Polycystic Ovarian Syndrome (PCOS) – Symptoms and Causes
January 29, 2025

Polycystic ovarian syndrome, also known as PCOS, is a hormonal condition that affects women’s hormonal levels. Due to this, women may experience irregular periods, excess hair growth, acne, and infertility.
Polycystic Ovarian Syndrome is a hormonal imbalance caused by ovaries creating excess male hormones. For instance, in women with PCOS, the ovaries produce elevated levels of androgens, leading to an imbalance in their reproductive hormones. This causes her reproductive hormones to become imbalanced. Women with PCOS often have erratic menstrual cycles, missed periods, and unpredictable ovulation. In addition, small cysts may develop on their ovaries due to a lack of ovulation. However, despite the name “polycystic,” they do not need cysts on their ovaries to have PCOS.
Ovulation happens when a fully developed egg is released from the ovary. This happens so a male sperm can fertilize it. If the egg is not fertilized, it is sent out of the body during the menstrual period. A woman doesn’t make enough of the hormones needed to ovulate in some cases. When ovulation doesn’t happen, the ovaries may develop many small cysts. These cysts produce hormones called androgens.
Women with PCOS often tend to have high levels of androgen, which causes more problems with a woman’s menstrual cycle. Thus, treatment for PCOS is usually done with medication.
What Role Do Hormones Play With PCOS?
When women have PCOS, their reproductive hormones are unbalanced, leading to problems with their ovaries, such as not having their period on time or not getting it.
The hormones that play a role in Polycystic ovarian syndrome include:
- Androgens: Although typically associated with males, women also produce these hormones. Women with PCOS frequently experience higher levels of androgens.
- Insulin: This hormone regulates blood sugar, but in women with PCOS, their bodies may not respond to insulin as effectively.
- Progesterone: With PCOS, the body may not have enough of this hormone. As a result, women might miss their periods for a long time.
Causes of PCOS
The exact cause of PCOS is unknown. However, most experts think that several factors play a role, including genetics,
- High Levels of Androgens: Androgens are sometimes called “male hormones, and all women make small amounts of androgens. Women with PCOS have more androgens than usual. In women, an increase in androgen levels can disrupt the ovulation process, hindering the release of an egg each cycle while also contributing to excessive hair growth and acne.
- High Insulin Levels: Insulin plays a key role in transforming the nutrients from food into usable energy for the body. Insulin resistance happens when the body’s cells no longer respond effectively to insulin. As a result, the insulin blood levels become higher than usual. Insulin resistance is common among women with PCOS, particularly those who are overweight, lead a sedentary lifestyle, follow an unhealthy diet, or have a family history of diabetes.
- Genetics: In some cases, PCOS is linked to hereditary also.
Symptoms of PCOS
- Irregular Periods: A lack of ovulation may cause irregular periods, preventing the uterine lining from shedding every month.
- Heavy Bleeding: Because the uterine lining accumulates over a longer period, the menstrual flow tends to be heavier than normal.
- Hair Growth: More than 70% of the women with PCOS grow hair on their face and body (arms, chest, belly and back)
- Acne: Elevated male hormones increase oil production in the skin, leading to breakouts on the face, chest, and upper back.
- Obesity: Around 80% of women with PCOS experience weight gain and face challenges in shedding extra pounds.
- Darkening of the Skin: Darkened skin patches often appear in areas like the neck folds, armpits, groin, and beneath the breasts.
- Infertility: The most common cause of infertility in women is PCOS, as it can prevent ovulation, leading to challenges in getting pregnant.
- Skin Tags: Skin tags are small, soft flaps of extra skin commonly found in areas like the armpits or neck.
Can PCOS Cause a Miscarriage?
While PCOS can raise the likelihood of specific pregnancy complications, many women and individuals assigned female at birth (AFAB) with PCOS successfully carry pregnancies to full term. Potential pregnancy-related complications for those with PCOS include:
- Gestational diabetes, preeclampsia, and high blood pressure.
- Preterm birth (before 37 weeks) or C-section delivery due to factors like obesity, diabetes, or high blood pressure.
How Does PCOS Affect the Body?
- Metabolic Syndrome: As many as 80 percent of women with PCOS are either overweight or have obesity. Both obesity and PCOS increase the risk for
- High blood sugar
- High blood pressure
- Low HDL “good” cholesterol
- High LDL “bad” cholesterol: These factors are known as metabolic syndrome, and they elevate the risk for:
- Stroke
- Diabetes
- Heart disease
Sleep Apnea
This condition leads to frequent pauses in breathing throughout the night, disrupting sleep. Overweight women, particularly those with PCOS, are more likely to experience sleep apnea. The likelihood of sleep apnea is 5 to 10 times greater in women who have both obesity and PCOS than in those who don’t have PCOS.
How to Avoid Miscarriage with PCOS
While it is not always possible to prevent a miscarriage, women with PCOS can take proactive steps to reduce the risk and increase the chances of a healthy pregnancy. While factors such as genetic or chromosomal abnormalities are uncontrollable, the following strategies can enhance pregnancy outcomes:
1. Preconception Care and Planning
Before trying to conceive, consulting a healthcare provider with expertise in fertility is essential. They can review your health and PCOS situation, provide customized recommendations, and propose effective treatments to increase your chances of a successful pregnancy.
2. Maintain a Healthy Weight
Maintaining a healthy weight can support hormone balance and improve insulin sensitivity, both of which are important for effectively managing PCOS. Engaging in regular, moderate activities like walking or swimming can help manage weight, lower stress, and support hormone balance.
3. Nutrition and Supplements
A well-balanced diet, rich in whole grains, leafy vegetables, lean proteins, and healthy fats, can support both hormonal balance and overall health. Prenatal vitamins containing folic acid, iron, and vitamin D are essential, as they help prevent neural tube defects and support both mother and baby’s health.
4. Monitor and Manage Blood Sugar Levels
Keeping blood glucose levels stable is crucial for lowering the risk of complications like gestational diabetes, which can raise the likelihood of miscarriage. Regular blood sugar monitoring and working with a healthcare provider to create a management plan, including diet, exercise, or insulin therapy if needed, is key.
5. Limit Stress
While stress doesn’t directly cause miscarriage, it can negatively impact overall health and exacerbate PCOS symptoms. Practicing stress management methods like yoga, meditation, or deep breathing can enhance emotional health and alleviate physical tension during pregnancy.
6. Avoid Harmful Substances
It is important to quit smoking and excessive alcohol consumption, as they can greatly raise the risk of miscarriage and other pregnancy-related complications. Limiting or eliminating caffeine consumption is also advisable, as it has been linked to higher risks of pregnancy loss and low birth weight.
7. Early Prenatal Care and Regular Monitoring
Regular visits to an experienced healthcare provider, such as a gynecologist or endocrinologist, are critical for those with PCOS. Early and consistent prenatal care allows for early detection of potential complications, such as gestational diabetes or preeclampsia, and facilitates prompt intervention to manage these risks.
8. Fertility Treatments and Ovulation Induction
If you experience irregular menstrual cycles or have trouble ovulating, your doctor may suggest fertility treatments, including medications to stimulate ovulation. These treatments can assist in regulating menstrual cycles and enhance your chances of conceiving and sustaining a pregnancy.
By following these steps, you can enhance the chances of a successful pregnancy while managing the unique challenges of PCOS. However, it’s important to remember that every pregnancy is different, and the support of a healthcare team is crucial for the best possible outcome.
How is PCOS Diagnosed?
In most cases, doctors can diagnose PCOS after an examination. They may take blood tests or perform an ultrasound to help with the diagnosis.
The doctors will:
- Talk about the symptoms and medical history.
- Ask about the family’s medical history.
- Check weight and blood pressure.
- Conduct a pelvic exam to check for enlarged ovaries or any abnormal growths in the uterus.
- Conduct blood tests to assess hormone and glucose levels.
- Use a pelvic ultrasound to examine the ovaries for cysts and evaluate the thickness of the uterine lining.
Frequently Asked Questions
1. What age does PCOS appear?
PCOS can develop at any point after puberty, with most diagnoses occurring in women and individuals assigned female at birth (AFAB) during their 20s or 30s, particularly when they are attempting to conceive. Obesity and a family history of PCOS can elevate the likelihood of developing the condition.