and helps prevent potential complications.

Causes

PCOS develops from several possible factors, though researchers haven’t identified a single definitive cause.

Insulin resistance plays a major role in many PCOS cases. When cells don’t respond properly to insulin, the body produces more of this hormone to manage blood sugar. This excess insulin may trigger increased androgen production.

Signs of insulin resistance include:

• Dark, velvety skin patches on the neck, armpits, or groin
• Increased hunger
• Weight gain

Inflammation contributes to PCOS as well. People with this condition often have chronic, low-grade inflammation that prompts their ovaries to make more androgens. This inflammatory response can also increase the risk of heart and blood vessel problems.

Genetic factors appear important in PCOS development. The condition often runs in families, suggesting that specific genes may make some people more likely to develop it.

PCOS Risk Factors	How It Affects the Body
Insulin Resistance	Triggers excess androgen production
Inflammation	Stimulates ovaries to produce androgens
Genetic Factors	Inherited traits increase susceptibility
Excess Androgens	Disrupts normal ovulation

Excess androgens represent both a cause and an effect in PCOS. High levels of these “male hormones” prevent regular egg release from the ovaries. This disrupts normal menstrual cycles and can cause visible symptoms like unusual hair growth and acne.

The relationship between these factors creates a cycle that maintains the condition. For example, excess androgens lead to irregular ovulation, which may worsen hormone imbalances.

Complications

PCOS can lead to several health problems. Women with this condition often struggle with fertility issues due to irregular ovulation. During pregnancy, they face higher risks of gestational diabetes, high blood pressure, miscarriage, and premature delivery.

Many patients develop liver inflammation from fat buildup (nonalcoholic steatohepatitis). They’re also at risk for metabolic syndrome, which combines high blood pressure, elevated blood sugar, and abnormal cholesterol levels.

Other serious complications include:

• Type 2 diabetes or prediabetes
• Sleep apnea
• Mental health issues (depression, anxiety, eating disorders)
• Uterine cancer

Weight problems commonly occur alongside PCOS and can make these complications worse.