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Table of Contents
Signs of PCOS
How to Get a Diagnosis
Ultrasound and Labs
Risks of Delayed Diagnosis
Treatment Options
Next in PCOS Guide
Home tests and certain blood tests can show changes, such as high hormone levels, that can cause these symptoms. Since PCOS symptoms are common in several other conditions, those must be ruled out before you get a PCOS diagnosis.
PCOS is often undiagnosed even though it impacts up to 10% of females of childbearing age. Not knowing you have PCOS can threaten your long-term health. Having this problem raises your risk of developing severe conditions like diabetes, high blood pressure, and high cholesterol.
This article describes PCOS symptoms, how to get a diagnosis, and what happens after a diagnosis.
Signs of PCOS Before an Official Diagnosis
Everyone experiences PCOS differently. Signs of PCOS usually begin around the time ofpuberty, though it is not uncommon for symptoms to begin in late adolescence or early adulthood. Many symptoms are related tohigherandrogenlevelsliketestosterone.
The following signs of PCOS can occur before you seek a healthcare provider for an official diagnosis:
Menstrual Irregularity
With PCOS, people usually haveoligomenorrhea(infrequent or unusually light bleeding during periods), with fewer than six to eight menstrual periods annually. Menstrual irregularities can also include the following symptoms:
It is also possible to have normal cycles, especially during puberty.
Being overweight increases the likelihood of irregular periods with PCOS.
Weight Gain
Around 50% of people with PCOS experience gradual weight gain, especially around the waist, as well asobesity. Obesity usually develops at the same time as puberty in people with PCOS. Weight gain may occur quickly with no obvious cause within a few months. The weight may also be difficult to lose despitedietand exercise.
However, it is a myth that PCOS only affects overweight people. About 20% of people with PCOS have normal or lowbody mass index (BMI). Having this variation, calledlean PCOS, can extend the delay for these people in getting a diagnosis because they don’t have the excess weight that’s considered a classic symptom of PCOS.
Infertility
PCOS is the most common cause of infertility related to ovulation.Because PCOS interferes with regular ovulation, it can be harder to get pregnant with PCOS. People who have few other classic PCOS symptoms may not find out they have the condition until they try to get pregnant, encounter difficulty, and seek medical care.
While PCOS is related to infertility, it is a myth that you can’t get pregnant with PCOS. This syndrome is one of the most treatable causes of infertility in females.
Acne/Skin Problems
PCOS can cause acne on your face, chest, or back that starts in puberty and lasts well into your adult years. This type of acne can also be more difficult to clear with traditional acne treatments.
Skin tags oracanthosis nigricans(dark patches that look dirty but never come off when you scrub them) are signs ofhigh insulinassociated with PCOS. Insulin levels rise in PCOS as the body doesn’t respond to this blood sugar-regulating hormone efficiently.
Excess Hair
Hirsutism, a term for excess hair growth in females, is common with PCOS.The hair growth tends to increase in areas most often seen in males, such as the upper lip, back, chest, abdomen, inner thigh, chin, and jawline.
Hair Loss
Hair lossin PCOS, calledfemale androgenic alopecia(FAGA) or female pattern hair loss, causes thinning hair on top of your head and along your hairline. However, it doesn’t lead to baldness.
Since many of these symptoms are not unique to PCOS, people may not recognize them as being problematic. As a result, many people don’t seek a diagnosis until they have abnormal periods or fertility problems. Most people find out they have PCOS in their 20s and 30s.
How to Know If You Have PCOS
How to Get a PCOS Diagnosis
To get aPCOS diagnosis, the Endocrine Society guidelines require that you have two of the three following conditions:
Since there are no standard guidelines, the recommendations regarding how to test for PCOS can vary across different specialties.
Despite meeting PCOS criteria, diagnosis in adolescents is typically reserved until two to three years after a person’s first menstrual cycle. This is because it can take up to two years after a person starts menstruating for the cycle to become regular.
A PCOS diagnosis can often be confirmed with the following evaluations:
What Is an Endocrinologist?
PCOS Diagnosis Using Ultrasound and Labs
If you have symptoms that align with PCOS, ultrasound and labs can help confirm the diagnosis.
Ultrasound
Atransvaginal ultrasoundis a type ofultrasound that can help in diagnosing PCOS. This type of ultrasound involves placing a lubricated ultrasound probe in your vagina to view your reproductive organs from the inside.
The images from a transvaginal ultrasound can show whether an excessive number of small follicles are present in your ovaries. The appearance of these follicles is a defining characteristic of PCOS.
In cases of PCOS, ultrasound images typically show many small cysts that usually occur around the surface or just below the surface layer of the ovary. Their appearance is often compared to a “string of pearls.”
Blood Tests
While there is not just one blood test to determine PCOS, your healthcare provider may confirm your diagnosis usingblood tests that check levelsof one or more of the following biomarkers of this syndrome:
At-Home PCOS Testing
Ruling Out Other Conditions
Since many symptoms of PCOS are common to other disorders and diseases, getting a PCOS diagnosis involvesruling out other medical conditions, including tumors of the ovaries or adrenal glands. Based on your symptoms, your healthcare provider may request additional blood tests to rule out the following conditions:
Risks of Delayed PCOS Diagnosis
It is not uncommon to experience a delay in getting a PCOS diagnosis. Up to 75% of people with PCOS remain undiagnosed despite visiting a healthcare provider.
Research indicates that it is not uncommon for people to have symptoms for two years or longer and visit up to three or more healthcare professionals before a diagnosis of PCOS is established. Even with a diagnosis, people report unmet information needs about their condition.
Since PCOS affects your health and well-being at all stages of life, a delayed PCOS diagnosis can have both short-term and long-term consequences. In the short term, researchers report a link between the length of time it takes to receive a PCOS diagnosis and an increase in symptoms ofanxietyanddepressionamong those who have symptoms.
Having PCOS increases your risk of developing serious health problems, especially if you are overweight. The longer you go without a diagnosis, the longer you remain at risk for health problems that can impact your fertility, mood, and quality of life without a diagnosis or treatment. These conditions include:
Importance of Getting Labs DoneGetting an early and accurate diagnosis is key to reducing the effects of PCOS. Unfortunately, the symptoms of PCOS are often ignored or misunderstood, resulting in delayed diagnoses.If you have symptoms of PCOS and/or a family history of the condition, it’s important to get labs that measure common PCOS biomarkers like reproductive hormones, androgens, and metabolism.If your healthcare provider doesn’t work with you to order these labs, don’t ignore your concerns. It may be time to find a healthcare provider who will honor your requests.
Importance of Getting Labs Done
Getting an early and accurate diagnosis is key to reducing the effects of PCOS. Unfortunately, the symptoms of PCOS are often ignored or misunderstood, resulting in delayed diagnoses.If you have symptoms of PCOS and/or a family history of the condition, it’s important to get labs that measure common PCOS biomarkers like reproductive hormones, androgens, and metabolism.If your healthcare provider doesn’t work with you to order these labs, don’t ignore your concerns. It may be time to find a healthcare provider who will honor your requests.
Getting an early and accurate diagnosis is key to reducing the effects of PCOS. Unfortunately, the symptoms of PCOS are often ignored or misunderstood, resulting in delayed diagnoses.
If you have symptoms of PCOS and/or a family history of the condition, it’s important to get labs that measure common PCOS biomarkers like reproductive hormones, androgens, and metabolism.
If your healthcare provider doesn’t work with you to order these labs, don’t ignore your concerns. It may be time to find a healthcare provider who will honor your requests.
After PCOS Diagnosis: What Are the Treatment Options?
While there is no cure for PCOS, treatment can help you manage your symptoms and reduce your risk of any potential problems.Common treatment options like PCOS medication include the following:
Lifestyle Changes
Hormonal Oral Contraceptives
Hormonal oral contraceptives, or birth control pills, are the primary treatment for people with PCOS who don’t want to become pregnant. These medications contain a combination of estrogen and progestin. They can achieve the following:
Insulin-Sensitizing Agents
Insulin-sensitizing agents can make the body more responsive to insulin and stabilizeglucoselevels.Metforminis the best-studied insulin-sensitizing agent available in the United States. It can help achieve the following:
Anti-Androgens
Anti-androgens prevent the production of androgens or limit the activities of the effects of those hormones.Aldactone (spironolactone)is the most commonly prescribed androgen receptor blocker. It is typically used in combination with oral contraceptives because this drug can lead to irregular periods and potential congenital (present at birth) anomalies or disabilities.
Anti-androgens can achieve the following:
Fertility Drugs
Removing Unwanted Hair
There are many options for hair removal. A drug called Vaniqa (eflornithine) is a cream that slows hair growth, especially on the face. Other options forhair removalinclude the following:
Acne Treatments
There are many prescription and over-the-counter medications to treat acne. The type of treatment used depends on the severity of your acne and its duration. Common treatments cause the following:
When a diagnosis of PCOS is confirmed, your healthcare provider may order follow-up testing:
If you have PCOS, you should be seen regularly to check on the metabolic and reproductive issues that may occur. It is also important to maintain a check on symptoms of depression and anxiety, which are common with PCOS.
Summary
Polycystic ovary syndrome (PCOS) occurs as a result of a hormone imbalance. The syndrome causes a set of symptoms that include insulin resistance and higher levels of androgen hormones.
PCOS is one of the most common causes of infertility. It hinders normal ovulation (the release of eggs) and stable menstrual periods. Other common symptoms include acne, extra weight, and excess hair on your face, chest, and back.
While there is no cure for PCOS, treatments can reduce symptoms of this lifelong problem. Getting an early diagnosis can reduce your risk of having one of the more severe health problems linked to PCOS.
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