Symptoms of PCOS may begin shortly after puberty, but can also develop during the later teen years and early adulthood. Because symptoms may be attributed to other causes or go unnoticed, PCOS may go undiagnosed for some time.
Women with PCOS typically have irregular or missed periods as a result of not ovulating. Although some women may develop cysts on their ovaries, many women do not.
Other symptoms include:
- Weight gain. About half of women with PCOS will have weight gain and obesity that is difficult to manage.
- Fatigue. Many women with PCOS report increased fatigue and low energy. Related issues such as poor sleep may contribute to the feeling of fatigue.
- Unwanted hair growth (also known as hirsutism). Areas affected by excess hair growth may include the face, arms, back, chest, thumbs, toes, and abdomen. Hirsutism related to PCOS is due to hormonal changes in androgens.
- Thinning hair on the head. Hair loss related to PCOS may increase in middle age.
- Infertility. PCOS is a leading cause of female infertility. However, not every woman with PCOS is the same. Although some women may need the assistance of fertility treatments, others are able to conceive naturally.
- Acne. Hormonal changes related to androgens can lead to acne problems. Other skin changes such as the development of skin tags and darkened patches of skin are also related to PCOS.
- Mood changes. Having PCOS can increase the likelihood of mood swings, depression, and anxiety.
- Pelvic pain. Pelvic pain may occur with periods, along with heavy bleeding. It may also occur when a woman isn’t bleeding.
- Headaches. Hormonal changes prompt headaches.
- Sleep problems. Women with PCOS often report problems such as insomnia or poor sleep. There are many factors that can affect sleep, but PCOS has been linked to a sleep disorder called sleep apnea. With sleep apnea, a person will stop breathing for short periods of time during sleep.