Polycystic ovarian syndrome (PCOS): How do I know if I have it?
- Dr Natalie Hutchins
- Mar 6
- 3 min read
Polycystic ovarian syndrome is the commonest endocrinological (everything to do with hormones) condition in women, affecting between 5-10%. Given it is so common and can take some time to be diagnosed, being aware of the symptoms, is a good idea.
1. Your period is irregular and comes infrequently
A cycle that indicates that your body is functioning optimally, is one that on average lasts between 21-35 days. Women with PCOS often have a cycle that is longer than this and irregular, so that you can never predict when it’s coming and neither can your period tracker. If you’ re having less than 9 periods per year, then PCOS may be one of the causes. In some women, the hormonal dysfunction, will be significant enough so that they have no periods at all.
2. Signs of having high androgens
Androgens are sex hormones, the most well-known being testosterone. Although often thought of as a male hormone, they play a role in female pubertal development and reproductive health. The problem in PCOS is that these androgens become too high, causing symptoms like excess hair in unwanted areas, hair loss around the front and crown of the head and acne.
The excess hair tends to happen in areas associated with male hair growth, like on the chin, upper lip, chest, around the nipples, abdomen and upper back.
3. Polycystic ovaries on a scan
This is the one that can cause confusion amongst women when found on a pelvic scan. Normal ovaries look like similar to chocolate chip cookies on ultrasound; the ovary being the slightly squashed cookie and the chocolate chips being the follicles (sac containing an egg), at various stages of development scattered inside it. Polycystic ovaries look more like an ovary with a necklace of beads within it; small follicles of similar size that form a ring around the edge.
This finding on its own doesn’t mean that you have polycystic ovarian syndrome though; there are some women that have polycystic ovaries on scan but have no other symptoms. This is particularly true in teens for example. On the other hand, there are some women with signs and symptoms of PCOS that won’t have polycystic ovaries on a scan and this doesn’t mean that they don’t have PCOS. So, in essence, despite the name, seeing this on scan is only part of the puzzle.
If you are a woman that has been told that your scan shows polycystic ovaries but you do not have any other symptoms or signs of the syndrome on blood tests, then you do not need to worry that the complications of having PCOS apply to you. It might be that you have a very mild form of the hormone dysfunction, albeit not severe enough to cause the full syndrome.
4. Finding it difficult to get pregnant
Women with PCOS find it more difficult to get pregnant because they ovulate less frequently due to the underlying hormone dysfunction. PCOS is a common cause of subfertility.
The irregular and less frequent ovulation characteristic of PCOS, is the cause for irregular and less frequent periods. And the periods when they do come, might be heavy and more painful. These are called anovulatory cycles.
5. Being overweight or having obesity, binge eating and mood disorders
PCOS is not just a condition that affects reproductive health; it is a whole-body disorder. Whilst not all women with PCOS are overweight or have obesity (up to 20-30% are normal weight), the majority do. They are also more likely to have insulin resistance*, and that is true even for the women of normal weight. It is important to emphasise though, that just because you are lean, doesn’t mean you can’t have PCOS. There is also evidence to show that women with PCOS are more likely to have anxiety, depression and binge eating disorder.
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