PCOS symptoms: the signs doctors look at
Updated
In short
PCOS (polycystic ovary syndrome) shows up mainly through 3 kinds of signs: irregular or missing periods, signs of excess androgens (acne, excess hair, thinning hair) and ovaries that look a certain way on ultrasound. It affects 10 to 13% of women, and up to 70% don't know it. Only a doctor can diagnose it.
Your cycles
Cycles longer than 35 days, fewer than 8 periods a year, or no periods at all. On the pill, there's no way to tell: the bleeds aren't real periods.
Your skin and hair
- Breakouts that keep coming back on the chin and jaw.
- Thicker hair on the face, belly or chest (hirsutism).
- Hair thinning on top of the head.
Your body and energy
- Sugar cravings, or an energy crash after meals.
- Weight that builds up fast, especially around the belly.
- Darker patches of skin in the folds (neck, armpits).
- Fatigue, low mood.
These signs aren't used for the diagnosis, but they matter for your follow-up.
When to see a doctor
No period for more than 3 months, or several of these signs for more than 6 months: book an appointment with your GP, a gynecologist or a midwife. Write down your period dates and your signs first: they're your best evidence.
Frequently asked questions
Can you have PCOS with regular periods?
Yes. The diagnosis needs 2 out of 3 criteria: you can have androgen signs and polycystic-looking ovaries with regular cycles.
Can you have PCOS without being overweight?
Yes. Many slim women have PCOS.
Does PCOS show on an ultrasound?
Ultrasound is one of the 3 criteria, but it isn't enough on its own. In the 8 years after your first period, it isn't used for the diagnosis.
Sources
- Teede et al., Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of PCOS, Human Reproduction, 2023
- Monash University, 2023 International PCOS Guideline
- World Health Organization, PCOS fact sheet
- Inserm, Syndrome des ovaires polykystiques (SOPK)
- NHS, Polycystic ovary syndrome (PCOS)
This guide informs; it does not diagnose and does not replace medical advice. Information from the international PCOS guidelines (2023) and the WHO.