Polycystic Ovarian Syndrome (PCOS) is a tricky diagnosis to get. It often takes two years and up to three doctors to figure out what all your symptoms mean. But, it’s also one of the most common causes of female infertility, affecting 6% to 12% (as many as 5 million) of U.S. women of reproductive age. Outside of getting pregnant, PCOS can negatively affect a woman’s life and make her feel emotionally and physically imbalanced by the repeated shift in hormones.

But what does having PCOS mean? It can help to know what symptoms to look out for, and to talk to your doctor about. Let’s take a closer look.

3 Symptoms of PCOS to Ask Your Doctor About

1. Cystic acne, hair growth in unwanted places and oily skin

A lot of this PCOS story starts with insulin. Insulin is a hormone routinely talked about with diabetes, but in PCOS patients, insulin is created in larger quantities than in their non-PCOS women-identifying population.

But how does that higher insulin lead to cystic acne?

First, insulin increases a hormone called luteinizing hormone (LH for short). LH is responsible for causing ovulation. At the right time of the month, your LH will spike and your ovary will release an egg.

LH also has another function: to stimulate the creation of testosterone. It makes sense evolutionary-wise—release an egg from the ovary and give you the libido spike you need to fertilize it. 

However, with PCOS-based insulin dysregulation, you get a continuous release of LH…and with that, a continuous release of testosterone. 

Testosterone is the cause of cystic acne around the jawline, neck, chest, shoulders and back. Hair growth on the upper lip and sideburns, as well as accelerated hair growth on the arms, legs, and underarms can be an indication too.

2. Weight gain & unbalanced blood sugars

PCOS patients are also at high risk of developing insulin-resistance. With all the extra insulin floating around, it can induce hypoglycemia (or low blood sugar). Insulin Is the key that opens the cell and allows glucose in, when you’ve got a lot of insulin without a lot of glucose, it can cause you to feel hangry, shaky, and faint, and experience flushes of heat when your blood sugar is dropping. 

With this blood sugar instability, often times eating a balanced diet becomes difficult because your appetite is unstable. 

These episodes of hypoglycemia can cause excess cortisol, which can result in excess fat deposition around the midsection. That being said, insulin alone can cause weight gain—cortisol and insulin are two very loud megaphones that tell our bodies to store excess energy into more long term storage!

3. No period or irregular period

In a non-PCOS patient, LH is generally suppressed (low) throughout the month and only spikes for one to three days around ovulation. This spike is what causes ovulation. 

In a PCOS patient, there is a steady stream of LH being secreted by the brain, which is confusing to your ovaries. Without the ‘spike’ to say ‘time to ovulate!’ there is no egg released. Without an egg being released, there is no regular/consistent cycle.

PCOS patients often have a very long cycle with a one week or so sporadic bleed—however this withdrawal bleed isn’t a true period. Learn more about that here.

Think You Have PCOS? Talk to Your Doctor First

What we’re finding is that PCOS is a spectrum disorder—each person will present in their own unique way. This is generally due to genetics, diet, stress levels, past history of contraceptive use, and other factors that make each person different! It’s important to get worked up first because skipping the underlying factors and jumping straight to hormone balancing typically will result in an ineffective treatment plan.

Dr. Cassie Wilder

Dr. Cassie Wilder is a registered Naturopathic Medical Doctor (NMD) and founder of MIMC. Her passion is empowering her patients through education, understanding, and support through their healing journey. After graduating from Iowa State University with a Bachelors of Science in Kinesiology and Health, Dr. Wilder earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine & Health Sciences, a fully accredited and nationally recognized institution in Phoenix, AZ. During her clinical training, she received extensive hands-on training with many leading experts in the field of functional medicine and developed a passion for treating hormonal imbalances, thyroid disorders, cardiovascular concerns, and adrenal fatigue.