PCOS presents as a combination of varying symptoms with no definitive cause or cure. Possible causes include insulin resistance, chronic inflammation, long-term use of the contraceptive pill, genetics and stress. If it turns out that PCOS is actually an autoimmune condition, then we can add gut health to the list of possible causes. In fact, there is a growing number of women who are already treating PCOS as an autoimmune condition and are experiencing incredible results with improving their gut health.

It is common for signs of PCOS to begin soon after a person begins getting their period or later in reproductive years. Any combination of the symptoms below can be seen in someone suffering from PCOS, some people only showing a few signs and others showing many.

I have broken the list of symptoms into 2 categories. The first is a list of PCOS features that are testable or measurable. The second is a list of symptoms that can be seen or felt. I have also included a list of conditions that people with PCOS have an increased risk of developing.

Testable/measurable features of PCOS:

Polycystic Ovaries

High Androgen (male hormone) levels

Anovulation/Amenorrhea (irregular periods indicating difficulty ovulating)

Low Progesterone levels in the Luteal Phase of your cycle

Imbalanced Lutinising Hormone (LH): Follicle Stimulating Hormone (FSH) ratio

Insulin Resistance

PCOS symptoms that can be seen, felt or experienced:

Difficulty falling pregnant

Disproportionate amount of body fat around middle

Hirsutism (excess facial and body hair)

Acne

Moodiness

Hair fall from the scalp

Fatigue

Difficulty losing weight

Miscarriage

Depression

Anxiety

Many people with PCOS can experience heavy and painful periods, but this is not actually a symptom of PCOS. It can be a symptom of many other conditions or can be due to a hormonal imbalance or stagnation.

Conditions PCOS sufferers have an increased risk of developing:

Sleep Apnea

Type 2 diabetes

Heart disease

Heart attack

Stroke

Cholesterol and blood fat abnormalities

Endometrial Carcinoma

If you think you might have PCOS – go to your Doctor. Explain all the symptoms you are experiencing and ask if they think PCOS could be the cause.

To find out, your Doctor will likely assess you under the Rotterdam Criteria. In western medicine, the Rotterdam Criteria are widely accepted as the best way to diagnose PCOS.

Diagnosis of PCOS under the Rotterdam Criteria is dependent on identifying two of the following three features:

Oligo/Anovulation. This can be displayed as irregular or infrequent periods that are greater than 35 days apart or less than 21 days apart, indicating that the woman may have had difficulty ovulating, or may not have ovulated at all. Some women have a normal cycle length but still are not ovulating. To test for this, your Doctor will measure your progesterone levels in the luteal phase (after day 21 in a 28 day cycle). If progesterone levels are low in this phase, it indicates that ovulation has yet to happen – anovulation.

Hyperandrogenism. This means you have increased androgen levels, commonly thought of as male hormones. Hyperandrogenism can present itself physically with increased body and facial hair (Hirsutism), adult acne or severe adolescent acne or a loss of hair on your scalp (Androgenic Alopecia). However, as these physical symptoms aren’t always apparent, your Doctor will order a blood test, testing your free testosterone levels.

Polycystic ovaries. This can be shown through the use of ultrasound and is diagnosed when 10 or more small antral follicles are seen in each ovary. The follicles represent eggs that failed to release properly, indicating a difficulty to ovulate.

So, to get a diagnosis of PCOS, your Doctor will need to find at least two of the above testable features of PCOS. If for example, the only feature you’re exhibiting is polycystic ovaries, you won’t be diagnosed with PCOS, you will be diagnosed as having polycystic ovaries. However, if you are found to have for example, Polycystic Ovaries AND Hyperandrogenism, you will get a diagnosis of PCOS because you are presenting with two symptoms of PCOS, under the Rotterdam Criteria.

There are other tests your Doctor will give you to fill in the larger picture of your PCOS, such as your resistance to insulin and your Lutinising Hormone (LH) : Follicle Stimulating Hormone (FSH) ratio.

Unfortunately, there is no definitive cure for PCOS. However, there are MANY treatment pathways that can create BALANCE within your body and LEAD YOU BACK TO WELLNESS. These include, but are not limited to, Western medicine, naturopathy, traditional Chinese medicine, functional medicine, Ayurveda (traditional Indian medicine), yoga, massage, meditation and, importantly, changes in diet, lifestyle and exercise.

Please click here to go to the Treatment Pathways page. This page explores the many treatment options that are available for people with PCOS.