How to diagnose and recognize Polycystic Ovary Syndrome (PCOS)?

How to diagnose and recognize Polycystic Ovary Syndrome (PCOS)?

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects approximately 5 to 10% of women, making it one of the most prevalent hormonal issues among women of reproductive age. PCOS is characterized by a range of symptoms, including irregular or absent periods, excess weight or obesity, excessive hair growth, acne, and elevated levels of male hormones called androgens. This article will provide an in-depth understanding of PCOS, its symptoms, and available treatments. If you have just been diagnosed with PCOS and none of the symptoms mentioned above apply to you, feel free to check out our Blog article: PCOS vs. PCOD - Why They Are Not the Same Thing.

What is PCOS? PCOS gets its name from the numerous follicles, not cysts, filled with fluid that often form in the ovaries, causing them to enlarge. These follicles can disrupt the normal function of the ovaries and lead to hormonal imbalances.

PCOS Symptoms:

It is important to note that you will not typically experience all of these symptoms at the same time. Generally, women with Polycystic Ovary Syndrome (PCOS) may experience 3 to 4 symptoms from those listed below.

Irregular Periods or Amenorrhea

Women with PCOS often have irregular or absent periods (Amenorrhea - Absence of periods for more than 90 days). This can result from infrequent ovulation (called ovulation) or complete absence of ovulation (anovulation).

Infertility and Fertility Issues:

PCOS is one of the leading causes of infertility in women, affecting nearly half of all women with the disorder. It can lead to difficulties in conceiving or complete infertility. Why? Women with PCOS suffer from infertility because they ovulate less frequently or not at all. Without ovulation, women with PCOS have more difficulty getting pregnant. However, once ovulation returns, they can get pregnant without difficulty.

Increased Hair Growth (Hirsutism):

High levels of androgens, (male hormones), are a hallmark of PCOS. This overproduction of androgens, particularly testosterone (but it can also be DHEA, DHT, or a decrease in SHBG), can lead to hirsutism, excessive hair growth in typically male areas such as the chin, upper lip, chest, back, and buttocks. About 70% of women with PCOS have hirsutism, which can be a source of emotional distress. Oral contraceptives are often prescribed as a first-line treatment for hirsutism. But if you are looking for a natural method to reduce your hair growth, we have developed Andromaque.

Hair Loss (Alopecia):

Another symptom of excess androgen production in PCOS is hair loss, which can manifest as thinning hair on the top of the head and receding hairlines. So in summary, you have fewer and thinner hairs.


Elevated levels of testosterone caused by PCOS can also contribute to acne. It is not uncommon for acne and oily skin to persist beyond the age of 20 in women with PCOS.

Reduction in Breast Volume:

Some women with PCOS may have hypoplastic breasts, characterized by low breast volume. During pregnancy, breast growth may be limited, and there may be a significant difference in size between the breasts, as well as reduced production of breast milk.

Skin Darkening:

PCOS may be associated with darkening and thickening of the skin in areas such as the armpits, neck, groin, and skin folds. This condition, called acanthosis nigricans, is linked to insulin resistance, which is more commonly observed in women with PCOS.

Weight Gain:

Many women with PCOS have excess weight. Hyperandrogenism, resulting from overproduction of male hormones, can lead to excessive fat accumulation and difficulty losing weight. There is a correlation between body mass index (BMI) and infertility in PCOS. Conversely, a 10% weight loss has been shown to be beneficial in regulating menstrual cycles and improving fertility. Lifestyle changes, dietary habits, and regular physical activity can have a positive impact on fertility.

Insulin Resistance and Diabetes:

PCOS can have metabolic effects on the body, including insulin resistance. In some cases, cells become resistant to insulin, leading to high blood sugar levels and an increased risk of prediabetes and type 2 diabetes. You can determine if you are insulin resistant by undergoing a blood test called the HOMA Test. This test can be performed in a laboratory for around thirty euros. If you want to learn more about this topic, feel free to check out our dedicated blog article.

PCOS Diagnosis:

The diagnosis of PCOS involves a combination of medical history analysis, clinical examination, and specialized tests. Pelvic ultrasound identifies the presence of numerous immature ovarian follicles (resulting from disrupted follicular maturation due to excess androgens) and enlarged ovaries. But it is not sufficient to make the diagnosis. A blood test, usually performed at the beginning of the menstrual cycle, measures hormone levels, revealing high levels of androgens, altered ratio between follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and sometimes high blood sugar levels in case of metabolic involvement.

Blood tests are imperative, while ultrasound remains optional.