Menstrual Irregularities & Polycystic Ovary Syndrome (PCOS): Signs & Symptoms

May 31st, 2024 | 12:11 pm


PolyCystic Ovary Syndrome, or PCOS, is a common reproductive health problem that affects females and causes hormonal fluctuations in the body. About 15% of women worldwide are affected by it. It is among the top reasons for infertility in women. Most people are diagnosed with it in their twenties when they’re trying to get pregnant. Women who are obese or have a biologically related family member with PCOS are more likely to develop this medical condition.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a medical condition that affects a female’s hormone levels. Females with PCOS produce higher than normal amounts of male hormones, called androgens, which are usually present in very small amounts otherwise. The term’ polycystic ovary’ refers to numerous small fluid-filled cysts that develop in the ovaries. However, not all women with PCOS develop cysts. Some may develop this condition without developing any cysts. These cysts may be visible on the ovaries on an ultrasound due to lack of ovulation (anovulation). 

This condition impacts the ovulation process in some females which affects their fertility. Ovulation occurs when a mature egg is released from an ovary. The egg can then be fertilised by a sperm or it can be sent out of the body during the next menstrual cycle. PCOS causes less production of hormones needed to ovulate. When ovulation doesn’t occur, the ovaries can develop many small cysts which start making male hormones, called androgens. 

With an imbalance in reproductive hormones, patients with PCOS often have irregular menstrual cycles, miss their periods, and have unpredictable ovulation. PCOS increases the person’s risk of other health conditions.

What Age Does PCOS Start?

Females can develop PCOS any time after they hit puberty. Most people are diagnosed with it when they experience difficulty in conception, often in their 20s and 30s. 

Causes of PCOS: Understanding the Risk Factors of PCOS

The exact cause of PCOS is not known. It is commonly believed that high levels of specific male hormones prevent the ovaries from producing hormones and producing eggs normally. However, there are many factors that may contribute to PCOS.

  • Insulin Resistance: An increase in insulin levels causes the ovaries to produce and excrete male hormones, i.e., androgens. Increased androgen production suppresses ovulation and contributes to other symptoms of polycystic ovary syndrome. Insulin resistance means that the body doesn’t process insulin correctly. It leads to higher glucose levels in the blood. Being obese (overweight) can also contribute to insulin resistance, which in turn causes the body to make too much of androgens.
  • Low-grade Inflammation: People with PCOS usually have chronic low-grade inflammation. This is a common activity of white blood cells in response to infection or injury. It can even lead to heart and blood vessel problems.
  • Genes: Research has suggested that certain genes may be linked to PCOS. Additionally, having a family history of PCOS plays a major role in developing the condition. 

Symptoms of PCOS: How Do I Know I Have PCOS?

The symptoms of PCOS often start around the time of the first menstrual period. Sometimes, the symptoms develop a lot later than a female has had their first period. The symptoms of PCOS may also vary from person to person. The most common signs of PCOS include the following.

  • Irregular periods: Absence of menstruation or abnormal menstruation is a common occurrence in females with PCOS. It also involves heavy bleeding during periods. Some females may experience having periods that last longer than normal for many days. In some females, a menstrual cycle may occur after more than 35 days.
  • Heavy bleeding: The uterine lining in the females builds up for a long time due to a longer menstrual cycle. This leads to having heavier than normal periods that usually lasts longer than normal.
  • Excessive/Abnormal hair growth: High levels of the androgen hormone may result in excessive facial hair and body hair. This condition is known as hirsutism. 
  • Acne: There can be severe acne and breakouts in areas like the face, chest, and upper back along with causing oilier skin. Having such acne prone skin may continue well past the teenage years and may be difficult to treat. 
  • Unintentional weight gain: Between 40% to 80% of people with PCOS are obese. They also have trouble maintaining a healthy weight.
  • Darkening of the skin: Skin darkening with patches of dark skin, particularly in the folds of the neck, armpits, groynes, and under the breast. Such an occurrence is known as acanthosis nigricans.
  • Skin tags: Skin tags are small extra flaps of the skin which are often found in the armpits or on the neck.
  • Headaches: Hormonal changes and fluctuations can trigger headaches in some females.
  • Hair thinning: People with PCOS may lose patches of hair on their head or at the hairline. This may look like male pattern baldness.
  • Infertility: PCOS is among the leading causes of infertility in females. Not ovulating frequently or regularly, or at all, could lead to not being able to conceive. 

Can You Have PCOS But Not Have Any Symptoms?

Yes, it is possible to have PCOS and not experience any symptoms. Many females don’t even realise they have PCOS until they are trying to conceive without success or they are gaining weight without any apparent reasons. It is also possible that they may have mild PCOS symptoms, but the symptoms are not noticeable. 

How Does PCOS Impact a Person’s Health?

Having hormonal imbalances can affect the affected person’s fertility as well as other aspects of their health.

  • Infertility: It is often the first sign noticed by females as absence or irregularity in periods doesn’t provide an environment for the eggs to be fertilised. It leads to infertility in women.
  • Metabolic syndrome: Up to about 80% of women with PCOS are obese or overweight. Both PCOS and obesity can increase their risk of a number of health conditions, such as:
    • high BP (blood pressure)
    • high blood sugar
    • high LDL “bad” cholesterol
    • low HDL “good” cholesterol
  • Sleep apnea: It is a medical condition which causes repeated disruptions in breathing during sleep. It is more common in women with obesity, especially if they also have PCOS. The risk of sleep apnea is five to ten times higher in women with both PCOS and obesity than in those without PCOS.
  • Endometrial cancer: During menstruation in women, the uterine lining sheds every month. If a person doesn’t ovulate, there is no shedding of the uterine lining, which then builds up over time. Having a thickened uterine lining increases the risk of endometrial cancer in women.
  • Depression: Both hormonal changes & symptoms of PCOS, such as excessive hair growth in the face and body, loss of hair from the head, and weight gain, can negatively affect body image. Infertility concerns can also negatively affect emotions in females. It can eventually lead to anxiety and depression in women with PCOS.


It is important to understand PCOS symptoms can be managed with simple medications, treatment, lifestyle modifications, and emotional support. By adopting a daily routine including balanced diet, regular exercise, & stress management techniques, along with the guidance of healthcare professionals, women with PCOS can significantly improve the persistent symptoms and overall quality of life.

Remember, every journey is unique, so stay informed, stay proactive, and take control of your health!