Polycystic Ovary Syndrome, more often known as PCOS, is one of the most common hormone conditions for women and people assigned female at birth (AFAB) of reproductive age. Celebrities like Victoria Beckham, Emma Thompson, Keke Palmer, and Daisy Ridley have opened up about having PCOS and its impact on their lives. But what is PCOS? What should you do if you think you have PCOS? 

The Basics: characteristics, symptoms, and diagnosis
There are three main characteristics of PCOS: irregular periods, excess androgens, and polycystic ovaries. People with PCOS produce an excess of androgens, often referred to as “male sex hormones,” which AFAB people produce in low levels naturally. This hormonal disruption prevents regular ovulation from occurring, which may in turn result in polycystic ovaries. Polycystic ovaries are enlarged ovaries with follicles, or fluid-filled sacs known as cysts, surrounding the eggs. These are very common with PCOS, but (despite the name) not everyone with PCOS experiences cysts. Some people with PCOS may have all three of these characteristics, but all three are not necessary to be diagnosed with PCOS. 

These characteristics may manifest through a variety of symptoms, typically beginning in the late teens to early twenties. The symptoms of PCOS include: 

• Irregular periods or no periods
• Irregular ovulation or no ovulation
• Difficulty conceiving 
• Excessive hair growth, particularly on the face, bottom, back, and chest
• Thinning hair or hair loss on head
• Oily skin and/or acne 
• Weight gain, particularly around the belly 
• Skin tags
• Dark or thick skin patches

While some people with PCOS may experience all of these symptoms, roughly half of people with PCOS have no obvious symptoms.  

So, you’re experiencing these symptoms, but how do you know it’s PCOS? 
To be properly diagnosed with PCOS and get treatment, we suggest raising the concern with your healthcare provider. Your doctor will conduct a physical exam, typically including a pelvic exam. They may choose to do an ultrasound to look for cysts and enlargement of the ovaries, as well as blood tests to measure hormone levels. As stated earlier, not all people with PCOS have cysts. Generally, PCOS is diagnosed if you have two out of the three main characteristics. Most people with PCOS aren’t diagnosed until their twenties or thirties, even if they have been experiencing symptoms since puberty! 

Causes, Risks, and Treatment
While it’s clear that the symptoms of PCOS are largely caused by hormonal imbalances, the questions about what causes PCOS remain unanswered. You are more likely to have PCOS if a relative, such as a mother, sister, or grandmother, has PCOS. Additionally, higher insulin levels may be responsible or increase the likelihood of PCOS, as increased insulin causes increased hormone activity.

Despite PCOS’ difficult symptoms, the syndrome by-and-large does not have significant impacts on the long-term health of most people living with it. However, there are a few health issues that those with PCOS may be at increased risk of developing: 

• Type 2 diabetes
• High cholesterol
• High blood pressure 
• Sleep apnea
• Depression and anxiety 
• Endometrial cancer

The symptoms of PCOS without treatment can make daily life challenging. However, there are several methods to manage its symptoms. 

• Change in diet and activity
• Medication to treat symptoms such as hair loss, irregular periods, and infertility
• Birth control pills to control cycle, lower androgen levels, and reduce acne
• Diabetes medication to lower insulin resistance
• Spironolactone to balance hormones
• Laparoscopic ovarian drilling to destroy androgen-producing tissue and increase fertility, however this is not commonly done or recommended often by OBGYN’s

Even though more and more women and AFAB people are speaking out on platforms such as Instagram and TikTok about their experiences with PCOS, living with the syndrome can feel isolating. Finding a community to discuss your experiences with PCOS and treating it can aid these feelings, and if you believe you may be experiencing symptoms of PCOS, talk to a health care provider to address your concerns.