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Symptoms
By Mayo Clinic staffPolycystic ovary syndrome signs and symptoms often begin soon after you first begin having periods (menarche). In some cases, PCOS develops later on during your reproductive years, for instance, in response to substantial weight gain.
Signs and symptoms vary from person to person, in both type and severity. To be diagnosed with the condition, your doctor looks for at least two of the following:
- Menstrual abnormality. This is the most common characteristic. Examples of menstrual abnormality include menstrual intervals longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy.
- Excess androgen. Elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair (hirsutism); adult acne or severe adolescent acne; and male-pattern baldness (androgenic alopecia). However, the physical signs of androgen excess vary with ethnicity, so depending on your ethnic background you may or may not show signs of excess androgen. For instance, women of Northern European or Asian descent may not be affected.
- Polycystic ovaries. Enlarged ovaries containing numerous small cysts can be detected by ultrasound. Despite the condition's name, polycystic ovaries alone do not confirm the diagnosis. To be diagnosed with PCOS, you must also have abnormal menstrual cycles or signs of androgen excess. Some women with polycystic ovaries may not have PCOS, while a few women with the condition have ovaries that appear normal.
Other conditions associated with PCOS
- Infertility. Women with polycystic ovary syndrome may have trouble becoming pregnant because they experience infrequent ovulation or a lack of ovulation. PCOS is the most common cause of female infertility.
- Obesity. About half the women with polycystic ovary syndrome are obese. Compared with women of a similar age who don't have polycystic ovary syndrome, women with PCOS are more likely to be overweight or obese.
- Prediabetes or type 2 diabetes. Many women with polycystic ovary syndrome are insulin resistant, which impairs the body's ability to use insulin effectively to regulate blood sugar. This can result in high blood sugar and type 2 diabetes. Prediabetes is also called impaired glucose tolerance.
- Acanthosis nigricans. This is the medical term for darkened, velvety skin on the nape of your neck, armpits, inner thighs, vulva or under your breasts. This skin condition is a sign of insulin resistance.
When to see a doctor
Early diagnosis and treatment of polycystic ovary syndrome may help reduce your risk of long-term complications, such as type 2 diabetes, high blood pressure, heart disease and stroke.
Talk with your doctor if you have menstrual irregularities — such as infrequent periods, prolonged periods or no menstrual periods — and have excess hair on your face and body or acne.
- Wilson EE. Polycystic ovarian syndrome and hyperandrogenism. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=3157034. Accessed June 22, 2009.
- Barbieri RL, et al. Clinical manifestations of polycystic ovary syndrome in adults. http://www.uptodate.com/home/index.html. Accessed June 22, 2009.
- Ehrmann DA. Polycystic ovary syndrome. New England Journal of Medicine. 2005;352:1223.
- Azziz RA, et al. The androgen excess and PCOS society criteria for the polycystic ovary syndrome: The complete task force report. Fertility and Sterility. 2009;91:456.
- Polycystic ovary syndrome (PCOS): Frequently asked questions. U.S. Department of Health and Human Services Office on Women's Health. http://www.4woman.gov/faq/pcos.pdf. Accessed June 16, 2009.
- Guzick DS. Polycystic ovary syndrome. Obstetrics & Gynecology. 2004;103:181.
- Radosh L. Drug treatments for polycystic ovary syndrome. American Family Physician. 2009;79:671.
- Barbieri RL, et al. Treatment of polycystic ovary syndrome in adults. http://www.uptodate.com/home/index.html. Accessed June 22, 2009.
- Tapanainen JS, et al. Effective regimens for ovulation induction in polycystic ovary syndrome. In: Dunaif A, et al. Polycystic Ovary Syndrome: Current Controversies, From the Ovary to the Pancreas. Totowa, N.J.: Humana; 2008:307.
- Gonzalez F (expert opinion). Mayo Clinic, Rochester, Minn. July 3, 2009.
