What are the First Signs of PCOS? Early Symptoms Every Woman Should know?

1. Irregular or absent periods

One of the most common early signs of PCOS is irregular periods or a complete absence of menstruation. Women with PCOS often experience periods that are either very infrequent, irregular, or heavy. 

Some may go for several months without having a period, while others might experience prolonged bleeding. This is because of the hormone imbalances present in PCOS, that is., between estrogen, progesterone, and androgen (male hormones).

2. Excessive hair growth (Hirsutism)

A second characteristic symptom of PCOS is excessive hair growth, specifically in those areas of the body where men usually grow hair. This condition is referred to as hirsutism. 

Women with PCOS often develop hair on the face, chest, back, or abdomen. This symptom is caused by an increased level of androgen (male hormone), which can stimulate hair follicles in these regions.

3. Acne and oily skin

Another visible sign of PCOS is an increase in acne, especially in the lower half of the face, including the jawline, chin, and neck. Elevated androgen not only contributes to hirsutism but can also make the skin produce more sebum, which clogs pores and causes acne breakouts.

4. Weight gain or difficulty losing weight

Most women with PCOS are prone to gaining weight without explanation or struggling with weight loss. This is largely due to insulin resistance, which is common among women with PCOS. Once the body develops resistance to insulin, it results in the body storing more fat. 

Also, being overweight further worsens the hormonal imbalance, leading to a vicious cycle. If you find that you are gaining weight without a noticeable change in diet or exercise pattern, or if weight loss becomes very challenging, PCOS can be a contributing factor.

5. Thinning hair or hair loss

Another sign of PCOS, mainly when associated with elevated androgens, is thinning hair or hair loss. Women may notice that their hair appears less full or shedding more hair than usual.

This symptom is unlike excessive facial growth of hair (hirsutism) and can appear on the scalp. Thinning or visible hair loss can be intimidating, but keep in mind that this is an easily treatable symptom of PCOS.

6. Darkening of the skin

PCOS women can have patches of darkened skin that tend to develop on the neck, under the arms, or in the genital area. This condition, acanthosis nigricans, is most often linked with insulin resistance, a characteristic of PCOS. 

Occasionally, these darkened areas can become thicker or velvety to the touch. Acanthosis nigricans is not harmful but can be a clear indicator of an underlying condition like PCOS.

7. Fertility issues

For some women with PCOS, fertility issues may be one of the first signs they experience. PCOS is one of the leading causes of female infertility due to irregular ovulation. Women with PCOS might not ovulate at all or might not ovulate regularly, which can make it hard to get pregnant.

Consulting a medical professional is necessary if you’ve been having trouble getting pregnant. Dr Marwa Elajami can walk you through fertility procedures, such as drugs that can induce ovulation and enhance your chances of pregnancy.

8. Pelvic pain or discomfort

Another potential symptom of PCOS is pelvic pain. Pelvic pain may range from mild to more severe, crampy pain and may occur at any phase of the menstrual cycle.

The discomfort is usually associated with cysts on the ovaries, which may develop as part of PCOS. If you have pelvic pain in combination with other PCOS symptoms like irregular periods or too much hair growth, it may be a good idea to see a healthcare provider.

9. Fatigue

PCOS can also cause significant fatigue, which is often overlooked as a symptom. Hormonal imbalances and insulin resistance can cause fatigue, leaving women feeling drained or sluggish all day. If you frequently feel tired, even after adequate sleep, PCOS might be a contributing factor.