Polycystic ovary syndrome (PCOS) is when a female produces too many androgens, also known as “male hormones.” Symptoms can include irregular periods, unwanted hair, and weight gain.

People may experience more severe symptoms of PCOS for several reasons, with some occurring if they have other conditions such as diabetes or overweight. In other cases, a person may not receive treatment early enough, leading to PCOS symptoms worsening over time and further complications, such as infertility.

This article explains why some PCOS symptoms are worse for some people, along with suitable treatment options.

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PCOS may start soon after puberty, but it can also develop later in a person’s life. Healthcare professionals often overlook or misdiagnose early and mild symptoms of PCOS.

Early symptoms to look out for include:

  • irregular periods
  • acne
  • weight gain
  • coarse hair growth on the face, chest, or back

Irregular periods due to an absence of ovulation is a common symptom of PCOS. Some people may also develop fluid-filled sacs on the ovaries, which are also known as follicles. Some may also refer to them as cysts, and while many females have follicles, those with PCOS have more of them.

Symptoms can vary from person to person, which can make the condition difficult to diagnose.

Other indicators of PCOS include:

  • fatigue and low energy
  • thinning hair on the top of the head
  • unwanted hair growth
  • weight gain
  • mood changes
  • acne
  • sleeping difficulties
  • headaches
  • changes in mood

These symptoms can range in severity depending on the person. For some, PCOS may also affect fertility.

According to the Office of Women’s Health, PCOS has links with other health conditions, including:

Additional symptoms can vary based on a person’s other conditions. For example, those with type 2 diabetes and PCOS may also experience hypoglycemia, or low blood sugar.

Accompanying type 2 diabetes symptoms

More than 50% of females with PCOS could develop diabetes before they reach 40 years of age.

According to the American Diabetes Association, common symptoms of type 2 diabetes include:

  • extreme thirst
  • frequent urination
  • extreme fatigue
  • slow-healing cuts or bruises
  • blurry vision
  • pain, numbness, or tingling sensations in the hands or feet
  • persistent feelings of hunger

Learn more about type 2 diabetes symptoms here.

Accompanying endometrial cancer symptoms

Females with PCOS have a higher risk of developing endometrial cancer due to them experiencing consistently high estrogen levels.

When ovulation occurs, estrogen levels fall while progesterone levels increase. As females with PCOS do not ovulate, their body does not keep these estrogen levels in check.

Approximately 90% of females experience abnormal periods, bleeding, or discharge in the early stages of endometrial cancer. In later stages, they may feel a lump, have pelvis pain, or lose weight without trying.

As symptoms are similar to other conditions, a person can talk with their doctor if they experience any new symptoms.

Learn more about endometrial cancer here.

Accompanying anxiety and depression symptoms

A person with PCOS may have a higher risk of developing anxiety and depression.

PCOS symptoms that may trigger anxiety include infertility and alopecia. Acne may also lead to a person with PCOS developing depression.

When someone feels anxious, they may experience

  • racing thoughts
  • trouble sleeping
  • an impending sense of dread for long periods

Some symptoms of depression include:

  • irritability
  • reduced weight
  • decreased appetite
  • aches and pains
  • trouble sleeping
  • changes in mood
  • feeling worthless or helpless
  • persistent sadness or feeling of being empty
  • lowered energy or fatigue
  • difficulty concentrating
  • suicidal thoughts

Learn more about depression here.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

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Researchers are still not sure of what exactly causes PCOS. According to the Office of Women’s Health, two potential causes include higher than usual levels of insulin or a high level of androgens.

The Department of Health and Human Services add that the condition is a mixture of genetic and environmental factors. They go on to state that an excessive level of androgens is responsible for many PCOS symptoms.

Excessive levels of insulin stimulate the production of androgens, which can cause and exacerbate PCOS symptoms.

A person can consult with their healthcare provider to diagnose PCOS.

For a doctor to consider a PCOS diagnosis, an individual must have at least two of the following conditions:

  • hyperandrogenism — too much androgen hormone
  • ovulatory dysfunction — irregular periods
  • polycystic ovaries — small follicles or fluid-filled sacs on the ovaries

However, if people present with symptoms of hyperandrogenism, for example, acne or hair growth, they may not need a blood test to measure their levels of androgens.

A doctor will also need to review the person’s medical history and physically examine them to rule out other conditions. They may also use ultrasounds and blood tests to reach a diagnosis.

According to the Office of Women’s Health, a person should work with their doctor to develop a bespoke treatment plan that addresses their needs.

Treatment strategies should include:

  • symptom management
  • preventing complications such as obesity or type 2 diabetes
  • endometrial protection
  • contraception
  • help with getting pregnant if this is a person’s goal

Treatment often consists of medical interventions and home remedies.

Some common medications include:

  • Metformin: Although metformin typically treats type 2 diabetes, it can help with PCOS symptoms by lowering androgen levels and treating insulin resistance.
  • Anti-androgen medicines: These medicines reduce androgen levels and can ease symptoms such as acne and unwanted hair growth.
  • Hormonal birth control pills: These treat anovulation — the lack of ovulation, acne, and unwanted hair growth.

A person with PCOS can also try several home remedies to help them feel better, including:

  • removing unwanted hair using removal creams
  • staying mindful of stress levels and knowing when to rest
  • keeping up a regular exercise routine and healthful diet

Diet plays an important role in managing PCOS symptoms, as what a person eats influences how much insulin they produce.

Learn more about a PCOS diet here.

If a person with PCOS is finding it difficult to conceive, in vitro fertilization or medication to stimulate ovulation may be worth considering.

A person should talk with their doctor if they experience PCOS symptoms. A healthcare professional can rule out other conditions, and depending on the outcome, diagnose PCOS.

If symptoms become worse or do not respond to treatment, it is important that people let their doctor know. It can take some time to find a suitable and effective treatment for a person with PCOS.

If people have concerns about their chances of conceiving, they can also discuss fertility treatments with their doctor.

There is no cure for PCOS. Treatments focus on reducing the severity of symptoms and preventing complications such as infertility.

However, people with overweight may find that symptoms ease if they try and maintain a moderate weight through a healthful diet and sufficient physical activity.

With a suitable treatment plan, it is possible to manage PCOS symptoms so that the condition does not affect a person’s day-to-day life.

People can speak with their doctor to discuss personal treatment plans and fertility options if they need help with conceiving.

PCOS triggers symptoms including irregular periods and unwanted hair growth, while people may also develop health complications such as type 2 diabetes.

Those with PCOS may wish to speak with their doctor to discuss effective treatment plans, as what works well for some may not be as effective for others.