Signs and Symptoms of Polycystic Ovary Syndrome
Ovulation does not occur regularly in women who have polycystic ovary syndrome. Signs of PCOS include irregular menstrual periods (e.g., light or infrequent menstruation [oligomenorrhea], absence of menstruation [amenorrhea]) and infertility. Infertility is difficulty achieving pregnancy after 1 year of unprotected intercourse.
In many women who have PCOS, the first menstrual period (called menarche) occurs within the normal age range (i.e., between 9 and 17 years old), but the onset, length, and extent of bleeding are unpredictable.
Women who have PCOS often develop ovarian cysts (fluid-filled sacs on the ovaries). However, ovarian cysts also can occur in women who do not have the condition.
Other signs of polycystic ovary syndrome include the following:
- Acne, oily skin
- Dark areas of skin (e.g., on the neck, underarms, stomach, or breasts; called acanthosis nigricans)
- Excessive growth of body hair (e.g., on the face, chest, stomach, back; called hirsutism)
- High blood pressure (hypertension)
- High cholesterol (hypercholesterolemia)
- Obesity (especially extra weight around the waist)
- Pelvic pain
- Skin tags (tiny flaps of extra skin)
- Thinning hair
Studies have shown that women with polycystic ovary syndrome are at increased risk for heart disease, type 2 diabetes, and endometrial cancer. Weight gain associated with the condition can cause sleep apnea, a condition in which the patient stops breathing temporarily during sleep. In some cases, depression or anxiety occurs, possibly as a result of issues related to appearance or infertility.
Diagnosis of PCOS usually is based on a family and personal medical history, physical examination, and laboratory tests. Early diagnosis is important to help reduce the risk for complications, such as heart disease and diabetes. Conditions that can cause similar symptoms (e.g., hypothyroidism, ovarian cancer, adrenal cancer) often must be ruled out before a definitive diagnosis can be made.
During physical examination, the health care provider may measure the patient's blood pressure, weight, body mass index (BMI), and waist size, and examine areas of excessive hair growth (hirsutism). In many cases, a pelvic exam also is performed to determine if the ovaries are enlarged.
Blood tests may be used detect high levels of certain hormones (e.g., DHEA [dehydroepiandrosterone], testosterone) and to measure cholesterol and blood glucose (sugar) levels.
Ultrasound, which uses high-frequency sound waves to create images of the ovaries, may be used to detect ovarian cysts and to examine the lining of the uterus (endometrium). However, the presence of ovarian cysts does not necessarily mean that a woman has PCOS. If other conditions, such as ovarian cancer or adrenal cancer are suspected, other imaging tests (e.g., CT scan, MRI scan) may be performed.