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Symptoms and causes of PCOS

Learn about the symptoms and causes of polycystic ovary syndrome (PCOS).

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Symptoms of PCOS

Women with PCOS may experience different symptoms, and they can range from mild to severe. Symptoms can also change at different stages of your life.

Irregular or no periods

With PCOS, high levels of androgens (male-type hormones) and insulin in your body can disrupt your menstrual cycle. This means your periods may be irregular or stop altogether.

Some girls may not start their periods at all due to PCOS.

Learn more about how to treat and manage irregular periods.

Excess hair (hirsutism)

PCOS can cause excess hair growth on your face and body due to high levels of the androgen hormone. This hair is thicker and darker than normal. It usually grows in areas where men grow hair. For example, on your sideburn area, chin, upper lip, lower abdomen, chest, thighs and around your nipples.

About 60% of women with PCOS have excess hair growth.

Hair loss (alopecia)

PCOS can cause scalp hair loss in a male-like pattern (i.e. hair that recedes at the front and thins on top).

Skin conditions

With PCOS, higher levels of androgens can enlarge oil-production glands on your skin, which can cause acne (pimples). Acne is common in teenage years, but young women with PCOS may continue to have severe acne.

PCOS can cause skin tags, which are thick lumps of skin that can grow in your armpits, on your neck or along your bra line.

You might also develop rough, dark, velvety patches of skin in your armpits or on your neck.

Learn more about how to treat and manage hair and skin conditions.

Stress, anxiety and depression

Stress, anxiety and depression are common symptoms of PCOS. This could be due to hormonal changes, but more research is needed to understand how certain hormones affect emotional wellbeing.

It’s common for PCOS symptoms (e.g. excess body hair and weight) to cause self-esteem and body image issues. This can be distressing, especially if you don’t know where to get support.

You may also feel anxious or depressed if you’re planning to have a child (or more children) as PCOS can cause fertility issues.

Learn more about how to manage stress, anxiety and depression.

In this short video, psychologist, Dr Leah Brennan, talks about common experiences for women with PCOS, including anxiety depression and body image.

This video is captioned

Weight

It can be hard to manage your weight when you have PCOS, and you may gain weight. Research suggests that hormones involved in controlling appetite and hunger aren't regulated properly in some women with PCOS.

Learn more about how to achieve and maintain a healthy weight.

Could I have PCOS?

Fill out our PCOS symptom checklist and take it with you to your doctor's appointment.

Download PCOS symptom checklist (PDF 114KB)

Causes of PCOS

We don’t know the exact cause of PCOS, but genetics and family history play an important role. PCOS may be associated with the hormone levels in your body before birth and your lifestyle or environment.

The name ‘polycystic ovary syndrome’ suggests the problem is mainly with the ovaries, and that you might have multiple cysts on your ovaries. But the cause of PCOS is hormonal.

In some women diagnosed with PCOS, an ultrasound image of the ovaries shows multiple follicles in the ovaries. These are not cysts. They are eggs that haven’t developed properly.

Genetics and family history

No single gene has been found to cause PCOS, so the link is likely to involve multiple genes.

It’s estimated that up to a third of women with PCOS have a relative who has PCOS (e.g. mother, aunt, sister or daughter). This may be higher in some ethnic groups.

Hormones

Hormones are chemicals made in your body that carry messages through your bloodstream. They help control many functions in your body, such as growth, energy, sexual function, reproduction, digestion and temperature.

With PCOS, it’s thought that increased levels of insulin in the body causes the ovaries to work differently, which produces high levels of androgens (male-type hormones). These hormones cause various symptoms, such as irregular periods and hair and skin conditions. If the hormone levels are controlled, the ovaries often function normally and symptoms may improve.

Insulin

About 85% of women with PCOS have insulin resistance. If you are insulin resistant, your body blocks glucose from going into your cells. This causes your body to produce more insulin. Higher levels of insulin increases the production of androgens (male-type hormones) in your ovaries.

Insulin resistance may be caused by lifestyle factors (e.g. being overweight) or genetic factors.

Androgens

Androgens are normally present in men and women, but at much lower levels in women. Many women with PCOS have increased levels of androgens. This can cause symptoms such as excessive body hair growth, scalp hair loss, acne and irregular periods.

Increased levels of androgens in women may also lead to eggs being underdeveloped. This can make it hard to get pregnant.

Weight

PCOS can affect women of all weight ranges. But a heavier weight can increase the hormones responsible for PCOS symptoms. Weight loss can normalise hormone production and lead to improvements in PCOS symptoms.

Learn more about how physical activity and diet can help improve PCOS symptoms.

Can you prevent PCOS?

There’s no proven way to prevent PCOS, but there are many things you can do to improve your symptoms.

Learn more about treatment and management of PCOS symptoms.

This con­tent has been reviewed by a group of med­ical sub­ject mat­ter experts, in accor­dance with Jean Hailes pol­i­cy.

1
Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012 Jan;97(1):28–38.
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Deeks AA, Gibson-Helm ME, Paul E, Teede HJ. Is having polycystic ovary syndrome (PCOS) a predictor of poor psychological function including anxiety and depression? Human Reprod. 2011 June;26(6):1399–407.
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Deeks A, Gibson-Helm ME et al. Anxiety and depression in polycystic ovary syndrome: a comprehensive investigation. Fertil Steril. 2010 May 1;93(7):2421–3.
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Monash University. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. 2018. Melbourne, Australia.
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Kahsar-Miller MD, Nixon C, Boots LR, Go RC, Azziz R. Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. Fertility and Sterility. 2001;75(1):53-58.
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Monash University. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. 2018. Melbourne, Australia.
Last updated: 
23 October 2024
 | 
Last reviewed: 
21 October 2024

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