PCOS stands for Polycystic Ovary Syndrome, a disorder characterized by excess androgen production, menstrual irregularities, and ovarian cysts. PCOS can interfere with your reproductive and metabolic health and cause many symptoms. It is the main cause of infertility.
While the causes of PCOS are not fully understood, genetics are suspected to play a role, possibly in addition to certain health and lifestyle risk factors.
Symptoms of PCOS may overlap with other disorders. But there are nine common symptoms that could lead you straight to PCOS as the real cause.
If you have ovaries and are of reproductive age, your chance of developing PCOS is about 10%.
Hair loss in PCOS is sometimes called female androgenetic alopecia (FAGA) or female pattern baldness. This is because of androgens (male hormones) associated with PCOS. Similar to male pattern baldness, FAGA causes thinning of the hair on the crown and hairline. It doesn’t cause baldness like men do because the hair follicles don’t die. This means the hair may grow back again. A variety of conditions other than PCOS can cause FAGA, including:
- Hyperprolactinemiaa condition known for excess prolactin, the hormone that produces milk in women’s breasts
- adrenal hyperplasiaadrenal disease
- Ovarian and adrenal tumors (rarely)
Several other conditions cause generalized thinning of the hair rather than the unique pattern of FAGA. They include:
- autoimmune disease
- Thyroid disease
Some medications can also cause unpatterned hair thinning. Ask your healthcare provider if your drug is on the list.
Treating Hair Loss in PCOS
Fatigue is one possible symptom of PCOS, but it is also a symptom of many other diseases and lifestyle factors. This reality makes it nearly impossible to diagnose any disease based on fatigue alone. It must be viewed in conjunction with your life and any other symptoms you may be experiencing.
Lifestyle factors that can contribute to fatigue include:
- lack of sleep
- Long work time
- drug side effects
- nutritional deficiencies
Chronic conditions of extreme fatigue that can have a serious impact on your life and function include:
- autoimmune disease
- chronic infection
- heart disease
- myalgic encephalomyelitis (chronic fatigue syndrome)
- sleep disorders, such as sleep apnea and insomnia
- Thyroid disease
To help you and your healthcare provider figure out what’s causing your fatigue, look for possible triggers. Do you feel tired after eating certain foods? After a stressful event? After a little exercise?
Try to describe the specifics of your fatigue. Is it a “constantly tired but functional” fatigue, or does it keep you in bed for days at a time? Does it come and go? Is it accompanied by pain or depressive symptoms? Each piece of information should help your provider piece the puzzle together.
Why am I always so tired?
You probably already know that female hormones can cause mood swings, especially during certain times of your menstrual cycle. It can be difficult to distinguish them from PCOS mood swings. However, PCOS often disrupts your cycle by preventing ovulation, so if you miss your period and have mood swings, PCOS is possible.
Mood swings are theoretically associated with PCOS because of abnormal brain chemistry and potential disruption of the brain-gut connection, the chemical and physical link between the brain and the gastrointestinal tract. In addition to mood swings, PCOS is associated with an increased risk of diagnosis of depression, anxiety, bipolar disorder, and obsessive-compulsive disorder. It’s also been linked to more severe symptoms of depression, anxiety, obsessive-compulsive disorder, and somatization, or when someone’s emotional distress takes the form of physical symptoms.
Lifestyle changes can help
It is difficult to determine whether mood swings are caused by the menstrual cycle or PCOS. But lifestyle changes can have a big impact on stabilizing mood. Follow a low-calorie diet, stick to regular exercise, and prioritize getting a good night’s sleep.
Few studies have addressed migraine and PCOS. But a 2019 study appears to confirm the link. It found that migraine was “highly associated” with PCOS.
However, many people without PCOS have migraines. Migraine headaches may be an indicator of PCOS if you:
- Never use them until you start having other symptoms that suggest PCOS
- Had it before, but noticed a change in frequency and potential triggers
- Tendency to migraines at certain points in the menstrual cycle
- Use them when other underlying PCOS symptoms are particularly severe
What to do when you have a migraine
A constant craving for sweets is a common symptom of PCOS, possibly due to insulin resistance. Women with PCOS tend to have high levels of insulin in their blood. All of this insulin interferes with the function of other appetite-regulating hormones, leading to increased hunger. Eating sugar and refined carbs in particular can lead to a cycle of sugar eating and crashing that can trigger more cravings.
Cravings for PCOS can lead to unhealthy behaviors. For example, people with PCOS are particularly prone to overeating. If you’re obese, you’re more likely to develop strong food cravings, which can make weight loss more difficult.
To tell if your cravings are insulin-related, watch for symptoms of low blood sugar. They can surface hours after overeating, when high insulin levels can cause blood sugar levels to plummet. Symptoms include:
- anger caused by hunger
Watch for symptoms of hypoglycemia
Insulin is known for its role in triggering type 2 diabetes, so if you report food cravings that may be caused by insulin resistance, your healthcare provider may be looking for this drug.
difficulty gaining or losing weight
When you have PCOS, weight loss can be very slow. It is also easy to gain weight, especially around the abdomen. Again, insulin resistance is likely to be the culprit.
Another job of insulin is to promote fat storage. But some people with PCOS gain weight even when they eat a healthy diet, avoid overeating, and exercise regularly. Other symptoms of insulin resistance include:
- Dark, dry patches of skin in the armpits, groin, or back of the neck
- excessive thirst
- frequent urination
How Weight Loss Helps Improve PCOS
High androgen levels in PCOS cause many people to develop coarse, dark hair on the face and body, often with body hair in men and only vellus hair (“peach down”) in women. This condition is called hirsutism.
While hirsutism is a sign of possible PCOS, it can also be due to several other conditions, such as:
- adrenal tumor or cancer
- Congenital adrenal hyperplasia, a disease of the adrenal glands
- Cushing’s syndrome, an endocrine disorder
- Hyperthecosis, or a series of changes that affect the ovaries
- ovarian tumor or cancer
- Thyroid disease
Not everyone with PCOS has hirsutism. But 75% to 80% of women with hirsutism have PCOS.
PCOS and unwanted facial hair
Testosterone — the main male hormone — is a cause of acne, so high levels associated with PCOS can lead to the zits you might think you had left in puberty. However, not all adult acne is caused by PCOS. Common reasons include:
- family history
- Hormonal fluctuations (related to periods, pregnancy, menopause)
- drug side effects
- reaction to skin care products
10 Facts About Adult Acne
PCOS is one of the most common causes of female infertility. This can be the hardest part of the disease for women who are trying to have children now or in the future. Specifically, PCOS interferes with ovulation, causing irregular or absent periods and difficulty conceiving.
Talk to your healthcare provider if you have been skipping or having irregular periods. Remember that other things can interfere with conception, including:
- age-related infertility
- low body weight
- premature menopause
- Premature ovarian failure
- structural problems of reproductive organs
- Thyroid disease
How to get pregnant with PCOS
Polycystic ovary syndrome diagnosis
If you suspect you may have PCOS, pay attention to your symptoms and their triggers. Most importantly, consult your healthcare provider. Because the symptoms listed here can be traced back to other conditions, it may take a while for your healthcare provider to determine your diagnosis. You may need the following tests to confirm it:
- pelvic exam
- blood test
- Ultrasound or other imaging tests
Diagnostic criteria for PCOS include:
- Polycystic ovaries (12 or more small follicles in each ovary)
- hyperandrogenism (elevated testosterone, or DHEA)
- Ovulation dysfunction (periods that are infrequent or absent)
If you’ve been diagnosed with PCOS, it may be helpful to know that the various treatment options can help you manage your symptoms. For example, even a 5% weight loss can alleviate many PCOS symptoms and make life with the disease more bearable, day in and day out.
Most medical conditions tell their existence by triggering warning signs. It’s no different from polycystic ovary syndrome. This hormonal disturbance can disrupt a woman’s menstrual cycle and interfere with the ability to conceive. Since PCOS can also put you at a higher risk of type 2 diabetes, there are nine PCOS warning signs you need to be wary of: hair loss, fatigue, mood swings, migraines, cravings for sweets, weight gain (or difficulty losing weight), Unusual facial or body hair growth, acne and fertility problems.
Of course, a warning sign is not a confirmation. Many of these symptoms can be attributed to other causes.But if your period is irregular and If you have two or more of these symptoms, it is wise to make an appointment with your healthcare provider to check for PCOS.
How to treat PCOS